SGN2009-00149 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2009 -00149
COMMUNITY DEVELOPMENT Date Issued: 06/16/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102AA05500
Jurisdiction: Tigard
Name of Business:
Business Address: 12215 SW MAIN ST
Applicant/Agent: Trinity Fitness,
Work Description: Placement of (1) one 6 ft helium balloon. Balloon must be securely fastened and not to
exceed 25 ft in height nearest roof line.
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: No Electronic: No
Billboard: No Balloon: Yes
Banner: No A- Board: No
Sign Dimensions: 6 ft
Total Sign Area:
Wall Area:
Wall Face (Direction):
Sign Height: ft.
Projection From Wall: in.
Illumination:
Materials:
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.
( 1)
Approved By:
Permittee Signature: _%
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SIGN PERMIT APPLICATION
City of Tigard Permit Center 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development /Project
l I „ „� 5
Address/
FOR STAFF USE ONLY
11( 4
Site '� V1 6 ��" L00 - 00 )`f
Address/ Street Address Permit No.:
Location 1 1/1 j I M A/( �/I Expiration Date: w ` /
/1- 42 l 7 - 7 /62
Suite /Bldg. # C ity/State Zip
'Il / "V VA 0t a Receipt #: j /�
Name Q Approved By: 1 3 i"
Property 1\A O S -((OW- Date: /110 j p 9
Owner Mailing Address C� /� Suite Map /TL #: Q
( �1/ ( ✓ � V �4iVl�j. -. Zoning: CBi)
City/State Zip Phone
/ N-
A t d I e� ll� so' I Electrical Permit Required? [11 Yes [6o
Tenant or Nan
Business 1 V' V\ ; H " l ✓ `“5 Building Permit Required? ❑ Yes 0
Name Rev. 7/1/07
is \curpin \ masters \land use applications \ sign permit app.doc
Sign
Contractor Mailing Address Sulu
(Prior to permit
issuance, a
copy of all (:m 'Sei« 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 g.Temporar ❑ wail ❑ —t, Electronic (3 copies, if a building permit is required)
(Check all that ❑ Billboard 7YI Balloon t " " 11" 17"
apply) �"� size requirement: 8 /2 x 11 , or 11 x 17
New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: f 1' ` 1 ,1 rl (1 (3 copies, if a building permit is required)
T �'N ?GIGO bY� size requirement. 81/2" x 11", to 24" x 36"
Total Sign Area (sq. ft.):
❑ $40.00 Fee (Permanent sign, any size)
Total Wall Area (sq. ft.)
Sign Data $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): 1.10 c..1.--* • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): CO tobV must include dimensions of wall face and sign
Copy: placement.
Materials: Vfri • Wall signs do not require site /plot plans.
• 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 !: o
NULL AND VOID.
If "yes", a list or diagram of all si . • 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 0 c l
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Contact Pet&son N. 4 Phone No.
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Job Addje . i Da,o _b b I GlC 1
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Er l CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
nGARD
Receipt Number: 174011 - 06/16/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00149 Temp Sign Perm 100 - 0000 - 438050 $17.00
SGN2009 -00149 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 00501C KPEERMAN 06/16/2009 $19.00
Payor: Amy Steigmeyer
Total Payments: $19.00
Balance Due: $0.00
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