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aim <br /> ell <br /> SIGN PERMIT APPLICATISI <br /> EVERETT CITY OF EVERETT PERMIT SERVICES <br /> 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( ` -1 �� 1 �71G:w� EL#: <br /> CRY <br /> STA ZIP <br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential): " 1 � <br /> CONTACT INFORMATION ti <br /> Sul_ 0 B 20L1 *` <br /> OWNER NAME: <br /> OWNER MAILING ADDRESS: STREET Ci1Y OP EVERETT <br /> Servic�S <br /> perm it <br /> CITY <br /> STATE ZIP <br /> •OWNER PHONE: <br /> (OWNER EMAIL: <br /> CONTRACTOR CONTACT NAME: `� ( <br /> /r Q ,14G ��� � ��T11iEC f <br /> WA STATE CONTRACTOR LICENSE#(kEQUIRED): G 1 <br /> ` 7-- r l� F EVERETT BUSINESS LICENSE#(REQ IRED): ) <br /> CONTRACTOR ADDRESS: 17!( � 4 ./ ) 4� o <br /> STREET <br /> CITY �L.'\L,{11' l.Lti,./ % / (,,�/' ^w <br /> STATE (%l Y,4 j <br /> CONTRACTOR PHONE: �)( t7 _ 51I ZIP V ) )� <br /> ,I !CONTRACTOR EMAIL: i,Cicc y4.-f'/f �C;!�I f-���'f ,e a�Yj <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:Gyr � /1('-)2 /1 <br /> .- .-J)l a . �/1. .F , ) CONTACT EMAIL: ii, r,-' � <br /> SIGN PERMIT INFORMATION / <br /> VALUATION OF WORK:$ (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 /> DE. CRIPTI`OlN OF WO K: )ry , q 'n ( l/� l � i( { / <br /> 6 ��f �.1/1` �� I46,t{4t - ���L� t 1 isc (ly1 41 I ,J��1� �VLJ � kI 1lV <br /> d. <br /> .) V., gh-1- -eLt..\13cci--itY1 c.,i__VN(‘)..nes tri -)40 crtauxtLf <br /> SIGN DIMENSIONS: <br /> Sign 1: Width: Height: <br /> Square Feet: <br /> Sign 2: Width: Height: <br /> Square Feet: <br /> Sign 3: Width: Height: <br /> Square Feet: <br /> SIGN TYPE&QUANTITY: ❑Wall/Awning/Canopy-Qty: ❑Window-Qty: ❑Electronic Changing Message-Qty: <br /> ❑nrujecting-Gtty: ❑Freestanding-Qty: -Type(monument,etc.): <br /> SIGN LIGHTING: ❑Non-Iluminated ❑Illuminated-Type(backlit cabinet etc.): <br /> *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 /> 4CKNOWLEDGEMENT: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 /> :urrent 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 /> 3uilding 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/comply with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> f j_ _ City of Everett Official Use Only <br /> L77-2/k?0( <br /> � PERMIT#I . r/Authori �'rf j � '1F �� ✓ Ld " W��-f7--zed Agent ignature J <br /> Date (Revised 2lt3/2021) I <br />