SGN2004-00046 C ITY OF TIGARD SIGN PERMIT
1 DEVELOPMENT SERVICES PERMIT #: SGN2004 -00046
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/8/2004
PARCEL: 1S135DD-04400
BUSINESS NAME: SOUTHWEST FAMILY PHYSICIANS ZONE: C -P
SIGN LOCATION: 11900 SW GREENBURG RD BLDG 1 JURISDICTION: TIG
APPLICANT /AGENT: CLASSIC SIGN SYSTEMS
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: 12 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Install freestanding sign. Previously permitted and permit expired
(SGN2002- 00254). Sign has new location. (Revised 8/5/04 to new location see
site plan.) (Revised 2nd time to be at original location. 10/5/01 See site plan
submitted on that date.) I D /C:.(o4
MATERIALS: METAL /ACRYLI
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: Y
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 31.00
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. (18,
APPROVED BY:
PERMITTEE SIGNATURE: .f n
DATE: 3/8/2004
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CITY OF TIGARD Approved E ��4*/. I
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For only the wor' as described in:
PERMIT NO. •• k aAO�". Oa°4b W ` � '
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CITY TIGARD SIGN PERMIT
I�
DEVELOPMENT SERVICES PERMIT #: SGN2004 -00046
c 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/8/04
PARCEL: 1S135DD-04400
BUSINESS NAME: SOUTHWEST FAMILY PHYSICIANS ZONE: C -P
SIGN LOCATION: 11900 SW GREENBURG RD BLDG 1 JURISDICTION: TIG
APPLICANT /AGENT: CLASSIC SIGN SYSTEMS
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: 12 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Install freestanding sign. Previously permitted and permit expired
(SGN2002- 00254). Sign has new location. (Revised 8/5/04 to new location see
site plan.)
MATERIALS: METAL /ACRYLI
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: Y •
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 31.00
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: 6 �� ~C t— ‘
PERMITTEE SIGNATURE:
DATE: 3/8/04
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CITY TIGARD SIGN PERMIT
i4 DEVELOPMENT SERVICES PERMIT #: SGN2004 -00046
6.'m 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
DATE ISSUED: 3/8/04
PARCEL: 1S135DD-04400
BUSINESS NAME: SOUTHWEST FAMILY PHYSICIANS ZONE: C -P
SIGN LOCATION: 11900 SW GREENBURG RD BLDG 1 JURISDICTION: TIG
APPLICANT /AGENT: CLASSIC SIGN SYSTEMS
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: 12 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Install freestanding sign. Previously permitted and permit expired
(SGN2002- 00254). Sign has new location.
MATERIALS: METAL /ACRYLI
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: Y
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: (114.14—
PERMITTEE SIGNATURE:
DATE: 3/8/04
- .4hpsi
1=``` i'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
L(XA — n-! w 6 5 T
Site Pioni PHY AA) S-
Address/ Street Address 1 / 76O ,s-, w , Permit No.: SAM a(2a`i —0004
Location ! , 6E11.):N L l,t2 6 i 0 , Expiration Date:
Suite/Bldg. # City/State Zip
I 7- l(r14ie el -7'2-2.3 Receipt #: aOUy - n°) G , I-
Name Approved By: CkP,i J t/_ ( �.r
Property ....5 v� Aso • �
/114 ci- is -"2._T Ali)/ / L Date: * - - Oq
Owner Mailing Address Suite Map/TL #: t c i "S OD - U 4 on
225 b ELt L000D DR Zoning: " P
City/State Zip Phone
LK OSurE-G o 7
Electrical Permit Required? lin Yes ❑ No
Tenant or Name Solt II'? W s-r- Building Permit Required? Yes 0 No
Business F1 / L.), Ph/ VS 1 C (/
Name Rev. 30-Jul-01 i:tcurptnunaster trevised1sign permit app.doc
Sign Gt.-it SS 1. c- SL GJ Sy S S
Contractor Mailing Address -78 Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit 2 C� (Note: applications will not be accepted
issuance, a S it �u /2 r t.q� /2
copy of all City/state Zip Phone S 03 without the required submittal elements)
licenses are 71 6 , b
required if LI 7 2-2- 4 / 4n39 . 5& 56 El, Completed Application Form
expired In the Oregon Const. Conl Board Exp. Date
City of Tigard's License # 1 7 8 ! -1 O aq 2 Copies of Site/Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
size requirement 81/2" x 11 ", or 11" x 17"
Proposed ErPerrnanent F2rFreestanding ❑ Freeway
Sign ❑ Temporary ❑ Wall ❑ Electronic 2 copies of elevations, drawn to scale
(Check all that ❑Other ❑ Billboard El Balloon (3 copies, if a building permit is required)
apply) size requirement 8'/f x 11 ", to 24" x 36"
❑ New sign? ❑ Alter to existing sign? fig $50.00 Fee (Permanent sign, any size)
Sign Dimensions: / r, g / ❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.):
Z. NOTES: .
Total Wall Area (sq. ft.) • Wall signs do not need to be drawn to scale,
N
Sign Data l but must include dimensions of wall face and
(Complete all Direction Wall Faces (circle one): sign placement. 1
items In this
section) N S CO NE NW SE SW o Wall signs do not require site /plot plans.
• Freestanding signs over 6 ft. required a
Height to top of sign (feet): /Q , 5 ' building permit. .
Projection From Wall (inches): A/7/4 • If work authorized under a sign permit has not
Copy: •S FE f177 -(F j been completed within ninety (90) days after
Materials: mE-774 -C_ Ei p ejakY -1 G the issuance of the permit, THE PERMIT WILL
Will sign have illumination? (S Yes ❑ No ,
BECOME NULL AND VOID.
Type: •�C Internal ❑ Extemal
Are there any existing freestanding or wall signs at this (Not all jurisdictions accept credit cards, please call jurisdiction for more information.
❑ Visa 0 MasterCard
location, including wall signs that overlap a tenant space?
Credit card number / /
❑ Yes r No Expires
If "yes ", a list or diagram of all sign dimensions and Nara of cardholder as shown on credit card
square footage must also be submitted. $
Cardholder signature Amount
IAVFR FAR SIGNATUIRESI
I hereby acknowledge that I have read this application, that the information given is
correct, that 1 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 20
Signature of Owner /Agent
4
Contact Person Name Phone No.
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TAX LOT 4402 /'
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South es�
4 o
am► ir
Physician
Creating Maximum Impact
For Business Identities
Date:
11/18/02
Client:
CABINET: Southwest
4' x 8' sign cabinet Family
2" retainers
Acrylic Lense Physicians
Florescent internal lighting Contact:
UL approved Dr. Cynthia Gulick
Weight: 150 lbs. Benjamin R. Stutz
12'6"
8'6"
SUPPORT:
8.5' above grade Grade
schedule 40 pipe CLIENT
4" diameter, or as required APPROVAL
4' through sign FOOTING: Please initial & date
4' below grade 3' X 3'x 3' Colors:
Spelling:
Graphics:
Dated: ii `` (r SHIN
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1 i (USSIt SlHIN
Grade • / •S•1 •fCM'S
7800 SW Durham Rd., Ste. 200
Portland, OR 97224 -7577
Phone: 503 -639 -5656
These plans are the exclusive property of Classic Sign Systems and the result of the original work of itS employees. They are submitted to your company for the sole purpose of your consideration of whether to purchase Fax: 503- 624 -8706
these plans or to purchase from Classic Sign Systems a sign manufactured according to these plans. Distribution or exhibition of these plans to anyone other than employees of your company, or use of these plans to email: classigns.com
construct a sknliar sign is expressty forbidden. In the event exhibition occurs, Classic Sign Systems will be reimbursed $500 for time and effort Scale: /z =1'0"
CITY OF 'TIGARD 3/8/2004
13125 SW HaII Blvd. 4:21:39PM
to ,: „,M, i ,,' l Tigard, Oregon 97223
(503) 63 9-4 17 1
Receipt #: 27200400000000000904
Date: 03/08/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00046 [SIGN] Sign Permit 100- 0000 - 437000 31.00
BUP2004 -00091 [BUPPLN] Pln Rv 245- 0000 - 433000 65.59
BUP2004 -00091 [FLS] FLS Pln Rv 245- 0000 - 433020 40.36
ELC2004 -00109 [ELPRMT] ELC Permit 220 - 0000 - 431510 53.40
ELC2004 -00109 [TAX] 8% State Surcharge 100- 0000 - 207020 4.27
SGN2004 -00047 [SIGN] Sign Permit 100- 0000 - 437000 31.00
Line Item Total: $225.62
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check CLASSIC DIMENSIONAL CAC 11501 In Person 225.62
GRAPHICS
Payment Total: $225.62
•