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SIGN PERMIT APPLICATI. <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application&plans to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> WASHINGTON CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET S. eve-d"ere4l� uuou C� ES PARCEL#: �`CJc I(UCH-4 L, OC <br /> CITY ti VE.,' re STATE ZIP a`72.O <br /> SUITE/UNIT#: 1 ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential): Ior.y Ma',Vt tl�? <br /> CONTACT INFORMATION <br /> /� <br /> OWNER NAME: CAN Y-b 5 heV 131'1 vvvi <br /> OWNER MAILING ADDRESS: STREET Si 3�j �%VL'-i� �(L� ,r:! (A)ci 1 <br /> CITY LVe-t 1 STATE W A- ZIP C9ra <br /> OWNER PHONE: OWNER EMAIL: ` 4€ IIACCI rdcc C"a V+1c4 �.Ce9 Kry <br /> CONTRACTOR CONTACT NAME: 1-1)4A/C4'_ h L.'rti U ca.O lam.,t`tic 1/LC").. <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): 5i 144 M E VCITY OF EVERETT BUSINESS LICENSE#(REQUIRED): (0 0 1 <br /> CONTRACTOR ADDRESS: STREET 30_`. (-. [%Vr 4 C RAIL Lk)c.u. f S L;•4e / <br /> CITY � tfe — STATE Lk) ei ZIP zC <br /> CONTRACTOR PHONE: '.Z-5 5`--)?- - 0 I(� c'� CONTRACTOR EMAIL: `NCI V ee el cJ Vitt at VWLCk. <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ElOTHER(Please Specify) c`' <br /> CONTACT NAME: CONTACT PHONE: t4 <br /> �c, tJC t,1ij C161,144j VC P; .rt' <br /> CONTACT EMAIL: V 'i o�('P C t IJ(t.(1.1'T'iiJitCt —C �Jl"l :ten, <br /> SIVN PERMIT INFORMATION <br /> VALUATION OF WORK: $ '1 • 4 S— ASSOCIATED PERMIT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> DESCRIPTION OF WORK: e `��v, <br /> (3 t- I et i I reteA.A. ?� Pj C& -t`C 1�i -��<<( L VI 1lc l Vt ( ;ce <br /> �CtM V <br /> SIGN DIMENSIONS: <br /> C <br /> Sign 1: Width: 1 0 Height: � - Square Feet: 3 <br /> Sign 2: Width: Height: Square Feet: <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY: Wall/Awning/Canopy-Qty: I ❑Window-Qty: ❑Electronic Changing Message-Qty: <br /> ❑Projecting-Qty: El Freestanding-Qty: Type(monument,etc.): <br /> SIGN LIGHTING: ❑Non-Iluminated ®illuminated-Type(backlit cabinet,etc.): 1`Q�17tcc���,�� `yt, "requires a separate electrical permit <br /> PLAN REVIEW REQUIREMENTS:Submit 2 hard copies of sign plans with permit application to Permit Intake Drop Box. <br /> ACKNOWLEDGEMENT:l 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 1 am 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 /> ti/g2+ /240 7-42—I05— <br /> 0 ter/Authorized Agent Signatur Date (Revised 2/8/2021) y <br /> 7 <br />