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VGN PERMIT APPLICATION <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 1(E)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 405 Riverside Dr PARCEL#: 29050800402500 <br /> cIiv Everett STATE WA ZIP 98201 <br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):PODS <br /> CONTACT INFORMATION <br /> OWNER NAME:Pine Forest Everett LLC <br /> OWNER MAILING ADDRESS: STREET 11980 NE 24th St Suite 200 <br /> cm. Bellevue STATE WA�� �~� ZIP 98005 f)�� F <br /> OWNER PHONE:425-454-1900 OWNER EMAIL' . WL'LO @)�.U,I�tfVYlr ll�t'h 1*A <br /> CONTRACTOR CONTACT NAME:Spry � ; 'j� pfa' <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):CI LNI099DG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 41415 <br /> CONTRACTOR ADDRESS: STREET902 NW 49th St <br /> clm' Seattle STATE WA zip 98107 <br /> CONTRACTOR PHONE:206-789-4747 CONTRACTOR EMAIL:sarah@citylightssign.com <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-789-4747 <br /> Sarah Terry CONTACT EMAIL:sarah@citylightssign.com <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK:$2000.00 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: <br /> Install 99.65 SF non-illuminated dimensional letter wall sign for PODs <br /> SIGN DIMENSIONS: <br /> Sign 1: Width: 16.-10" Height 5'-11" Square Feet: 99.65 <br /> Sign 2: Width: Height: Square Feet: <br /> Sign 3: Width: Height Square Feet: <br /> SIGN TYPE&QUANTITY: I7IWall/Awning/Canopy-Qty:1 ❑Window-Qty: ❑Electronic Changing Message-Qty: <br /> ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc.): <br /> SIGN LIGHTING: ©Non-Iluminated ❑Illuminated-Type(backlit cabinet,etc.): "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 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.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 Official Use Only <br /> 6/14/21 PERMIT# c 2J 0 6 -003 <br /> Owner/Authorized Ag Signature Date (Revised 2/8/2021) <br />