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MIGN 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 10505 19th Ave SE Suite B PARCEL#: 28052000203200 <br /> cay Everett STATE WA ZIP 98208 <br /> SUITE/UNIT#: B ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):Edward Jones <br /> CONTACT INFORMATION <br /> OWNER NAME:Dan Kosnik <br /> OWNER MAILING ADDRESS: STREET 10505 19th Ave SE <br /> cry Everett STATE WA ZIP 98208 <br /> OWNER PHONE:425-357-9600 OWNER EMAIL:dan@kosnik.com <br /> CONTRACTOR CONTACT NAME:City Lites Neon <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):CITYLNI099DG CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 41415 <br /> CONTRACTOR ADDRESS: STREET902 NW 49th St <br /> clry Seattle STATE WA ZIP 98107 <br /> CONTRACTOR PHONE:206-789-4747 CONTRACTOR EMAIL:sarah@citylightssign.com <br /> PRIMARY CONTACT: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-789-4747 <br /> Sarah Terry CONTACT EMAIL:sarah@citylightssign.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: <br /> Install and maintain (1) s/f channel letter wall sign and REFACE existing d/f monument <br /> for Edward Jones <br /> SIGN DIMENSIONS: <br /> Sign 1: Width: 8'-0 3/8" Height: 12" Square Feet: 8.03 <br /> Sign 2: Width: 4'-9 3/4" Height: 1'-9" Square Feet: 8.6 <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY: ✓❑Wall/Awning/Canopy-Qty: 1 El Window-Qty: ❑Electronic Changing Message-Qty: <br /> El Projecting-Qty: ©Freestanding-Qty:1 -Type(monument,etc.): multi-tenant monument <br /> SIGN LIGHTING: ❑Non-liuminated ❑✓Illuminated-Type(backlit cabinet,etc.):channel letter *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.I am 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 /> ri\. City of Everett Official Use Only <br /> PERMIT# 2u 1 - <br /> 0 0 9 <br /> 11/16/21 I <br /> Owner/Authorized Agent nature Date (Revised 2/8/2021) <br /> VZ. <br />