SGN2009-00064 -, rl SIGN PERMIT
� , '!y� CITY OF TIGARD
1 - Permit #: SGN2009 -00064
. � COMMUNITY DEVELOPMENT Date Issued: 03/17/2009
TI G A RDi
�� 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S115BA02500
Jurisdiction: Tigard
Name of Business:
Business Address: 16200 SW PACIFIC HWY U
Applicant/Agent: 123 - Fit,
Work Description: Placement of one (1) temporary sign (A- Frame) 3' X 2' Valid 3/23/09 - 4/23/09 Must be
placed on private property, not in public right of way. Must meet visual clearance area 4/' m'
requirements
Permanent: Freestanding: Freeway:
Temporary: 1 Wall: Electronic:
Billboard: Balloon:
Banner: A- Board: Yes
Sign Dimensions: 3' X 2'
Total Sign Area: 6
Wall Area:
Wall Face (Direction):
Sign Height: 3 ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: Plastic
Electrical Permit Required: No
Building Permit Required: No
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.
Approved By: diLex-ii
Permittee Signature: 0/11/VAbYAIN'L9 G -mot .Lh'N.AVI��
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SIGN PERMIT APPLICATION
,
City of Tigard Permit Center 13125 SW Hall Blud, Ti:, Et7223
Phone 503.639.4171 Fax: 503.598.19, VED
MA 1 7
GENERAL INFORMATION CI OF TIGARD 2009
• PLANNIA143 /F�`�INEERING
Name of Development/Project FOR STAFF USE ONLY
Site -- r) la al - Tm r A li 1 � � ,ors,
Address / Street Etldress Permit No.: SC V ?Di q — ov - V �
O
Location 1 (DZC ?ocQ v
Suite /Bldg. # Gty/State Zip f Expiration Date:
(A ( lip f " 6 (V —72-14 Receipt #: Dl-o-a4010
Name 1 Approved By. S, T72EAr(
Property fbh TIr t1/ sSIVIVr 'n Date: 3l ( ? jD4
Owner Mailing Add{e Suite lap /TL# : 9-5 1t S ILA 61-cab
Ss tc' Ave . 56D Zoning:
Gry /St e �, Phone
�v� +turd C CI-7261 � W 73 •o� ( Electrical Permit Required? ❑ Yes 3
Tenant or Na
Business I Z 3 — F Cnrdlne urnner Building Permit Required? ❑ Yes ErNo
Rev. 7/1/07
is \ cumin \masters \land use applications \sign permit app.doc
Sign •
Contractor Mailing Address Suite
(Prior to permit '
issuance, a
copy of all Gry/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
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 a Temporary ❑ Wall ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other ❑ Billboard ❑ Balloon size requirement: 8 /z" x 11 ", or 11" x 17"
apply) �l
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: a' x 2-1 (3 copies, if a building permit is required)
size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): //�
CS/ ❑ $40.00 Fee (Permanent sign, any size)
Total Wall Area (sq. ft.) `�
Sign Data Y"` $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): 3.1 • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): must include dimensions of wall face and sign
placement.
Copy • Wall signs do not require site /plot plans.
Materials: 'LAI-1e_, • Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes n No permit.
Type: ❑ Internal ❑ 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.
1 42_3 , � (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.
h
DATED this day of , 20 Q 9
.. 4k . JIL L If
Signature of Owner /Agent
C k t 1 341 OP A_ utl- (Q c 53.stia isx)
Contact Person Name Phone No.
_ _ _
-- - - p It Y h-Q In 14 -
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CITY OF TIGARD RECEIPT
it 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
T. I G A R L7'
Receipt Number: 2009 -00610 - 03/17/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00064 Temp Sign Perm 100 - 0000 - 438050 $17.00
SGN2009 -00064 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
Check STREAT 03/17/2009 $19.00
Payor: Christine Sumner LLC
Total Payments: $19.00
Balance Due: $0.00