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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)everetlwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 530 SW Everett Mall Way PARCEL#: 00518200000101 <br /> CITY Everett STATE WA zip 98204 <br /> SUITE/UNIT#: 104 ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):Partners Personnel <br /> CONTACT INFORMATION <br /> OWNER NAME:Partners Personnel Everett <br /> OWNER MAILING ADDRESS: STREET 530 SW Everett Malll Way <br /> CITY Everett STATE WA zip 98204 <br /> OWNER PHONE:(425)366-4150 OWNER EMAIL: <br /> CONTRACTOR CONTACT NAME:Clearway Signs <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):CLEARS'802QC CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 601848813 <br /> CONTRACTOR ADDRESS: STREET 9426 Canyon RD E <br /> CITY Puyallup STATE WA Z,P 98371 <br /> CONTRACTOR PHONE:2533145623 CONTRACTOR EMAIL:john@clearwaysigns.Com <br /> PRIMARY CONTACT: ❑OWNER ❑CONTRACTOR r❑OTHER(Please Specify) Project Manager <br /> CONTACT NAME: CONTACT PHONE:4255180529 <br /> Sam Olmstead CONTACT EMAIL:Sam.Olmstead@pugetsoundsigns.COm <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK:$20000 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 /> DESCRIPTION OF WORK: <br /> Illuminated Channel Letter Sign Installation. <br /> SIGN DIMENSIONS: <br /> Sign 1: Width: 143" Height: 2811 Square Feet: 27.81 <br /> Sign 2: Width: Height: Square Feet: <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY: El Wall Mounted-Qty:1 ❑Awning-Qty: []Canopy-Qty: ❑Window-Qty: <br /> []Electronic Changing Message-Qty: ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc.): <br /> SIGN LIGHTING: ❑Non-Illuminated mllluminated-Type(backlit cabinet,etc.):Internally lit channel on raceway *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..t 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.1 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 with the State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> PERMIT# <br /> 09/14/2023 /y <br /> Owner/Authorized Agent Signature Date (Revised 11/8/2022) <br />