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SIGN PERMIT APPLICATION <br /> `i <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 i(E)PermitServicesQeverettm,gov I(W)everettwa.gov/permits <br /> (Blue or Black Ink Only Please) PROJECT SITE INFORMATION <br /> PROJECT SITE ADDRESS: STREET 2112 Madison St PARCEL#: 00545001800600 <br /> cm Everett STATE WA ziv 9820 <br /> SUITE/UNrr#: ADDITIONAL LOCATION INFORMATION:Main Level <br /> [TENANT/BUSINESS NAME(if non-residential):Eye Doctors of Everett 71 <br /> CONTACT INFORMATION <br /> OWNER NAME:Quang Nguyen <br /> OWNER MAILING ADDRESS: sTREET 2527 236th St Sw <br /> Brier STATE WA ziv 98036 <br /> OWNER PHONE:503-442-5558 1OWNER EMAIL:nguyeng503@gmaii.com <br /> CONTRACTOR CONTACT NAME:Meyer Sign Company Inc <br /> A STATE CONTRACTOR LICENSE#(REQUIRED): <br /> MEYERSC83238 CITY OF EVERETT BUSINESS LCENSE#(REQUIRED): 57310 <br /> CONTRACTOR ADDRESS: ,T,,,,2608 Old Hwy 99 S <br /> cu, Mount Vernon IATE WA zp 98273 <br /> CONTRACTOR PHONE: (360)424-1325 1CONTRACTOR EMAIL:ken@meyerSlgn•COm <br /> PRIMARY CONTACT: El OWNER ❑CONTRACTOR ❑OTHER(Please Specify) <br /> CONTACT NAME: CONTACT PHONE: <br /> CONTACT EMAIL: <br /> SIGN PERMIT INFORMATION <br /> AL.UATION OF WORK:$1000 ASSOCIATED PERMIT#(if applicable): B2504-050 <br /> ak-b-sha1 ireeiide the prevaiiiro8 fa`market vakm of al labs.,materih,and equipment needed to complete dw work,whether ackk*paid or roc) <br /> DESCRIPTION OF WORK:Non-illuminated sign panel with graphics applied as per Design <br /> Installation of non-illuminated sign panel on new location. <br /> SIGN DIMENSIONS: <br /> Sign 1: Width:$ Height: 1 7 Square Feet: 12.67 <br /> Sign 2: Width: HeigW She Feet <br /> Sign 3: Width: Height: Square Feet: <br /> sm TYPE&QUANTnY: ©Wa1 Mounted-Qty: ❑Awning-Qty-. ❑Canopy-Qty ❑WkxlDw-Qty <br /> ❑Electronic Changing Message-Qty: ❑Projecting-Qty: ❑Freestanding-Qty -Type(montment ftj: <br /> SIGNLWAITING: ONon-1111iuninated ❑Irtrrtinated-Type toad*cabb t aye): -'9aVuY as a sparaM d0CVieal VM.it <br /> PLAN REVIEW REQUIREMENTS:Submit 2 hard copies of sign plans with permit application to Permit Intake Drop Box <br /> ACKNOWLEOGEAdENT I hatro rsviswed#*aPPkaiiorr and aonfknt ft kdb MAbn cordakad herskr it bus and cm oct.V#Wk dons pursuarif b M paring mat amp*m b <br /> anent federal,stet,and beat law.The granting of a pemwt only aulhoiizes approved work and no deviations Uwafrom.DoWadons must&V be authonzerd in writing►Tern to <br /> 84AI&y OMOW before bakV suU►onzed under any dreumstnce.I am the owner,or I am auttioda d by Um owner of M property to podbern Vie work for whidi appscason a mWw <br /> and i comply with tits Stet Contractors Law 18.27 RCW and 298.200A WAC. <br /> City of Everett OAkalal Use On* <br /> PERMIT# <br /> Autl I�naturs Date ,L <br />