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E 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 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 8402 Evergreen Way PARCEL#: 28041300101500 <br /> - - - <br /> CITY <br /> Everett STATE ZIP WA 98208 <br /> SUITE/UN `#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):Casino Chevron <br /> CONTACT INFORMATION <br /> OWNER NAME:AMAN'S III LLC <br /> OWNER MAILING ADDRESS: STREET 8402 Evergreen Way <br /> CITY Everett STATE WA zip 98208 <br /> OWNER PHONE:425-917-2109 OWNER EMAIL:steven@insigniasign.com <br /> CONTRACTOR CONTACT NAME:Insignia Sign & Re-Imaging <br /> WA STATE: CONTRACTOR LICENSE#(REQUIRED):INSIGSR813QA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 63283 <br /> CONTRACTOR ADDRESS: STREET325 Burnett Ave N <br /> CITY Renton STATE WA zip 98057 <br /> CONTRACTOR PHONE:425-917-2109 CONTRACTOR EMAIL:steven©insigniasign.com <br /> PRIMARY CONTACT: ❑OWNER ❑✓ CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:425-917-2109 <br /> Steven Thomson CONTACT EMAIL:steven@insigniasign.com <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK: $8,000.00 ASSOCIATED 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 /> DESCRIPTTION OF WORK: <br /> (P1): Replace existing price faces with LED price faces like for like (REFACE ONLY): <br /> (P2): Replace existing price faces with LED price faces like for like (REFACE ONLY): <br /> SIGN DIMENSIONS: <br /> Sign 1: Width: 5'-7" Height: 14'-3" Square Feet: 79.56 REFACE ONLY <br /> Sign 2: Width: 5'-7" Height: 12'-8" Square Feet: 70.68 REFACE ONLY <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY: ❑Wall/Awning/Canopy-Qty: El Window-Qty: ❑Electronic Changing Message-Qty: <br /> El Projecting-Qty: ❑✓Freestanding-Qty:2 -Type(monument.etc.): POLE#1 &#2(REFACE ONLY) <br /> SIGN LIGHTING:TING: ❑Non-Iluminated ❑✓Illuminated-Type(backlit cabinet,etc.): LED Illumination `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 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 I 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 /> PERMIT ^ f' �O� <br /> Steven Thomson D'9aa"ysigned bvSteven Thomson r y/^L(�xyl <br /> Date:2021.03.23 23:38:32-07'00' 04/20/22 <br /> Owner/Authorized Agent Signature Date (Revised 2/8/2021) <br /> • <br />