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ItIGN PERMIT APPLICATION <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 <br /> PROJECT SITE ADDRESS: STREET I() la fI Cve, jytRj" \_�" ,�,c,� 3ARCEL#: c t0,21.S O <br /> crrY �YG✓y¢-� ` STATE V ZIP -I�.i(�`1 <br /> SUITE/UNIT#: $ui 1'e 15 ADDITIONAL LOCATION INFORMATION: V 111 <br /> TENANT/BUSINESS NAME(if non-residential): 5 <br /> CONTACT INFORMATION <br /> OWNER NAME: )4.55>'+ 0\ny4r <br /> OWNER MAILING ADDRESS: STREET I I 6✓wg,ree eN. , _`�`u S�� lc <br /> CITY .\rlJ✓ /1 1- J STATE W A ZIP 9 3D:3-i <br /> OWNER PHONE: 1,1o) S a ao .- ci8314 OWNER EMAIL:).ecSi c.4...36k#save k4;rts Alevoe •cQv\.\ <br /> CONTRACTOR CONTACT NAME: �c,S-1-Sfs1v.S Ever <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):FASTS$' g323\<CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): "3C0 7Jt✓l� <br /> CONTRACTOR ADDRESS: STREET 'va 2ue,L.c,,v <br /> CITY L V STATE ZIP 12.101 <br /> CONTRACTOR PHONE: a5-43 3—,cI O CONTRACTOR EMAIL: 1-17 - },s; ,,,5 <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR 1Sl OTHER(Please Specify) (✓ia. ,..cie.Ar <br /> CONTACT NAME: CONTACT PHONE: Li C43 c)t5o <br /> CONTACT EMAIL: 1.0.r.�4,n,n , ;#.)„..S •canev> <br /> SIGN PERMIT,INFORMATION <br /> VALUATION OF WORK:$ e ,Z 1 t.?(o ASSOCIATED PERMIT#(if applicable): <br /> (Valuation shall include the prevailing fair men., of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> DESCRIPTION OF WORK: <br /> 111• 14"JS a.IU144:virks-t)in. ,Q( f 5 t'51�5 4-1,w4- 0-✓c. Incv <br /> t«Utn�v✓`�k cX 1 o�3,,,x oZ�h ►J i uv�Q� nop^rj cvt e Sic(G (VP - e S vt k. , <br /> SIGN DIMENSIONS: <br /> o <br /> Sign 1: Width: k C7 • Height: 019 Square Feet: )o <br /> Sign 2: Width: a,() Height: avl Square Feet: po <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY:‘NWali/Awning/Canopy-Qty:a ❑Window-Qty: ❑Electronic Changing Message-Qty: <br /> ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc.): <br /> SIGN LIGHTING: . ion-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 I 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 /> eviougu.96}141 a.°lad PERMIT# S 23 01 , 001 <br /> „I <br /> • ner/Authorized Agent Signature Date (Revised 2/8/2021) <br /> TZ- <br />