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1 3c�_( sc__�_ <br /> SIGN PERMIT APPLICATION <br /> EVERETT SUBMITTAL INSTRUCTIONS: <br /> OF EVERETT PERMIT SERVICES <br /> S:Drop off hard copy paper application&plans to 3200 Cedar Street 2nd Floor Intake Drop Box. <br /> WASHINGTON CONTACT INFORMATION:(P)425-257-8890 (E)PermitServices@everettwa.gov I(W)everettwa-.govlpermlts <br /> (Blue or Black Ink Only Please) PRO40et SITE INFORMATION { <br /> PROJECT SITE ADDRESS: sTREEr 152-1 — PiflGF! l WA,1PARCEL#: <br /> CITY STATE ZIP <br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: <br /> TENANTIBUSINESS NAME(€f non-residential): <br /> CONTACT INFORMATION <br /> OWNER NAME: I-etrreo) <br /> OWNER MAILING ADDRESS: sTREEr /� jr1J r Pap td/ <br /> CITY a(tru STATE <br /> OWNER PHONE: ;k-S-3 - 7a - S75 OWNER EMAIL: ''�✓tlX�T1 I• C G <br /> CONTRACTOR CONTACT NAME: <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED); CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 23a,�5- <br /> CONTRACTOR ADDRESS: STREET fr <br /> CITY �� STATE /t ZIP � / r <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: I r eSC6, cc" <br /> PRIMARY CONTACT: D OWNERCONTRACTOR Cl OTHER(Please Specify) / <br /> CONTACT NAME: CONTACT PHONE: Fa10 CeS'Ij <br /> V W1Yv�' %1Iy�iLV?7CC�[lQ CONTACT EMAIL: I/eenw l tai Z`•sco.Ina rvl <br /> SIGN PERMIT INFORMATION - <br /> VALUATION OF WORK:$ �3 �� ASSOCIATED PERMIT# if applicable).- <br /> (Valuation$ha4lnclude the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether 0olualty paid or not. <br /> DESCRIPTION OF WORK: <br /> +1V0 5etS 1� luwl in af�D C vt� l � fc� 51��5 <br /> r <br /> SIGN DIMENSIONS: <br /> r Ir t <br /> Sign 1; Width: Height: Square Feet: f 3 <br /> Sign 2: Width: �� Height: . SquareFeet: &S S~� <br /> Sign 3., Width: Height: Square Feet; <br /> SIGN TYPE&QUANTITY: P611 Mounted-Qty: DAwning-Qty: []Canopy-Qty: OWindow-Qty: <br /> ❑Electron€c Changing Message-Qty: L1 Projecting-Qty: ❑Freestanding-Qty: Type(monument,eta.): <br /> SIGN LIGHTING: ONon-Illuminated aluminated-Type(backlit cabinet,etc,): G -*requires a separate electrical pe <br /> mtlt <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 hereln Is true and correct.Work done pursuant to this permit must comply with <br /> current federal,slate,and local law, The granting ofa permit only authorizes approved work and no deviations therefrom,Deviations must ffrsfbe authorized in wntrng 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 ROW and 286.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> Owner/Arazed Agerorgnature Date (Revised 11/8!2022) <br />