SGN2009-00146 I
IFL CITY OF TIGARD SIGN PERMIT
II IK . ` y , Permit #: SGN2009 -00146
- COMMUNITY DEVELOPMENT Date Issued: 06/11/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S101AB01606
Jurisdiction: Tigard
Name of Business:
Business Address: 7357 SW BEVELAND RD 100
Applicant/Agent: Clarke, Susan
Work Description: Placement of one (1) temporary sign (A- Frame) 3' X 4' Valid 6/11/09 - 7/11/09 Sign #1
Must be placed on private property, not in public right of way. Must meet visual
clearance area requirements
Permanent: Freestanding: No Freeway: No
Temporary: Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: Yes
Sign Dimensions: 3' X 4'
Total Sign Area: 12
Wall Area:
Wall Face (Direction): West
Sign Height: 3 ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: West
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: eJ' ��tit&Q.y
Permittee Signature:
, �((
1 C-i-a-4--4-°----
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SIGN PERMIT APPLICATION
City o 'Tigard Pemit Center 13125 SW Hall Blzd, Tigan:4 OR 97223
Phone. 503.639.4171 Fax: 503.598.1960 RECEI
GENERAL INFORMATION PL�NNrn UN 20 09
CITY OF TIGA
Name of Development /Project D
��n J1 �, FOR STAFF UT71`dERING
Site J1 t�U(�
Address/ Street Address 2,� r ,, / Permit No.:
S6A) 9- i - d vrYb
Location (35 3 CSI ,S1--
Suite /Bldg. # City/State �^ Zip Q Expiration Date:
t ) l . t.J1'. t 1i3 Receipt # : / 7 . $
Name `J Approved By S • 7/
Property -. 1 - • .- 1 0.Yl CAW Date: (0 (t a.O c i
Owner Mailing Address 1C
Suite y� Map / TL# : al.5 ( Ot P4 6 01(0
1 Svc 'beA r � ACtrlddt 1 00 Zoning:
City/State Zip Phone
�l r` 5 -to7o -063 Electrical Pemut Required? ❑ Yes la-No Tenant or Name
Business Building Permit Required? ❑ Yes [yNo
Name Rev. 7/1/07
is \curpin \ masters \land use applications \sign permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to pertntt ,
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 -- Er Freestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Sign ,® Temporary ❑ 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) �l
❑ New sign? ❑ Aker to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: 3 X (3 copies, if a building permit is required)
size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
Z ❑ $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 0 NE NW SE SW
Height to top of sign (feet): 3 ♦ 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 pe ♦ Wall signs do not require site /plot plans.
Materials: 0 ♦ 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.
(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.
DATED this I ( day of , 20 U `�
Signature of Owner /Agent
SUSan cJar, 'e 603 - 670 -/7&
Contact Person Name Phone No.
VX6COPA Cdt:rc t '' se
CITY OF TIGARD RECEIPT
. g 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIPA
Receipt Number: 173938 - 06/11/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00146 Temp Sign Perm 100 - 0000 - 438050 $17.00
SGN2009 -00146 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
Check 3514 STREAT 06/11/2009 $19.00
Payor: Triangle Coffee and Gifts Inc
Total Payments: $19.00
Balance Due: $0 00
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