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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 /> WASHINGTON CONTACT INFORMATION: (P)425-257-8810 1(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 3520 Paine Ave PARCEL#: <br /> CITY Everett STATE WA zip 98201 <br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):Alaska Rubber Group <br /> CONTACT INFORMATION <br /> OWNER NAME: Alaska Rubber Group - Attn: Travis Gavala <br /> OWNER MAILING ADDRESS: STREET 5811 Old Seward Hwy <br /> CITY Anchorage STATE AK zip 99518 <br /> OWNER PHONE: 425.258.3476 OWNER EMAIL: travis@alaskarubbergroup.com <br /> CONTRACTOR CONTACT NAME:Cascade Signs and Graphics <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):CASCASG807RT ICITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 62992 <br /> CONTRACTOR ADDRESS: STREET 1065 12th Ave NW, Suite E2 <br /> CITY Issaquah STATE WA zip 98027 <br /> CONTRACTOR PHONE:425-818-0672 CONTRACTOR EMAIL:laurle@cascadesg.com <br /> PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-818-0672 <br /> Laurie Ruselowski CONTACT EMAIL:laurle@cascadesg.com <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK: $$3100 1ASSOCIATED PERMIT#(if applicable): <br /> (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) <br /> DESCRIPTION OF WORK: <br /> Installation of two 3mm aluminum composite signs to the East and South sides of the <br /> building. <br /> SIGN DIMENSIONS: <br /> Sign 1: Width: 24' Height: 41 Square Feet: 96 SF <br /> Sign 2: Width: 24' Height: 4' Square Feet: 96 SF <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY: OWall Mounted-Qty:2 ❑Awning-Qty: ❑Canopy-Qty: ❑Window-Qty: <br /> El Electronic Changing Message-Qty: El Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc.): <br /> SIGN LIGHTING: E]Non-Illuminated El 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.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.I am 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 296.200A WAC. <br /> City of Everett Official Use Only <br /> n � /��/ PERMIT# <br /> Z_aa4-� /CGGO�B6y'4 , 6/15/2023 <br /> Owner/Authorized Agent Signature Date (Revised 11/8/2022) <br />