SGN2004-00103 S.
CITY OF TIGARD SIGN PERMIT
dhkock DEVELOPMENT SERVICES DATEEISSUIED: 5/G2/2004 N2004-00103
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 PARCEL: 2S103DD-00800
BUSINESS NAME: SUZANNE GALLAGHER CAMPAIGN ZONE: C-G
SIGN LOCATION: 13815 SW PACIFIC HWY 100 JURISDICTION: TIG
APPLICANT/AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 32"X 48"
TOTAL SIGN AREA: 11 sq.ft.
WALL AREA: sq.ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one, temporary lawn sign. Sign #1. Must be placed outside of
public right-of-way and vision clearance triangles. Valid 5/12/04 -6/12/04.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. A permanent sign must be
placed within 90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity
date. A balloon sign shall expire 10 days from validity date. ,
APPROVED BY: &/6661 �' ��^
PERMITTEE SIGNATURE: I,
DATE: 5/1 04
04/19/2004 08:52 FAX 5035981960 CITY OF TIGARD IZ 002
Ak •
�.." ,'"'L SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hail Blvd., Tigard, OR 97223(503) 639-4171 FAX;;(503) 684-7297
GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY
Site
Address/ Street Address c5" `-�(?MO Permit No.: s 6K) ,=:). 00‘$ — DO I O
Location 13 a t s Su e € & (o -ra - 4Expiration Date:
SulleBldg.# City/State Zip 72Z3I -fl c , oz Receipt#: a o a'd —
Name Approved By: C• �
Property .. L..,./ iS CO. Date: 5 - l a- o `{
Owner Mailing Address Suite qui /O/ Map/TL#: A6/0 0 1) '-• 001600
4730 5 W /14 ' ' * a Avo, Zoning: _C
City/State Zip Phone
tPee.:rLely D/ 0 4 61" .Z.,39 Electrical Permit Required? 0 Yes ❑ No
Tenant or Name
Business Building Permit Required? 0 Yes EtNo
Name Rev,e/7/2009 i:\curpin\mestersVrevisedtsipn permit app,doe
Sign ik/O"f, ,p'ii Cj1-I L
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit I (Note: applications will not be accepted 1
Issuance,a all of all c:lty/Stelae Zip Phone without the required submittal elements)
licenses are
required If • 0 Completed Application Form
expired in the Oregon Cons[Cont Board I Exp.Date
City of Tigard's License# 1 0 2 Copies of Site/Plot Plan, Drawn to Scale '
database) (3 copies, if a building permit is required)
Proposed ❑ Permanent 0 Freestanding 0 Freeway size requirement: 81/2"x 11", or 11"x 17'
Sign 'f Temporary El ID Electronic
(Check all that ❑ other D Billboard Balloon A 2 copies of elevations, drawn to scale
apply) I (a copies, if a building permit is required)
New sign? 0 Alter to existing sign? size requirement; 81/2" x 11", to 24" x 36"
Sign Dimensions: !/
32// x 4 0 $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq.ft.):
10.6 5 F .A$15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq.ft.) A Jurisdiction: City ❑ Urb
I
(Complete all Direction Wall Faces (circle one): NOTES:
items in this :
section) N S E W NE NW SE SW
Height to top of sign (feet): e r? • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wail face and
sign placement.
Copy: 1 • Wall signs do not require sitelplot plans.
Materials: _ • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes Vi No building permit.
Type: 0 Internal f Exter al • If work authorized under a sign permit has not
Are there any existing freestanding or wall signs at this I been completed within ninety (90) days after
location, including wall signs.that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
121 Yes ❑ No BECOME NULL AND VOID.
If"yes", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES) •
05/10/04 14:01 FAX 5032232750_ DWSIVER __ a003
May-10-04 02:51gm From-Norrls Beggs 8 Simpson +503 2T30256 T-488 P.003/005 F-051
•
1 hereby acknowledge that I have read this application, that the information given is
correct, that I am the owner or authorized agent of the owner, and that plans submitted are
in compliance with the City of Tigard.
0A4
n
DATED this /0 day of - (_ ,20 O C-
. . -� � —
-4(
Signature of Owner/Agent•
•
�.'� rzo2S SO 24.E 0
Contact Person Name Phone No.
A CITY OF TIGARD 5/12/2004
13125 SW Hall Blvd. 10:19:52AM
Tigard,Oregon 9 72 23
Ir. (503) 63 9-417 1
Receipt #: 27200400000000001986
Date: 05/12/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004-00103 [SIGN] Temp Sign Perm 100-0000-437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct./Check Approval No. How Received Amount Paid
Check JOHN/SUZANNE GALLAGHER CAC 296 In Person 15.00
Payment Total: $15.00
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ps,t AMERrc
, iy First American Title Insurance Company of Oregon
An assumed business name of TITLE INSURANCE COMPANY OF OREGON
�f AIL 1700 SW Fourth Avenue Portland, OR 97201-5512
Phone: (503)222-3651
This map is provided as a convenience in locating property
First American Title Insurance Company assumes no liability for any variations as may be disclosed by an actual survey
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options for the 48" x 32" lawn sign
GALLAGHERaZanne
FO►R STATE REPRESENTATIVE
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