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sf+,J T T SUBMITTAL INSTRUCTIONS:Drop off hard copy paper application&pious to 3200 Cedar ,fi
<br /> 1Yr CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov 1(W)ever,f'
<br /> WASHINGTON
<br /> jplue or Black Ink Only Please) PROJECT SITE INFORMATION -"
<br /> PROJECT SITE ADDRESS: STREET /40 k3 Q.1%i')v\\ \J Q PARCEL#: 004---'?,91(Q(r, ( o'- • " " '
<br /> CITY V-e. Y \T"' STATE Sl-.04C:1V1\'(-AC., 1 1 ZIP q Q}.LV
<br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION:
<br /> TENANT/BUSINESS NAME(if non-residential): I_ , ' _ -, L,._, - c., 1 - '_,,,,�' _,,c Y\ . . ♦
<br /> CONTACT INFORMATION
<br /> OWNER NAME: \ ANG "c\C1`ire 5 cam, v-Erk.
<br /> OWNER MAILING ADDRESS: STREET� 9 C j�4c� ),�Q4(\Q._'� �� - I. "
<br /> CCITYr(`�•JY\\\�4\`v- \ STATE ) ZIP ��, 3 '1
<br /> OWNER PHONE:C oc��y�O .L.cii JV�OWNER EMAIL:ckA,vc,,,no,C,c>,r44x c\> 0., c o c, ,\• C0 (1^
<br /> S' I
<br /> CONTRACTOR CONTACT NAME:\L -: I/\ UC,q--)-
<br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): CITY OF EVERETT BUSINESS LICENSE#(REQUIRED):
<br /> CONTRACTOR ADDRESS: STREET
<br /> CITY STATE ZIP
<br /> CONTRACTOR PHONE: CONTRACTOR EMAIL:
<br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE:
<br /> CONTACT EMAIL:
<br /> SIGN PERMIT INFORMATION
<br /> VALUATION OF WORK: $ tf11')0/" 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 /> 3 C.0 X l 2 �, 9c,l , ._\ ,\- �, ; Sr>e.c--e. 0 �C��Z Nye
<br /> -\, N., Cu...;N. �� cti _.) r CC..--k \- 'sr..
<br /> SIGN DIMENSIONS: �_ .
<br /> Sign 1: Width: .1 t Height: •,__y\ Square Feet: 2 =t
<br /> Sign 2: Width: Height: Square Feet:
<br /> Sign 3: Width: Height: Square Feet:
<br /> SIGN TYPE&QUANTITY: DWall/Awning/Canopy-Qty: 1 ❑Window-Qty: Li ❑Electronic Changing Message-Qty:
<br /> EProjecting-Qty: ❑Freestanding-Qty: -Type(monument.etc.):c),A,C \c>_S ' '_-C cA.
<br /> SIGN LIGHTING: ❑Non-Iluminated ❑Illuminated-Type(backlit cabinet,etc.): *requires a separate electrical permit'.s
<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 ma.
<br /> and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC.
<br /> City of Everett Official Use Only''
<br /> �ifl PERMIT# U
<br /> Owner/Authorized Age - Date (Revised 2/8/2021)
<br />
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