3025 LOMBARD AVE 2023-05-23 - Laserfiche WebLink

E qIGN PERMIT APPLICATION tit 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 3 0D.; Lorv,lp,\ ) ii PARCEL#: 0043907-130MOD cm' e veireA4 STATE ,iJA ZIP 01gZO` SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: �/� TENANT/BUSINESS NAME(if non-residential): V o`UVI\eeil/S OF Arvidi to. C 61 j'son G leAt e i / _ ^L CONTACT INFORMATION OWNER NAME: GI C- rVu✓efr* OWNER MAILING ADDRESS: STREET Zq 30 t,,Javvore, kit CITY ,vr r',J(f STATE ZIP CigUI OWNER PHONE:(420 7 S'9--Voo OWNER EMAIL: d mAi(on,„\\a emiy)k Aa.. cc CONTRACTOR CONTACT NAME: •)cuA-ek VotA,-- dYDI l-y( 3I WA STATE CONTRACTOR LICENSE#(REQUIRED):cc. FAS(s °r4,3M CITY OF EVERETT BUSINESS LICENSE#(REQUIR D):6rHL- CONTRACTOR ADDRESS: STREET Z w)7 C.ouoi Ave CITY evo STATE W✓Z ZIP alvol 1 CONTRACTOR PHONE: 42 -4?g_ei3g0 CONTRACTOR EMAIL: &Aria co,a,ek 006v4c,.f•pirA _ ... PRIMARY CONTACT: ❑OWNER XCONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE: C/�j ?1"]. _Gt CJ.4 6 IDc ,�`,� ,A CONTACT EMAIL: _1 lex. c Uo t ,n T\S �� SIGN PERMIT INFORMATION ,L�' VALUATION OF WORK:$ 2.61, 7 4.1 .--41 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.) vu DESCRIPTION OF WORK: Div v►6i 6)tR0..1 Va - ,it vim., oked L.,tA.k.al Sc.'hic, . SIGN DIMENSIONS: Sign 1: Width: 2,ci a •4 6 II Height: S 1•74 II Square Feet: 4 S.63 sfz, Sign 2: Width: Height: Square Feet: Sign 3: Width: Height: Square Feet: SIG TYPE&QUANTITY: fINaII/Awning/Canopy-Qty: I *" ❑Window-Qty: ❑Electronic Changing Message-Qty: DN 4 pf45) ❑Projecting-Qty: El Freestanding-Qty: -Type(monument,etc.): SIGN LIGHTING: ❑Non-Iluminated Aluminated-Type(backlit cabinet,etc.):Iv hiltW.‘2aGk-V1k tQkCWS *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 PERMIT L�^A(pJ(^/C7/ �i/ZF?zz �• T7CIA•14:itA wner/Authorized Agen ignature Date (Revised 2/8/2021) la