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SGN2007-00010 is r • R P CITY OF TIGARD SIGN PERMIT DEVELOPMENT SERVICES PERMIT #: SGN2007 -00010 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/19/2007 PARCEL: 1 S 136DD -03400 BUSINESS NAME: OREGON MEDICAL ASSOCIATION ZONE: MUE SIGN LOCATION: 11740 SW 68TH PKWY JURISDICTION: TIG APPLICANT /AGENT: OREGON MEDICAL ASSOCIATION BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: Y FREEWAY: TEMPORARY: WALL: ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 3' X 8' TOTAL SIGN AREA: 24 sq. ft. WALL AREA: sq. ft. WALL FACE (DIRECTION): SIGN HEIGHT: 4 ft. PROJECTION FROM WALL: in. ILLUMINATION: INT DESCRIPTION OF SIGN: Installation of one (1) permanent freestanding sign. 3' X 8' MATERIALS: ALUM /ACRYLIC EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: Y BUILDING PERMIT REQUIRED: N ADMINISTRATIVE EXCEPTIONS: TOTAL PERMIT FEES: $ 39.00 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. 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: tjA-L PERMITTEE SIGNATURE: 6u--.0 DATE: 1/19/2007 otc , 0 ,009sr)- , . ,. `°-`, ° SIGN PERMIT APPLICATION :. • . , CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) _ 68,4.7297 GENERAL INFORMATION - " /A Name of Development/Project Site ig Sj g* t C,lf FOR STAFF USE ONLY �:; Address/ Street Address 1 Permit No.: � .)"� 7'" DOQ/O _ ) '�" Location coec A�5 j Expiration Date: Suite/Bldg). # City/State Zip E .... _ , 1) 0q— `1 7-7,6 Receipt #: � co 0 0 1,- Na ' me Approved By: 5 • 04r Property ked 11 car ./ t Y'aC 1 ur LL G Date: l I ► Q 10 7 Owner tP Mailing Address /,, Suite Map/TL #: '/ 513 J 0 -03 1 kJ hut.) L 1 Zoning: ItA L(6 City/Stat Zip (� Phone ..,.....< lad 111 ` 17- Electrical Permit Required? [iYes ❑ No Tenant or Business0(Ze - MQ[k,&, pas o_9 Building Permit Required? ❑ Yes ❑ No Name Rev. 8/7/2003 is \curpin \masters \revised\siqn permit app.doc • Sign - �5 � , C1•(y5 . Contractor Mailing Address 1 Suite REQUIRED SUBMITTAL ELEMENTS (Prior to permit 7��� + 16 ` , (� (Note: applications will not be accepted issuance, a i�i�- �J`CY�I��( copy of all City/State i Phone without the required submittal elements) licenses are required �/ 6 (1(D � ICJ required if Q. � ❑ Completed Application Form expired in the Oregon Const. Cont. Board Exp. Date City of Tigard's License # 2 Copies of Site /Plot Plan, Drawn to Scale database) ��T�I YI ❑ p " / (3 copies, if a building permit is required) Proposed Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17" Sign Temporary ❑ Wall ❑ Electronic (Check all that ❑ Other ❑ Billb ❑ Balloon ❑ 2 copies of elevations, drawn to scale apply) (3 copies, if a building permit is required) ' ] New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36" Sign Dimensions: ` it U X O ❑ . - OO Fee (Permanent sign, any size) Total Sign Area (sq. ft.): , 24 ❑ $15.00 Fee (Temporary sign, any type) Sign Data Total Wall Area (sq. ft Jurisdiction: ❑ City ❑ Urb (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): 4 ` • Wall signs do not need to be drawn to scale, Projection From Wall (inches): but must include dimensions of wall face and • sign placement. Copy: 0'0 e9f1Q1 MectiCoLk Ii c, • Wall signs do not require site /plot plans. Materials: p r 0 orA kkge31 ic__ • Freestanding signs over 6 ft. required a Will sign have illumination? gj Yes ❑ No building permit. Type: yl Internal ❑ External • If work authorized under a sign permit has not Are there any existing freestanding or wall signs at this been completed within ninety (90) days after location, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL • Yes ❑ No BECOME NULL AND VOID. If "yes ", a list or diagram of all sign dimensions and • square footage must also be submitted. , VL U/' -\\(\Q. ©llia On d`CaGLY 1' (OVER FOR SIGNATURES) • •1 1 hereby acknowledge that 1 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 1C.-- day of c ,�1 , 20 07 Signature o Owner /Agent 646 7iIq Contact Person Name Phone No. 4 ' (2YOU V(/(47a17 0/Of Or i -(/(/f & 77C1 /,er .7Z( fsey- 4-ceCt. i H 1 i r 1 0 s. ; c % - - - i _____--- 1 4T _s,.._ [ — - , FIFE. Z i G v l _' 11 vfCrc' CPMGer--- M CITY OF TIGARD 1/19/2007 13125 SW Hall Blvd. 8:38:25AM Tigard, OR 97223 503.639.4171 T.IGARD Receipt #: 27200700000000000228 Date: 01/19/2007 Line Items: Case No Tran Code Description Revenue Account No Amount Paid ELC2007 -00040 [ELPRMT] ELC Permit 220- 0000 - 431510 106.80 ELC2007 -00040 [TAX] 8% State Surcharge 100- 0000 - 207020 8.54 SGN2007 -00010 [SIGN] Sign Permit 100- 0000 - 437000 34.00 SGN2007 -00010 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00 SGN2007 -0001 1 [SIGN] Sign Permit 100- 0000 - 437000 34.00 SGN2007 -0001 1 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00 Line Item Total: $193.34 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid CreditCard MELISSA HAYDEN ST 655830 In Person 193.34 Payment Total: $193.34 A cReceipt.rpt Page 1 of 1