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_ �N PERMIT APPLICATION pc3o ' 3 <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)everetteps@everettwa.gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 1 300 :fy ; l'') • 1 PARCEL#: L , Llaa <br /> CITY t'►1.1') STATE \�V i ZIP g rfr'1 73 <br /> SUITE/UNIT#: ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential): L-C JJ fly;; ' - <br /> CONTACT INFORMATION <br /> OWNER NAME: \,C"tc, n j`illl t=" "y Vr✓( t"ta LI , <br /> OWNER MAILING ADDRESS: STREET ji T-6 tAE JWt. <br /> CITY -Al A Yi(I STATE \fvf'1 ZIP $u 3'V <br /> OWNER PHONE: OWNER EMAIL: <br /> CONTRACTOR CONTACT NAME: ,r (T (V �t 1 1 <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED): \ y t L C.33 2jS CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): II <br /> CONTRACTOR ADDRESS: STREET L tyG� '(`j%A \--hul 'Y''t 5 p —/ <br /> cITY An Y e✓r(j„� STATE yi f G ZIP p <br /> CONTRACTOR PHONE: CONTRACTOR EMAIL: <br /> PRIMARY CONTACT: ❑OWNER CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: ( 1, a) "Iq - / <br /> -�-��� 1 CONTACT EMAIL: i IrYl0(,),.j O e k'1 @ L' i71/1 t I • (t:'? <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK: $ 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: iPi <br /> iC E O /)( a (C e * - p1( 5 �j t) <br /> JUN 3 0 2023 J <br /> ' <br /> CITY OF EVERETT <br /> SIGN DIMENSIONS: Permit Services <br /> Sign 1: Width: `‘1 -it" Height: 11— 1 1 Square Feet: Si;h• sc <br /> Sign 2: Width: Height: Square Feet: <br /> Sign 3: Width: Height: Square Feet: <br /> SIGN TYPE&QUANTITY: ❑Wall/Awning/Canopy-Qty: ❑Window-Qty: ❑Electronic Changing Message-Qty: <br /> ❑Projecting-Qty: (Freestanding-Qty: 1 -Type (monument,etc.): <br /> SIGN LIGHTING: ❑Non-Iluminated ❑Illuminated-Type(backlit cabinet,etc.): j21)1C -*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.lam 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 /> 151931n3 PERMIT# n .5OU 00� <br /> Owner/Authorized Agent Signature u Date (Revised 2/8/2021) <br />