1422 HEWITT AVE BREAKFAST @ TIFFANIS 2022-08-04

•GN PERMIT APPLICATIOS E 1l E R E T T SUBMITTAL INSTRUCTIONS: OF EVERETT PERMIT SERVICES Drop off hard copy paper application&plans to 3200 Cedar Street 2nd Floor Intake Drop Box. WASHINGTON CONTACT INFORMATION:(P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 1422 Hewitt Ave PARCEL#: 00439168103200 CITY Everett STATE WA ZIP 98201 SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential):Breakfast@Tiffanlrs CONTACT INFORMATION OWNER NAME:Tiffany Palpong OWNER MAILING ADDRESS: STREET 1422 Hewitt Ave CITY Everett STATE WA ZIP 98201 OWNER PHONE:4259239700 OWNER EMAIL:tiffiny_palpong@yahoo.com CONTRACTOR CONTACT NAME:Fastsigns of Everett----Michael Bishop WA STATE CONTRACTOR LICENSE#(REQUIRED): FA- l '43Z ' CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 056308 " CONTRACTOR ADDRESS: sTREET28O2 Colby Ave CITY Everett STATE WA ZIP 98201 CONTRACTOR PHONE:42529901 13 CONTRACTOR EMAIL:michael.bishop@faStsignS.Com PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:4252990113 Michael Bishop CONTACT EMAIL:Michael.bishop@fastsigns.com SIGN PERMIT INFORMATION VALUATION OF WORK:$1039.23 ASSOCIATED PERMIT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) DESCRIPTION OF WORK: Installing 3mm Dibond Identification sign on business exterior using steel screws. SIGN DIMENSIONS: Sign 1: Width: 120" Height: 36" Square Feet: 30 Sign 2: Width: Height: Square Feet: Sign 3: Width: Height: Square Feet: SIGN TYPE&QUANTITY: ❑✓Wall/Awning/Canopy-Qty: ❑Window-Qty: ❑Electronic Changing Message-Qty: ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc.): SIGN LIGHTING: EINon-Iluminated ❑Illuminated-Type(backlit cabinet,etc.): *requires a separate electrical permit PLAN REVIEW REQUIREMENTS:Submit 2 hard copies of sign plans with permit application to Permit Intake Drop Box. 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 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 Building Official before being authorized under any circumstance.1 am the owner,or I am authorized by the owner of this property to perform the work for which application is made, and 1 comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# G 2_' O- -00 5 07/20/21 Owner/Authorized Agent Signature Date (Revised 2/8/2021) Y2—