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IGN PERMIT APPLICATIO. <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 /> WASHtN6sQN CONTACT INFORMATION:(P)425.257.88101(E)everetteps@everettwa.gov 1(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 4808 Evergreen Way PARCEL#: <br /> cry Everett STATE WA ZIP 98203 <br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):J.G.S.LLC <br /> CONTACT INFORMATION <br /> OWNER NAME:Joshua G Shade <br /> OWNER MAILING ADDRESS: STREET 15544 Beach Drive NE <br /> cln. Lake Forest Park STATE WA ZIP 98155 <br /> OWNER PHONE:206 271 5468 OWNER EMAIL:thekuShery502@mail.COm <br /> CONTRACTOR CONTACT NAME:Mikes Neon Signs <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): h rK ESA)SO334 ,Ty OF EVERETT BUSINESS LICENSE#(REQUIRED): , cl,e, <br /> CONTRACTOR ADDRESS: sTREET2216 100th ST SE 35 t/ <br /> cry Everett STATE WA ZIP 98208 <br /> CONTRACTOR PHONE:425 750 0824 CONTRACTOR EMAIL:evercole@aol.Co , <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ID OTHER(Please Specify) agent <br /> CONTACT NAME: CONTACT PHONE:360 794 8614 <br /> Eric Stiemert CONTACT EMAIL:eric@deksignco.com <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK:$2000.00 ASSOCIATED PERMIT#(if applicable): <br /> (Valuation shah include the prevailing fair market value of aN labor,materials,and equipment needed to complete the work,whether actually paid or not) <br /> DESCRIPTION OF WORK:replace 4 sign faces on existing commercail sign pole see before and after drawing of <br /> current sign as is and planned change. <br /> SIGN DIMENSIONS: <br /> Sign 1: Width:13' Height: 44" Square Feet:47 <br /> Sign 2: Width: 13' Height: 22" Square Feet:24 <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY: ❑WalllAwning/Canopy-Qty: ❑Window-Qty: ❑Electronic Changing Message-Qty: <br /> ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc.): <br /> SIGN LIGHTING: ❑Non-Iluminated ❑Illuminated-Type(backlit cabinet,etc.):all ready installed and permited *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 /> PERMIT#6/14/2021 2-1 0 _0 0 <br /> � �j <br /> Owner/Authorized Agent S gl nature Date (Revised 2/8/2021) <br /> C� <br />