SGN2009-00112 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2009 -00112
COMMUNITY DEVELOPMENT Date Issued: 05/06/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102BD01700
Jurisdiction: Tigard
Name of Business: Jiffy Lube
Business Address: 12860 SW PACIFIC HWY
Applicant/Agent: Jiffy Lube,
Work Description: Placement of one (1) temporary sign (A- Frame) 3' X 2' Valid 5/6/09 - 6/6/09 Sign #1
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: okted
Permittee Signature:
j„, „
lig SIGN PERMIT APPLICATI
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City ciTig rd Permit Center 13125 SW Hal 1 Blul, Tigarch OR 9722 k*I�/ n
Phone. 503.639.4171 Fax: 503.598.1960
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GENERAL INFORMATION '� jy iliG
itili
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. Name of Development/Project y / niF�
Site rc L� b FOR STAFF USE ONLY C A1/�,'G
Address / Street Address./ Permit No.: SQ#i q - CD j Pal
Location Ill, p
5 ,...L. t`r t Expiration Date:
Suite /Bldg. # City /State Zip
t o n p 7Z '13 Receipt#: t 234 q
Name /5 Approved By. S'olr
Property SQ,r.•". Td'ti' I'4- 1 Date: 51A0 /
Owner Mailing Address Suite Map /n,#/ : ,P S/ 6 D 0171T°
S4 t -R— Zoning:
Gty /State Zip Phone
Tenant or Name Electrical Permit Required? ❑ Yes V o
Business r „4. ,.J� Building Permit Required? ❑ Yes No
Name Rev. 7 /1/07
5 is \curpin \ masters \land use applications \ sign permit app.doc
Sign
Contractor ' Mailing Address Suite
(Prior to permit
issuance, a all City/State REQUIRED SUBMITTAL ELEMENTS
copy of 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 n 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) q
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: . � (3 copies, if a building permit is required)
3 x Z Z �' size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): 2 — l ❑ $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
placement.
Co py • Wall signs do not require site /plot plans.
Materials: ( jQ • Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes No permit.
Type: ❑ Internal ❑ Ext • 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 s ace? of the permit, THE PERMIT WILL BECOME
El Yes o NULL AND VOID.
If "yes ", a list or diagram of sign dimensions and square .
footage must also be submitted.
(OVER FOR SIGNATURES)
6- 4/64 - 194
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 day of , 20
•
Signa e of Owner /Agent
m �/7 5 5 a- ®
Contact Person Name Phone No.
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 173443 - 05/06/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00112 Temp Sign Perm 100 - 0000 - 438050 $17.00
SGN2009 -00112 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
Credit Card 956608 STREAT 05/06/2009 $19.00
Payor: Tim
Total Payments: $19.00
Balance Due: $0.00
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