SGN2005-00278 1•
CITY TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2005 -00278
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/5/2005
PARCEL: 2S 102AB -03600
BUSINESS NAME: NOBLE FITNESS CENTER ZONE: CBD
SIGN LOCATION: 12271 SW MAIN ST JURISDICTION: TIG
APPLICANT/AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X10'
TOTAL SIGN AREA: 30 sq. ft.
WALL AREA: 425 sq. ft.
WALL FACE (DIRECTION): S
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Installation of (1) one permanent 30 sq ft wall sign
MATERIALS: ALUMINUM
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.
4i
APPROVED BY:
PERMITTEE SIGNATURE:
DATE: 10/5/201
A y ,
A 1 SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Ha11 Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
,. L 1 FOR STAFF USE ONLY
Site Oh 1e.. r. 1 4c Cc.. t c
Address/ Street Address Permit No.: 5 / 2- 00 z-7?
Location 1 ;47) S.G>. 044:r1 Sf' Expiration Date:
Suite /Bldg. # City /State Zip
7i(,t /CI C.X 9 7) 3 Receipt #: ? 5 — 5�Q 7
Name .J Approved By: /
Property ES Ad Peep cr 44/ FL +vr,s ra(,
Date: f6 /y'!
Owner Mailing dress Suite Map/TL #:
is» S.U. -S ti ^5s Zoning: CO D
City /State Zip Phone
Per L oK 97 )3y (s ),2`4S >> Electrical Permit Required? ❑ Yes E "N
Tenant or Name
Business NU .b IL r; "I'4cs3 C44c, ✓. Building Permit Required? ❑ Yes o
Name Rev. 7/1/05 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
copy of all City /State Zip Phone without the required submittal elements)
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database)
(3 copies, if a building permit is required)
Proposed ff4 Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign ❑ Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other El Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
IS New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: 3 X 10 1 ❑ $38.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft .) :
s `f , c f ❑ $18.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) 4. s— Sc �� Jurisdiction: ❑ City III Urb
(Complete all '
items in this Direction Wall Faces (circle one): NOTES:
section) N C) 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): i but must include dimensions of wall face and
sign placement.
Copy: ♦ Wall signs do not require site /plot plans.
Materials: !a I uw,:.1.,44 ♦ Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes t, No building permit. I
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 f«s.Jc w0h5s m __ .
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
r ,
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 +ti day of 0(_ , 20 C? S
w vl -ci .6 Z, Signature of Owner/Agent
M 6 / CS -03 Ste- g).6
Contact Person Name Phone No.
CITY OF TIGARD 1u/ /2uu)
13125 SW Hall Blvd. 12:42:21PM
",,,,,,,4 , �i; Tigard, Oregon 97223
li (503) 63 9-4 17 1
Receipt #: 27200500000000005007
Date: 10/05/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid ,
SGN2005 -00278 [SIGN] Sign Permit 100 - 0000 - 437000 33.00
SGN2005 -00278 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 5.00
Line Item Total: $38.00
Payments:
Method Payer User ID AcctJCheck No. Approval No. How Received Amount Paid
Cash NOBLE FITNESS CENTER KJP In Person 40.00
Change CITY OF TIGARD KJP In Person (2.00)
Payment Total: $38.00
cReceipt.rpt Page 1 of 1
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k Y OF TIGARD
App oved
Conlciitionpy Approved [ ;
For Only tthe work as described in:
PEFIMIT NO. Scz-t4c-- -
Seel Letter to: Follow
Attach
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