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Iwo 03N PERMIT APPLICATIO• <br /> rai <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 (W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECTTp .X <br /> SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 12$I 6 IA ' ,we j PARCEL#: 28052'11)0303c-1DO <br /> CITY . ere44-- STATE IDA ZIP 9g2p1 <br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential): Si lYer tare e *,,ry <br /> 1� CONTACT INFORMATION <br /> OWNER NAME: 'e -0- SckDoi s-11 i z <br /> OWNER MAILING ADDRESS: STREET 47 ,r Co[bi e vu e <br /> CITTYM .eve.{- '"J STATE 1 ' / ZIP g 2.0 <br /> OWNER PHONE: y Z5-3gs= IWV /t, OWNER EMAIL:�1/�uitbm -c Q�titreTT-6c • trCj <br /> CONTRACTOR CONTACT NAME: M-ejer' SI yh COM 0, , 1►!C� <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): Ilf,Ynescg Z g CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 5131 b <br /> CONTRACTOR ADDRESS: STREET Z.ItG ' ,t.4w 99 41 <br /> CITY A1A'•Ve.Ynor► STATE WA ZIP 9go3 <br /> CONTRACTOR PHONE:3/p-gig- 1325 CONTRACTOR EMAIL: perm 1-)s@ w idersi jY)•Gom <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR L1 OTHER(Please Specify) <br /> CONTACT NAME: (�� CONTACT PHONE: 3 _yzy_ 132s <br /> J Mvtt TTI�i CONTACT EMAIL: Permr}-s WVle yrsieo• L'vr►i <br /> SIGN PERMIT INFORMATION ( poect) <br /> VALUATION OF WORK: $ Id,000• tA) ASSOCIATED PERMIT#(if applicable): ev -0)g(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 /> I I a —CAI -Fool- it 11) 32 sl ika►e -Earl melee-hen i c rvlessa f ce-n*r-cze spa vl�'r� <br /> Sign art I't-141 Ave . -b r p ka.et, .exi ski v19 6 N SR ua-ne h-I- Pie s 1 yn <br /> 'Me litre Ce ti-er v II be U p 2-I ar , <br /> SIGN DIMENSIONS: <br /> -I0--{1.i SQ.-PI-- 31.4�f <br /> Sign 1: Width: O, 'OD�r Height: ID �I- — 20•$S <br /> Sign 2: Width: Height: Square Feet: <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY: ❑Wall/Awning/Canopy-Qty: ❑Window-Qty: Electronic Changing Message-Qty: <br /> CI Projecting-Qty: Freestanding-Qty: 1 -Type(monument,etc.): Yol G <br /> SIGN LIGHTING: ❑Non-lluminated ,Illuminated-Type(backlit cabinet,etc.): L�i Ni G *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. I am 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 /> PERMIT# <br /> Silo ) —oos <br /> 0 er/Author d Agent Si t re Date (Revised 2/8/2021) <br />