08-105001 •
CITY OF ` / / D� / \J
Federal Way SIGN PERMIT ,, iL
APPLICATION ---771,c.11°
• (PROPERTY INFORMATION
SITE ADDRESS L {�/3O PO.CA CL a W' f ().-96 SUITE/UNIT x
ASSESSOR'S TAX/PARCEL# --/ - 9 / ZONING DESIGNATION
• PROJECT INFORMATION
TYPE OF PROJECT(Check all that apply): ❑PERMANENT [TEMPORARY ❑NEW ❑ALTERATION • - : 4 - �I VAST
❑ ELECTRICAL(To attach to existing J-box-include on this✓permit) OCT 2 2 �I If//r/.�\{ y
❑ ELECTRICAL(New/altered circuit&J-box added-separate permit is required) �1 (Irk C jam/
NUMBER OF SIGNS APPLIED FOR WITH THIS APPLICATION: Wall Mounted: T Reuel Adl ''.'/�/� Zo93
TOTAL ESTIMATED PROJECT COST: $ `�
J70-4 6 �4-s �ca�f COS RA` WA Y
DETAII.ED PROJECT DESCRIPTION: ,-4
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BUSINESS NAME ON SIGN: 1 V C9``d'\ OA\'Ico jJ ft-kJ-Lc ei}i.'4 1
• PEOPLE INFORMATION
SIGN OWNER: NAME:
—(Jr- kC,hcc\ 5 [ )e' 71.-t -61 ct
MAILING ADDRESS(STREET ADDRESS:CITY,STATE.ZIP): FAX NUMBER
3 CI-1 30 Pa M ct c_ l-kW u.-4kl p3 )S-7Lt So-to
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER Required prior to permit Issuance) E-MAIL ADDRESS
Fe(k � \k - (C1� 1� �kC � L-o12.2-��.
CONTRACTOR: COMPANY NAME APPLICANT NAME OFFICE PHONE
( )
MAILING ADDRESS(STREET AD,• :CITY,STATE,ZIP): CELL PH•■
( )
CITY OF FEDERAL WAY BU:I LICENSE NUMBER EXPIRATION DATE: F .is ER
)
rn� 'd'dred r-� CONTRACIGHS REGI` ' TION NUMBER EXPIRATION DATE: MAIL ADDRESS
APPLICANT ` / COMPANY NAME APPLICANT NAME PRIMARY PHONE
a11k-e_ C a u--U ( )
MAILING ADDRESS CITY,STATE.ZIP FAX NUMBER
( )
RELATIONSHIP TO PROJECT E-MAIL ADDRESS
❑ Contractor ❑Tenant ❑ Other
PROJECT NAME , PRIMARY PHONE �J E-MAIL ADDRESS
CONTACT Y-0 C1-\ ►`k\\ C CA\-(J 5 0-S 5)1E 0 6- -(-f" i-t-Fi (. C9 rlsc2-1e
146/,-. eon
I certify under penalty -liza that the information furnished by me is true and correct to the best of my knowledge,and
further,that I am authori�Ed . . the owner of the above premises to perform the work for which the permit application is made
'
SIGNATURE ' DATE: /0 — /7 --C-2k
V
COMMUNITY DEVELOPMENT SERVICES•33325 89)AVENUE SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-835-2607•FAX:253-835-2609