SGN2004-00129 / 1
A CITY OF TIGARD SIGN PERMIT
.044061, DEVELOPMENT SERVICES PERMIT #: SGN2004 -00129
••••-• 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/9/2004
PARCEL: 2S112DA -00700
BUSINESS NAME: BALLY'S TOTAL FITNESS ZONE: I -P
SIGN LOCATION: 15353 SW SEQUOIA PKWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X6'
TOTAL SIGN AREA: 18 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 18 sq ft banner. Banner must be placed on
private propoerty and not in the public right -of -way or visual clearance area. Valid
7/1/04- 7/31/04. Sign #1
MATERIALS: BANNER
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 days from • ' ity date.
APPROVED BY: X r
PERMITTEE SIGNATURE: -
DATE: 6 • - 1 % '
ZS I / -M -UO
A i 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/Project
FOR STAFF USE ONLY
Site • t
Address/ Street Address Permit No.: 5q / N at S!_ 00 / Z f
Location i 53s �) `z[.00 I A P,11441 Expiration Date: i t 1 4 y -7 h /i /
Suite /Bldg. # City /State Zip (
t44/0 97ZZ l Receipt #: 2- / - 2 (-15"-- Name S -40(16 & 4140 l Approved By: F. e
Property AL44 - Vri¢C 17'-MeSS Date: O/(�'/Q 4 /
Owner Mailing Address Suite Map/TL #: 2-5 y)-- 04 - OU 703
1S353 5t) i1x64 f 4../ Zoning: f
City /State 6 � Zip �/ Phone
R17/449 1 7�( so Electrical Permit Required? ❑ Yes 0 No
Tenant or Name
Business gA1l_i —6-pq . F-we Building Permit Required? ❑Yes 1:11 No
Name Rev. 8/7/2003 i:\curpin \masters \revised \sign permit app.doc
Sign C avk61t tOA( S ) CO -
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit applications will not be accepted
issuance, a k 1 City/State /t),Zi eo Ve Zip Phone C -3 Q
copy of all City /State w ithout the required submittal elements)
licenses are f Q2 d� C. 6 5 / 1 / 7
required if - tc � -+'J •G7 X' J (D 7 ❑ 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 ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign Temporary ❑ Wall ❑ Electronic
(Check at that ❑ Other ❑ Billboard ❑ 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: r +
(o k 3 ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
1� ` - r- ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft /g 5s. Pr Jurisdiction: ❑ City ❑ Urb
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S W NE NW SE SW
Height to top of sign (feet): • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes 'No building permit.
Type: ❑ Internal ❑ External • If work authorized under a sign permit has not
Are there any existing freestanding or wall signs at this been completed within ninety (90) days after
location, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
❑ Yes idNo BECOME NULL AND VOID.
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
I hereby acknowledge that I have read this application, that the information given is
correct, that I am the owner or authorized agent of the owner, and that plans submitted are
in compliance with the City of Tigard.
DATED this ( day of e , 20 C j
Sigfi`ature of Owner /Agent
/0AZ6 76 444 0 d3 I (Zo - 77Z
Contact Person Name Phone No.
, Same Day Sign Co. Fax : 5036392430 Jun 09 08:17
Sign Resources, LLC dba
SAME DAY SIGN COMPANY
:iUl,k_t
Artwork 1 & Job Approval
410 0 0 1
00.......em .
__
,$) To sTART
- 3xb' White Vin I Banner
y Hems & Grommet
Vinyl Text Color RED
Pace - $93.00
Approval S gnature
#36681
CITY OF TiGARD % ' r '0 e
Conditionally Approved [ / ` i1
For only the wo k as described in:
PERMIT NO. /J 2 Z5
See etter to: Follow l 1 1
Attach
Job Addr: A. 'k
By: AZ _ Dat 4 /
Main Office: 10120 S.W. Nimbus Ave., Suite C -3, Portland, Oregon 97223
Ph: 503.620.5147 Fax: 503.639.2430 Toll Free: 888.322.7446 Email: info @samedaysign.net
A CITY OF TIGARD 6/9/2004
13125 SW Hall Blvd. 2:27:01PM
4 it (,\ Tigard, Oregon 9 72 23
Afall■ � '� L� (503) 63 9-4 17 1
Receipt #: 27200400000000002452
Date: 06/09/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00129 [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
CreditCard . MARSHALL A RASARIO KJP 002565 In Person 15.00
Payment Total: $15.00
„s
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