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BLD2022-1650+Application+12.5.2022_2.03.34_PM+3252523CITY OF EDMONDS MyBuildingPermit.com Building Application #1238364 - Crown Castle for Verizon 855640 Applicant First Name Last Name Company Name Emilie Deschamps GMA Network Services Number Street Apartment or Suite Number E-mail Address 2006 PO Box 2006 Emilie(cDgmanetworkservices.com City State Zip Phone Number Extension Bellevue WA 98009 (802) 777-3358 Contractor Company Name Contractor Unknown Number Street Apartment or Suite Number City State License Number Project Location State Zip License Expiration Date Number Street 9920 EDMONDS WAY City Zip Code EDMONDS 98020 Associated Building Permit Number Additional Information (i.e. equipment location or special instructions). Work Location Property Owner Phone Number UBI # E-mail Address Floor Number 0 County Parcel Number 27033600113900 Tenant Name Crown Castle for Verizon Extension Suite or Room Number 0 First Name Last Name or Company Name Jerri Eilert Number Street Apartment or Suite Number 12521 226TH ST SE City State Zip SNOHOMISH WA 98296 Certification Statement - The applicant states: 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. 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: 12/5/2022 Submitted By: Emilie Deschamps Page 1 of 2 CITY OF EDMONDS MyBuildingPermit.com Building Application #1238364 - Crown Castle for Verizon 855640 Project Contact Company Name: GMA Network Services Name: Emilie Deschamps Email: Emilie@gmanetworkservices.com Address: PO Box 2006 Phone #: (802) 777-3358 Bellevue WA 98009 Project Type Activity Type Scope of Work Personal Wireless Service Facilities Modification Eligible Facilities Request Project Name: Crown Castle for Verizon 855640 Verizon proposed minor modifications to the existing wireless tower. Tower Scope of Work: Description of -Remove (6) Antennas -Install (6) Antennas -Install (6) Triplexers -Install (3) BIAS-TS -Install Work: (3) OVPs -Install (3) Hybrid Cables -Install (1) Tower Extension Ground Scope of Work: -Remove (6) RRHs -Remove (12) Diplexers -Install (6) RRHs -Install (1) OVP -Install (6) Triplexers -Install (2) BBUs -Install (3) Upconverters -Install (1) Rectifier Project Details Type of Request Eligible Facilities Request Modification Type Replacement of Transmission Equipment Page 2 of 2