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SGN2006-00204 r , `.,t„ CITY OF TIGARD I - SIGN PERMIT DEVELOPMENT SERVICES PERMIT #: SGN2006 - 00204 TIGA 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/14/2006 PARCEL: 1S135DD-05106 BUSINESS NAME: DR BRUNO DA COSTA DENTISTRY ZONE: C - G SIGN LOCATION: 11995 SW PACIFIC HWY JURISDICTION: TIG APPLICANT /AGENT: DR . BRUNO DA COSTA DENTISTRY BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: Y ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 2'X7' - 1/2" TOTAL SIGN AREA: 15 sq. ft. WALL AREA: 840 sq. ft. WALL FACE (DIRECTION): S SIGN HEIGHT: ft. PROJECTION FROM WALL: 2 in. ILLUMINATION: NON DESCRIPTION OF SIGN: Installation of (1) one permanant 15.33 sq. ft. wall sign. MATERIALS: ALUM /PLEX EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: N 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! . . PERMITTEE SIGNATURE: ,� DATE: 11/14/21 94` SIGN PERMIT APPLICATION °` = City of Tigard Permit Center 13125 SW Hall Blul, TigZrg OR 97223 Phone. 503.639.4171 Fax: 503.598.1960 GENERAL INFORMATION Name of Development /Project (2 ' �O L a FOR STAFF USE ONLY Site (( � Address/ Street Address Permit No.: ✓7 6 �" z- ' Z+07 Location If' S W. p441v1e }t,L}/ Expiration Date: Suite /Bldg. # City/State Zip a - 1 - f g a l" / a . 7 3 Receipt # : "Ll Name I Approved By: is Property Date: / i I l `(I < Owner Mailing Address Suite lip /TL# : Zoning: CC-7 . City/State Zip Phone , Tenant or Name Electrical Permit Required? ❑ Yes El./ICTo Business P1Q b!/€tp0 14 ast-gt Building Permit Required? ❑ Yes 11—No Name Rev. 7/5/06 Sign , � Jp si �� is \curpin \masters \l and use applications permit app.doc Si °i v�/ Contractor Mang Address Suite (Prior to permit 0ae a) HaaZ1d issuance, copy a REQUIRED SUBMITTAL ELEMENTS copy of all City /State Zip Phone s 3 Q required if `� 19'�1lr 012, 9 !o O� , (Note: applications will not be accepted °I ��o� without the required submittal elements) expired in the Oregon Const. Cont. Board License # Exp. Date City of Tigard's database) /O 4'f'5-9 . a' //7 0 7 ❑ Completed Application Form • Proposed ❑ Permanent reestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale Sign ❑ Temporary fl ❑ Electronic (3 copies, if a building permit is required) (Check all ❑ Other ❑ Billboard ❑ Ba 1 a ppl y ) si ze requirement: 8 /z" x 11 ", or 11" x 17" ew sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale Sign Dimensions: , t r t . , uJA'ya (3 copies, if a building permit is required) w1. 'V (...A a >4 I' 7At.7 7I ' size requirement: 81/2" x 11 ", to 24" x 36" Total Sign Area (sq. ft.): $i taebvd _ u./A a- i' e 40 4' — 1 5.33 ❑ $39.00 Fee (Permanent sign, any size) Si n Da Total Wall Area (s ft / g c� ❑ $19.00 Fee (Temporary sign, any type) (Complete all Direction Wall Faces (circle one): items in this NOTES: section) N & E W NE NW SE SW Height to top of sign (feet): s p o Wall signs do not need to be drawn to scale, but Projection From Wall (inches): / //z., 1, must include dimensions of wall face and sign placement. SPY Op. dof An S o Wall signs do not require site /plot plans. Materials: A.tpd/j1, L't/ j. 7 ?Ley., ' o Freestanding signs over 6 ft. required a building Will sign have illumination? 74 Yes ❑ No permit. Type: ',, Internal ❑ External o 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 ® 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. DA 1'ED this / day of P © him iCgA , 20 D Co S :n. e • 'Owner /Agent 6 G 'fr 4D 57,3 - 02e)- 80201_ Contact Person Name Phone No. r p1-f'4L) 0012--tri ,f 1bwovcte9 ao slew "i 5 Rw • • iNz 06 dt --, Le . a 4 rov ,41 6 41104 'woo/ 51144 5c) . 194, GI FI G )-1-)(1 ih _ CITY OF TIGARD 11/14/2006 .. 13125 SW Hall Blvd. 12:43:16PM _ Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200600000000005434 Date: 11/14/2006 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2006 -00203 [SIGN] Sign Permit 100 - 0000 - 437000 34.00 SGN2006 -00203 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 5.00 SGN2006 -00204 [SIGN] Sign Permit 100- 0000 - 437000 34.00 SGN2006 -00204 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00 ELC2006 -00656 [ELPRMT] ELC Permit 220 - 0000 - 431510 53.40 ELC2006 -00656 [TAX] 8% State Surcharge 100 - 0000 - 207020 4.27 Line Item Total: $135.67 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid Check HIGHLIGHT SIGN CORP DEB 5824 In Person 135.67 Payment Total: $135.67 cReceipt.rpt Page 1 of 1 ( ;rev, S. (;l'ntry. D.M.U., P.( 7-7-1/2' -1/2' I I' / - - -- Cosmetic & Restorative Dentistry .. +# Bruno da Costa DDS, MS, PC LAG EXPA.NSIO ‘ ANCHO' 1< SleSN BOXED LATALUM. (503) 639 -6900 INTO wAU. p W/ rX ;ALUM I \ ANGLE / 1/4' q,INTRA FLIT GUT OUT LETTERS © SIGN LAYOUT PAINTED IBLUE I ►PAGE &. IS IDES I BRUSHED CITY OF TIGARD ALLUM. Approved _. _ [x 1 i Cor;drttoriaily ANpro„z Fct only the work as described in: \ - - - ` � %. / ?I. , AJZde (O - (13 .7-)41e .C`.7-)41e S FE e M ! etter T NO to: FOIIOw Attach .. -M ti i Job Addr s: A l .. , cy: • - '�+�.:. _ Da +e. " r . . — — — _ Higillight N O t t : i CONTACT i ILt:: DR. BRUNO tl,r COSTA DOS � i , •nh au: iindermy f 1(i RF1LLN � OQ � UR t3RUN0 IL COSTA ti r c x< lu property of H SIGN pk a SIGN L O('A DON until inns !lad Any tiALESMAN DATE un.wlhonzcd rcproductinn 11995 SW PACIFIC HWY STEVE LAWHEAD 10 ` 27 00 tot : ury purpos win incur 503- 620 -8205 TIGARD. OR 97 223 11 0.? :1, in,n Copynght 199? I