06-106028 •City of Federal Way 'u b Sign Perm#: 06-106028-00-SG
Community Development Services
P.O.Box 9718
Federal Way,WA 98063-9718
Ph:(253)835-2607 Fax:(253)835-2609 Inspection Request Line: (253) 835-3050
Project Name: NW SPORTS REHAB
Project Address: 33400 13TH PL S Parcel Number: 768190 0045
Project Description: Install 32 square foot (16 per face)internally illuminated pedestal sign.
Owner Applicant Contractor
NW SPORTS REHAB CORP MILAN MICHALEK FEDERAL WAY SIGN CO
33400 13TH PL S FEDERAL WAY SIGN CO FEDERWS110JL 3/22/07
FEDERAL WAY WA 98003 1908 S 341ST PL SUITE 5 1908 S 341ST PL SUITE 5
FEDERAL WAY WA 98003 FEDERAL WAY WA 98003
Free Standing Sign Information
Reg.# Sign Type Illuminated #Sign Setback Sign Face Sign Face Sign Height Base Landscape
Faces (Ft.) Width (Ft.) Height(Ft.) (Ft.) Height(Ft.) Area(Sq Ft.)
Sign A 06-0224 Pedestal Yes 2 3.00 4.00 4.00 6.00 2.00 64.00
Additional Permit Information
Comprehensive Plan Designation Community Zoning Designation BC
Business
PERMIT EXPIRES Wednesday, December 17, 2008
Permit Issued on Monday, December 18, 2006
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
anti the.City of Federal Way.
Owner or agent: Pa*V-! - J(, c 2 Date: 1
THIS CARD IS TO REMAIN ON-SITE
•
CITYOF Irommunity Developn nt Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT#: 06-106028-00-SG
Owner: NW SPORTS REHAB CORP
Address: 33400 13TH PL S
FEDERAL WAY, WA 98003-6357
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 pproved
By Date By Date 3-2i.-®� By g Date
0 Attachment(4010)
Approved
By Date
-Re-:sive)
w l
(ra.. CSG
•�� SUS GN PERMIT APPTION
CITY OF 4.---, ND APPLICATION NUMBER: __ - j---/Q .,,,1-51
Federal Way0�
Iv
�
L* i he followin• is re•uired information-Please •rint in ink or •e**
iii PROPERTY INFORMATION
SITE ADDRESS: 33itto1zAtcrez, '- teat ASSESSOR'S TAX/PARCEL#: 7 S/97) -00 AlS
wl PROJECT INFORMATION
TYPE OF PROJECT(Check all that apply): 0PERMANENT ❑TEMPORARYEW ❑ALTERATION ❑REFACE ❑EXEMPT
❑ ELECTRICAL(To attach to existing 3-box) [k,LECTRICAL(New/altered circuit&j-box added)
(Separate permit is required)
NUMBER OF SIGNS APPLIED FOR WITH THIS APPLICATION: 1
PROJECT DESCRIPTION(Provide detailed description): -It-e-W 'C.t. _Q- 2_ &-,-( €-.oQ- r L V n,,,
BUSINESS/TENANT NAME: N W SPOR2t' RGttIac$
• PEOPLE INFORMATION
SIGN OWNER: NAME: DAYTIME PHONE:
N W S PoILTS �.. 4-R$ (2s3 ) 83S - 60 0
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP):
334-00(5 'L1/4_. VC i FEa .I--- w6ItY /LO rt- Cl S-on 3
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: EXPIRATION DATE:
(Required)OS /OGJS ( -- -- l / 3/ / c
CONTRACTOR: NAME: DAYTIME PHONE:
csl:
MAILING ADDRESS(STREET ADDRESS;CITY,STA ,ZIP): EVENING PHONE:
tot o & S . -14-( g-* V2 4-5e-aC • tun_ ( ) 52-9 - 20 c t
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER: ( FAX NUMBER:
I CI ` ( 0"1 t�7 Oo g 1- -- ( ) -
CONTRACTOR'S REGISTRATION NUMBER: EXPIRATION DATE:
(Copy required) 17>i=RW S l l0 J L_ 3 / 22. / Zm
APPLICANT: NAME: O _ DAYTIME PHONE:
l�lJ�
Iwc.t. ( ) -
MAILING ADDRESS(STREET ADDRESS;CITY,STATE,ZIP): EVENING PHONE:
-. OtA O era-LK-- (2-S1) 529 -• -0 II
FAX NUMBER:
CONTACT FOR THIS PROJECT: ( ) -
❑ PROPERTY OWNER JPPLICANT p CONTRACTOR E-MAIL ADDRESS:
• **TEMPORARY SIGN APPLICATIONS ONLY**
TYPE/PURPOSE OF EVENT:
DATE OF INSTALLATION: DATE OF REMOVAL:
TEMPORARY SIGN TYPE: o BANN ❑INFLATABLE o PORTABLE ❑ SEARCH LIGHTS/BEACON
NUMBER OF EACH TYPE:
• PROJECT DETAILS
PROPOSED NUMBER OF WALL SIGNS: ___, PROPOSED NUMBER OF FREE STANDING SIGNS: t,
TOTAL ESTIMATED PROJECT COST:$ 2-t &b'o NUMBER OF TENANTS/BUSINESS SPACES ON PROPERTY: ,
YPE OF SIGN(S) (Check all that app(
PERMANENT FREE STANDING: ❑ MONUMENT o OTHER [3;PEDESTAL ❑ POLE ❑TENANT DIRECTORY
NUMBER OF EACH TYPE:
PERMANENT BUILDING MOUNTED:❑AWNING ❑CABINET o CANOPY ❑ CENTER IDENTIFICATION(CID) ❑ CHANNEL LETTERS
NUMBER OF EACH TYPE:
❑ MARQUEE ❑OTHER ❑ PROJECTING o TENANT DIRECTORY
NUMBER OF EACH TYPE:
• DETAILED SIGN INFORMATION
FREE STANDING SIGN SIGN AREA(SQ.FT.) ILLUMINATED?: REFACE? PART OF CID TOTAL SIGN BASE
TYPE WIDTH X HEIGHT X#OF FACES NO/INT/EXT YES/NO SIGN? HEIGHT(Fr) HEIGHT(Fr)
B
C
STREET FRONTAGE(Fr):
BUILDING MOUNTED ILLUMINATED? SIGN AREA(SQ.FT.) BUILDING EXPOSED BUILDING
SIGN TYPE NO/INTERNAL/EXTERNAL WIDTH X HEIGHT X#OF FACES ELEVATION(N,S,E,W) FACE(SQ.FT.)
A
B
C
D
E
• DISCLAIMER/SIGNATURE BLOCK
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 application is made
NAME/TITLE:
` AA,
,�DATE: _ Z� 'LOO�o
SIGNATURE
NAME(Print) bl( t-tc tN) C-0-Pc
PRINT
FOR OFFICE USE ONLY:
ZONING DESIGNATION: COMP PLAN DESIGNATION:
BUILDING MOUNTED SIGN FREE STANDING SIGN
AREA PERMITTED: AREA PERMITTED: SSU '
AREA PROPOSED: AREA PROPOSED: 32
LARGEST BUILDING FACADE: STREET FRONTAGE: 20
NUMBER OF SIGNS ALLOWED: NUMBER OF SIGN ALLOWED:
LAND USE APPROVER INITIALS: DATE: a" Z1 0(0
STRUCTURAL APPROVER INITIALS: DATE: /2...4.5:Qrp
REGISTRATION NUMBER: REGISTRATION NUMBER: (%--O 2 2
REGISTRATION NUMBER: REGISTRATION NUMBER:
REGISTRATION NUMBER: REGISTRATION NUMBER:
COMMUNITY DEVELOPMENT SERVICES•33325 8TM AVENUE SOUTH•PO BOX 9718•FEDERAL WAY,WA 98063-9718•253-835-2607•FAX:253-835-2609
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