9501 19TH AVE SE 2025-03-24 - Laserfiche WebLink

SIGN PERMIT APPLICA Y IUN D ECEOVIE CITY OF EVERETT PERMIT SERVICES EVERETT SUBMITTAL INSTRUCTIONS: Drop off hard copy paper application&plans to 3200 Cei I treet.UANF12o91n*,37rop WASHINGTON CONTACT INFORMATION: (P)425-257-8810 1(E)PermitServices@everettwa.gov I(A everettwa.gov/permits (Blue or Black Ink Only Please) PROJECT SITE INFORMATION PROJECT SITE ADDRESS: STREET 9501 19th ave se PARCEL#: 2805170030 CITY everett STATE wa zip 98208 SUITE/UNIT#: na ADDITIONAL LOCATION INFORMATION:Coffee stand located at this location TENANT/BUSINESS NAME(if non-residential):LEDI Coffee Company, LLC CONTACT INFORMATION OWNER NAME:Rusian Cherkasskikh OWNER MAILING ADDRESS: STREET 215 196th st sw cITY Bothell STATE WA A 1, 98012 OWNER PHONE:425387531 1 1OWNER EMAIL:russ.cks@gmail.com CONTRACTOR CONTACT NAME:Ruslan Cherkasskikh �b ( = v)U-4L (�l,�i�,f ✓�'L �. �L L WA STATE CONTRACTOR LICENSE#(REQUIRED)LD/IA:T tf177+�k KJA CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 62789 CONTRACTOR ADDRESS: STREET215 196th st sw CITY Bothell STATE WA A zi, 98012 CONTRACTOR PHONE:425387531 1 1CONTRACTOR EMAIL:russ.cks@gmail.com PRIMARY CONTACT: El OWNER El CONTRACTOR ❑OTHER(Please Specify) CONTACT NAME: Ruslan Cherkasskikh CONTACT PHONE:4253875311 CONTACT EMAIL:russ.cks@gmail.com SIGN PERMIT INFORMATION VALUATION OF WORK:$500 1ASSOCIATED 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:Purchase and install 2 signs on exterior of coffee stand "LEDI Coffee Co" SIGN DIMENSIONS: Sign 1: Width:6ft Height: 6inches square Feet: 3 Sign 2: Width: 6ft Height: 6inches Square Feet: 3 Sign 3: Width: 4 Height: Square Feet: SIGN TYPE&QUANTITY: E]Wall Mounted-Qty:2 ❑Awning-Qty: ❑Canopy-Qty: []Window-Qty: ❑Electronic Changing Message-Qty: ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc.): SIGN LIGHTING: ❑✓Non-Illuminated [Illuminated-Type(backlitcabinet,etc.): -'requires a separate electrical pormlt 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 will) current federal,state,and local law. The granting of a permit only authorizes approved woik and no deviations therefrom.Deviations must first be authorized in 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 I comply with the State Contractors Law 18.27 RCW and 296.200A WAC. City of Everett Official Use Only PERMIT# 2 `� 2- �C6 - COY Owner/Au orized Agent Signature Date (Revised 111612022)