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im <br /> SIGN PERMIT APPLICATI4IN <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 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:Y� STREEr 'g 70 1 a--Vexu y�0 Uhl PARCEL* a 77 I Scf a <br /> 5 v i J CnY i�V .- .J STATE GO A ZIP ' 3 ZO <br /> SUITE/UNIT#: g ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(If non-residential): e(iSc u&e L I t'ire (1 QA epX- (e Ii.CI I.h. reithih i`et, . <br /> CONTACT INFORMATION <br /> OWNER NAME: Cc-LA-re e ' vlctefrcp h <br /> OWNER MAILING ADDRESS: STREEr <br /> j . 7(( ,I �e V��, WC-Lis k,7 i tire-- 1 t�CrtY `—..V''�_^' STATE �..0 14 zipIC? 8 Zo <br /> OWNER PHONE: q ZJS--q(A. - 0-2 I C) OWNER EMAIL: C tr-t`e (". CaISco e et` at p_,.ar o <br /> CONTRACTOR CONTACT NAME: V'cW et <br /> ,,(tile, v4 C.t�tnfi� <br /> bduolp1,ycut <br /> ! V0 Vtq <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): 5 C ci dk$17 L7 CRY OF EVERETT BUSINESS LICENSE#(RE(iiIRED): (a CA 7`3 <br /> CONTRACTOR ADDRESS: MEET jCS- Se .—Ue-titM CW Li -A 5,- Nits- <br /> cm' Z`:� , - STATE U�(1- ZIP —I ce ZO Z <br /> CONTRACTOR PHONE: 4 2S- e1 1 -D 3( CONTRACTOR EMAIL: --F14.coree-CO 3 t _ <br /> euefittlicc <br /> PRIMARY CONTACT: 0 OWNER grCONTRACTOR 0 OTHER(Please Specify) <br /> CONTACT ill�NAME: teal <br /> PHONE: 14 ZS-Ce S ( —dam Z <br /> k <br /> f�-E'- li(Aimyi6 p tea. ONTACT EMAIL: .... cc/0_1e (0 4' ` e,,ve _ceit e <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK:$ // '? `Z:g9 — ASSOCIATED PERMIT it(if applicable): CI (.Pa I)vte^-i <br /> {tie(uation shag ink the prevailing fair market value of al labor,materials,and equipment needed to complete the work,whether echo*paid or not.) (� <br /> DESCRIPTION OF WORK: <br /> 15 �5 t t �C ss 7` 2c ,ci�,v, 1tr s <br /> c� Co �� s ( 1 0 / A) , 14 tit <br /> SIGN DIMENSIONS: <br /> e( _ c <br /> I <br /> Sign 1: Width: ` 249 Height S L.( '7. S Square Feet d <br /> Sign 2: Width: Height ^ Square Feet: <br /> n 3: Width: Height _ Square Feet - <br /> Si <br /> SIGN TYPE&QUANTITY: Wall/Awning/Canopy-Qty: I DWindow-Qty: DElectronic Changing Message-Qty:____ <br /> DProjecting-Qty: OFreestanding-Qty: -Type(monument;etc.: <br /> SIGN UGHTING: [Non-Ruminated Piluminated-Type(back*cabinet etc.): i h 42-016td -*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:I have reviewed this application and confirm the information contained herein is true and coned.Work done pursuant to this permit must comply with <br /> current federal,state,and local law.The granting of 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.lam the owner,or I am authorized by the owner of this property to perform the work for which application is made, <br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett O Use Only <br /> PERMIT* S I V <br /> 1(4(z-1 — 0107i <br /> Owner razed Agent Signature Date '(Revised 2/8/2021) <br />