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SGN2004-00341 CITY TIGARD SIGN PERMIT DEVELOPMENT SERVICES PERMIT #: SGN2004 -00341 44,114,i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/18/2004 PARCEL: 2S 112AB -R -O -W BUSINESS NAME: ZONE: SIGN LOCATION: SW NO ADDRESS JURISDICTION: TIG APPLICANT /AGENT: OBIE MEDIA CORPORATION BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 24" X 84" TOTAL SIGN AREA: 14 sq. ft. WALL AREA: sq. ft. WALL FACE (DIRECTION): SIGN HEIGHT: ft. PROJECTION FROM WALL: in. ILLUMINATION: DESCRIPTION OF SIGN: Placement of one bench with sign within public right -of -way. Approved by Gus Duenas (City Engineer). MATERIALS: BENCH EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: N BUILDING PERMIT REQUIRED: N 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: ��'� / D — /� - PERMITTEE SIGNATURE: cz t C��C . DATE: 11/18/2004 F, ; • • ...,„ . SIGN PERMIT A PPL1 _Ti l N CtTY•OF • • 13125 SPVHall Blvd, Tigard, OR 97223 (503) FAX: (503) 684 -7297 # 6 GENERAL INFORMATION - Name of Development/Project FOR STAFF USE ONLY r2 5"7" lv �e2C Site Address/ Street Address� � c•G - n – o z `'`1" Permit No:: , C7 M a Oo`°I- - bC) 3 `4 Location 5(4/ 7 — ( r L � A71-2(7-0( Expiration Date: • Suite/Bldg # City /State • Zip • 1-- -, ©n '7.-M7 Receipt #: Nam /� I Approved By: P b/ - l ` t 6t0b1/ / ' Date: Property / � Suite Map/TL#: Owner Maling A dre // Zoning: City /State Zip Phone Electrical Permit Required? ❑ Yes ❑ No . Tenant or Name • /1 Permit Required? El Yes ❑ No . Business I/15 ��� Rev. 01.10 -02 1 :1curpinl masters \revlsed\stgn permit app.doc Name Sign d b (e e /,,r Cd,-1 Contractor Mailing Address .�-1 Suite REQUIRED SUBMITTAL ELEMENTS (Priorto permit q2// . k/ / / Ave (Note: applications will not be accepted issuance. a without the required submittal elements) • copy of all City/State Zip Phone ��� 3 ricenses are f • � eii& 77 r{ ��� 3 req uired it ` [ Completed Application Form City of i g ar r d'c License on Const Cont. Board Exp. Date C .❑ 2 Copies of Site /Plot Plan, Drawn to Scale database) naci`�` /S Oivnr∎^ 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 alt that FxI 0therQe�/ ❑ Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale a.. (3 copies, if a building permit is required) a New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11", to 24" x 36" Sign Dimensions: i «q It 0 $30.00 Fee (Permanent sign, any size) Total Sign Area (sq. ft.): I S1 7/f-. ❑ $15.00 Fee (T �� ry sign, a Y Yom) A Total Wall Area (sq. ft) � l /} e �J o 7`D of e �d �A Sign Data N (Complete all Direction Wall Faces (circle one): NOTES: . Items in thls section) N S E W NE NW SE SW a 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: • o Wall signs do not require site /plot plans. Materials: o Freestanding signs over 6 ft. required a building permit. WII sign have illumination? ❑ Yes T No o If work authorized under a sign permit has not Type: jJ Internal ❑ External been completed within ninety (90) days after Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL location, including wall signs that overlap a tenant space? BECOME NULL AND VOID. ❑ Yes X No • If "yes ", a list or diagram of all sign dimensions and • s • uare footage must also be submitted. - - --- (OVER FOR SIGNATURES) • • ' 0 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 / I 20 0 Signature of Owner /Agent fir / RPi 5tAi v1," e'-fzp'_ o ®per 7L7 ofrz ®(�r eI'1 X0 3 - Z Z- 3 - ? 77, Contact Person Name • Phone No. ,I \\ , - I 1 - - ' %, `d r 1' • , , . , . ' i ,-, 1 fT7 r _,_,, I I 111 . • ', {1. 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(503) 63 9-417 1 Receipt #: 27200400000000005009 Date: 11 /18/2004 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2004 -00332 [SIGN] Sign Permit 100- 0000 - 437000 30.00 SGN2004 -00333 [SIGN] Sign Permit 100- 0000 - 437000 30.00 SGN2004 -00334 [SIGN] Sign Permit 100- 0000 - 437000 30.00 • SGN2004 -00335 [SIGN] Sign Permit 100- 0000 - 437000 30.00 SGN2004 -00336 [SIGN] Sign Permit 100 - 0000 - 437000 30.00 SGN2004 -00337 [SIGN] Sign Permit 100- 0000 - 437000 30.00 SGN2004 -00338 [SIGN] Sign Permit 100- 0000 - 437000 30.00 SGN2004 -00339 [SIGN] Sign Permit 100- 0000 - 437000 30.00 SGN2004 -00340 [SIGN] Sign Permit 100- 0000 - 437000 30.00 SGN2004 -00341 [SIGN] Sign Permit 100- 0000 - 437000 30.00 Line Item Total: $300.00 Payments: Method Payer User ID Acct. /Check Approval No. How Received Amount Paid Check OBIE MEDIA CORPORATION CAC 67864 In Person 300.00 Payment Total: $300.00 cReceipt.rpt Page 1 of 1 •