SGN2009-00056 , CITY OF TIGARD SIGN PERMIT
It Permit #:.SGN2009 -00056
-..,- ;` COMMUNITY DEVELOPMENT
� ;#� UN Date Issued: 03/06/2009
T &Y� 13125 SW Hall Blvd., T and OR 97223 503.639.4171 Parcel: 2S102BD02600
Jurisdiction: Tigard
Name of Business:
Business Address: 12957 SW PACIFIC HWY
Applicant /Agent: Kim. Penny
Work Description: Placement of one (1) temporary sign (Banner) 8' X 3' Valid 3/6/09 - 4/6/09 Sign #2
Must be placed on private property. not in public right of way. Must meet visual
clearance area requirements
Permanent: Freestanding: Freeway:
Temporary: 1 Wall: Electronic:
Billboard: Balloon:
Banner: Yes A- Board:
Sign Dimensions: 8' X 3'
Total Sign Area: 24
Wall Area:
Wall Face (Direction): East
Sign Height: ft.
Projection From Wall: in
Illumination: No Illumination
Materials: Vinyl
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: S19.00
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: 4 t/L&1 7 '
t
Permittee Signature: E-e ,0i)
3
t om.
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SIGN PERMIT APPLICATION
Cuy of Tigard Permit Center 13125 SW Hall Blzd, Tigarc4 OR 97223
Phone. 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY
Site
Address/ Street Address Permit No.: 5- ° °°61— 5v-i)51°
Location / 2_21-4 ‘iv-- PQ e f r HI Expiration Date:
Suite /Bldg. k ty /State / Zip
7 9 � of ! p
1 2z3 Receipt #I :
Name '' // Approved By. 5 TILE"
Property ,f //V QS/ K,/ /t4 Date:
Owner M ress Suite Map /TL# :
3 q ov , W Sfbier4 / o Pk- Zoning:
City/State , / Zip Phone . .--p 3
�c1Ve/L rl. ? 0 s� G p � — J / El ectrical Permit Required? ❑ Yes ❑ No
Tenant or Name `
Business Building Permit Required? ❑ Yes ❑ No
Name Rev. 7/1/07
is \cutpin \ masters \land use applications \sign permit app.doc
Sign
Contractor - Mailing Address Suite
(Prior to perm[
issuance, a
copy of all City/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 11 Temporary ❑ all ❑ 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 ) q
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions , 3 (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)
Sign Data Total Wall Area (sq. ft.) a q ❑ $19.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S 6 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
placement.
Co py • Wall.signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes ❑ 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.
44, (OVER FOR SIGNATURES)
s.
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 Fh day of M c4. , 20 0 7
Signal of Owner Agent
ey yF / 2_0
Contact Person Nam
Phone No.
CITY OF TIGARD RECEIPT
M,
13125 SW Hall Blvd.. Tigard OR 97223
41 .. _241 503.639.4171
Receipt Number: 2009 -00544 - 03/06/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00056 Temp Sign Perm 100 - 0000 - 438050 S17.00
SGN2009 -00056 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 1629 STREAT 03/06/2009 S19.00
Payor: Penny Kim
Total Payments: S19.00
Balance Due: S0.00