SGN2009-00199 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2009 -00199
COMMUNITY DEVELOPMENT Date Issued: 09/14/2009
TIGrART1 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102BD01900
Jurisdiction: Tigard
Name of Business:
Business Address: 12910 SW PACIFIC HWY
Applicant/Agent: Swift, Teri
Work Description: One temporary sign (A- frame) 24" X 32" 9/15/09 to 10/15/09 Sign #1 for 2009 Must be
placed on private property, not in public right -of -way. Must meet visual clearance area
reuirements.
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: Yes
Sign Dimensions: 24 "X32"
Total Sign Area: 5.32
Wall Area:
Wall Face (Direction):
Sign Height: 3 ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: wood
Electrical Permit Required:
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.
I
Approved By: 2
Permittee Signature: 1 / e 1 iggf
SIGN PERMIT APPLICATION
� : City of Tigard Permit Center 13125 SW Hall Blvd, Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960
TI ADD
GENERAL INFORMATION
Name of Develop /Project FOR STAFF USE ONLY
1" KJ t 1 6 l Site rtd Fusv/ A
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Address/ Street Address �, p� �,, TRW Permit No.: �/ /�,/VVV WO/
Location 1 02k 4 0 L PV`C.` - y
Expiration Date: t
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Suite /Bldg. # City/State i Zip
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Name 1 Approved By: kk„,,,p
Property f110.V1 I \t [ l ki fOYN Date: r � r }.� "l /� 1 jj�' ` ' i'v q // �� n
Owner Mailing Address Suite Map /TL #: Si V7� (7 ` 6v9 V �/
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City/State � Zip Phone
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` C9a y d'- 6 1 72 Electrical Permit Required? ❑ Yes o
Tenant or N e `'
Business Nr n ■ny Rvs1f-1 Building Permit Required? ❑ Yes 1214o
Name . 7 /1/09
� VA � S is \curpin \masters \land use applications \sign permit app.doc
Sign
Contractor' Mailing Address �% 1 /� Suite
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(Prior to permit C PU .
issuance, a lJ
copy of all City/State 1 Zip Phone REQUIRED SUBMITTAL ELEMENTS
licenses are r\--'t. p� OE t 7 (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 Pi; Temporary ❑ Wall ❑ Electronic (3 copies, if a building permit is required)
(Check all that
apply) II Other ❑ Billboard p Balloon size requirement: 8 x 11 ", or 11" x 17"
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: it tt X � 1■ s (3 copies, if a building permit is required)
` A size requirement: 8 x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): k ❑ $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): 3 i ♦ 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: j 1 ? • Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes ,' No permit.
Type: ❑ Internal `I 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.
(OVER FOR SIGNATURES)
w
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 -0 day of 1 4 , 20 O9
do' '&W4
Signature of Owner /Agent
�\ c� l�� �F 624 a I
Contact Person Name Phone No.
CITY OF TIGARD RECEIPT
t g i. 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
71GARp!
Receipt Number: 175201 - 09/14/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00199 Temp Sign Perm 1003100 -43115 $17.00
SGN2009 -00199 Temp Sign Perm - LRP 1003100 -43117 $2.00
Total: $19.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Cash STREAT 09/14/2009 $19.00
Payor: Morning Rush
Total Payments: $19.00
Balance Due: $0.00
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