SGN2009-00060 CITY OF TIGARD SIGN PERMIT
-- ( D. Permit #: SGN2009 -00060
COMMUNITY DEVELOPMENT Date Issued: 03/11/2009
ArkAlis .4 RRARI 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S126CA00100
Jurisdiction: Tigard
Name of Business:
Business Address: 9225 SW HALL BLVD
Applicant/Agent: LaRog Jewelers,
Work Description: Placement of one (1) temporary sign (A- Frame) Valid 4/12/09 - 5/12/09 Sign #2 Must
be placed on private property not in public right of way. Must meet visual clearance area
requirements.
Permanent: No 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: Wood
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: V J41
Permittee Signature: 0- X/ air) �G2 ;c,
4
SIGN PERMIT APPLICATION
1. s. , x � Ili i
" CO of Tigard Permit Center 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development /Protect NP
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FOR STAFF USE ONLY
Site 't r t �v /�
Address / St Addre s Permit No.: 1 o t1 �d
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Location S "'. #a
Expiration Date:
Suite /Bldg. # ,, y /State Zip , �� OAS' )
w> 7 Receipt #:
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Name � Approved By: S ' T
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Property ..4 1 4.<.-li S ti f f ' , r � Date: //aa OT-.) Owner ^^�� Mailing ad Addresss�� f Suite Map /TL #: / 5 /=• 1 4 " c 1 ((
a / tell " 5.1 G 7, / , I ' Zoning:.
644 on City/State ip ph one (.y 0 1 O
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f Electrical Permit Required? 111 Yes ❑ No
Tenant or Name a' /. j p;
Business f .,,. , ° °"' Building Permit Required? ❑ Yes ❑ No
Name - Rev.7 /1/07
- 1. \curpin \ masters \land use applicatons \sign permit app doc
Sign �!' ,t --p,..;-...,:,„„..i,
Contractor Mailing Ad ress Suite
(Prior to permit
issuance, REQUIRED SUBMITTAL ELEMENTS
copy 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 'emporary ❑ 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"
apply)
i , sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: (3 copies, if a building permit is required)
size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
❑ $40.00 Fee (Permanent sign, any size)
Total Wall Area (sq. ft.) �,.
Sign Data 1 Fee (Temporary sign, any type) •
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E W NE NV/ SE SW
Height to top of sign (feet): to 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: o Wall signs do not require site /plot plans.
Materials: ! ,;' ': ;- ' o Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes ❑ No permit.
Type: ❑ Internal ❑ External o 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
NULL AND VOID.
1=1 Yes =1 No
If "yes ", a list or diagram of all sign dimensions and square
footage must also be submitted.
(OVER FOR SIGNATURES)
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4r
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 Ar day of , 20
AgalAidi
Signa • Owner /A: nt r*
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# Atatile
Contact erson Name Phone No.
•
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
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1 �+ 44,11 503.639.4171
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Receipt Number: 2009 -00577 - 03/11/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00060 Temp Sign Perm 100 - 0000 - 438050 S17.00
SGN2009 -00060 Temp Sign Perm - LRP 100- 0000 - 438050 S2.00
Total: $19.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 23199 STREAT 03/11/2009 S19.00
Payor: LaRog Jewelers
Total Payments: S19.00
Balance Due: 50.00