220 SE EVERETT MALL WAY 2024-05-02

• SIGN PERMIT APPLICATION CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS:Drop off hard copy paper application&plans to 3200 Cedar Street 2nd Floor Intake Drop Box. WASHINGTON CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov I(W)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 220 SE EVERETT MALL WAY PARCEL#: cirr Everett STATE WA ZIP 98208 SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): CONTACT INFORMATION OWNER NAME:Jatinder Singh OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE:253-332-6001 OWNER EMAIL:everettmallampm@yahoo.com CONTRACTOR CONTACT NAME;Project CSI WA STATE CONTRACTOR LICENSE#(REQUIRED):6042217720010001 CITY OF EVERETT BUSINESS LICENSE#(REOUIRED): 62225 CONTRACTOR ADDRESS: STREET 1411 Overlook Drive CITY Fishers STATE IN ZIP 46037 CONTRACTOR PHONE:317-449-0645 CONTRACTOR EMAIL:matt@projectcsi.com PRIMARY CONTACT: ❑OWNER ©CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: CONTACT PHONE:317-449-0645 Matt Gray CONTACT EMAIL:Matt@projectcsi.com SIGN PERMIT INFORMATION VALUATION OF WORK:$ io,000 ASSOCIATED PERMIT#(if applicable): (Valuation shall include the prevailing fair market value of all labor,materials,and equipment needed to complete the work,whether actually paid or not.) DESCRIPTION OF WORK:REMOVE EXISTING AMPM SIGN- INSTALL WOODGRAIN ACM (FRONT AND RIGHT ELEVATION, INSTALL NEW AMPM WALL SIGN ON FRONT ELEVATION AND RIGHT ELEVATION. PAINT EXISTING BUILDING SIGN DIMENSIONS: 88" 3g 23.83 Sign 1: Width: Height: Square Feet: Sign 2: Width: 553" Height: 43" Square Feet: 165.13 Sign 3: Width: Height: Square Feet: SIGN TYPE&QUANTITY: ©Wall/Awning/Canopy-Qty: 1 ❑Window-Qty: DElectronic Changing Message-Qty: ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc): SIGN LIGHTING; ❑Non-Iluminated ©Illuminated-Type(backlit cabinet,etc.):pre existing internally illuminated *requires a separate electrical permit PLAN REVIEW REQUIREMENTS:Submit 2 hard copies of sign plans with permit application to Permit Intake Drop Box. ACKNOWLEDGEMENT:I have reviewed this application and confirm the Information contained herein is true and correct. Work done pursuant to this permit must comply with 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 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, and I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. A� r� PERMIT# City of Everett Official Use Only 7r�' 5/25/22 �+ 22 0,0-Coto Owner/Authorized Agent Signature Date (Revised 4/21/2022)