SGN2006-00201 4';
CITY OF TIGARD SIGN PERMIT
' DEVELOPMENT SERVICES PERMIT #: SGN2006 -00201
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/8/2006
PARCEL: 2S 103 D D -00600
BUSINESS NAME: TRI SQUARES SQUARE DANCE CLUB ZONE: C -G
SIGN LOCATION: 13770 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT: TIGARD SQUARES SQUARE DANCE CLUB
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X6'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one 3'x6' temporary banner. Sign #1 Valid 11/18/06 - 12/17/06
MATERIALS: PLASTIC
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 19.00
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. Atemporary sign shall expire 30 days from validity date. A balloon sign shall expire 10 days from validity date.
//:
APPROVED BY:
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PERMITTEE SIGNATURE: /` CO, Vf"0 )-ce
DATE: 11/8/2006
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• .. SIGN PERMIT APPLICATION
City of Tigard Permit Center 13125 SW Hall Blul, Tigarzl; OR 97223
Phone 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development/Project
Site 1 (j /4-12 �` , 4Ot/ c;E- FOR STAFF USE ONLY
Address/ Street Address Permit No.: S Ci� t-K7-s, 6 - 47 - (
Location 37 AO q �� 4 q y / /
Suite/Bldg. N Cicy /State zip
� Expiration Date: 1 1 / r /p fo - ( `'((7 / 0
l ati d 6 , - 7 - Receipt # : LvJ 4 .- - . 5 �
Name Approved By K -
0 :
, f /
Property Date: f � o
Owner Mailing Address Suite M /TL#
Zoning: 6 0
City/State Zip Phone
Tenant or Name _ Electrical Permit Required? ❑ Yes E -No
•
Business I6 b / ri - ,C�Gfa i-� Building Permit Required? ❑ Yes 13
Name Rev. 7/5/06
ikpl_ is \curpin \ masters \land use applications \sign permit app.doc 1
Sign t° � 1pl - �
Contractor Mailing Address Suite
(Prior to
issuance, permit if l„/ (Lt.) �,'', _ �IICQ C t
copy of all City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
licenses are /-� 1 ,�� (Note: applications will not be accepted
required if t r 9 2--)--3 ,C0 0 7 arZ:
without the required submittal elements)
expired in the Oregon Const. Cont. Board License # Exp. Date
City of Tigard's j
database) ❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway ' ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Sign gi Temporary ❑ Wall ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other ❑ Billboard 1
apply) d ❑ Balloon size requirement: 8 h" x 11 ", or 11" x 17"
❑ New sign? to Aker to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: k / (3 copies, if a building permit is required)
size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
l - t ❑ $39.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.)
g ] $19.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one): / 2 - /i -Cb -- / - / 7 - O
items in this NOTES:
section) N S ENE NW SE SW
Height to top of sign (feet): • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): must include dimensions of wall face and sign
Copy placement.
Materials: (A;:/.1-, l • Wall signs do not require site /plot plans.
I • Freestanding signs over 6 ft. required a building
Will sign have illumination? El Yes N No permit.
Type: ❑ Internal ❑ External • 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 jt. 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.
DATED this day of ' v v ve t , 20 °
Cocte
Signature of Owner /Agent
ble Pe+611W-k 4t)3 J -9.5
Contact Person Name Phone No.
CITY OF TIGARD 11/8/2006
13125 SW Hall Blvd.
li
11:37:51AM
Tigard, OR 97223 503.639.4171
TIGARD
Receipt #: 27200600000000005329
Date: 11/08/2006
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2006 -00201 [SIGN] Temp Sign Perm 100-0000-437000 17.00
SGN2006 -00201 [MISC] Misc Fee 100-0000-451000 2.00
SGN2006 -00202 [SIGN] Temp Sign Perm 100-0000-437000 17.00
SGN2006 -00202 [LRPF] LR Planning Surcharge 100-0000-438050 2.00
Line Item Total: $38.00
Payments:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
Check TRI SQUARES SQUARE DANCE KJP 1245 In Person 38.00
CLUB
Payment Total: $38.00
it
cReceipt.rpt Page 1 of 1
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