04-102856City of Federal Way
Community Development Services Sign Permit #: 04 - 102856 - 00 - SG
33530 1st Way S
Federal Way, WA 98003-6210
Ph: 253.661.4000 Fax: 253.661.4129 Inspection request line: 253.835.3050
Project Name: 76 GAS STATION
Project Address: 33520 21ST AVE SW Parcel Number: 132103 9098
Project Description: Replacing existing monument sign using existing base & existing footing and existing footing anchor
bolts for attachment.
Owner
Applicant
Contractor
KAYO OIL CO
AMERICAN NEON INC (GENERAL) & TOSC
AMERICAN NEON INC (GENERAL)
315 S JOHNSTONE
PO BOX 431
PO BOX 431
BARTLESVILLE OK
TACOMA WA 98401
TACOMA WA 98401
74004-0001
(253) 627-7446
Comprehensive Plan Designation .............Neighborhood Business Zoning Designation .................................. BN
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.)
4-0110i Monument Yes 2 i 4 4.54 8.13 6 1.33 1 660
PERMIT EXPIRES January 24, 2005.
Permit issued on July 28, 2004
I hereby certify that the above information is correct and that the construction on the above described propert;
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washing
the City of Federal
Owner or agent: Date: / y
a
THIS CARD IS TOR AIN ON-SITE
f
CITY GP 1A Loommunity Developme t Inspection Record
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 04 -102856 -00 -SG
Owner:
Address: 33520 21 ST AVE SW
FEDERAL WAY, WA 98023-2874
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 - Electric 55) Final - Sign (4085)
Approved to place concrete Ap ed Approved
By Date By Date -� ` By Date Z ��
❑ Attachment (4010)
Approved
By Date
Aye —,JUL 2 0 2004 `PPLICATION NUMBER: - -
MWred information - Please print (in ink) or type**
SITE ADDRESS: 33`x% 0 — -.P- ,/vim SO ASSESSOR'S TAX/PARCEL #: /32/0-? -V-098
M-Y'"JECT • • • •
TYPE OF PROJECT (Check all that apply): ERMANENT oTEMPORARY oNEW /ALTERATION oREFACE oEXEMPT
4�
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:
PROJECT DESCRIPTION (Provide detailed description):
b'Y).O vl 4- l zy
BUSINESS/TENANT NAME: Z14 / 4p'1 '/ 750
SIGN OWNER:
CONTRACTOR:
APPLICANT:
I ••" % ./ �, ! / I DAYTIME PHONE:
(AW 7de - ;�2
1 &.:3.5.20 - / I
I (Required)
NAME.
e Y C_� 1L�3�'l
_�
DAYTIME PHONE:A,o
P-52)
MAI (S,7EEr ADDRESS; Wry, STATE, ZIP):
EVENING PHONE:
-
C1TY OF FEDERAL WAY BUSINESS LICENSE NUMBER:
FAX NUMBER
CONTRACTOR'S REGISTRATIONNUMBER
/�
(Copy required) T I (YL L /9 , —Z7
CS cJ �-� �j
EXPIRA'jION DATE:
CONTACT FOR THIS PROJECT:
l e r l c. -.--,Z Avif.-A-el ) -
)RESS (STREET ADDRESS; a7y, STATE, P):
"v Z -
o PROPERTY OWNER -APPLICANT P(CONTRACTOR E-MAIL ADDRESS:
EVENING PHONE: -
7 FAX NUMBER:
"TEMPORARYAPPLICATIONSONLY"
TYPE/PURPOSE OF EVENT:
DATE OF INSTALLATION: DATE OF REMOVA •
TEMPORARY SIGN TYPE: o BANNER
NUMBER OF EACH TYPE:
PROPOSED NUMBER OF WALL SIGNS:
1140
L
o INFLATABLE a PORTABLE o SEARCH LIGHTS/BEACON
PROPOSED NUMBER OF FREE STANDING SIGNS:
ON PROPERTY:
It
PERMANENT FREE STANDING:
NUMBER OF EACH TYPE:
9; UMENT OTHER PEDESTAL 4 POLE TENANT DIRECTORY
PERMANENT BUILDING MOUNTED: o AWNING o CABINET o CANOPY o CENTER IDENTIFICATION (CID) o CHANNEL LETTERS
NUMBER OF EACH TYPE:
NUMBER OF EACH TYPE: o MARQUEE o OTHER o PROTECTING o TENANT DIRECTORY
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
HEIGHT FT
A
"x r x2 = 7q
T.
MIT.
D
B
E
C
., 11 1
STREET FRONTAGE (FT): .�S
BUILDING MOUNTED
A SIGN TYPE
ILLUMINATED?
NO INTERNAL EXTERNAL
SIGN AREA (SQ. FT.)
WIDTH X HEIGHT X # OF FACES
BUILDING
ELEVATION NSE
EXPOSED BUILDING
FACES . FT.
B
G FACADE:
S�►
LARGEST=SIGNS
?
STREET FRONTAGE:
N R ALLOWED:
NUMBER OF SIMS ALLWED:
LAND USE APPROVER INITIALS:
C
D
E
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
ANAME/TITLE: DATE:
A
SI�G^NATU /� 010
NAME (Print) C L-l5A (} c
PRINT
FAR AFFTf C I ICC AINI v.
ZONING DESIGNATION:
COMP PLAN DESIGNATION:
BUILDING MOUNTED SIGN
AREA PERMITTED:
FREE STANDING SIGN p� O
AREA PERMITTED: V
AREA PROPOSED:
AREA PROPOSED:
G FACADE:
S�►
LARGEST=SIGNS
?
STREET FRONTAGE:
N R ALLOWED:
NUMBER OF SIMS ALLWED:
LAND USE APPROVER INITIALS:
DATE:
STRUCTURAL APPROVER INITIALS:DATE:
� .. �� I
REGISTRATION NUMBER:
REGISTRATION NUMBER:
REGISTRATION NUMBER:
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
SIGN PERMIT APPLICATION CHECKLIST
3`4dtwt V -d
336TH St.7 P f L I L -
E ' in monum t 5 i
Sidewalk 5e ac ro orn er
Driveway Landscape I Driveway
��ay,ed av,4, Anuo
6o010
Store
FINAL SIGN INSP CTI is
-REQUIRED in ord r to re eive sign
registration numbe . Call 253-835-
3050 to schedule i soect n.
G OF LDERAL WAY
PR"A OF G MM LAITY DEVELOPMENT
33520 21ST AVE SW 04 -102856 -SG
NEW -
UNION 76 07-20-04 -
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Canopy
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Driveway
Driveway
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CITYOF FEDERAL
AY
ILDING DEPT.
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RECEIVED
JUL 2 0LJ—�`,
CITY OF FED iR',�L koY
BUILDING DEPT.
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Brand Face 181h
Price Face 101/2
1
2X Face 8
37 seg F -T
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RECEIVED
JUL 2 0 2004
CITY OF FEDERAL WAY
BUILDING DEPT.
ATTACH TO EXI5TING FOOTING
REMOVE EXI5TING 5'X 10' MONUMENT & IN5TALL NEW t �! NG00/Z
SI CSN To Be. ATTA C ti ED T4 E-xtST /� �
130LT5 (oft) IN p=00TWO- To pjoMAA o