SGN2004-00004 s .
CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2004 -00004
�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/9(04
PARCEL: 2S110DC-00700
BUSINESS NAME: SUMMERFIELD CLUBHOUSE ZONE: R -25
SIGN LOCATION: 11205 SW SUMMERFIELD DR JURISDICTION: TIG
APPLICANT /AGENT: HOLIDAY RETIREMENT CORP
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4' X 8'
TOTAL SIGN AREA: 32 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: IND
DESCRIPTION OF SIGN: Placement of one permanent monument sign. (4' x 8')
MATERIALS: STUCCO
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES:
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: `^taL L ��
PERMITTEE SIGNATURE: 1
DATE: 1/9/04
,
AL. i SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Nall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
, ENERAL INF_ORMATION
Name of Development/Project
Site 1 1 FOR STAFF USE ONLY
Address/ Street Address �11 Permit No.: _SG J cROOLF-c000 4
Location I WDC 5w S w.r- art // � .p �ri Gtr,
Suite /Bldg. # City/State Zip Expiration Date:
�[ G l rnYr 9i )-a�� Receipt #: (may —
Name Approved By: C • (cwY )
Property .\(2\ ,) R , iLe b4 o Date: 1 — `3 - oLi
Dwner Mailing Address Suite Ma R • 4A5 1I b DC --- b0
p L #. D 7 oo
O DX \L\ Zoning: -A5
City/State Zip Phone SD3)
5i,. \,eiv,. 9730)_ 4 4 3 7cD7 /
tenant or Name Electrical Permit Required? 53 Yes ❑ No
3usiness Building Permit Required? ❑ Yes No
Name Rev. 8/7/2003 is \curpin \masters\revised\sign permit app doc
Sign CX>'1-e.A. 11 'I n ` (
:ontractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
Prior to permit 1 _
>suance, a U yJOk 1 (- 1 1 I (Note: applications will not be accepted
opy of all City/State Zip Phone S D;) without the required submittal elements)
censes are S Or , 2 - 3 o -) 07
°quired if .J
cv
xpired in the Oregon Const. Cont. Board Exp. Date Completed Application Form
:ity of Tigard's License #
atabase) 2 Copies of Site /Plot Plan, Drawn to Scale
pro osed (3 copies, if a building permit is required)
p • P ermanent Freestanding ❑ Freeway size requirement: 81/2" x 11 ", or 11" x 17"
)tgn ❑ Temporary ❑ Wall
Check all that ❑ Electronic
apply) ❑ Other ❑ Billboard ❑ Balloon El
copies of elevations, drawn to scale
IIII New sign? (3 copies, if a building permit is required)
g ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions:
k ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): sii ch
v`/ ❑ $15.00 Fee (Temporary sign, any type)
>ign Data Total Wall Area (sq. ft.
Jurisdiction: ❑ City ❑ Urb
Complete all Direction Wall Faces (circle one):
ems in this NOTES:
ection) N S E W NE NW SE SW
Height to top of sign (feet): -E-t y i/`- • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
Copy: sign placement.
Materials: • Wall signs do not require site /plot plans.
• Freestanding signs over 6 ft. required a
Will sign have illumination? ', Yes ❑ No building permit.
Type: ❑ Internal ® External • If work authorized under a sign permit has not
kre there any existing freestanding or wall signs at this been completed within ninety (90) days after
)cation, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
® Yes CI No BECOME NULL AND VOID.
f "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 / ,9 , O`/ day of jG,,nc,t y , 20 0 1
(re i ���.,� 1
Signature of r /Agent
Contact Pers on ame Phone No.
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CITY OF TIGARD 1/9/2004
13125 SW Hall Blvd. 9:47:24AM
. ,,1 1 Tigard, Oregon 9 72 23
� (503) 63 9-4 17 1
Receipt #: 27200400000000000044
Date: 01 /09/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00004 [SIGN] Sign Permit 100- 0000 - 437000 31.00
ELC2004 -00006 [ELPRMT] ELC Permit 220 - 0000 - 431510 46.85
ELC2004 -00006 [TAX] 8% State Surcharge 100- 0000 - 207020 3.75
Line Item Total: $81.60
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
CreditCard RICK JONES cap 314833 In Person 81.60
Payment Total: $81.60
•
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