BLD2020-1414+Application+12.30.2020_10.32.32_AM+1967555CITY OF EDMONDS MyBuildingPermit.com
Sign Application #901967 - CHIC Monument Sign
Applicant
First Name
Last Name
Company Name
Mike
Lee
Berry Siqn
Number
Street
Apartment or Suite Number E-mail Address
5002
South Washinqton St
mikel(c�berrysign.com
City
State Zip
Phone Number Extension
Tacoma
WA 98409
2538303600 151
Contractor
Company Name
Berry Siqn Systems
Number Street Apartment or Suite Number
5002 S Washington St
City State Zip Phone Number Extension
Tacoma WA 98509 253 232-5620
State License Number License Expiration Date UBI # E-mail Address
BERRYSS857137 1 /27/2021 603454590 mikel(�i)_berrysign.com
Project Location
Number Street Floor Number Suite or Room Number
23320 HIGHWAY 99
City Zip Code County Parcel Number
EDMONDS 98026 00576700002003
Associated Building Permit Number Tenant Name
Additional Information (i.e. equipment location or special instructions).
Work Location
Property Owner
First Name Last Name or Company Name
COMMUNITY HEALTH CENTER OF SNO CO
Number Street Apartment or Suite Number
8609 EVERGREEN WAY
City State Zip
EVERETT WA 98208-2619
Certification Statement - The applicant states:
I certify that I am the owner of this property or the owner's authorized agent. If acting as an authorized agent, I further certify that I have full power and
authority to file this application and to perform, on behalf of the owner, all acts required to enable the jurisdiction to process and review such application. I
have furnished true and correct information. I will comply with all provisions of law and ordinance governing this type of application. If the scope of work
requires a licensed contractor to perform the work, the information will be provided prior to permit issuance.
Date Submitted: 12/30/2020 Submitted By: Mike Lee
Page 1 of 2
CITY OF EDMONDS MYBuildingPerrnit.com
Sign Application #901967 - CHC Monument Sign
Project Contact
Company Name: Berry Sign
Name: Mike Lee Email: mikel@berrysign.com
Address: 5002 South Washington St Phone #: 2538303600 151
Tacoma WA 98409
Project Type
Nonresidential
Activity Type
Permanent Sign
Project Name: CHC Monument Sign
Description of Work: Install one D/F monument sign
Project Details
Sign 1 Type
Monument
Additional Project Information
Total number of signs installed 1
Total number of signs removed 0
Scope of Work
Freestanding
Page 2 of 2