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SGN2005-00228 CITY OF TIGARD SIGN PERMIT DEVELOPMENT SERVICES PERMIT #: SGN2005 -00228 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/3/2005 PARCEL: 2S101 DA -00104 BUSINESS NAME: FARMERS INSURANCE ZONE: MUE SIGN LOCATION: 13333 SW 68TH PKWY JURISDICTION: TIG APPLICANT /AGENT: FARMERS INSURANCE BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: Y ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 7' X 20' TOTAL SIGN AREA: 140 sq. ft. WALL AREA: 3,617 sq. ft. WALL FACE (DIRECTION): W SIGN HEIGHT: ft. PROJECTION FROM WALL: in. ILLUMINATION: NON DESCRIPTION OF SIGN: Placement of a wall sign (framed banner). 7' x 20' MATERIALS: VINYL EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: N BUILDING PERMIT REQUIRED: N ADMINISTRATIVE EXCEPTIONS: TOTAL PERMIT FEES: $ 38.00 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: 0'G (I., PERMITTEE SIGNATURE: DATE: 8/3/2005 �i ..„041 SIGN PERMIT APPLICATION CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297 GENERAL INFORMATION Name of Development/Project FOR STAFF USE ONLY Site raa vv. ekr 5 S- v Slnxrav■-c.e Address/ Street Address Permit No.: 5C7N Oo5-- 00,)„,05 ,05 Location (3333 S. 6�5 Pour Suite /Bldg. # k ity /State zip Y Expiration Date: t witi Q1Z2 Receipt #: 31a Name Approved By: C . C'ccL✓L•Z3-i Property E T. G. (4o(dite GO. Date: 8 - 3 -t E Owner Mailing Address � uite Map/TL #: c S 10) 17#1 — oc3 t 4 1 -160 tAJ;(5Litre Wud Zoning: /4 t L City /State Zip Phone LOS Avv `?i23- `13Z-3zo0 Electrical Permit Required? ❑ Yes No Tenant or Name Business bcAS i Building Permit Required? 111 Yes No Name Rev. 7/1/05 i:\curpin\masters\revised\sign permit app.doc Sign \�C�vv-SG st _$ Contractor Mailing Address 3 suite REQUIRED SUBMITTAL ELEMENTS permit issuance, a U((6o s.. ? & tic (Note: applications will not be accepted issua copy of all City /State Zip Phone without the required submittal elements) licenses are required if POC446 q12.01, 503 - Th —1"(5S- ❑ Completed Application Form expired in the Oregon Const. Cont. Board Exp. Date City of Tigard's License # database) 06 3 qZZ /thy ZOCA ❑ 2 Copies of Site /Plot Plan, Drawn to Scale (3 copies, if a building permit is required) Proposed Ef Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17" • Sign IXf Temporary 12 Wall ❑ Electronic (Check all that ❑ Other ❑ Billboard ❑ Balloon 111 2 copies of elevations, drawn to scale apply) (3 copies, if a building permit is required) ❑ New sign? fXI Alter to existing sign? size requirement: 8 x 11", to 24" x 36" Sign Dimensions: 1 1 k y ZO .J ❑ $38.00 Fee (Permanent sign, any size) Total Sign Area (sq. ft.): (1(0 ❑ $18.00 Fee (Temporary sign, any type) Sign Data Total Wall Area (sq. ft.) 36t Jurisdiction: 11 City El Urb (Complete all Direction Wall Faces (circle one): items in this NOTES: section) N S E ® NE NW SE SW Height to top of sign (feet): (O • Wall signs do not need to be drawn to scale, Projection From Wall (inches): but must include dimensions of wall face and sign placement. Copy: s,,,p, A4- 4o,c,4.�2 • Wall signs do not require site /plot plans. Materials: v 0 .i ( Q4,..u.v.t41' • Freestanding signs over 6 ft. required a Will sign have illumination? ❑ Yes building permit. No • If work authorized under a sign permit has not Type: ❑ Internal XI External been completed within ninety (90) days after Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL location, including wall signs that overlap a tenant space? BECOME NULL AND VOID. ❑ Yes zi No If "yes ", a list or diagram of all sign dimensions and square footage must also be submitted. (OVER FOR SIGNATURES) I 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. DATED this day of AI c,LS'f" 20 OS ,hcA/4d6A Signature of Owner/ gen 306 e) (A CcA (e .5 L-( 3 - 6 Z w Co act Person Name Phone No. W 0- (0371 Farmers first-ever multi-lines sales promotion! iti iiii *go a iii AIM ( .4 i r- r dill' ".. 204,- )1‹ 2-41 s t I . t _ _ --- cmr - orriGARa - , ,, r 17,,ove1 Ek ':c only the work as described in: N) ,—, SG, Quo , o __AB --.0 Se Letter to: Follow 1 ] • - 41111 - ft, , P1 7 J .‘`o Addres& C. . Date: - ° -- 5- E%isIsiAtss_ciske,...;„21.6 sa -c4- 7112c: bctNeAr ---- .C2(.4.............+._ Ceti. L,L5,9 so3.:2118:vi5A___ Pecivki Cev.tesr (3kzff 5w. k-kau ivii.,1 I. ... i / 1 8 - t FARMERS At 174147(EtN4 FARMERS ,--_----.; Gets you back where you belong: IIIIID,';i�!! Illl cg;;ii FA ERS INSURANCE GROUP OF COPANES 13MT og RKwr. r19A170. OREGON 97223 1 U991. Rood ME. R®79 j i r • 0 4 4////iti OK; :) / ..e. 0 V Fora noon PLAN FOURTH FLOOR GC/ . w . 0872-4006 A1.04 - holding line only - do not print 1 For Auto Insurance call a Farmers Agent at FARMERS before after /! omits i FARMERS* Gets you back where you bdong: , 12' x 24' poster Q 1/2" scale (5.375" x 11.5") Craig Mills, cpcu Marketing Specialist FARMERS -! ►,, FARMERS' • 13333 SW 68th Parkway Tigard, Oregon 97223 Phone: (971) 506 -4026 Fax: (503) 443 -6364 Craig .mills@farmersinsurance.c Registered principal Farmers Financial Solutions, LLC 2423 Galena Avenue, Simi Valley, CA 93065 Phone (805) 306 -3400, Member NASD • CITY OF TIGARD 13125 SW Hall Blvd. 4,;,aii, � �, Tigard, Oregon 97223 - 11. (503) 639 -4171 Receipt #: 27200500000000003677 Date: 08/03/2005 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2005 -00228 [SIGN] Sign Permit 100- 0000 - 437000 33.00 SGN2005 -00228 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00 SGN2005 -00229 [SIGN] Sign Permit 100 - 0000 - 437000 33.00 SGN2005 -00229 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00 SGN2005 -00230 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00 SGN2005 -00230 [SIGN] Sign Permit 100 - 0000 - 437000 33.00 Line Item Total: $114.00 Payments: Method Payer User ID AcctJCheck No.Approval No. How Received Amount Paid CreditCard CRAIG R MILLS CAC 413871 In Person 114.00 Payment Total: $114.00 cReceipt.rpt Page 1 of 1