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�IGN PERMIT APPLICATICS <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(IN)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET.3 5 1 ro f c-SJ\ 'ak-{ << PARCEL#: <br /> CITY �V C��'Z( STATE w (k ZIP 9 28 I <br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: l" <br /> TENANT/BUSINESS NAME(if non-residential): ri C Cj <br /> CONTACT INFORMATION <br /> OWNER NAME: I'i : $ `-r <br /> OWNER MAILING ADDRESS: STREET j�Z�r7 13 Ac ) S <br /> CITY CT STATE LOA- ZIP ' 8 <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR CONTACT NAME: 'PA Ll (L �L G t-i �t L<a�S l l� <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):Ph(:.i F'SF Gj(0S de--CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): <br /> CONTRACTOR ADDRESS: STREET,Z2. Cy L °./ A-u£ U.) <br /> q(� <br /> crry v" t)U n t (A K G�/` /`7k L4- STATE zip (O a CONTRACTOR PHONE: 2.17C -f -' () CONTRACTOR EMAIL: fll1C(FtLs-[c, ,G&'t- <br /> PRIMARY CONTACT:rWNER INTRACTOR )THER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: -2_0 („H e •- q (9 <br /> ff -f �— C� CONTACT EMAIL: <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK:$ '7 G0 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 /> Z irc VM,bJi' E,E D 5-e-7S Of <br /> 1 LL ) Yv.( Ncl -c-E-7 L --F-r A 11..F(7Ac f lttN <br /> (}.3 t s-r ( N C b� (� hn, f 6 N <br /> SIGN DIMENSIONS: <br /> / � t ( l+ it /. <br /> Sign 1: Width: l`7 L Height: ( Square Feet: ((f <br /> Sign 2: Width: t 2 2_ Height: 14011 Square Feet: 23 <br /> Sign 3: Width: )Z'Z Height: Li N b Square Feet: 2_' , <br /> SIGN TYPE&QUANTITY: all/Awning/Canopy-Qty:2— 0/indow Qty: electronic Changing Message-Qty: <br /> projecting-Qty: Elreestanding-Qty: -Type(monument,etc.): <br /> Kt�1�L . <br /> SIGN LIGHTING:Don-Iluminated kuminated-Type(backlit cabinet,etc.):( D ,p��?�rx- *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 /> currant 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.lam the owner,or tam authorized by the owner of this properly 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 /> ! -3 Zz `2Z�1' 60I <br /> Owner/Authorized A nt Signature Date (Revised 2/8/2021) <br /> /Z <br />