SGN2009-00177 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2009 -00177
COMMUNITY DEVELOPMENT Date Issued: 08/13/2009
.II KD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S103DD00600
Jurisdiction: Tigard
Name of Business:
Business Address: 13770 SW PACIFIC HWY
Applicant/Agent: Schnetky, Mark
Work Description: Placement of (1) one 18 s.f temporary banner. Valid 8/13/09 - 9/13/09. Sign #1 Sign
must be placed on provate property and not in the public right -of -way or visual clearance
area
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: Yes A- Board: No
Sign Dimensions: 3'x6'
Total Sign Area: 18
Wall Area:
Wall Face (Direction): Northwest
Sign Height: 18 ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: Pllastic
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.
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Approved By:���
Permittee Signature: ,✓ U,.•% J • '
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SIGN PERMIT APPLICATION
City c Tigard Permit Center 13125 SW Hall Blzd, Tigarcl OR 97223
Phone. 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY
Site rkr--• l"RIA, L j 2 - 03 / �o D 1
Address/ Street Address Permit No.:
Location /0''7 1 7O5,,tc2.4c. / 4 /3_.�
Expiration Date: r"
Suite/Bldg. # Ci /State Zip a�/h}��/
i AzM o r - l goo Receipt # :
Name Approved By: K-- e
Property . $RD < "4-V— Date: $ '" /;°9
Owner Mailing Address Suite Map /TL# : __ `i 1 1 - 01 i V
Zoning: C. 4
City /State Zip Phone
Tenant or Name
Electrical Permit Required? El Yes No
Business 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,
oppyof all a REQUIRED SUBMITTAL ELEMENTS
copy of 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
Qty of Tigard's
database) ❑ Completed Application Form
Proposed ❑ 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 L h
Oter Billboard Balloon 1 " 11", 11"
appl)) ❑ ❑ size requirement: 8 /z x 11 , or 11 x 17 "
,g New sign? ❑ Aker to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: 3�C 4 (3 copies, if a building permit is required)
size requirement: 8 x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
8 ❑ $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) ! f:3. ❑ $19.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E OW NE NW SE SW
Height to top of sign (feet): / EA I • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): Alil4-' must include dimensions of wall face and sign
t 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: ❑ Intemal El Externs • 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.
DAZED this day of , 20
.(2. ,!« _ -#J - 0 ../
Signature of • , er /Agent
/A/1 (.... v L S c_,4-ki e I k 56 3 — Y07 — 7 C t 7
Contact Person Name 7 Phone No.
1
Site Plan
Driveway Gravel and Grass Parking
I - I
‘ 8411" Tigard Grange
13770 SW Pacific Highway
3x6' Banner Ah
MY OF TIGARD
t< Approved I c ■dii..421.-1-.7. (2w, j
Driveway Gravel and Grass Parking CoriPftierially ApprOVed ....... ............... fr‘ j
Po odIV the work as described in:
PERMIT NO.
See Letter to: Follow [
Attach -1 1
Job A _02 - o r
PC/I Z
Sign Elevation
Tigard Grange North Side
L
1
44-_ _ -- 100' __ _ -- -------0. _
7 7---\._ I 23 j
15'
1
r 1 ,I. i
_________
1 1
1 Square Dance Lessons
Call: 503- 231 -9030
I
I: .
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
?1GARD
Receipt Number: 174823 - 08/13/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00177 Temp Sign Perm 1003100 -43117 $17.00
SGN2009 -00177 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 720675 KPEERMAN 08/13/2009 $19.00
Payor: Mark Schnetky
Total Payments: $19.00
Balance Due: $0.00
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