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SGN2004-00013 CITY TIGARD SIGN PERMIT i i l DEVELOPMENT SERVICES PERMIT #: SGN2004 -00013 c 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/16/04 PARCEL: 2S 102AA - 05500 BUSINESS NAME: COFFEE CABANA ZONE: CBD SIGN LOCATION: 12215 SW MAIN ST 120 JURISDICTION: TIG APPLICANT /AGENT: BUSINESS TAX NO: SIGN PERMANENT: FREESTANDING: FREEWAY: TEMPORARY: X WALL: Y ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 4'X6" TOTAL SIGN AREA: 2 sq. ft. WALL AREA: sq. ft. WALL FACE (DIRECTION): SE SIGN HEIGHT: ft. PROJECTION FROM WALL: in. ILLUMINATION: NON DESCRIPTION OF SIGN: Placement of (1) one temporary 2 sq ft banner. Valid 1/16/04 thru 2/16/04. Sign #1 MATERIALS: VINYL BANNER 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 or sign hall expire. A temporary sign shall expire 30 days from validity date. A balloon sign shall expir ays from validit sate. ~, p O P 4 O ,,, r AP BY ,,,� PERMITTEE SIGNATURE: �`tt-4 \ -. - . " C ---., DATE: 1/16/04 t A ,t"` 1 SIGN PERMIT APPLICATION CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297 ENERAL INFORMATION Name of Development/Project Site OZ-'e. CA.CIJCX\ FOR STAFF USE ONLY Address/ Street Address Permit No.: S L7 �� 0 9 - O of ) Location 12-23 "S rn 2 \Y) N" _1 i Suite /Bldg. # City /State Zip Expiration Date: 102, T AK )12_ 1-72214,_ Receipt #: r2 00 1 S 9 Name �/ Approved By: Property II�C,,T�;l 1�7 Date: 1 / /S� p r Owner Mailin dress Suite Map/TL #: t?... sv.:2\�- Zoning: C j� City/State Zip Phone J renant or Nam , Electrical Permit Required? ❑Yes Q -too 3usiness (If e_e_. C - Building Permit Required? ❑ Yes 0—P40 Name Rev. 8/7/2003 i:lcurptn\masters\revised\sign permit app doc )I tra r Mailing Address Suite Prior to permit REQUIRED SUBMITTAL ELEMENTS ;suance, a (Note: applications will not be accepted opy of all City/State Zip Phone without the required submittal elements) censes are squired if xpired in the Oregon Const. Cont. Board Exp. Date ❑ Completed Application Form ;ity of Tigard's License # atabase) ❑ 2 Copies of Site /Plot Plan, Drawn to Scale 'ro osed (3 copies, if a building permit is required) >I n ❑ P ermanent ❑ Freestanding ❑ Freeway size requirement: 8 x 1 1 ", or 11" x 17" Chec all that Et Temporary El Wall El Electronic pptv1 ❑ Other El Billboard 12 Balloon ❑ 2 copies of elevations, drawn to scale ❑ New sign? (3 copies, if a building permit is required) g ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36" Sign Dimensions: L / x (0 ❑ $31.00 Fee (Permanent sign, any size) Total Sign Area (sq. ft.): � ( ; � ' $15.00 Fee (Temporary sign, any type) >ign Data Total Wall Area (sq. ft. Jurisdiction: ❑ City ❑ Urb Complete all Direction Wall Faces (circle one): ems in this NOTES: ection) N E W NE NW , SE SW Height to top of sign (feet): • Wall signs do not need to be drawn to scale, Projection From Wall (inches): but must include dimensions of wall face and Copy: sign placement. Materials: • Wall signs do not require site /plot plans. • Freestanding signs over 6 ft. required a Will sign have illumination? ❑Yes nk,t10 building permit. Type: ❑ Internal ❑ External • If work authorized under a sign permit has not kre there any existing freestanding or wall signs at this been completed within ninety (90) days after Dcation, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL ❑ Yes ❑ No BECOME NULL AND VOID. f "yes ", a list or diagram of all sign dimensions and , quare 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 Pn LA?Ar , 20 0 G &A� Sig natu(o O /A `?DAs ( 132 ) Contact Person Name Phone No. 7 ,---, c---. 1--, Q. 0 -• .____,, k._ c> 6 GI ___, i c) n 0 LI .:_. „4/7):,,,_ , : F TIGARD , 0,0.,. 2r �� VJ2-v 2- Approved .- [ , l 2 j r ! C� C,lti �!� Conditionally Approved For only the work as described in: PERMIT NO. ..... ............ . .[ 1 See Letter to: FOIIOW- • .... ... ... ... ..... ...� / 2-U h v' c �- Job Addre Date: t/� �2G "' © (2 �'r 2 C� re tY*81 co-virS,1 ' 6) a , , Sy; ,..4110 � /, �� , . , . ,‘,\_, nr,i(y) c.4_ CITY OF TIGARD 1/16/2004 13 12 5 SW Hall Blvd. 3:53:27PM d� �mu ; v�� ` ,, 4 ilk 1 Tigard, Oregon 97223 `� - �'� 1� (503) 63 9-4 17 1 Receipt #: 27200400000000000159 Date: 01/16/2004 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2004 -00013 [SIGN] Temp Sign Penn 100 - 0000 - 437000 15.00 Line Item Total: $15.00 Payments: Method Payer User ID Acct. /Check Approval No. How Received Amount Paid Check J. CRICKET ENTERPRISES INC KJP 2846 In Person . 15.00 Payment Total: $15.00