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BLD2023-0186+Application+2.14.2023_3.21.25_PM+3369637CITY OF EDMONDS nnyst,ilaingPermit.com Building Application #1268994 - 88th UTILITY POLE Applicant First Name Last Name Company Name Linda Williams Mastec Network Solutions Number Street Apartment or Suite Number E-mail Address 12672 Limonite Ave Ste 3E185 linda(D_amwireco.com City State Zip Phone Number Extension Eastvale CA 92880 (949) 373-6377 Contractor Company Name MASTEC NETWORK SOLUTIONS INC Number Street Apartment or Suite Number 12672 Limonite Avenue 3E185 City State Zip Phone Number Extension Eastvale CA 92880 (949) 373-6377 State License Number License Expiration Date UBI # E-mail Address MASTENS876KN 5/14/2023 603235974 linda(a_amwireco.com Project Location Number Street Floor Number Suite or Room Number 19311 88TH AVE W 0 None City Zip Code County Parcel Number EDMONDS 98026 27041800308700 Associated Building Permit Number Tenant Name SPRINT/TMOBILE Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name Scott E Gann Number Street Apartment or Suite Number 19311 88TH AVE W City State Zip EDMONDS WA 98026 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: 2/14/2023 Submitted By: Linda Williams Page 1 of 2 CITY OF EDMONDS MyBuildingPerrnit.com Building Application #1268994 - 88th UTILITY POLE Project Contact Company Name: Mastec Network Solutions Name: Linda Williams Email: linda@amwireco.com Address: 12672 Limonite Ave Ste 3E185 Phone #: (949) 373-6377 Eastvale CA 92880 Project Type Activity Type Scope of Work Personal Wireless Service Facilities Modification Eligible Facilities Request Project 88th UTILITY POLE Name: SPRINT / T-MOBILE PROPOSES TO MODIFY AN EXISTING UNMANNED WIRELESS COMMUNICATIONS FACILITY. THIS MODIFICATION WILL CONSIST OF THE FOLLOWING: UTILITY POLE EQUIPMENT - TO BE REMOVED BY SNO PUD: REMOVE EXISTING (3) PANEL ANTENNA (1 PER SECTOR, 3 TOTAL) REMOVE EXISTING (3) RRU'S (1 PER Description SECTOR, 3 TOTAL) REMOVE EXISTING MOUNTING HARDWARE REMOVE EXISTING of Work: COAX AND LINES GROUND EQUIPMENT - TO BE REMOVED BY GC: REMOVE EXISTING (1) WOODEN FENCE ENCLOSURE REMOVE EXISTING (1) CONCRETE PAD REMOVE EXISTING (1) EQUIPMENT CABINET REMOVE EXISTING (1) METER REMOVE EXISTING (1) DISCONNECT REMOVE EXISTING (1) WOODEN POST REMOVE EXISTING (1) GPS ANTENNA Project Details Valuation Fair Market Value of Remodeling Work $20,000 Type of Request Eligible Facilities Request Modification Type Removal of Transmission Equipment Page 2 of 2