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•IGN PERMIT APPLICATI
<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) 1cj0 - PROJECT SITE INFORMATION
<br /> PROJECT SITE ADDRESS: STREET. (SIN jTil A V e_ PARCEL#: / 2 6-G 4
<br /> CITY v6RC 7 STATE Wy9- ZIP 9320/
<br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION:
<br /> TENANT/BUSINESS NAME(if non-residential): ,)0AT) (`'0A1 T eIecT/2/c__
<br /> / / CONTACT INFORMATION
<br /> OWNER NAME: NoIS7- ('p{�IS7 FiCet7//G OD
<br /> OWNER MAILING ADDRESS: STREET Y Sv 8 /}ve S. STt a 0 I)/ p,e��yy{ -
<br /> CITY Se�}Tr STATE W/ . ZIP 7g/3541
<br /> OWNER PHONE:906_//1/g- 9 9' OWNER EMAIL: j }k)ec), N9n74 eo q.s-r,- 'on-1
<br /> CONTRACTOR CONTACT NAME: C11
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<br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): L7G s/'&AI L'`n CITY eO�OF EVERETT BUSINESS LICENSE#(REQUIRED): 1/a? -
<br /> CONTRACTOR ADDRESS: STREET/g/ p , w y 2)/fv/L`e,
<br /> CITY )7IJeie/voaJ STATE 4,7,09,- ZIP 98?
<br /> CONTRACTOR PHONE: , go—Lr(nZg a 4/896— CONTRACTOR EMAIL:Caw-0 &'i ilmi,' O,aS,4` c0A/,
<br /> PRIMARY CONTACT: ❑OWNER (CONTRACTOR ❑OTHER(Please Specify)
<br /> CONTACT NAME: CONTACT PHONE: 3 /)_Y s
<br /> P_`7— CONTACT EMAIL: /j1 t7 V s/9,10,7„frer.e.tS'1 Cd4I
<br /> SIGN PERMIT INFORMATION
<br /> VALUATION OF WORK:$ )7 941, 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: R.e ,�qg,)P'r CI.) SA- Rep Ciyee rn e,vreffi9e es -f-tm Top S/9y c,9i3/,var a.)0s7-:°v g
<br /> D �- ,8497)e fr14ottur7) S %N. S F Siit/ P410el l'ot cre�u;v724.
<br /> (...1)NON �;r s /P,r�:")Q7 �ecerv�:Ug PA>veCS. �NSTi�// Cl� 9
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<br /> florz � i�°e"'o ��E'Geivi�%g
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<br /> TA)sTg/l / Se7 N©M L,ir AoccTet, ,Le7'�ei25/ eyo Fore fi?o,v7 e�e11q%io,V�
<br /> /3��►D2 5; ✓i e r o a X 5l v
<br /> Q �� /'AAi Fg4es clt7, S ,f�va-
<br /> 14-
<br /> SIGN DIMENSIONS: sJ ppi A Ae•C r?lv'i`'y V=if",ua � _ 1 S.a�. (. X ,^6") '
<br /> Cou,uT�ie '0. - fo sq./-7; Q ' s
<br /> Sign 1: Width: s I,40/0„ul Pepe_e 1 yi A)c)Height: /r X ,r 6 445-s f,it, Square Feet:
<br /> Sign 2: Width: Height: Square Feet:
<br /> Sign 3: Width: Height: Square Feet:
<br /> SIGN TYPE&QUANTITY: I1dWall/Awning/Canopy-Qty: El Window-Qty: ❑Electronic Changing Message-Qty:
<br /> ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc.):
<br /> SIGN LIGHTING: Non-Iluminated ❑Illuminated-Type(backlit cabinet,etc.): *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.1 am the owner,or 1 am authorized by the owner of this property to perform the work for which application is made,
<br /> and l comply with the State Contractors Law 18.27 RCW and 286.200A WAC.
<br /> City off Everett,� Official Use Only
<br /> c� Jld�/D r9/ l 3 e? cl 0� PERMIT# 2/-!1 -WI
<br /> Owner/Authorized Agent Signature Dade (Revised 2/8/2021
<br /> 9 9 1
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