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smi <br /> •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) PROJECT SITE INFORMATION 2,<:ro "I g(0030 6 i;n o <br /> PROJECT SITE ADDRESS:\1TREET .S 6 E'lz_.Cs�—s.it wpm\ tthlThit PARCEL#1. QS i QsCO b 6/ On <br /> CRY av1Q1-`-' STATE 11.4.2LCIP ZS <br />- SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: D �©���� <br /> TENANT/BUSINESS NAME(if non-residential): i cc,t+j T /k <br /> ((�� <br /> CONTACT INFORMATION <br /> OWNER NAME: ' \ tS C\ . Rtii—(ram\ �L APR 2022 <br /> N <br /> OWNER MAILING ADDRESS: sTREET g 6 g. "73 CITY OF EVERETT <br /> cry F'C42.12.,t M( STATE ' .rmit ServeServigeSa Li <br /> OWNER PHONE: .sue OWNER MAIL: <br /> CONTRACTOR CONTACT NAME: JAS°p.) `--A- 14-01 van GQC:e S i rkS <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED)iA 1)VANS L9c.)3 Dp CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): C 3 90 <br /> CONTRACTOR ADDRESS: STREET A?7r I�T7J 4.) C <br /> CnY ,/'T C.�.LC/J STATE -- ZIP 970516 <br /> CONTRACTOR PHONES13-9g'7-c"C)IIq CONTRACTOR EMAIL: PSL , F'e_sM ,'+ G G'it^/E LI C(3V2-i <br /> PRIMARY CONTACT: Cl OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: C,A.Imo, ,, ('(3,4-,1"c___A evr- <br /> 1,ot- t f o-r CONTACT EMAIL: -+L, 7 r <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK: $ - ()r 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:7,A) S�h\ <br /> SIGN DIMENSIONS: <br /> Sign 1: Width: O •_LA Height: Square Feet: , <br /> L t ('� L <.f. <br /> 6 <br /> Sign 2: Width: _ D . 11 Height: L , 9 , 11 Square Feet: 20 , Sl� <br /> Sign 3: Width: Height: / Square Feet: <br /> SIGN TYPE&QUANTITY: ❑Wall/Awning/Canopy-Qty: ❑Window-Qty: ❑Electronic Changing Message-Qty: ` <br /> Cl Projecting-Qty: 'Freestanding-Qty:3- -Type(monument,etc.):I et) k-z.A,d C \C- A4" S <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.I am the owner,or 1 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# <br /> 1 C — a-ate SZ70q -0014 <br /> Owner/A thorized Agent Signature Date (Revised 2/8/2021) <br /> 1/2_, <br />