SGN2004-00078 CITY TIGARD SIGN PERMIT
I& DEVELOPMENT SERVICES PERMIT #: SGN2004 -00078
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/23/2004
PARCEL: 2S 110AB -00200
BUSINESS NAME: DENTAL DYNAMICS (FOR SUZANNE GALLAGHER) ZONE: C -G
SIGN LOCATION: 14465 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 32 "X48"
TOTAL SIGN AREA: 10 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 6 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one temporary 12 sq ft sign. Sign must be placed on private
property and not in the public right -of -way or visual clearance area. Valid 4/23/04
thru 5/23/04. Political for Suzanne Gallagher. Sign #1
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
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 day�.f�pm validity dat .
APPROVED BY: /
PERMITTEE SIGNATURE:
DATE: 4/23/2004
04/19/2004 08:52 FAX 5035981960 CITY OF TIGARD 11002
A •
,� ,sl SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX (503) 684 -7297
GENERAL INFORMATION
Name of Development/PrcJect FOR STAFF USE ONLY
Site - 2/2,63c, pt��- -A CC P � O �ld '
Address/ Street Ad re Permit / e
Location q SW AC-IA.) Expiration Date:_ y /z� /v5� — .51 f
J 1 L /l Suite /Bldg. # City /State Zip 7 3
� 7 . 7 -- / ��- 02 Receipt #: `f - 170
Name Approved By:
property
. G, `4 Iv j. Date: . v/2 3
Owner Mailing Address QQ ? Suite Map/TL #:
LiC� 1�9 9 5�o � i fb Zoning:
C — ry/State Zip Phone Z 0 _ ''
' y
� M' f 0 c3 7 � ID -5 � Electrical Permit Required? ❑ Yes No
N ame �
Tenant or
Business 14 4 - G C �
p �� d
G � Building Permit Required? El Yes ❑ No
'
Rev, e/7/2003 i:kurpinlmasters per app,doC
—Name /
Sign / `; CA-8 S L
Contractor Meiling Address Suite REQUIRED SUBMITTAL ELEMENTS i
(Prior to permit (Note: applications will not be accepted
Issuance, a without the required submittal elements)
copy of all City /Stage Zip Phone
licenses are
required if ❑ 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) (3 copies, if a building permit is required)
Proposed ❑ Permanent CIF Freestanding ❑ Freeway size requirement: 8 x 11", or 11" x 17"
Sign Temporary • Wall ❑ Billboard ❑ Balloon /I�� CI Electronic �j 2 copies of elevations, drawn to scale
(Check all that ❑ other p
apply) (a copies, if a building permit is required)
Z New sign? ❑ Alter to existing sign'? size requirement: 8 x 11 ", to 24" x 36"
Sign Dimensions: // x 4 g U
32 ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): /0.6 5 .. a $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.)
Sig , Jurisdiction: ID City El Urb
.
(complete aII Direction Wall Faces (circle one): NOTES:
items in this
section) N S E W NE NW SE SW
Height to top of sign (feet): 6 P7 • Wall signs do not need to be drawn to scale,
but must Include dimensions of wall face and
Projection From Well (inches):
�placement.
Copy:��cc �` 6i� �0/ - �I I's n s do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes 21 No building permit.
Type: ❑ 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
BECOME NULL AND VOID.
❑ Yes ❑ No
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 red 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 al day of 4pe4 , 20_0 4
Contact Person Name
Z0 3Jdd
Phone No.
ANddW00 3A10>1 II85b89E05 9Z :II b00Z /IZ /b0
466 20
/2
04
CITY OF TIGARD 8 4 2 2004
13125 SW Hall Blvd.
tfx ie, Tigard, Oregon 9 72 23
WAIL. (503) 63 9-4 17 1
Receipt #: 27200400000000001705
Date: 04/26/2004
Line Items: Amount Paid
Case No Tran Code Description Revenue Account No
SGN2004 -00078 [SIGN] Temp Sign Perm
100-0000-437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check JOHN & SUZANNE GALLAGHER kjp 285
In Person 15.00
Payment Total: $15.00
options for the 48" x 32" lawn sign
1, '
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\ FOR STATE REPRESENTATIVE
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CITY OF T GARD
Approved [1(
Conditionally Approved [ ]
For only the work as described in:
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Attach 1
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An assumed business name of TITLE INSURANCE COMPANY OF OREGON
.� \.. ` .40 1700 SW Fourth Avenue Portland, OR 97201 -5512
Phone: (503) 222 -3651
• This map is provided as a convenience in locating property
. First American Title Insurance Company assumes no liability for any variations as may be disclosed by an actual survey
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