SGN2005-00346 ,
1
4 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2005 -00346
.A A! 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/10/2005
PARCEL: 2S 112DD -00400
BUSINESS NAME: COOKIE LEE ZONE: I -L
SIGN LOCATION: 15912 SW 72ND AVE B17 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC: Y
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 25.75" X 114"
TOTAL SIGN AREA: 20 sq. ft.
WALL AREA: 425 sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 14 ft.
PROJECTION FROM WALL: 2 in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Installation of 20.4 sq. ft. wall sign.
MATERIALS: GATOR FOAM
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: / ` f
PERMITTEE SIGNATURE: '--�� ((�
DATE: 11/10/2005
11.09/2005 09:45 FAX 5035981960 CITY OF TIGARD 4 001
.404/r SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX (503) 689 -7297
GENERAL INFORMATION
Name of Development/Project -
Site
FOR STAFF USE ONLY
N� —
Address/ street Address A �.cq� L
Permit No.: G 3
Location 1(,)112- ` S 7 Z A' � '' Expiration Date:
Suite /Bldg, # city/State tip
P ,r(4...4 , 04_ ' 7 ZZY' Receipt #: - 2 " :435. -
Name Approved By:
Property / v h / P r 7 ' t 't'I S Date: r r i' �7 os
Owner Mailing Address Suite Map/TL #:
/ 535D 503 .Se1, o r PKet J • Zoning: C t
City /State ' ZIp Phone
PO NW Oat 9 7Ity So3- 6. Z -6
Tenant or Name 1 Electrical Permit Required? ❑ Yes M--No
Business COOIC r Q.. 4e R., Building Permit Required? ❑ Yes I -'qo
Name Rev. 7 /1/05 I:lcu •Inlmastarstrevlsedlsi.n •ermit ao.,doc
Sign 5/6, - - 4 - 724414
Contractor Mailing Address suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit
issuance, a ✓b Z63 Sk y^' IC i (Note: applications will not be accepted
copy of all City /State zip Phone ra , without the required submittal elements)
G
licenses are / ,' " 3
required If �'f �/C. 1 p 7 /S 7yy�1/�t4y
expired In the Oregon Const. Cont. Board Exp. Date ❑ Completed Application Form
City of Tigard's License #
database) w f r4 _ ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
i (3 copies, if a building permit is required)
Proposed 0 Permanent ❑ Freestanding ❑ Freeway
• Sign ❑ Temporary Wall 1:71 Electronic size requirement: 81/2" x 11 ", or 11" x 17"
(Check all that ❑ Cthe billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
ff New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: -4. , i y (I ` i,
38.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):• • _ 1., r'r
$ 18.00 Fee (Temporary sign, any type)
i ❑
Sign Data Total Wall Area (sq• ft.) LiZ <�y� I Jurisdiction: ❑ City 0 Urb
(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,
Project From Wall (inches): ,� - ' but must include dimensions of wall face and
Copy: (�;v 6-y sign placement.
�c' ` � ' 1 • Wall signs do not require site/plot plans. ■
Materials: r ∎ 6 / -rv'- rcil '
— _
- • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes j building permit.
No • If work authorized under a sign permit has not
Type: ❑ Internal tis External I 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? i 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)
11/0'9/2005 09:45 FAX 5035981960 CITY OF TIGARD [6'002
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.
DATED this A0 day of / `'� �— 20 C
Signature of Owner /Agent
/20, c03- 7ey -W7 ci
Contact Person Name Phone No.
C;11'Y OF '1'1UARD 11/ 1 V,LVVJ
13125 SW Ha11 Blvd. 12:16:20PM
ii, ,,,,*, , Tigard, Oregon 97223
- '�
,- (503) 639-4171
Receipt #: 27200500000000005791
Date: 11/10/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2005 -00346 [SIGN] Sign Permit 100 - 0000 - 437000 33.00
SGN2005 -00346 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 5.00
Line Item Total: $38.00
Payments:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
CreditCard RONALD D COLARCHIK/JDK KJP 410151 In Person 38.00
ENTERPRISES LLC
Payment Total: $38.00
cReceipt.rpt Page 1 of 1
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