SGN2009-00067 CITY OF TIGARD SIGN PERMIT
a Permit #: SGN2009 -00067
ti COMMUNITY DEVELOPMENT Date Issued: 03/25/2009
T [ G11AL?: 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171
9 Parcel: 2S 103DD00800
Jurisdiction: Tigard
Name of Business: H & R Block
Business Address: 13815 SW PACIFIC HWY 90
Applicant/Agent: Eisenbach, Ike
Work Description: Temporary A -frame sign. Sign #1.
Permanent: No Freestanding: Freeway:
Temporary: 1 Wall: Electronic:
Billboard: Balloon:
Banner: A- Board: Yes
Sign Dimensions: 2.5' x 3.5'
Total Sign Area: 17.5
Wall Area:
Wall Face (Direction):
Sign Height: 3.5 ft.
Projection From Wall: in.
Illumination:
Materials: corrugated foam
Electrical Permit Required:
Building Permit Required:
Total Permit Fee: $19.00
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.
6 •
Approved By:
Permittee Signature: C ( \ \ Gti \ . 9 � -�-'
c;
SIGN PERMIT APPLICATION
City cf Tiga7d Penrit Center 13125 SW Hall Blzd, Tiizrrt OR 97223
Phone 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY
Site e , • or . 8, --
Address/ Street Address q 4 Permit No.: 361 000c. 7
Location 13 c6 1 G j lid" r ;;t,.tf l WIAJ Expiration Date: 1 + - d 5 - 0 °)
Suite /Bldg. # City /State Zip
D _ 1 I r v k { 0 . c \ 223 Receipt # : e' ) 7 1 7 O
Name Approved By. C. 'Cam` �
.
tJ Sr ve . s Co.
Property d- ) Date: 3 -d S— U 5
X Owner Mailing Address Suite Map /TL# : 23/ 03 1) -6() 5 0
4 '7 .0 S 0. MucadoM 44l61 Zoning: C - G
City /State Zip Phone
Po404 q `] a31 - Electrical Permit Required? ❑ Yes No
y Tenant or Name
A Business M 4- CZ Building Permit Required? ❑ Yes Of No
N a1e Rev. 7/1/07
is \curpin \ masters \land use applications \sign permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to permit
issuance, a REQUIRED SUBMITTAL ELEMENTS
copy y of all City/State Zip Phone
licenses are (Note: applications will not be accepted
required if without the required submittal elements)
expired in the Oregon Const. Cont. Board License # Exp. Date
City of Tigard's
database) ❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Sign 8:1 Temporary ❑ Wall ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other ❑ Billboard ❑ Balloon size requirement: 8 x 11 ", or 11" x 17"
appl) � q
❑ New sign? ❑ Aker to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: G (3 copies, if a building permit is required)
"�� °� ' �, X 3• size requirement: 81/2" x 11 ", to 24" x 36"
- Total Sign Area (sq. ft.):
14 P -- ❑ $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft ❑ $19.00 Fee (Temporary sign, any type)
(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, but
Projection From Wall (inches): must include dimensions of wall face and sign
( Py “4 a ax 5 a placement.
Materials: • Wall signs do not require site /plot plans.
` r t° -C, �Or)a'I i 04 • Freestanding signs over 6 ft. required a building wu
Will sign have ilIu min a u nti 4 permit.
Type: ❑ Intemal ❑ External • If work authorized under a sign permit has not been
Are there any existing freestanding or wall signs at this location, completed within ninety (90) days after the issuance
including wall signs that overlap a tenant space? of the permit, THE PERMIT WILL BECOME
❑ Yes ❑ No NULL AND VOID.
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.
DA" 1'ED this �S� day of ' I N fIV\ , 20r
"P _C}2-ectiLL
Signature ofDpa-ier /Agent
Contact Person Name Phone No.
I
7 BLoa
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http: / /tiggisiw /mox52 /enter.cfm ?act mox52_v pr 3/25/2009
fr t or-q CITY OF TIGARD RECEIPT
$ 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
w aste
Receipt Number: 172970 - 03/25/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00067 Temp Sign Perm 100- 0000 - 438050 $17.00
SGN2009 -00067 Temp Sign Perm - LRP 100 - 0000 - 438050 $2.00
Total: $19.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Cash LSELLERS 03/25/2009 $19.00
Payor: Ellen Sedell
Total Payments: $19.00
Balance Due: $0.00