SGN2009-00190 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2009 -00190
COMMUNITY DEVELOPMENT
Date Issued: 08/27/2009
TiGA1 D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102BD01700
Jurisdiction: Tigard
Name of Business:
Business Address: 12860 SW PACIFIC HWY
Applicant/Agent: Mueller, Tim
Work Description: Placement of one (1) temporary sign (Banner) Valid 8/27/09 - 9/27/09 Sign #2 Must be
placed on private property, not in public right of way. Must meet visual clearance area
requirements
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: No Electronic: No
Billboard: No Balloon: No
Banner: Yes A- Board: No
Sign Dimensions: 2.5' X 8'
Total Sign Area: 20
Wall Area:
Wall Face (Direction): West
Sign Height: 3 ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: Vinyl
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: -
Permittee Signature:
FIF CITY OF TIGARD RECEIPT
; 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
T1GARLT
Receipt Number: 175015 - 08/27/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00190 Temp Sign Perm 1003100-43115 $17.00
SGN2009 -00190 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
Credit Card 478151 STREAT 08/27/2009 $19.00
Payor: Tim Mueller
Total Payments: $19.00
Balance Due: $0.00
Page 1 of 1
SIGN PERMIT APPLICATION
` � C i t y o f T i g a r d P e r m i t Center 13125 SW H a l l B l v d . , T i g a r d , 0 1 /
Phone: 503.639.4171 Fax: 503.598.1960 A UG 2 7 ��
C,,- 20 09
GENERAL INFORMATION P��N� �r r a
Name of Development /Project
--� FOR STAFF USE ONLY
Site V 1 A, 4
Address/ Street Addr Permit No.: oA -0-6C/ — CM 0 30
Location 12_ CU Expiration Date:
Suite /Bldg. # Zip
� 57 223 Receipt #:
Name ! •� ( Approved By: S . - r
Property Date: C 1 a 0
Owner Mailing Address Suite Map /TL #: o-St 02. If 0 116 ,1)
Zoning:
City/State Zip Phone
Electrical Permit Required? ❑ Yes LNo
Tenant or Name
Business Building Permit Required? ❑ Yes o
Name Rev. 7/1/09
is \curpin \ masters \land use applications \sign permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to permit
issuance, a REQUIRED SUBMITTAL ELEMENTS
copy of all City/State Zip Phone
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 emporary ❑ Wall p Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other ❑ Billboard ❑ Balloon
apply) size requirement: 81/2" x 11 ", or 11" x 17"
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: % sr (3 copies, if a building permit is required)
ri size requirement: 8 x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
c_ 0 ❑ $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 r • 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: L • Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Ye — 11"6' 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.
qfr (OVER FOR SIGNATURES)
c — .)/
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 Z 7 day of 749 , 20 O
:ignature of Owner /Agent
/,^? /74K `� r 5 5 7 2- e`135
Contact Person Name Phone No.