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SIGN PERMIT APPLICATION <br /> CITY OF EVERETT PERMIT SERVICES <br /> EVERETT SUBMITTAL INSTRUCTIONS:Drop off hard copy paper application 8,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)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 908 SE Everett Mall Way PARCEL#: <br /> CITY Everett STATE WA Z,P 98208 <br /> SUITE/UNIT M ADDITIONAL LOCATION INFORMATION: <br /> TENANT/BUSINESS NAME(if non-residential):MerCury's Coffee <br /> CONTACT INFORMATION <br /> OWNER NAME:Rand's 910 Center LLC, Robert Randolf <br /> OWNER MAILING ADDRESS: STREET PO Box 873 <br /> CITY Freeland STATE WA ZIP 98249 <br /> OWNER PHONE:206-755-1418 1OWNER EMAIL:Bobrand@Whldbey.com <br /> CONTRACTOR CONTACT NAME:New Image Creative Sign Inc. <br /> WA STATE CONTRACTOR LICENSE#(REQUIRED):NEWIMIC961 B9 CITY OF EVERETT BUSINESS LICENSE#(REQUIRED): 57624 <br /> CONTRACTOR ADDRESS: STREET4549 125th Ave SE <br /> Clry Bellevue STATE WA Z,P 98006 <br /> CONTRACTOR PHONE:206-406-3437 CONTRACTOR EMAIL:Shari@newlmagecreative.com <br /> PRIMARY CONTACT: ❑OWNER El CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE:206-406-3437 <br /> Shari Rust CONTACT EMAIL:shari@newimagecreative.com <br /> SIGN PERMIT INFORMATION <br /> VALUATION OF WORK: $$ 15,000.00 1ASSOCIATED 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:Install (1) new illuminated wall sign to read MERCURY'S COFFEE and (2) illuminated <br /> logo disks. <br /> SIGN DIMENSIONS: <br /> Sign 1: Width: 17'-5" Height: 2'-7„ Square Feet: 29.75 sqft. <br /> Sign 2: Width:4,-0„ Height: 4,-0„ Square Feet: 16sgft. <br /> Sign 3: Width: 4,-0„ Height: 4'-0" Square Feet: 16 sgft. <br /> SIGN TYPE&QUANTITY: E]Wall Mounted-Qty:3 ❑Awning-Qty: ❑Canopy-Qty: []Window-Qty: <br /> ❑Electronic Changing Message-Qty: ❑Projecting-Qty: ❑Freestanding-Qty: -Type(monument,etc): <br /> SIGN LIGHTING: ❑Non-Illuminated ❑✓Illuminated-Type(backlit cabinet,etc ):Neon '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:1 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 O icia! re eing 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 I com ith th State Contractors Law 18.27 RCW and 296.200A WAC. <br /> City of Everett Official Use Only <br /> ( 04/17/2024 <br /> !Authorized_ ASZent Signature Date (Revised 111812022) <br />