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MIN SIGN PERMIT APPLICATION <br /> ra <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£j l if j L7 4. hut, 't PARCEL#: <br /> CITY ,E.-t ,p i+ STATE IAA- ZIP q8 `-OA <br /> SUITE/UNIT#: ( 8A ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential): I!Oim j Cairn i 5'(2A <br /> CONTACT INFORMATION <br /> OWNER NAME: (CA 5--4 I 5,Qtekel•P <br /> OWNER MAILING ADDRESS: STREET P 6 Goi 13g3 <br /> CITY Ya k j NIA STATE VV A ZIP <br /> OWNER PHONE: 425--ZS Z c(cOt) OWNER EMAIL: ' <br /> ` <br /> CONTRACTOR CONTACT NAME: J(,'(t„�los p4 y�— -- SS re.. ('S. <br /> STATE CONTRACTOR LICENSE#(REQUIRED):"V 'S�Lq(v"jb ICIT/F EVERETT BUSINESS UCENSE#(REQUIRED): c39,243 <br /> CONTRACTOR ADDRESS: STREET /9/6 6 1407 pq I_ <br /> CITY t <l 0"704 STATE 1 . ZIP ,'I 0(2- <br /> CONTRACTOR PHONE: �{2T-2-?7_0c,,2__ p 0114 <br /> CONTRACTOR EMAIL: er,[ �},��T �6 ( <br /> r!'CO <br /> PRIMARY CONTACT: ❑OWNER SNTRACTOR 0 OTHER(Please Specify) r <br /> CONTACT NAME: CONTACT PHONE: 4 -- ,2 7�_bb 7 2_ <br /> jit..ee$ )Clti� CONTACT EMAIL: C01.S�® leiLin . C <br /> I SIGN PERMIT INFORMATION <br /> VALUATION OF WORK:$ f CIO 0 ASSOCIATED PERMIT#(if applicable): <br /> (Valuation shall Include the prevailing ma et value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> DESCRIPTION OF WORK: <br /> 'Ile.\ --fall e I(Y)410-e 1 Le45 6.11 '-fie_ k(4611 <br /> SIGN DIMENSIONS: <br /> Sign 1: Width: 15 Height: 2 2// Square Feet: 2-S <br /> Sign 2: Width: Height: Square Feet: <br /> Sign 3: Width: �/ Height: Square Feet: <br /> SIGN TYPE&QUANTITY: ' WaII/Awning/Canopy-Qty: ( OWindow Qty: ❑Electronic Changing Message-Qty: <br /> ❑Projecting- ty: ❑Freestanding-Qty: -Type(monument,etc.): <br /> SIGN LIGHTING: ❑Non-Iluminated Illuminated-Type(backbit 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.1 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.lam the owner,or 1 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 g98.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# 2(p p —0 <br /> 03 <br /> Owner/Authorized Age ature ate (Revised 2/8/2021) <br /> /Z <br />