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04err PERMIT APPLICATION <br /> BUILDING I MECHANICAL/ PLUMBING /SIGN /SORINKLER/ DEMOLITION <br /> CITY OF EVERETT PERMIT SERVICES <br /> 3200 CEDAR STREET,EVERETT,WA 98201 <br /> (P)425-257-8810 I FAX 425-257-8857 I(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#:00392000006005 <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: STREET2930 Wetmore Ave <br /> CITY Everett STATE WA zip 98201 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR NAME:TBD <br /> CONTRACTOR ADDRESS: STREET <br /> CITY STATE ZIP <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> PRIMARY CONTACT: ❑OWNER 0 CONTRACTOR 0 OTHER(Please Specify) Authorized Agent <br /> CONTACT NAME: CONTACT PHONE:42•55_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:$25,000 <br /> Proposed Use of Building lid Heat Source: ❑Gas ■ ]tric 00-11m— <br /> BUILDING USE: ■ I/A,nhouse • plex ■,.,IU PP.' . ' Fa ' • Uni �(�mmercial rcessor <br /> Structure <br /> Type of Project: ■"r w rdition ==model ■:•pair Mtn •rinkler ■S molition LJS. nge 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): <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 /> - <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 I SUPPRESSION SYSTEM Sewage Ejector or Sump Pump Other: <br /> Water Suppression System No.of Heads <br /> Chemical Suppression System 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 lam authorized by the owner of this property to perform the work for which application is made, <br /> and!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 ate 2019nade 132500 WOO a(�j 0 I-6' <br /> —0 ✓2 <br /> Date zos.n01.15 edby 13 25 00- 1/15/19 �- I LL <br /> Owner/Authorized Agent Signature Date (Revised 10/10/2018) \" <br />