SGN2004-00015 CITY OF TIGARD SIGN PERMIT
I DEVELOPMENT SERVICES PERMIT #: SGN2004-00015
° 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/21/04
PARCEL: 1 S136DB - 02601
BUSINESS NAME: CASH CONNECTON ZONE: C -
SIGN LOCATION: 11608 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X8'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: 720 sq. ft.
WALL FACE (DIRECTION): NW
SIGN HEIGHT: 10 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) 24 sq ft banner. Valid 1/21/04 thru 2/21/04. Sign #1
MATERIALS: VINYL
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 permit shall expire. A temporary sign shall expire 30 days from
validity date. A balloon sign shall expire ys from validity date.
APPROVED BY: \ c ��
PERMITTEE SIGNATURE: ' ,. ' AI ■ / J .L "��,
DATE: 1/21/04
.,:a i'�I° 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 V f O WA i /CA FOR STAFF USE ONLY
Address/ Street Address Permit No.: `j E 4 Z� 4/ - (p / S
Location ; 1 leo CC 5 (Fe-
Suite /Bldg. # City/State Zip Expiration Date: YLr A y — /l /�, y
�� 0 t;-V q -3 Receipt #: J `3v- 0 ...)--d .�
Name
Approved By: jC
Property Date ,V'.Li /
Dwner Mailing Address Suite Map/TL #:
Zoning: c ( .
City /State Zip Phone
Tenant or Name Electrical Permit Required? ❑ Yes 24'1Go
3usiness li c )-1\S (t el ('j Building Permit Required? ❑ Yes Q No
Name � Rev. 8/7/2003 i \curpinlmasters\revised\sign permit app doc
iign
'ontractor 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
Nuked 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
' pro osed (3 copies, if a building permit is required)
n ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11", or 1 1 " x 17"
; ign all that R .Temporary ❑ Wall ❑ Electronic
pply) Other ❑ Billboard ❑ 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'/2" x 11", to 24" x 36"
Sign Dimensions: eg x
❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft): , i
P `� 4 rt. ❑ $15.00 Fee (Temporary sign, any type)
g Total Wall Area (sq. ft.)
>i n Data fa u sq f1' Jurisdiction: ❑ City ❑ Urb
Complete all Direction Wall Faces (circle one):
ems in this NOTES:
ection) N S E W NE 6 SE SW
Height to top of sign (feet): Q • 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.
• Wall signs do not require site /plot plans.
Materials: i N L_ • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes [7J- No building permit.
Type: p Internal ❑ External • If work authorized under a sign permit has not
\ re there any existing freestanding or wall signs at this been completed within ninety (90) days after
)cation, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
❑ Yes El No BECOME NULL AND VOID.
f "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.
DATED this / day of j r l , 20
Signature of Owner /Agent
AP% ilk (S43)glor
Contact Person Na 1 Phone No.
l,ll .Y jr 11161 - 11\.V
13125 SW Hal 1 Blvd. 11:09:32AM
4fo it ‘10 Tigard, Oregon 97223
II: (503) 63 9-4 17 1
Receipt #: 27200400000000000200
Date: 01/21/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00015 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Cash CASH CONNECTION KJP In Person 20.00
Change CITY OF TIGARD KJP In Person (5.00)
Payment Total: $15.00
Page 1 of 1 cReceipt.rpt
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