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BLD2022-1566+Application+11.14.2022_2.30.09_PM+3218763CITY OF EDMONDS MyBuildingPermit.com Building Application #1229536 - PINE RIDGE 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 8730 MAIN ST 1 None City Zip Code County Parcel Number EDMONDS 98026 00373600500404 Associated Building Permit Number Tenant Name Wood Pole Additional Information (i.e. equipment location or special instructions). Work Location Property Owner First Name Last Name or Company Name Christopher Linhardt Number Street Apartment or Suite Number 8730 MAIN ST 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: 11/14/2022 Submitted By: Linda Williams Page 1 of 2 i CITY OF EDMONDS MyBui[di ngPerrnit.com Building Application #1229536 - PINE RIDGE 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 Name: PINE RIDGE Description of Work: Sprint TMobile proposes to Remove anennas and gound equipment an existing unmanned wireless communications facility - Wood pole Project Details Type of Request Eligible Facilities Request Modification Type Removal of Transmission Equipment Page 2 of 2