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BLD2020-0988+Application+9.24.2020_4.51.35_PMCITY OF EDMONDS Building Application #860929 - WA6272 - 5G Applicant First Name Last Name Courtnee Gomez Number Street Apartment or Suite Number 11232 120th Ave NE 204 City State Zip Kirkland WA 98033 Contractor Company Name Contractor Unknown Number Street City State License Number Project Location State Zip License Expiration Date UBI # MyBuildingPermit.com Company Name Smartlink Group E-mail Address courtnee.gomez@smartlinkgroup.com Phone Number Extension 9165274157 Apartment or Suite Number Phone Number Extension E-mail Address Number Street Floor Number Suite or Room Number 9617 FIRDALE AVE Rooftop no suite number City Zip Code County Parcel Number EDMONDS 98020 00449900000100 Associated Building Permit Number Tenant Name BLD20180165 AT&T Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name FIRDALE ASSOCIATES LLC Number Street Apartment or Suite Number 9500 ROOSEVELT WAY NE 100 City State Zip SEATTLE WA 98115 Certification Statement - The applicant states: I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work requires a licensed contractor to perform the work, the information will be provided prior to permit issuance. Date Submitted: 9/24/2020 Submitted By: Courtnee Gomez Page 1 of 2 CITY OF EDMONDS Mysu;laingPerrnit.com Building Application #860929 - WA6272 - 5G Project Contact Company Name: Smartlink Group Name: Courtnee Gomez Email: courtnee.gomez@smartlinkgroup.com Address: 20232 120th Ave NE Phone #: 9165274157 Kirkland WA 98033 Project Type Nonresidential Activity Type Remodel Project Name: WA6272 - 5G Description of Install (6) Combiners to existing Antennas on rooftop. Inside equipment room add (3) RRHs Work: and (3) combiners, remove (1) cabinet, add (2) new H-Frames. No ground disturbance. All work will take place inside existing leased areas. Project Details Project Information Square Feet -Tenant 160 Valuation Fair Market Value of Construction Work $7,000 Exterior Changes? The work does not involve changes to the exterior Page 2 of 2