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HomeMy WebLinkAbout3521 172ND ST NE_BLD1636_2026 SIGN PERMIT APPLICATION Department of Community& Economic Development City of Arlington • 18204 59th Ave NE•Arlington, WA 98223• Phone (360) 403-3551 THIS APPLICATION MUST BE ACCOMPANIED BY TWO(2)SETS OF COMPLETE PLANS, INCLUDING STRUCTURAL CALCULATIONS WHERE APPLICABLE, TWO(2)FULLY DIMENSIONED PLOT PLANS SHOWING ALL SIGNS ON SITE. (EXISTING&PROPOSED) 3521 172nd St 31052100302900 Project Address: Parcel ID#: Lot#: Subdivision: Valuation: 10,000 Owner: SSA Properties LLC Phone Number: (877)745 -1563 Address: 11232 120th Ave NE Ste 202 City: Kirkland State: WA Zip Code: 98033 Contractor: Insignia Sign Inc. Phone Number: (425)917-2109 Cell Phone: (425)917-2109 E-mail: steven@insigniasign.com Address: PO BOX 2849 City: Renton State: W4 Zip Code: 98056 Contractor's License Number: INSIGS1062QZ Expiration: 02/19/19 WALL SIGN CALCULATIONS MONUMENT SIGN CALCULATIONS Wall Height: Wall Length: Street Setback: NO CHANGE Area of Wall: Height of Proposed Sign: 21'-0" (REFACE ONLY) Sign Length: Sign Height: Width of Proposed Sign: 6-8 3/4" (REFACE ONLY) Total Sign Area: Total Sign Print Area: 123.65 (NO CHANGE) Total Sign Structure Area: 123.65 (NO CHANGE) First Floor Square Feet First Floor Square Feet X .025= Is there other wall signage on the building? No_Vr Yes_ If yes, provide location and size of each sign. I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above-described property will be in accordance with the laws, rules and regulations of the State of ntnn us1erz�a� comic 09/06/2017 Applicants Signature Date Steven R. Thomson Print Applicants Name FOR STAFF USE ONLY Permit# Accepted By Amount Received Receipt# Date Received F(D sign 4& Re-/n7Aging PHYSICAL ADDRESS' ARCO 325 Burnett Ave North Renton, WA 98057 SIGN LEGEND �� .� � , 6 _ PO BOX 2849 ' a ,. � _ 4 s Renton, WA 98056 ® _ OF+ / y _ ' FICE: (425) 917-2109 — Arco Pylon Sign: I "� ate, FAX: (425) 917-2109 **PAGE 2 - REFACE ONLY** cw � GC LICENSE: INIIGS1062QZ 'J ELEC LICENSE: INSIGS1055JS HO Existin Spark Wall Si us: °- s **NO CHANGE** CUSTOMER: LED PRICE SIGN PROJECT �� •�,,, �, Arlington Arco #2952521 - Fxis ino A.rrn Wrlll Signs: **NO CHANGE" T� im _ - - �t Y �•1 .0 I& ARCO Existing AMPM Wall Sign: 015**NO CHANGE** �`'` j �- PAGE: 1 of 2 1. tie �1�I�1 Row PROJECT ADDRESS: " 3521 172nd St N CITY OF ARUNG ON Arlington, WA 98223 t • - ' f BUILDING DEPARTME r . APPROVED DATE: 09/06/17 DATE t" 7-0 BY C- CONTACT: Steven Thomson e r ` — NO CHAWIES AUTHORIZED Steven@insigniasign.com �s UNLESS APPROVED BY THE BU&DIN oIr — PARCEL#: 31052100302900 '`� •' � ''� , ISI JOB#: 17-7618 ZONING: HC (Highway Commercial) IN 4v6d This is an original design and drawing created for VICINIFY MAP -_j l 1 ~ the exclusive!rse of the customer. Until transfer b,v �O jy ;E P 06 2011 sale, all rights are reserved aor!it is only to be used k \ by customer in connection with this project It is not to be reproduced in any manner without the M express written approval of ln.5ignia Sign, Inc. Construction or Permitting condiiions n'ra;,cause a change in dimensions or specifications. ARCO Cue io the printing process, colors may vary. 8 314 I - ARCO 6 . 1'r'ff & Re-//n1 fib PHYSICAL ADDRESS: 325 Burnett Ave North 6-83-4 " ; Renton,WA 98057 MAILING ADDRESS- PO BOX 2849 ARCO Renton,WA 98056 OFFICE: (425) 917-2109 FAX: (425) 917-2109 GC LICENSE: INSIGS1062QZ •r, ���� to ELEC LICENSE: INSIGS1055JS EXISTING ARCO LOGO FACES ampm _ �^ CUSTOMER: Arlington Arco #2952521 ARCO € ■T � B B B B n • M NEW AMPM LOGO FACES _ y CM ARCO CM CASH :- " 1-�- PAGE: 2 or 2 W a 10 0 unleaded SCOPE OF WORK ���°� OGI�L� PROJECT ADDRESS: ITS: N * 3521 172nd St N Remove & discard existing AMPM & Regular gas price faces: Arlington, WA 98223 M NEW LED PRICE FACES * Install new AMPM faces in existing cabinet: * Install new Regular/Diesel LED gas price faces in existing cabinet: DATE: 09/06/17 * Wire new LED gas price faces to existing electrical circuit: unleaded 10 CONTACT: Steven Thomson =diesel#2 * Total Sicin S uare Foota u 123.65 NO CHANGE Steven@insigniasign.com 3 * Total Si yn Height = 21"-0" (NO CHANGE) PARCEL#: 31052100302900 * Total Sign Setbacl (NO CHANGE) ISI JOB#: 17-7618 71 Lsafe,afl NG: HC (Highway Commercial) B B an original design and drawing created for ALL ELECTRICAL COMPONENTS TOBEU.L LISTED, usive use of the customer. Until transfer by ./ SIGN TO BE U.L LISTED APPROVED AND MARKED PER N E.0 600-0. •, AND$HAL MEET M.E.C.STANDARDS ALL TO BE ELECTRICALLY GROUNDED PER N.EC 250. rights are reserved and it is only to be usec UrNlemitea ALLPOWEflSUPPUESTOBERISEDPERU L 48.26.2.1merin connection with this project. It is no S�gnResource �� Unboratnrlm GROUNDING AND BONDING PERNE.C.250.90,•92;94;96e reproduced in any manner without the SIGN TOMEEPN.EGANDU.L 4Bss written approval of Insignia Sign, Inc, ELECTRIC SIGN STANDARDS FOR ELECTRICAL SIGNS. ction or permitting conditions may cause a 6135 District Blvd.• Maywood,CA 90270 GROUNDING&BONDING 800.423.4283 Fax 323.560.7143 PRIN BY: AS PER N E.0 25M&NEC 600-7ange in dimensions or specifications_Website:www.signresource.com to the printing process, colors may vary. CITY OF ARLINGTON INSPECTION CARD No building construction shall be commenced until permit holder INSPECTION RECORD SHALL or his agent has posted this Inspection Record Card in a REMAIN AT JOB SITE conspicuous place on the premises. OWNER: SSA Properties, LLC CONTRACTOR: Insignia Sign, Inc. JOB ADDRESS: 3521 172nd Street NE LOT NUMBER TYPE GROUP NATURE of WORK: Reface Monument Sign USE of BUILDING: Convenient Store/Gas Station PERMIT No: 1636 DATE ISSUED: 9.7.2017 INSPECTOR MUST SIGN ALL SPACES PERTAINING TO THIS JOB DEPARTMENT INSPECTION DATE(S) PASS FAIL INITIALS FOOTING BUILDING FOUNDATION (360)403-3417 UNDERFLOOR SHEARWALL PLUMBING(groundwork) ROUGH PLUMBING GAS PIPING ROUGH HEATING&VENTILATION FRAMING INSULATION WALLBOARD(SHEAR/RATED WALLS) CEILING GRID STRUCTURALSLAB CROSS CONNECTION CONTROL IN PREMISE PUBLIC WORKS GRADING (360)403-3457 TEMPORARY TECSP ASBUILTS APPROVED MAINTENANCE BOND STORM DRAINAGE SYSTEM PAVING,SIGNAGE&MARKINGS LANDSCAPING PLANNING CONDITIONS ONSITE UTILITIES WATER ONSITE UTILITIES SEWER Sewer OFFSITE UTILITIES WATER (360)403-3508 OFFSITE UTILITIES SEWER SEWER PRETREATMENT Water CROSS CONNECTION CONTROL PREMISE (360)403-3526 SIDE SEWER/CLEANOUT/FINAL WATER SERVICE INSTALLATION WATER SERVICE FINAL FIRE DEPARTMENT (360)403-3526 HYDRO/FLUSH (360)403-3607 UNDERGROUND""INCL FDC (360)403-3607 FIRE ALARM /AUTOMATIC SPRINKLER (360)403-3417 HOOD SUPPRESSION SYSTEM (360)403-3607 FINAL FIRE WALK-THROUGH (360)403-3417 FINAL INSPECTION ALL SIGNATURE BLOCKS MUST BE COMPLETE CITY OF ARLINGTON 238 N. OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:3521 172nd Stree NE Permit#:1636 Parcel#:31052100302900 Valuation: 10000.00 OWNER APPLICANT CONTRACTOR Name:SSA PROPERTIES LLC Name:Insignia Sign Inc. Name:INSIGNIA SIGN,INC Address:29305 TERRENO LANE Address:PO Box 2849 Address:5808 LAKEMONT BLVD.SE. City,State Zip:VALENCIA,CA 91354 City,State Zip:Renton,WA 98056 City,State Zip:BELLEVUE,WA 98006 Phone: Phone:425-917-2109 Phone:425-643-8410 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Sign CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 0 OCC GROUP: BUILDINGS: O OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC I IOARC 110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in t ilingto st repo ed on your sales tax return form a odedC fArlington#3101. ignature Print Name Date Rol ed By Date CONDITIONS re to approved plans. Washington State Department of Labor and Industries electrical inspection approval is required prior to final inspection. T141S PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 9/7/2017 Processing/Technology Fee $25.00 9/7/2017 Sign Permit Fee $255.63 Total Due: 5280.63 Total Payment: $280.63 Balance Due: 50.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon Ankk CITY OF ARLINGTON r:0 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:3521 172nd Stree NE Permit#:1636 Parcel#:31052100302900 Valuation: 10000.00 OWNER APPLICANT CONTRACTOR Name:SSA PROPERTIES LLC Name:Insignia Sign Inc. Name:INSIGNIA SIGN,INC Address:29305 TERRENO LANE Address:PO Box 2849 Address:5808 LAKEMONT BLVD.SE. City,State Zip:VALENCIA,CA 91354 City,State Zip:Renton,WA 98056 City,State Zip:BELLEVUE,WA 98006 Phone: Phone:425-917-2109 Phone:425-643-8410 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Sign CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 0 OCC GROUP: BUILDINGS: 0 OCC LOAD: PERMIT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC 110/IRC 110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in th I =\ -RcS1ca repo cd on your sales tax return form and coded City of Arlington#3101. Signature Print Name DatedBy Date CONDITIONS Adhere to approved plans. Washington State Department of Labor and Industries electrical inspection approval is required prior to final inspection. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED.THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description Fee Amount 9/7/2017 Processingrrechnology Fee $25.00 9/7/2017 Sign Permit Fee $255.63 Total Due: $280.63 Total Payment: $280.63 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon SigJ► &Re-1A74r�►g � � r ■ ■ �■ � � r ■ 4; N PRUJ C IPHYSICAL ADDRESS: ARCO 325 Burnett Ave North Renton, WA 98057 SIGN LEGEND T�` PO B OX 849 MAILINOX2849SS: - � +� Renton, WA 98056 IN � � � . _ * - OFFICE: (425) 917-2109 ® = Arco Pylon Sign: FAX: (425) 917-2109 **PAGE 2 - REFACE ONLY** GC LICENSE: INSIGS1062QZ ® = Existing Spark Wall Signs: ELEC LICENSE: INSIGS1055JS **NO CHANGE** - CUSTOMER: il Arlington Arco #2952521 = Existing Arco Wall Signs: **NO CHANGE** •or _ ARCO s = Existing AMPM Wall Sign: **NO CHANGE** _ . -_ � _ ���— PAGE: 1 of 2 t - - PROJECT ADDRESS: ` _ 3521 172nd St N 1:7 V- — Arlington, WA 98223 DATE: 09/06/17 CONTACT. Steven Thomson Steven@insigniasign.com ' tir PARCEL#: 31052100302900 - ISI JOB#: 17-7618 !~ r. ' , . ZONING: HC (Highway Commercial) @ i This is an original design and drawing created for VICINITY MAP _ the exclusive use of the customer. until transfer by raTro acaiF �' - — - , sale,all rights are reserved and it is only to be used a Ir by customer in connection with this project. It is not • • to be reproduced in any manner without the express written approval of Insignia Sign, Inc. t Construction or permitting conditions may cause a change in dimensions or specifications. ARCO Due to the printing process, colors may vary. 1 �6 8 3/4 ARCO sign► &Re-/Anagh►g PHYSICAL ADDRESS: 0� 325 Burnett Ave North 1� Renton, WA 98057 6'-8 34' MAILING ADDRESS: ----- — ---- -- PO BOX 2849 ARCO ARCO Renton, WA 98056 OFFICE: (425) 917-2109 w FAX: (425) 917-2109 GC LICENSE: INSIGS1062QZ a - c ELEC LICENSE: INSIGS1055JS EXISTING ARCO LOGO FACES -- -- --- _ m CUSTOMER: Arlington Arco #2952521 ARCO, . . i � � �.. NEW AMPM LOGO FACES �,�. ,�- ARCO C-01M a W . . � Iof I PAGE: 2OF2 W ■ 0 o - • ' - ' 1 SCOPE OF WORK. �����° 70���� PROJECT ADDRESS: 3521 172nd St N 1 * Remove & discard existingAMPM & Regular as rice faces: g g p Arlington, WA 98223 M NEW LED PRICE FACES * Install new AMPM faces in existing cabinet: • * Install new Regular/Diesel LED gas price faces in existing cabinet: DATE: 09/06/17 1 '1 * Wire new LED gas price faces to existing electrical circuit: unleaded * Qpm CONTACT: Steven Thomson U. * Total Sign Square Footage = 123.65 (NO CHANGE) Steven@insigniasign.com 3 - * Total Sign Height = 21'-0" (NO CHANGE) PARCEL#: 31052100302900 * Total Sign Setback = (NO CHANGE) ISI JOB#: 17-7618 � ZONING: HC (Highway Commercial) `" This is an original design and drawing created for ALL ELECTRICAL COMPONENTS TO BE U.L.LISTED, the exclusive use of the customer. Until transfer by SIGN TO BE U.L.LISTED APPROVED AND MARKED PER N.E.C.600-4. AND SHALL MEET N.E.C.STANDARDS ALL TO BE ELECTRICALLY GROUNDED PER N.E.0 sale,all rights are reserved and it is only to be used .250. ��� • , ALL POWER SUPPLIES TO BE FUSED PER U.L.48,28.2.1 by customer in connection with this project. It is not Underwriters GROUNDING AND BONDING PER N.E,C.250-90,-92,-94,-96. to be reproduced in any manner without the , SignResource OLa6oratorieslnc. � SIGN TO MEET N.E.C.AND U.L.46 express written approval of Insignia Sign,Inc. Building your corporate identity..al"Y'on target ELECTRIC SIGN STANDARDS FOR ELECTRICAL SIGNS. 6135 District Blvd. • Maywood,CA 90270 GROUNDING&BONDING Construction or permitting conditions may cause a 800.423.4283 • Fax 323.560.7143 PRIMARIES AND FINAL CONNECTION TO SIGN BY: AS PER N.E.C.250-90&NEC 600-7 change in dimensions or specifications. Website:www.signresource.com Due to the printing process,colors may vary. 1,w a CITY OF ARLINGTON 238 N.OLYMPIC AVE-ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:3521 172nd Stree NE Permit#:1636 Parcel#:31052100302900 Valuation:10000.00 OWNER APPLICANT CONTRACTOR Name:SSA PROPERTIES LLC Name:Insignia Sign Inc. Name:INSIGNIA SIGN,INC Address:29305 TERRENO LANE Address:PO Box 2849 Address:5808 LAKEMONT BLVD.SE. City,State Zip:VALENCIA,CA 91354 City,State Zip:Renton,WA 98056 City,State Zip:BELLEVUE,WA 98006 Phone: Phone:425-917-2109 Phone:425-643-8410 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name; Address: Address: City,Stale,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Sign CODE YEAR: 2015 STORIES: CONST.TYPE: DWELLING UNITS: 0 OCC GROUP: BUILDINGS: O OCC LOAD: PERMIT APPROVAL I AGRI:F.TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTIiORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18,27 THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED BY THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID, IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC110/IRCl10. SAI,F TAX E.Sales tax relating to construction and construction materials in I rlingt 1 rcpo cd on your sales tax return form a oded C y f Arlington#3101. a GI - 7 tgnalure Print Name Date Releged By Date CONDITIONS re to approved plans. Washington State Department of Labor and Industries electrical inspection approval is required prior to final inspection. THIS PERMIT AUTHORIZE ONLY THE WORK NOTED,THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON TIIE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION PERMIT FEES Date Description Fee Amount 9/7/2017 Processing/Technology Fee mount 9/7/2017 Sign Permit Fee $$25,00 Total Due: $280.63 Total Payment: $280.63 Balance Due: $0.00 CALL FOR INSPECTIONS BUILDING(360)4113-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon " CITY OF ARLINGTON 238 N. OLYMPIC AVE -ARLINGTON, WA. 98223 PHONE; (360)403-3551 BUILDING PERMIT Address:3521 172nd Stree NE Parcel#:31052100302900 Permit#:1636 Valuation: 10000.00 OWNER APPLICANT CONTRACTOR Name:SSA PROPERTIES LLC Name:Insignia Sign Inc. Name:INSIGNIA SIGN,INC Address:29305 TERRENO LANE Address:1P0 Box 2849 Address:5808 LAKEMONT BLVD.SE. City,State Zip:VALENCIA,CA 91354 City,State Zip:Renton,WA 98056 City,State Zip:BELLEVUE,WA 98006 Phone: Phone:425-917-2109 Phone:425-643-8410 MECHANICAL CONTRACTOR PLUMBING CONTRACTOR Name: Name: Address: Address: City,State,Zip: City,State,Zip: Phone: Phone: LIC#: EXP: LIC#: EXP: JOB DESCRIPTION PERMIT TYPE: Sign CODE YEAR: 2015 STORIES: CONST,TYPE: DWELLING UNITS: Q OCC GROUP: BUILDINGS: Q OCC LOAD: PERNUT APPROVAL I AGREE TO COMPLY WITH CITY AND STATE LAWS REGULATING CONSTRUCTION AND IN DOING THE WORK AUTHORIZED THEREBY;NO PERSON WILL BE EMPLOYED IN VIOLATION OF THE LABOR CODE OF THE STATE OF WASHINGTON RELATING TO WORKMEN'S COMPENSATION INSURANCE AND RCW 18.27. THIS APPLICATION IS NOT A PERMIT UNTIL SIGNED 13Y THE BUILDING OFFICIAL OR HIS/HER DEPUTY AND ALL FEES ARE PAID. IT IS UNLAWFUL TO USE OR OCCUPY A BUILDING OR STRUCTURE UNTIL A FINAL INSPECTION HAS BEEN MADE AND APPROVAL OR A CERTIFICATE OF OCCUPANCY HAS BEEN GRANTED. IBC1 IO/IRC110. SALES TAX NOTICE:Sales tax relating to construction and construction materials in the I rlingto st repo ed on your sales tax return form and coded City of Arlington#3101. l\ Signature Print Name �- Date Relea-ed By Date CONDITIONS Adhere to approved plans. Washington State Department of Labor and Industries electrical inspection approval is required prior to final inspection. THIS PERMIT AUTHORIZS ONLY THE WORK NOTED,THIS PERMIT COVERS WORK TO BE DONE ON PRIVATE PROPERTY ONLY. ANY CONSTRUCTION ON THE PUBLIC DOMAIN(CURBS,SIDEWALKS,DRIVEWAYS,MARQUEES,ETC.)WILL REQUIRE SEPARATE PERMISSION. PERMIT FEES Date Description 9/7/2017 Process ingrrechnology Fee Fee Amount 9/7/2017 Sign Permit Fee $25.00 $255.63 Total Due: $280.63 Total Payment: $280.63 CALL FOR INSPECTIONS Balance Due: $0.00 BUILDING(360)403-3417 When calling for an inspection please leave the following information: Permit Number,Type of Inspection being requested,and whether you prefer morning or afternoon I I �� �� . .' .S y, ;: ,�:.. - �_ -� s ;si! n � �l Permit Information Date 9/6/2017 Permit Number 1636 Project Name Arco Applicant Name Insignia Sign Inc. Applicant Address PO Box 2849 City, State,Zip Renton,WA 98056 Contact Steven Thompson Phone 425-917-2109 Email steven@insigniasign.com Permit Type Sign Site Address 3521 172nd Stree NE Valuation 10000.00 Status Applied Permit Issued Permit Expires Square Feet 0 Type of Construction/Occupancy Load Number of Stories 0 Proposed Use Re-Face Monument Sign Assigned To Kristin Foster Property Information Owner Information Parcel#:31052100302900 SSA PROPERTIES LLC SSA PROPERTIES LLC 29305 TERRENO LANE 3521 172ND ST NE VALENCIA,CA 91354 Contractors Contractor Name Primary Contact Phone Email Contractor Type License License# INSIGNIA SIGN, INC 25-643-8410 teven insi niasi n.com ONTRACTOR Labor&Industries JINSIGS10620f Review Date Type Description Target Date Completed Date As ned To Status 9/6/2017 Sin 9/13/2017 Rick Karns lin Review Fees Fee Description Notes Amount Processing/Technology ProcessingITechnology Fee 341.43.00.02 $25 0 Sion Permit Fe 322.10.00.00 $255.6 Total smn F,31 Uploaded Files Upload File Date File Uploaded B 9/6/2017 3:51:07 PM 1636 Application.pdf Foster,Kristin x 9/6/2017 3:51:07 PM 1636 Plans.pdf Foster,Kristin x ,1 SIGN PERMIT APPLICATION Department of Community& Economic Development City of Arlington• 18204 59th Ave NE•Arlington, WA 98223• Phone(360) 403-3551 THIS APPLICATION MUST BE ACCOMPANIED BY TWO(2)SETS OF COMPLETE PLANS,INCLUDING STRUCTURAL CALCULATIONS WHERE APPLICABLE, TWO(2)FULLY DIMENSIONED PLOT PLANS SHOWING ALL SIGNS ON SITE. (EXISTING&PROPOSED) Project Address: 3521 172nd St N Parcel ID#: 31052100302900 Lot#: Subdivision: Valuation: 10,000 Owner: SSA Properties LLC Phone Number:(877)745 -1563 Address: 11232 120th Ave NE Ste 202 City:Kirkland State: WA Zip Code: 98033 Contractor:Insignia Sign Inc. Phone Number: (425)917-2109 Cell Phone: (425)917-2109 E-mail: steven@insigniasign.com Address: PO BOX 2849 City:Renton State: WA Zip Code: 98056 Contractor's License Number: INSIGS1062QZ Expiration: 02/19/19 WALL SIGN CALCULATIONS MONUMENT SIGN CALCULATIONS Wall Height: Wall Length: Street Setback: NO CHANGE Area of Wall: Height of Proposed Sign: 21'-0" (REFACE ONLY) Sign Length: Sign Height: Width of Proposed Sign: 6'-8 3/4" (REFACE ONLY) Total Sign Area: Total Sign Print Area: 123.65 (NO CHANGE) Total Sign Structure Area: 123.65 (NO CHANGE) First Floor Square Feet First Floor Square Feet X .025= Is there other wall signage on the building? No ✓ Yes If yes, provide location and size of each sign. I hereby certify that the above information is correct and that the construction on, and the occupancy and the use of the above-described property will be in accordance with the laws, rules and regulations of the State of 09/06/2017 Applicants Signature Date Steven R.Thomson Print Applicants Name r I FOR STAFF USE ONLY , Permit# Accepted dv Amount Received Receipt# Date Received �a•d t 9/6/2017 INSIGNIA SIGN INC " Search L&I �3ufety Health Clairns&I�isurancr; =hlorkplar e i lc;hts Dads Ltcr;nsw Washington State Department of " Labor & Industries INSIGNIA SIGN INC Owner or tradesperson PO BOX 2849 Principals RENTON,WA 98056 425-917-2109 THOMSON,CINDY A,PRESIDENT KING County THOMSON,BRYAN E,MEMBER BOWEN,BRYAN E (End:02/04/2002) Doing business as INSIGNIA SIGN INC WA UBI No. Business type 601 507 324 Corporation Governing persons BRYAN EUGENE BOWEN JEFFREY B KUCK; CINDY THOMPSON; License Verify the contractor's active registration/license!certification(depending on trade)and any past violations. Construction Contractor Active. Meets current requirements. License specialties GENERAL License no. INSIGS1062QZ Effective—expiration 11/09/1994—02/19/2019 Bond Lexon Ins Co $12,000.00 Bond account no. 9810589 Received by L&I Effective date 11/01/2011 11/01/2011 Expiration date Until Canceled Bond history Insurance Western National Assur Co $1,000,000.00 Policy no. cppl00571708 Received by L&I Effective date 03/01/2017 02/16/2017 Expiration date 0 2/1 612 01 8 https://secure.ini.wa.gov/verify/Detail.aspx?UBI=601507324&LIC=INSIGS1062QZ&SAW= 1/2 9/6/2017 INSIGNIA SIGN INC Western National Assur Co $1,000,000.00 Policy no. CPP1005717 Received by L&I Effective date 01/09/2017 02/16/2012 Expiration date 02/16/2018 Insurance history Savings No savings accounts during the previous 6 year period. Lawsuits against the bond or savings No lawsuits against the bond or savings accounts during the previous 6 year period. L&I Tax debts No L&I tax debts are recorded for this contractor license during the previous 6 year period,but some debts may be recorded by other agencies. License Violations No license violations during the previous 6 year period. Workers' comp Do you know if the business has employees?If so,verify the business is up-to-date on workers'comp premiums. L&I Account ID Account is current. 894,842-00 Doing business as INSIGNIA SIGN INC Estimated workers reported Quarter 2 of Year 2017"7 to 10 Workers" L&I account contact T1/DESTINY ADAMS(360)902-4873-Email:ADAF235@Ini.wa.gov Public Works Strikes and Debarments Verify the contractor is eligible to perform work on public works projects. Contractor Strikes No strikes have been issued against this contractor. Contractors not allowed to bid No debarments have been issued against this contractor. Workplace safety and health Check for any past safety and health violations found on jobsites this business was responsible for. Inspection results date 03/16/2015 Violations Inspection no. 317935109 Location 1 S Grady Way Renton,WA 98057 ©Washington State Dept of Labor&Industries,Use of this site is subject to the laws of the state of Washington. https://secure.Ini.wa.gov/verify/Detail.aspx?UBI=601507324&LIC=INSIGS1062QZ&SAW= 2/2 /yen o ui sioln;s Jo 3t o.s -gwlp.;u aga o7 ar?n �oub suotreoi�loads o suoisuau�lp u�i eb'up�}o a"1 _ e asneo�fE�u�St.rt7rlir�-�n,1 Bunxxu,�,ad,t;uoqlla;rs,,u:�, oul 'uGis e!u6/sul ao leno dde ua.7llun ssa_inxa f ���� 90 ��� ai)jt10t hn rauueLU-fUL-ui I !1 paoripojdaa an, o) lou sl;l -pofaid sigl ppm uonaau�_io:�ui.iaEr�n�sn;�Aq • �o pasn eq 07�fluo si J!00B pe rasar a_ae spjb-p Ile 'ales p81�19�2Zj - pi /(q aa�sueu Jqun �iawolsnn ag;,co asrn a,vsnpxa ay; � � _ � a� ��W �NI�I� jo/po�eaaa buuvieip pue ub)sap leugfiuo ue si srrlj (lopowwo) Aomg51H) )H :ONINOZ 9 L9L-L L :#80f ISI � �.,� .N• ' 0 • '� oo6ZOEoo�Zso« =#13)Nnd wa,lcls . .gr% 3HI AG 03AOHdd1d SS31Nf1 ` woru6isoiu6isui@u@A@jS pimuo invsa0NdHOON ' w. ��► uoswoyl uana4S l)d1N0) Ae.�.-..�""L"�,_�tdo l +' L 1/90/60 :old® Wl�ldd3a JNI011f19 EZZ86 VM UOIOUIIad T N IS P ZL [ L ZS C SS3daan 1)3f0md kd IAAO Z 'o I •39dd ` **39NVH)ON«* I: � :uu�s IIoM WdWd uiJsix3 = oouv - rs We t '� *.19NVH) ON** :Mls IIUM O)adfiffpx3 Al i� LZSZS6Z# 0)ad UOIOUI ad w �. .. �� i �. �r � •d3WOlsn) '� ' - �,. ., **39NVH) ON** Sdbl Ill- Jo III�SIX — SfSS01S91SNI :3SN3J1, J313 ' S !, M �I S 3 ZOMIS91SN1 ASN3J11 JD NJ 60LZ-LL6 (SZtl) :XVJ .� **AINO DVJH - Z 39dd** 601Z-L66 (SZ17) :3J13J0 .�.. v� ,, u is uolnd o)ad E ` t 95086 b'M'uozuab •'" y'��`,�1 •� ' 6t18Z X08 Od t '• +< � ~ � ` , :SS38a(]dON1,1bAI ¢.����i = ON3031 NJIS LS086 b'M 'uo;uaa q:pON any 1jauin8 SZ£ :SS3aa®b 1bJISkHd DS 33 lid a mi Xjen Aeuu s.lofoo 'ss000ad buquud aqj oI an(] woo aomosalubsNam:allsgaM suogeolpoadsao suolsuaup in a6ueyo t003N306-OSZ 03N83dSV ASN9ISO1NOUO3NNOO1WJQNVS3JNWiud CKL'099TZENJ • E9Z6Zb009 e asneo ifew suoflfpuo 5u. pi ad JO uoonsuo ONI0N0980NIONnodo OLZO6 V0'POomew . 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Applicant Address: PO Box 2849 Applicant, City, State, Zip: Renton,WA98056 Contact: Steven Thom pson Phone: 425-917-2109 Em al: steven@insigniasign.com Scope of Work: Re-Face M onum cat Sign Valuation: 10000.00 Square Feet: 0 Num ber of Stories: 0 Construction Type: O xupancy G ioup: ID Code: Permit Issued: 09/08/2017 Permit Expires: Form Permit Type: Status: LASERFICHE Assigned To: Kristin Foster Property Parcel# Address L egal Description O wner Nam e Caner Phone Zoning 31052100302900 3 521 172ND ST NE SSA PROPERTIES 549 Other Retail LLC Trade-Food NEC Contractors Contractor P rim ay Contact P hone A ddress C ontractor Type L icense License# INSIGNIA SIGN,INC 4 25 917 2109 5808 LAKEMONT CONSTRUCTION UBI 604 382 048 BLVD.SE. CONTRACTOR INSIGNIA SIGN,INC 4 25 917 2109 5808 LAKEMONT CONSTRUCTION Labor&Industries INSIGSR813QA BLVD.SE. CONTRACTOR Plan Reviews Date R eview Type D escription A ssigned To R eview Status 09/06/2017 S IGN INSTALLATION z .Rick Karns Fees Fee D escription N otes A m cant Processing/Technology $25.00 Signs Valuation Perm i Fee Only $255.63 Total $280.63 Attached Letters Date Letter D escription 09/07/2017 Building Perm i Paym ants Date Paid By D escription P aym ant Type A ccepted By A m cunt 09/07/2017 Steven Thom sin 6 6267879 c c $280.63 O ttstanding Balance $0.00 Uploaded Files Date File Nam e 09/08/2017 2589994-1636 Issued Permt.pdf 09/06/2017 2585018-1636 Plans.pdf 09/06/2017 2585019-1636 Application.pdf