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Eir. SIGN 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 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 305 SE Everett Mall Way, Suite 21 PARCEL#: 28051800304300 <br /> CITY Everett STATE WA ZIP 98208 <br /> SUITE/UNIT#: 21 ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):Visionworks <br /> CONTACT INFORMATION <br /> OWNER NAME:ACF Property-Trista Brown <br /> OWNER MAILING ADDRESS: STREET 12411 Ventura Boulevard <br /> cry Studio City STATE CA ZIP 91604 <br /> OWNER PHONE:818-505-6777 ext. 212 OWNER EMAIL:tbroWn@acfpm.cOnl <br /> CONTRACTOR CONTACT NAME:New Image Creative Sign Inc. <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):NEWIMIC961 B9 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57624 <br /> CONTRACTOR ADDRESS: sTREET4549 125th Ave SE <br /> CITY Bellevue STATE WA ZIP 98006 <br /> CONTRACTOR PHONE:206-406-3437 CONTRACTOR EMAIL:shari@newimagecreative.com • <br /> PRIMARY CONTACT: ❑✓ OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-406-3437 <br /> Shari Rust CONTACT EMAIL:shari©newimagecreative.com <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK: $3000.00 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:Install (1) new VISIONWORKS channel letter set on raceway, and (2) tenant panels on <br /> pylon sign <br /> SIGN DIMENSIONS: .-7'n YA k J73 ) ' <br /> Sign 1: Width:23' Height: 3'-4"/ Square Feet: 76 <br /> Sign 2: Width: Height.,_.. Square Feet: <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY: Wall/Awning/Canopy-Qty: 4 ❑Window-Qty: ❑Electronic Changing Message-Qty: <br /> ❑Projecting-Qty: ❑Freestanding-Qty ,_ —Type(,nonument;etc)y__, <br /> SIGN LIGHTING: ❑Non-Iluminatec‘ Xiliuminated-Type(backlit cabi (tc.):C- \ - L1�( S_--1'f sires 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 /> curren(fede I,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 Offi ial 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 /> d I compl with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> (n <br /> City of Everett Official Use Only <br /> �,,C`\ 4Q(Cri( •f P T .«2. — 00 2.=,-- <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br /> Vz_ <br />