SGN2005-00014 CITY TIGARD SIGN PERMIT
lit DEVELOPMENT SERVICES PERMIT #: SGN2005 -00014
.- DATE ISSUED: 1/26/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136DB-00201
BUSINESS NAME: FRED MEYER ZONE: C -
SIGN LOCATION: 11575 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2' X 4'
TOTAL SIGN AREA: 16 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one A- frame, temporary sign. (2' x 4') Sign #1. Valid from 1/27/05
through 2/27/05.
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:
PERMITTEE SIGNATURE:
DATE: 1/26/2005 -��
r ‘
,,:iriit, 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
e A 1\ e� ` lJ eS FOR STAFF USE ONLY
Site " l
Address/ Street Address _ Permit No.: C N a a O' - o 0 u 1
Location 1 5 65 Su) V t Suite/Bldg. # City /S t� G Expiration Date: . 1 - a - (U 5
J L ci �- Ts0a pig,., 912,7- Receipt #: v Z b O 5 03 3 7
Nam J Approved By: L' .
Property t'4 Meie-, Date: 1 -alp - 03
Owner Mailing Address Suite Map /TL #: i s13(0 DB -- c
Zoning: 0 C -6
1( City /State Zip Phone
Tenant or - Name Electrical Permit Required? ❑ Yes E1 No
Building Permit Required? Yes No
Business r� �.Q��' jie g q ❑
Name J Rev. 1/3/05 is \curpin \masters \revised \siqn permit app.doc
Sign 1
-
Contractor Mailing Address uite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a w ithout the required submittal elements)
copy of all City /St. - Zip Phone q
licenses are
required if
expired in • - Oregon Const. Cont. Board Exp. Date I=1 Completed Application Form
Cit • igard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
. atabase)
(3 copies, if a building permit is required)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign IS1--remporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11 ", to 24" x 36"
Sign Dimensions:
X ❑ $37.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
>z a ❑ $17.00 Fee (Temporary sign, any type)
Si n Data Total Wall Area (sq. ft.) 2 Jurisdiction: [I] City El Urb
9
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E W NE NW SE SW
Height to top of sign (feet): • 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: • Wall signs do not require site /plot plans.
Materials: • 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 ❑ 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 ❑ 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 04k day of J'c litLCc/'j , 20 0
v ill 04 -
Signatur f Owner/ t
503.2q3. 7
Contact Person Name Phone No.