11610 EVERGREEN WAY 2023-04-06 - Laserfiche WebLink

E ISIGN PERMIT APPLICATIc CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application&plans to 3200 Cedar Street 2nd Floor Intake Drop Box. WASHINGTON CONTACT INFORMATION: (P)425.257.8810 I(E)everetteps@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET I I L 1 0 VeVb Vt./rl wYAl PARCEL#: 0(XIuI 2.q CY0'-{0 Z 002pp CITY EVe✓e 1+ STATE W ZIP '1 O2 Dy SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME (if non-residential): PAndrn JCpveSS CONTACT INFORMATION OWNER NAME: C FT OCV1.\OID mtn-3 OWNER MAILING ADDRESS: STREET I Vr 83WG IrI(A+ flrovc CITY \Zoc erntad STATE CR ZIP °11110 OWNER PHONE: OWNER EMAIL: CONTRACTOR CONTACT NAME: MCNC✓ SI sn WA STATE CONTRACTOR LICENSE#(REQUIRED): '/ Ei2 SC 9 32 38 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): t5 7 3,I 0 CONTRACTOR ADDRESS: STREET Z L 08 016 Nwy G19 S• CITY M A. Ye✓rl 0rl STATE WA ZIP _t 027 J CONTRACTOR PHONE: 3lf 0) LAlL - 112 S CONTRACTOR EMAIL: TT b611 rn boy GI to b m ail- Co rr-1 PRIMARY CONTACT: ❑OWNER Xi CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: JUClf uycl� CONTACT PHONE: 31,,0) u2LI - 1721. CONTACT EMAIL: Tlldl(rig O4GI(r) 0 5rr,c1/ )- Cprrl SIGN PERMIT INFORMATION VALUATION OF WORK:$ h 1000'00 ASSOCIATED PERMIT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) DESCRIPTION OF WORK: AGldln� an urcicv, con firmrnfiDn mf-rlvt Iooavcl. SIGN DIMENSIONS: Sign 1: Width: B�I Height: L( � 1/3 " Square Feet: 'Li Sign 2: Width: Height: Square Feet: Sign 3: Width: Height: Square Feet: SIGN TYPE&QUANTITY: ❑Wall/Awning/Canopy-Qty: ❑Window-Qty: ❑Electronic Changing Message-Qty: ❑Projecting-Qty: Rreestanding-Qty: -Type(monument,etc.): 'M oV1LA.VYltrv} SIGN LIGHTING: ❑Non-Iluminated LJllluminated-Type(backlit cabinet,etc.): -*requires a separate electrical permit PLAN REVIEW REQUIREMENTS: Submit 2 hard copies of sign plans with permit application to Permit Intake Drop Box. 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 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only WA%th. LA I 11 I2I PERMIT# Owner/Authorized Agent Signature Date (Revised 2/8/2021)