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City of Federal Way Signn Pert#: 04 - 103984 - 00 - SG
r�ii
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718 Inspection request line: (253) 835-3050
Ph:(253)835-7000 Fax:(253)835-2609
Project Name: NORTHWEST CHURCH
Project Address: 34800 21ST AVE SW Parcel Number: 542350 0630
Project Description: Install(1)new monument sign and reface an existing monument sign; attaching to existing j-box.
Owner Applicant Contractor
NORTHWEST CHURCH TUBE ART DISPLAYS INC(GENERAL) TUBE ART DISPLAYS INC(GENERAL)
34800-21ST AVE SW 2730 OCCIDENTAL AVE S 2730 OCCIDENTAL AVE S
P.O.BOX 23085(98093) SEATTLE WA 98124-1333 SEATTLE WA 98124-1333
FEDERAL WAY WA 98023 (206)223-1122
Comprehensive Plan Designation SF-Medium Density Residential Zoning Designation RS 15.0
Free Standing Signs
Registration# Sign Type Illuminated #Sign Setback Sign Face Sign Face Sign Height Base Height andscape Areal
Faces (Ft.) Width(Ft.) Height(Ft.) (Ft.) (Ft.) (Sq.Ft.)
A 04-0170 Monument Yes 1 12 5.6 3.75 5 1 22
B 04-0171 Monument Yes 2 5 5.41 4.33 5 1 90
CONDITIONS:
This permit is issued based on the information provided by the applicant.Since property lines cannot be verified
without a survey,the property owner,his/her heirs or assigns shall assume all liability for any relocation or any other
associated costs should the sign be located in public right-of-way or within the required yard setback.
PERMIT EXPIRES April 18,2005.
Permit issued on October 20,2004
I hereby certify that the above information is correct and that the construction on the above described proper
the occupancy and the use will be in accordance with the laws,rules and regulations of the State of Washingt,
the City of Federal/ Way.
Owner or agent:( Q k. -- Date: 1(} U1--1
I2. — l A — .r-0494 euv-v-e 71-' -- `$ .
St SSS
•
` THIS CARD IS TO 'VAIN ON-SITE
CITY OF • Pommunity Development Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04-103984-00-SG
Owner: NORTHWEST CHURCH
Address: 34800 21ST AVE SW
FEDERAL WAY, WA 98023-3044
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
❑ Footings/Setback(4110) Final-Electrical(4055) Final- Sign (4085)
Approved to place concrete Approved Approved
By A.'"" ‘*.
/ Date ////92,71.
/!� (7 By k`r y Date 0,, t4 By ��i��L1� Date 2-7(1°=5.--e'
❑ Attachment (4010)
Approved
By Date
T
410
ci i5(.0
all'
Of7:— "AA) .
• b S N PERMlI APPLICATION
VV FAY - ,O [iI APPLICATION NUMBER: em - Q q -
-**The following is required information—Please print(in ink)or type**
. r.+- .-4 +3711...". -�:t-' •>''v 531...... -e.1:-•-_x•. - "mss c+ sra,..j i'. .r .r ..�...+pYT.
-'..- -...7.-....,.:---4:-,1-"=.-,�= ;if',-.• 4_-c 0,: '.r i; ROPEtt' Y: IIFORMA7301ll<;. T._ = •-_. ,; .. =. ;.
SITE ADDRESS: WC) Z I 5-1' ��•--- S(N ASSESSORS TAX/PARCEL#: -
- tea "Ks _.sem 'z? ' r. y - - _
1. :K'ate-- .:i! :-t phi..4 'r;Y''~ �«-a5.;'�!o 4:f- tfSr�3 �� -NWf l�y...yi.1 fit''.b zczr°° :a.^ "+Mi td.
��� Y.i � r... L .STsa-�:�r'�
TYPE-OF PROJECT(Check all that apply): ,ERMANENT ❑TEMPORARY lEW XLTERATION ❑REFACE , ❑EXEMPT
ELECTRICAL(To attach to existing.3-box) o ELECTRICAL(New/altered circuit&j-box added)
(Separate permit is required)
NUMBER OF SIGNS APPLIED FOR WITH THIS APPLICATION: TC/sic:'
PROJECT DESCRIPTION (Provide detailed description): IN STo.LL , /... . _---1,,,j IM`4'�l Vndi ser,....\-T. S
1 0,..)e Stoat...) c /N'ET o Ft T---7--X 1 STI N G 1? P-\ K- STe`--�-r-L C2-
BUSINESS/TENANT NAME: .1"401e-1-1A ST C U C_.-t\
-a'".a. Lrz 'ter _ „ y. ,, .: ,-�r;-�.
�.�s: .: y-� M0 aZO � - ti 's• -1 -7
�r � �. �.� '.�., �'x.�'.`=kv�' : :�e- �s� `L .�Xa.a ;cue'.r-•'x�E
r....""`.sF ..;-7'.'.'�4�5 �{- o,� .'6S,•,a�r:..-s . ^Ot„sdn-•b..�'*�'F5".�. �-• `..Y+a sq.
SIGN OWNER: NAME: DAYTIME PHONE:
N b4--M-f.J $-( L{-k-URG(-y- (253 ) t338: -63.Z I .
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
N � s rrE• ."‘ppia ss
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE:
(Required) -- -- / /
CONTRACTOR: NAME: • DAYTIME PHONE:
TugciL"r (? ) 3 - 1122+
MAILING ADDRESS(STREET ADDRESS!'CITY,STATE,ZIP): EVENING Pf1ONE:
' 2'�3, a"LIt) r L A s . S ,,v pi981YP ( ) -
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: FAX NUMBER:
oo'0 101 --"79. CSO --5t... ( ) -
CONTRACTOR'S REGISTRATION NUMBER: }� EXPIRATION DATE:
(Copy required) I-0&, -„44::,
s`-/`1.,' s ti S b / 30 I j
APPLICANT: NAME: �
( e---
7r S \ DAYTIME PHONE:
MAILING ADDRESS(STREET ADDRESS;CITY, ATE,ZIP): N EEEVENING PJ\HONE:
SAVA Avc=N ( ) -
CONTACT FOR THIS PROJECT: FAX NUMBER:
// ( ) -
o PROPERTY OWNER .o APPLICANT CONTRACTOR
E-MAIL ADDRESS:
fir- ..' '�--o s� � -..�. .r. � �w# n < v��...; �--� 'w
u-. - . ., • , �k #. _.. ISN P 1Yf' OAFS AML • -`
TYPE/PURPOSE OF EVENT:
DATE OF INSTALLATION: DATE OF REMOVAL:
4
TEMPORARY SIGN TYPE: 0 BANNER 0 INFLATABLE ❑ PORTABLE 0 SE'AROH"LIG(-'TS/BEACON -
NUMBER OF EACH TYPE:
x
yam>s r, '=.`* ` y- 0^-•7•.'.w1x . -- —_ mr i� 1 ' -a *1*-S . -17* '1 ,
PROPOSED NUMBER OF WALL SIGNS: 0 PROPOSED NUMBER OF FREE STANDING SIGNS: -51,30
TOTAL ESTIMATED PROJECT COST: S 10i C704-1. NUMBER OF TENANTS/BUSINESS SPACES ON PRC)PFR Y- C7/'.'It
e - _ .i-1 i rr .JO �a " ..j�`c - -1 .. xaSI �- athat
IA may. _ .-s-_:--1.-.1:.:t:w
.x.� -- _ _lit:?" -
PERMANENT FREE STANDING: ie<ONUMENT ❑ OTHER ❑ PEDESTAL 0 POLE 0 TENANT DIRECTORY
NUMBER OF EACH TYPE:
PERMANENT BUILDING MOUNTED:.❑AWNING 0 CABINET 0 CAt•IOPY 0 CENTER IDENTIFICATION (CID) ❑ CHANNEL LETTERS
NUMBER OF EACH TYPE:
❑ MARQUEE D OTHER 0 PROJECTING" ❑TENANT DIRECTORY
NUMBER OF EACH TYPE: -
.v.i a.-.�.T.�%+ i'.✓:.-+'wee' =�f3M1% 'gY 4''�i;:=i -�--nom•' •ice.'+-e"s�".q�i-i-±.%5; r`.a�:....'_..v.a�.ti.:�-. 'a?�.�.: .C- _w +�%•_ ?'_•`.s i- sem'..-..>.t""�+�+ i `
a.:f e;::rV—tff:t .;::+xti�. �T-,.'ts-"'-. -"T:; . s.--s`-. - e.=y" e.+•_-"s;�sWt-_..-
. ..:.v . _ . "moi:.. -
FREE STANDING SIGN SIGN AREA(SQ.FL) ILLUMINATED?: REFACE? PART OF CID TOTAL SIGN BASE
TYPE WIDTH X•HEIGHT X#OF FACES NO/INT/EXT • YES/NO SIGN?.. ..F HEIGHT(FT)`. =:HEIGHT_(FT)
`A• m ac1Uw►Ft-y r . - z - I" sit-'5 '7 ' i'Ju
B r'1oh!J`^'ti440T Z 1 1 hi T. N a YES 6 . )'.
C
`
STREET FRONTAGE(FT):
l? O
br '
BUILDING MOUNTED ILLUMINATED? SIGN AREA(SQ.FT.) BUILDING EXPOSED BUILDING
SIGN TYPE NO INTERNAL a• RNAL WIDTH X HEIGHT X#OF FACES .ELEVATION N S E W FACE S. FT.
A IIIIIPrP-_IdgllMll _
B IIIIPMII __
C
DW/
E
's'4,41.:a:-ft:-1 r s� 'r 7:-t x — giigiiy°' Fes, i..t , ., s 4-11 ttiv' _" '�
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I certify under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge,and
further,that I am authorized by the owner of the above premises to perform the work for which the permit
permitapplicatiion
is made
NAME/TITLE: SIURE DATE: I •2-9 •` 4
NAME(Print) ' t,P-30 1-2a0=1/4"e"7-4
PRINT •
FOR OFFICE USE ONLY:.
ZONING DESIGNATION: '` Y:` - :,;:::COMP,>PLAN DESIGNATION
BUILDING MOUNTED SIGN :FREESTANDING;SIGN,
AREA PERMITTEi: _ ..on r AREA P.ERMITTED�: : _ LaY�
AREA PROPOSE"i AREA PROPOSED! ..,-.-SCJ. pht5
LARGEST BUIL els N • F•.AD I� pr.
_STREET FRONTAGE`° .`:'.'N t
NUMBER OF S NS ALLOW D: 'NUMBER OF SIGNS ALLOWED:
LAND USE APPROVER INITIALS: D L DATE: 7 O it5t ell
STRUCTURAL APPROVER INe ITIALS: " BATE: 10 y.. \
REGISTRATION NUMBER: f$L. o REGISTRATION NUMBER:
REGISTRATION NUMBER: 0 - t I REGISTRATION NUMBER:
REGISTRATION NUMBER: REGISTRATION NUMBER:
COMMUNITY DEVELOPMENT SERVICES-33530 FIRST WAY SOUTH•P.O.BOX 9718•FEDERAL WAY,WA 98063-9718•253-661-4115- FAX:253-661-4129