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ii <br />EVERETT <br />SIGN PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />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 1(E) PermitServices0evereltwa.aov I (W) everettwa.novtoermlls <br />{Blae orBl�ck lntc Onlyls �;u : yMQRo�G sYTe rrr�oRMAo`N, <br />PROJECT SITE ADDRESS: STREET '7601 F-VER (K IEW wA.Y PARCEL #: $ 615 D-f a C 6700 <br />C0 <br />cnY F-V& Rri:T 1 STATE W A ZIP d a <br />,SUITE/UNIT #: ADDITIONAL LOCATION INFORMATION: <br />TENANT/BUSINESS NAME (If non-residential): 869012r _S <br />is - <br />- <br />OWNER NAME: C0 vr11dT A c:g5ch,06 j%-A?,A Lip(_ <br />OWNER MAILING ADDRESS: STREET P 0 a 0X 2.5.30t <br />cITY N A07 aw t o STATE ! ?C ZIP / ii Z 179 <br />OWNER PHONE: <br />OWNER EMAIL: <br />CONTRACTOR•CONTACT-NAME; <br />WA STATE CONTRACTOR LICENSE #(REQUIRED): ! 3f (/�/tJ �It7� CITY OF EVERETT BUSINESS LICENSE #(REQUIRED),. <br />CONTRACTOR ADDRESS: STREET SZO9 /27,' 57: P <br />G <br />CITY-ZA(o/"iAc � <br />STATE WA ZIP Pot! '[7e <br />CONTRACTOR PHONE: 253 1-195 70q f <br />CONTRACTOR EMAIL: b brosn a �. <br />PRIMARY CONTACT: TOWNER ® CONTRACTOR ❑ OTHER (Please Specify) <br />.... ... ------ <br />R1A 996S A _ <br />CONTACT PHONE: <br />..-.._... _... -- . _ . _ .. _ r <br />CONTACT EMAIL: b�/' o►i1 �dt r1 O �� C <br />- <br />IG1;`:RMITINFQIZ,NIA'197 777 a <br />VAL-UATION_OF_WORK::. _:_ -._. -.•.::_::::..:�_�_:�_.-:_:__._-:::-__:: <br />ASSOCIATED.PERMIT.#. ifap licable ::...:......_.....:_�:--. ::::._ .:::. _ . _ <br />(Vakiallon shay InrAuTo the prevailing fair market value of all labor, mate als, and equipment needed to complete the work, whether actually paid or not.) <br />DESCRIPTION—OF—WORK'_I.111.V�1lV .d.G l .l Ti �N/�7 _ :.Ul/tAr------_ S_lG..... ....... .. .5. - <br />MArlA) C(vGSc� Xre,Rt6k �C-�V��,oN. REp-AcC: rENhNT PAh1EL_<, <br />9 N My-7f • '1C-WAIV ' FAEE67A/V0 rNb <br />SIGN DIMENSIONS: <br />Sign 1:. Width: Height: Square Feet: C16. is. <br />Sign 2: Width: /I 6 f tr Height: : �l� ), Square Feet: 2—o <br />Sign 3: Width: Height: Square Feet: <br />SIGN TYPE & QUANTITY: ®G1/alllAwninglCanopy - Qty: II ❑Window- Qty: ❑Electronic Changing Message - Qty: <br />❑Projecting - Qty, L9Freestanding- Qty: I - Type (monument, e(c.): 'NIVA0 T Mitt SL- 9,01 CS oANirr <br />SIGN LIGHTING: ❑Non-Ilurninated millurninated -Type (backrilcabinel, 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 applkation and confirm the information contained herein is frue and correct. Work done pursuant to this permit must comply with <br />current federal, state, and locallaw. The granting of a permit only authorizes approved work and no deviations therefrom. Deviations must first be authortzed 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 l comply will) the State Contractors Law 18.27 RCW and 298.200A WAC. <br />City of Everett Official Use Only <br />PERMIT # <br />(Revised 4MI2022) <br />