4030 RUCKER AVE 2024-10-25 - Laserfiche WebLink

• 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. WASHIMOTON CONTACT INFORMATION:(P)425-257-8810 I(E)PermitServices@everettwa.gov I(11V)everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 4030 RUCKER AVE PARCEL#: CITY.Everett STATE WA ZIP 98204 SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: TENANT/BUSINESS NAME(if non-residential): CONTACT INFORMATION OWNER NAME:Reda Mikhail OWNER MAILING ADDRESS: STREET CITY STATE ZIP OWNER PHONE:206-446-5302 OWNER EMAIL:reda_2011@hotmail.com CONTRACTOR CONTACT NAME:Project CSI WA STATE CONTRACTOR LICENSE#(REQUIRED):6042217720010001 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 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:$ 10,000 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: Sign 1: Width: 16' Height: 36" Square Feet: 48 Sign 2: Width: 16' Height: 36.25" Square Feet: 48.33 Sign 3: Width: Height: Square Feet: SIGN TYPE&QUANTITY: ©Wall/Awning/Canopy-Qty:2 ❑Window-Qty: ❑Electronic Changing Message-Qty: ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc.): SIGN LIGHTING: ❑Non-Iluminated ©Illuminated-Type(backlit cabinet,etc.):tying into existing electric *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 rh writing from the 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, and 1 comply with the State Contractors Law 18.27 RCW end 296.200A WAC. ` City of Everett'et Official Use Only c520rtCZraf 71141444, 5/19/22 PERMia,� L^no�L/-1 .� Owner/Authorized Agent Signature Date (Revised 4/21/2022)