SGN2004-00200 C ITY OF TIGARD SIGN PERMIT
,I DEVELOPMENT SERVICES PERMIT #: SGN2004 -00200
All 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/6/2004
PARCEL: 2S 103 D D -00800
BUSINESS NAME: THAT COFFEE PLACE ZONE: C -G
SIGN LOCATION: 13815 SW PACIFIC HWY 80 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X4'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one temporary 3'x'4 A -frame sign. Sign must be placed on
private property and not in the public right -of -way or visual clearance area. Valid
8/9/04 thru 9/8/04. 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 • s • permit shall expire. A temporary sign shall expire 30 days from validity
date. A balloon sign shall expire 10 d y fro alidity date.
APPROVED BY: n
PERMITTEE SIGNATURE�C a, III --- DATE: 8 6/2004
"i: 46 .
it SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of DevelopmenUProject
Pa FOR STAFF USE ONLY
Site C OVA. �d F� I a Vif r CJ
Address/ Street Address Permit No.: 5 6 2 , 1J -243-0 Y-00 . 1-O
Location (3 S 1 5 Si/3 Fae r+c, THu Expiration Date:
Suite /Bldg. # City /State Zip (f C
F3O _ l ax-d 1 -7 ?'
2-2_ Receipt #: 0 J ( / 3 j 9
Name Approved By: ---c
Property bVti Sr ✓e.41S Co $ Date: Q,`k,`
Owner Mailing Address n Suite / Map /TL #:
k1% &i) /"! Arad 4P1(j Zoning: , (,
City/State / Zip Phone
3
J�'t7Q,Y1U 1 v-- :11De60 Electrical Permit Required? El Yes 111--No
Tenant or Name
f l Car-Fee-Ha � J Bu Permit Required? ❑ Yes E - No
r)
— Business
Rev. 7/1/04 is \curpin \masters \revised \sign permit app.doc
Name
Sign
Contractor Mailing Address - uite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City/State Zip Phone
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City o .-T-igard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
rda abase) (3 copies, if a building permit is required)
d
Pro ose size requirement: 8 x 11 ", or 11" x 17"
Proposed Permanent ❑ Freestanding ❑ Freeway q
Sign ..Temporary ❑ wall ❑ Electronic ❑ 2 copies of elevations, drawn to scale
(Check all that ❑ Other ❑ Billboard ❑ Balloon
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: 3 X 111 $32.00 Fee (Permanent sign, any size)
— Total Sign Area (sq. ft.): Iv `� [� $15.00 Fee (Temporary sign, any type)
Sign Data
Total Wall Area (sq. ft.) Jurisdiction: , City ❑ Urb
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N S E W NE NW SE SW
• Wall signs do not need to be drawn to scale,
Height to top of sign (feet): but must include dimensions of wall face and
Projection From Wall (inches): sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? El 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 ov rlap 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)
0
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 L( day of AIAu± , 2011t___
AMA .h L 1 i/ LL111it
Signature of Owner /Agent
S6 to20 e 507
j n `503. 38o, iy3
Contact Person Name Phone No.
CITY OF TIGARD oioizuu4
13125 SW Hall Blvd. 12:02:23PM
Tigard, Oregon 97223
(503) 639 -4171
Receipt #: 27200400000000003499
Date: 08/06/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00200 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
Line Item Total: $15.00
Payments: =a `i
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check JOHNSTON STEVKO LLC KJP 1024 In Person 15.00
Payment Total: $15.00
CITY OF TIGARD
Approved [ CJ
Conditionally Approved _ [ 1
For only the work as described in:
PERMIT NO. - tSC3Zr-RM
See Letter to: Follow.. [ 1
Atta h _,[
Job Addres : ! 3 / � 4-" By: X. �"t-L ti."'°''" Datc: ..8
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