SGN2005-00009 •
R
CITY TIGARD SIGN PERMIT
All DEVELOPMENT SERVICES PERMIT #: SGN2005 -00009
Ala � 1 S W Hall Blvd., Tigard, OR 9 7223 (503) 639 -4171 DATE ISSUED: 1/18/2005
PARCEL: 2S 102AA -00490
BUSINESS NAME: MADDYS ZONE: CBD
SIGN LOCATION: 12085 SW HALL BLVD 130 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4' X 2' 8"
TOTAL SIGN AREA: 22 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 A- frame. Sign #1. Must be placed outside of right of
way. Valid from 1/18/05 through 2/18/05.
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: g a . (20,„),
DATE: 1/18/2005
. •
iii. 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 I`Yluc►.?1,{ 5
•\ f Address/
Street Address Permit No.: SG N US S 0000 `�
( X \ Location �Zpg� 148-1( Ql ud�. Expiration Date: a - be - 0 5
Suite /Bldg. # City /State Zip
C- - cl4.v - Ga- n►c_ 9722-3 Receipt #: a
Name Approved By: C . �
Property St -,arm Z,LCLL Date: 9 �� /�
Owner Mailing Address Suite Map/TL #: As / o a /16- Do4 9v
izcs5 flAi 1_14,t( $lud. Zoning: L'13.°
City /State Zip Phone
T oc `1 So3 620 ?pi q`/ Electrical Permit Required? ❑ Yes ❑ No
[Tenant or Name
Business Building Permit Required? ❑ Yes ❑ No
Name Rev. 1/3/05 is \curpin \masters \revised \sign permit app.doc
Sign ______
Contractor Mailing Address suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a i
d i
w ithout the required submittal elements) of all City /State ip Phone q )
licenses are
required if i
expired in the Oregon Const. Cont. Board Exp. Date ❑ Completed Application Form
City of rd's License #
d ase) ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
(3 copies, if a building permit is required)
Proposed ❑ -- rmanent ❑ Freestanding ❑ Freeway size requirement: 81/2" x 11", or 11" x 17"
Sign lit Temporary ❑ Wall ❑ Electronic
(Check all that • Other ❑ 2 copies of elevations, drawn to scale
apply) ❑ Billboard ❑ Balloon
(3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11 ", to 24" x 36"
gn Dimensions:
❑ $37.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
❑ $17.00 Fee (Temporary sign, any type)
Si n Data Total Wall Area (sq. ft.) Jurisdiction: ❑ City ❑ 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 / 8 day of uo V , 20 0
Al2et■hm
Signature of Owner /Agent
Contact Person Name Phone No.
4 CITY OF TIGARD 1/18/2005
13125 SW Hall Blvd. 2:26:06PM
Tigard, Oregon 97223 ,
'� +
(503) 639 -4171
Receipt #: 27200500000000000223
Date: 01/18/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2005 -00009 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
SGN2005 -00009 [LRPF] LR Planning Surcharge 100- 0000 - 438050 2.00
Line Item Total: $17.00
Payments:
Method Payer User ID Acct /Check Approval No. How Received Amount Paid
Cash MADDYS CAC In Person 20.00
Change CITY OF TIGARD CAC In Person (3.00)
Payment Total: $17.00
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