SGN2005-00285 •
CITY TIGARD SIGN PERMIT
��� DEVELOPMENT SERVICES PERMIT #: SGN2005 -00285
Y I DATE ISSUED: 10/10/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102CB 03101
BUSINESS NAME: SUDDENLY SLIMMER ZONE: C -G
SIGN LOCATION: 12950 SW PACIFIC HWY 115 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2'X3'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placment of (1) one 12 sq ft A -frame sign. Sign must be placed on private
property and not in the pubic right -of -way. Valid 10/10/05- 11/10/05. Sign #1
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED:
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 18.00
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 si n shall expire 30 days from validity date. A balloon sign shall expire 10 days
from validity date.
APPROVED BY: ,
) / <C
■■••••
PERMITTEE SIGNATURE: X
DATE: 10/10/2005
1
.. ili' 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
Address/ Street Address e.N Peft—t Permit No.: 5 /t n 06Z-
Location 1 4 -'j C Expiration Date: i (ia c; ' / //° (-S"
Sui /Bldg # ,... 91y/State Zip
IS- (E g'3--z-z3 Receipt #: 2.0 5 76 r� �
Name Approved By: l "
Property il_a_l Yom ,'r1Z
as ,N) Date: l' /c
Owner Mailing Address Suite Map/TL #: C 6
1 275D5co i Zoning:
City /State Zip Phone S-1)3
q
1 (TN--• l Z 3 439- - 3 Electrical Permit Required? ❑ Yes [ —No
Tenant Nam�`
Business s NA:DOC,.A.)Ly S2 ,c(�t.( El LT
Building Permit Required? Yes FNo
Na 9e.1 Rev. 7/1/05 is \curpin \masters \revised \sign permit app.doc , __
Sign s (4,, se.OP(�
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit 131 g� 51.t, L ga.3 (Note: applications will not be accepted
issuance, a
copy of all City /State Zip Phone.. without the required submittal elements)
licenses are
required if { (2 Z -3 3`1- 37s/ ❑ 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 Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17" . 2 Sign Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other El Billboard ❑ Balloon El copies of elevations, drawn to scale
apply) I (3 copies, if a building permit is required)
F New sign? ❑ Alter to existing sign? size requirement: 8 x 11 ", to 24" x 36"
ign Dimensions:
2 , ❑ $38.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
❑ $18.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: 111 City El Urb
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E W N E N W S E S W •
Height to top of sign (feet): 3 • 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 j 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 sins at this the issuance of the permit, THE PERMIT WILL
location, including wall signs that overlap a tenant space? BECOME NULL AND VOID.
❑ Yes Fi 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 /6 -22-
day of (167/? /._x_ , 20 • S----
OPP
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Signaf` rf of Owner /Agen / SO 3 ficf --/ (( /7
Contact Person Name Phone No.
1 t 0 ce c _ / _S
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CITY OF TIGARD 10/10/2005
13125 SW Hall Blvd. 1:04:OOPM
� �" "`",,,J.��I�''�` Tigard, Oregon 97223
(503) 639 -4171
Receipt #: 27200500000000005102
Date: 10/10/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2005 -00285 [SIGN] Temp Sign Perm 100- 0000 - 437000 16.00
SGN2005 -00285 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 2.00
Line Item Total: $18.00
Payments:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
CreditCard LISA M SAVAGE LEFRANCO IS KJP 190738 In Person 18.00
Payment Total: $18.00
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