SGN2009-00191 . '
Er CITY OF TIGARD SIGN PERMIT
Permit #: SGN2009 -00191
COMMUNITY DEVELOPMENT Da Issued: 08/27/2009
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S110AA00900
Jurisdiction: Tigard
Name of Business:
Business Address: 14050 SW PACIFIC HWY
Applicant/Agent: ANdrews Agency,
Work Description: Placement of one permanent wall sign 27inches by 185 inches 25 ft to top of sign
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 27" X 185'
Total Sign Area: 34.69
Wall Area: 2184
Wall Face (Direction):
Sign Height: 25 ft.
Projection From Wall: 12 in.
Illumination: Internal
Materials: Glass
Electrical Permit Required: Yes
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.
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Approved By: M
Permittee Signature: 2 -° CR , a °' 4 °'d -<-i%L "1/
O
irl SIGN PERMIT APPLICATION
City Tigard Permit Center 13125 SW Hall Bh.d, Tigan:; 0 '22.3 -r
Phone. 503.639.4171 Fax: 503.598.1960 1 1 c u2 E I V E
AUG 2 7 2009
GENERAL INFORMATION CITY OF TIGARD
Name of Development/Project
FOR STAFF USE ONLY
Site +
Address/ Street Address PernritNo.: S(� / , ..0 1 '
Location 0(0547 Sz.T pActric o
Suite /Bldg. # City /State Zip Expiration Date:
/0 0 T G A-40 are g 72-11 Receipt # :
Name J e, S lt K 8. ,(C A-Al Approved By
Property -.4-4 E LL 1 /V C $ 0 r✓ Date: I
Owner Mailing Address Suite Map /TL1{ : �s 11 ii 0000
Is .z Si-'- 5 s e r 14v 1 Zoning: C-
Ci /State Zip Phone 5-03 -
X ‘17.2-31 S H-79- Electrical Permit Required? ,n. Yes ❑ No
Tenant or Name
Business A gDa € 's /7 & 'Vw Building Permit Required? ❑ Yes No
Name Rev.7 /1/07
is \ cumin \ masters \land use applications \sign permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to permit
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
Otyof Tigard's
database) ❑ Completed Application Form
Proposed S. Permanent ❑ 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"
appl �l
0 New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: (( ff (3 copies, if a building permit is required)
X S size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): .... q
❑ $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft / g7 ❑ $19.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S G W NE NW SE SW
Height to top of sign (feet): ,23 • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): l.Z must include dimensions of wall face and sign
placement.
Co • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a building
Will sign have illumination? ®' Yes ❑ No permit.
Type: ®' Interval ❑ 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
11 Yes CI 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 az7 day of , 202 CO 9
Signature of Owner /Agent
8 a z iv.� s ✓-� ��' so 3 -- /
Contact Person Name Phone No.
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PERMIT NO.
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CITY OF TIGARD
Approved
Conditionally Approved ... - •••• -.--- - [
For only the work as described in:
PERMIT NO.96 ZAW-
See Letter to: Follow [ 1
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Job Addr Sv
http : / /www.ussigns.com /Nationwide /images /c14.png 8/21/2009.
•
i CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
•TIGARD
Receipt Number: 175018 - 08/27/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00191 Sign Permit 1003100 -43115 $35.00
SGN2009 -00191 Sign Permit - LRP 1003100 -43117 $5.00
Total: $40.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 1511 STREAT 08/27/2009 $40.00
Payor: Andrews Agency, LLC
Total Payments: $40.00
Balance Due: $0.00
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