SGN2009-00210 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2009 -00210
COMMUNITY DEVELOPMENT Date Issued: 10/12/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1 S126CA00100
Jurisdiction: Tigard
Name of Business:
Business Address: 9225 SW HALL BLVD
Applicant/Agent: LaRog Jewelers,
Work Description: Placement of one (1) permanent wall sign 12' X 6'
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 12' X 6'
Total Sign Area: 72
Wall Area: 895
Wall Face (Direction): North
Sign Height: ft.
Projection From Wall: 1.25 in.
Illumination:
Materials: Alum Frame/Vinyl
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $40.00
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.
5
Approved By:
Permittee Signature:
U
k t t b r a
s, SIGN PERMIT APPLICATION
„ " • H .. Ci oJ2 ;ard Permit Center 13125 S1 %'Hall Blvd., Tigard, OR 97223
Y � f 3
, Phone: 503.639.4171 Fax 503.598.1960
W
ar g1
QEJ LERAL INFORMATION
Name of Development /hro ect
FOR STAFF USE ONLY
Site f �
Address/ Sew Addcss Permit No. 1 1() lip ! - 9-I °
Location ? 0,9 Sc-L3 (-f,A, ! (
Suite /I3idg. i# Cis /State J �r Zip
Expiration Date:
—
t' , yl„e1 /OVg 7 7d-.121-3 Receipt #:
/ moo,s,-0.....,--
Namc , } Approved Tay: S. — t Ge- 1
Property eG` t^ r �e Date: IN ia-�oR
Owner Mailing i \cldres,; Suite /t � i�fap /!'L#'r: i S I aW CTT � I ✓ c/
= ( ^ / 1 . -1 5(A) /�� ` s� � lJ Zoning:
City /State 'lip Phone
, e4'll . "'V%1 /CA f 4,c)S 50 3 - d-ot - 'T 'Yt:
Electrical Permit Required? ❑ Yes Q
Tenant or Name / f
G. --c.z. p j , 7-, L,,e_l . r5' Building Permit Required? ❑ Yes [N o
Business o T � _ o i
Name RL•r. 7/1/(11)
J (ten) 1 it \cunpin \nuster;\kmd use applications \s 0 ri
Pent app.doc
Sign i ` { 14: 3
permit Mailing Address t/ C Suite
t 3 Ni-:: ! ...... .. .
(Prior Ipermit .-J-_ __..... __....— _. ..."�......., _...
■ssu;u:ee, a N �:•a .I.SC'! r
copy of .11 Cicy /State zip Phone REQUIRED SUMMITTAL FLEi4IFNTS
licenses ate (Note: applications will not be accepted
required if
�, � �� /viz. ?761/),_ ����5.� -- r r � � c� Pl' p
without the required submittal elements)
expired in the Oregon Const. Cont. Bo;trd License tt I -sp. Date
City of Tibnn!'s
database : ( O 77 Completed Application Form
Proposed Q Permanent ❑ Freestanding ; t recteay ❑ 2 Copies of Site/Plot Plan, Drawn to Scale
Sign ❑ ?J
'1cmpor:u El Wall Electronic (3 copies, if a building permit is required) t
((:heck all that Ei (')ther ❑ 13illboatd El 3altuon t /'%
app) size requirement: 8. z x 11 ", or 11" x 17"
A New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale .
Sign Dimensions: id, ./.. ), , 6 s (3 copies, if a building permit is required)
size requirement: 8 x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): ��
7 2 ❑ $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. fr t
8 �� j S , ' -{— ❑ $1 J 00 Fee I'ernporary sign, any type)
(Complete all Direction Wall Faces (circle one): T � 7
i cnn in th,s a ,v 0 :
section) N S E W NE NW SE SW
Height to top of sign (feet): e Wall signs do not need to be drawn to scale, but
Projection From \X'all (inches): / , a j must include dimensions of wall face and sign
placement.
Lops'; ( "/ f `15 e Wall signs do not require site /plot plans.
INfarerials: /ti/....,1 ri +t • te- A-1:',71 k 4 c e Freestanding signs over 6 ft. required a building '
Will sign have illumination? ❑ Yes X No permit.
Tvpe: ❑ Internal {Ti External e If work authorized under a sign hermit has not been i
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 spaces of the permit, THE PERMIT WILL BECOME
y�{ NULL. AND VOID.
.mot Yes ❑ No
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.
=L•_
DATED thus / day of � 20 C>
j J
Signature of Owner /Agent
( 5C -- - //7 4 J
Contact Person Name Phone No.
/
/
GREENDURG CORNERS la
Tigard, Oregon
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' ''' -._ CITY OF TIGARD RECEIPT
. 13125 SW Hall Blvd., Tigard OR 97223
4 . 503.639.4171
. R D .
Receipt Number: 175595 - 10/12/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00210 Sign Permit 1003100 -43115 $35.00
SGN2009 - 00210 Sign Permit - LRP 1003100 $5.00
Total: $40.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 712154 STREAT 10/12/2009 $40.00
Payor: David Noel PDQ Signs
Total Payments: $40.00
Balance Due: $0.00
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