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i <br />SIGN 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 />CONTACT INFORMATION: (P) 425-257-8810 t (E) Perm itServicesOeverettwa anv 11W1 nvarattwn nn,clnarmita <br />(Blue or Black Ink Only Please) PROJECT SITE INFORMATION - <br />PROJECT SITE ADDRESS: 5dO STREET C� PARCEL #: <br />CITY _ STATE ,. ZIP <: <br />SUITE/UNIT #: ADDITIONAL LOCATION INFORMATION': <br />TENANT/BUSINESS NAME (if non-residential): Q <br />CONTACT INFORMATION <br />OWNER NAME: ( , <br />OWNER MAILING ADDRESS: TREETL <br />CITY t•'�'"' STATE ZIP 7-0 <br />OWNER PHONE; ' Z 6 <br />OWNER EMAIL: <br />CONTRACTOR CONTACT NAME: f 15howR � Rnu C <br />WA STATE CONTRACTOR LICENSE #(REQUIRED); �' L <br />CITY OF EVERETT BUSINESS LICENSE #(REQUIRED): <br />CONTRACTOR ADDRESS: STREET <br />clTy STATE > ` DP <br />CONTRACTOR PHONE: Z, 4 � CONTRACTOR EMAIL: t5e G3(O CCe-m <br />PRIMARY CONTACT: ❑ OWNER ❑ CONTRACTOR -1 OTHER (Please Specify) rJ ' <br />CONTACT NAME; ! <br />CONTACT PHONE: Z.0 & 69- C Cjcl <br />CONTACT EMAIL: t,i Szt t Ili ' C4'd . C'mm <br />SIGN PERMIT INFORMATION <br />VALUATION OF WORK: $ ASSOCIATED PERMIT # if applicable): <br />(Valuation shell include the prevailing fair markot value of all labor, materials, and equipment needed to complete the work, whether'acwally paid or not.), ;•; <br />DESCRIPTION OF WORK: 5�' <br />Trt�{c�i! �. �/7 � � I) ��:-f' c.,�lc�nr�! �.-i-�;er� tr�l,tt�f��•� _� (vim w� , �t��'i <br />Ir" <br />LET) ► �l Ltrtllrl�JYi <br />SIGN DIMENSIONS: <br />�_1 <br />g I ' i �a Height: 20 Square Feet: <br />Sign 1 � Width: <br />Sign 2: Width: Height: Square Feet: <br />Sign 3: Width: Height: Square Feet: <br />SIGN TYPE QUANTITY; 0 al Awning/Canopy - Qty:�_ ❑Window- Qty:__ ❑Electronic Changing Message - Qty: <br />❑Projecting - Qty: ❑Freestanding- Qty: - Type (monument, etc.): <br />SIGN LIGHTING: ❑Non-Iluminated Illuminated - Type (bacidlt cabinet, etc. ):l ^ <br />- requires a separate electrical permit <br />N REVIEW REQUIREMENTS: Submit 2 hard copies of sign plans with permit application to Permit Intake Drop Box. i�t <br />PLAACKNOWLEDGEMENT: 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, ) am the owner, or I am authorized by the owner of this property to perform the work for which application is n <br />and I comply with the State Contractors Law 18.27 RCW and 296,200A WAC. <br />City of EveretFOfflclal tlsa only <br />&,2 I I <br />( <br />f <br />ne thorize ge t Signature ate (Revised 412112022) T <br />�...• <br />