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grr PERMIT APPLICATIOC' <br /> BUILDINt;/ MECHANICAL/ PLUMBING /SIGN / SPRINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 1(E)everetteps@everettwa.gov I www.everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS:319 76th St. SW, Everett WA 98203 PROPERTY TAX it:003920000060055 <br /> LEGAL for new construction: Short Plat/subdivision N/A Lot No.N/A (attach copy of long legal description) <br /> CONTACT INFORMATION <br /> OWNER NAME: City of Everett TENANT BUSINESS NAME(Commercial): Tower Operator-Crown Castle <br /> OWNER MAILING ADDRESS: sTREEr2930 Wetmore Ave <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:Legacy Telecommunications <br /> CONTRACTOR ADDRESS: STREET PO BOX 360 <br /> CITY Burley STATE WA ZIP 98322 <br /> CONTRACTOR PHONE:(253) 858-0214 CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED):LEGACTL821 LL CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 042661 <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR D OTHER(Please Specify) Authorized Agent <br /> CONTACT NAME: CONTACT PHONE:425-622-7879 <br /> Amanda Imper, SAC Wireless on behalf of T-Mobile CONTACT EMAIL:amanda.imper@sacw.com <br /> BUILDING INFORMATION <br /> Existing Use of Building:Wireless Facility Contract Price of Work:$ 5,000 <br /> Proposed Use of Building iiiii Heat Source: OGas aoil tric Ebner- <br /> '',BUILDING USE: ■ ,nhouse a plex ■ I�T, ' Fa Uni . �f�mmercial C cessory Structure <br /> Type of Project: ■"r w I(,'dition WI model ■I pair •. min .rinkler •molition 17r.lfange of Use <br /> DESCRIPTION OF WORK: <br /> T-Mobile proposes to replace existing Powergen 7500 APU Generator with New Generac 25kW gas gas generator <br /> ASSOCIATED BUILDING PERMIT#(if applicable): Ci o .-0.3 2— <br /> MECHANICAL <br /> MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br /> Fixture Fixture Fixture Fixture <br /> Count List of Fixtures count List of Fixtures Count List of Fixtures Count List of Fixtures <br /> A/C—Air Handling Units Gas Piping Backflow Preventer(Inside Bldg) Shower,Tub,or Combo <br /> Boiler Gas Range Clothes Washer Sink-Commercial(3-comp,prep,floor) <br /> Clothes Dryer Heat Pump&Ductless Dishwasher Sink-Residential(kitchen,bath,bar) <br /> Duct System(Remodel) Refrigeration Drinking Fountain Sink-Utility,laundry,mop <br /> Exhaust Fans(Residential) Commercial Ventilation Floor Drain Toilet <br /> Exhaust Hood(Type I) (Not HeaVAC system) Hose Bibb Urinal <br /> Exhaust Hood(Type II) Water Heater Interceptor-Grease Waste/Water Piping Repair <br /> Exhaust Hood(Residential) Wood Stove Interceptor-Sand/Oil Water Service(behind meter) <br /> Forced Air Systems 1 Other: Generator Medical Gas Water Valves or Fixtures <br /> Gas Fireplace/Insert/Log Roof Drains Water Heater <br /> SPRINKLER/SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System I No.of Heads <br /> ACKNOWLEDGEMENT:I have reviewed this application and confirm the information contained herein is true and correct.Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of a permit only authorizes approved work and no deviations therefrom.Deviations must first be authorized in writing from the <br /> Building Official before being authorized under any circumstance.I am the owner,or I am authorized by the owner of this properly to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Amanda Imper Dig d 011301.151325 0-0801 1/15/19 �j_ ( 6 -7 - 0 3 <br /> Owner/Authorized Agent Signature a zo B.o,s�.z5.�-oe� Date (Revised 10/10/2018) <br />