SGN2009-00073 111111 CITY OF TIGARD SIGN PERMIT
P ermit #: SGN2009-00073
COMMUNITY DEVELOPMENT Date Issued: 04/02/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101AB01604
Jurisdiction: Tigard
Name of Business: Tigard Optometric Clinic
Business Address: 7307 SW BEVELAND RD 100
Applicant/Agent: Freedle, Eric
Work Description: Installation of (1) one permanent 12 s.f. wall sign.
Permanent: Yes Freestanding: Freeway:
Temporary: Wall: Yes Electronic:
Billboard: Balloon:
Banner: A- Board:
Sign Dimensions: 2'x6'
Total Sign Area: 12
Wall Area: 1000
Wall Face (Direction): West
Sign Height: 8 ft.
Projection From Wall: 2 in.
Illumination: No Illumination
Materials:
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $40.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all
other applicable law. 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.
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Approved By: —
Permittee Signature: ' Lr .. - _
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SIGN PERMIT APPLICATION
City ciTi,Zl Perri Center 13125 SW liall Bild, Tiga QR 97223
Phone' 503.639.4171 Fax: 503.598.1960
ca uERAL . INFORMATION
Name of Deti•elopment /Proicr
Site %6A Qi nereri� /C GL./ /vim • FOR STAFF USJ ONLY
Address/ Street Address Permit No. :_s C7 D9 n 0 s� 7 3
Location ? . 5 e> � sr •
Suite /Bldg. N City/State — zip $xp tion DaLC
'/ D 7 /64- '9? Receipt a :_. _ Y a b y
Name Approved By:_ _____& , T /
��
Property T G
/.ebt1 Date
Owner Mailing Address Suits/ — 7
Map /77,lt : - c.J i r: � ' / (0 0 T
- :� Lti g lX4 j ,# 0v Zoning: �i N 4-
Gry/State Zip Phone
Tenant or N' G '� Electrical Permit Required? ❑Yes ❑-110
Business - 7/6,0 p o�� G4, ,. Building Permit Required? ❑ Yes [—No
Narrrc - ''....*-----'i Rev. 7 /1/07
c \eurpin \masters \land we app \sign permit app,doc
Sign
Contractor Mailing Address Suite
(Prior to permit
isswinCe. a
copynf all City/State Zip Phone — JLZEOUIR.F„D S_ UBMI TAL ELEMENT
IC —it C, are (Note: applications m p
required it ( pp tions will of be accepted
expired in the Oregon Come. Cont. Board License # Exp. Date without the required submittal elemcn )
City of Tigard'
database
❑ Completed Application Form
Proposed Pern+ancnc ❑ Freestanding ❑ Freetva ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
�
Sign Temporary ❑ Wall D Electronic
(Check all that ( 3 copies, if a building pernrait is required )
AN* ❑ Other ❑ Billboard ❑Batt ° ° ° size requirement: 81/2" x 11 ", or 11" x 17"
' ❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn. to scale
Sign Dimensions: . Z + y 1 —` (3 copies, if a building permit is required)
'rota
otal Sign A rea (sq. f t.): l 2 , size requirement: 81/2" x 11", to 24" x 36" • [] $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) lv+ ,
�3 0 $19.00 Fee (Temporary sign, any type)
(Co rnplctc all Direction Wall Faces (circle one):
items in this
section) N S E W NE NW SE SW NOTES:
_Height to top of sign + ' o Wall signs do not need to be drawn to scale, but
Projection From Wall. (inches): 7 f eJt:4.4f�3 must include dirnensions of wall face and sign
Copy � f6� , /G placement.
Materials; a Wall signs do not require site /plot plans.
e Freestanding signs over 6 ft requited a building
Will sign have illumination? ❑ Yes ISCNo permit.
Type: ❑ Internal [ External _ , e If work authorized under a sign permit has not been
Are there any existing freestanding or wall signs at this Iocation, completed within ninety (90) days after the issuance
including wall signs that overlap a tenant space? of the permit, THE PERMIT WILL BECOME
El Yes ❑ No NULL .AND VOID.
If "yes ", a list or diagram of all sign dimensions and square
foots a must also he submitted.
• (OVER FOR SIGNATURES)
I hereby acknowledge that I have mead 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 �` da yo f � /U , 2O 1
Signature of Owner.. Agent
e igL°' � / ia j .
Contact Person N Phone No.
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CITY OF TIGARD RECEIPT
g ,., 13125 SW Hall Blvd. Tigard OR 97223
503.639.4171
T I5 B. LY
Receipt Number: 173064 - 04/02/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00073 Sign Permit 100 - 0000 - 437000 $35 00
SGN2009 -00073 Sign Permit - LRP 100 - 0000 - 438050 $5.00
Total: $40.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 05515D KPEERMAN 04/02/2009 $40.00
Payor: Eric S. Freedle, OD
Total Payments: $40.00
Balance Due: $0.00
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