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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 l(E)PermitServices@everettwa.gov l(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 3025 Rucker Ave PARCEL#: 00439171901300 <br /> CITY Everett STATE WA zip 98201 <br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):W Business Solutions, DBA TransBlue <br /> CONTACT INFORMATION <br /> OWNER NAME:W Business Solutions <br /> OWNER MAILING ADDRESS: STREET 3025 Rucker Ave <br /> CITY Everett STATE WA ZIP 98201 <br /> OWNER PHONE:206-804-0350 OWNER EMAIL:wescottj@transblue.org <br /> CONTRACTOR CONTACT NAME:Shari Helberg <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):BERRYSS857B7 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 24786 <br /> CONTRACTOR ADDRESS: STREET9402 39th Ave. Ct. SW <br /> CITY Lakewood STATE WA ZIP 98499 <br /> CONTRACTOR PHONE:253-830-3600 CONTRACTOR EMAIL:Shari@berrysign.com <br /> PRIMARY CONTACT: ❑ OWNER 0 CONTRACTOR ❑ OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:253-830-3600 X114 <br /> Shari H e I be rg CONTACT EMAIL:Shari@berryslgn.com <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK: $20000.00 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 /> DESCRIPTION OF WORK: <br /> Install (2) raceway channel letter sets on backer panels <br /> 3'6" X 28'6", one each on S and W elevations. <br /> SIGN DIMENSIONS: <br /> Sign 1: Width: 2816" Height: 3'611 Square Feet: 99.8 <br /> Sign 2: Width: 2816" Height: 316" Square Feet: 99•8 <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: ❑Non-Illuminated El Illuminated-Type(backlit cabinet,etc.):Internal LED *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 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 /> PERMIT# <br /> 8/29/23 <br /> Own thorized Agent Signature Date (Revised 111812022) <br />