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SGN2004-00019
CITY OF TIGARD SIGN PERMIT DEVELOPMENT SERVICES PERMIT #: SGN2004 -00019 c�I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/4/04 PARCEL: 2S103DD - 00800 BUSINESS NAME: JAVA JUICE ZONE: C - 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: 12 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 A -frame sign. Sign must be placed on private property and not in the public right -of -way or visual clearance area. Valid 2/4/04- 3/5/04. Sign #2 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 or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon sign shall expire 10da from validity date. APPROVED BY: � � �� .�_ PERMITTEE SIGNATURE: v DATE: 2/4/04 1 1 ,v. SIGN PERMIT APPLICATION 1 CITY OF TIGARD 13125 SW Hall Blvd, Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297 ENERAL INFORMATION Name of Development/Project Site _ ' FOR ST 1 AFF USE ONLY Address/ Street Address Permit No.: _ 2A) �q -coo Location )1 J C � ,/ Suite /Bldg. # City/State Zip Expiration Date: /,A — �� di 6 ��i , °\�� 2-40 Receipt #: v� v y ei Name Approved By: Property S e-5 C� 4 Date: 1 y n Owner / Mailing Address Suite. , Map/TL #: / () Stx) • P`Q.c Ac\ Zoning: Cl City /State Zip Ph p b(L, 97D3c) ;(,s-t tenant or Name - Electrical Permit Required? ❑ Yes 0- 3usiness Building Permit Required? ❑ Yes Name Rev. 8/7/2003 i:\curpin\masters\revised\sign permit app doc Sign :ontractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS 1 Prior to permit ssuance, 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 posed (3 copies, if a building permit is required) p ❑ P ermanent ❑ Freestanding ❑ Freeway , iign ❑ Temporary ❑ Wall y size requirement: 8t /z' x 11' , or 11" x 17" Check all that ❑ Electronic apply) ❑ Other ❑ Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale 11 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: ❑ $31.00 Fee (Permanent sign, any size) Total Sign Area (sq. ft.): - 3>( ❑ $15.00 Fee (Temporary sign, any type) >ign Data Total Wall Are (sq. ft. fp, S 'E, , Jurisdiction: ❑ City ❑ Urb ::omplete all Direction Wall Faces (circle one): ems in this NOTES: ection) N S 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 [ No 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 Jcation, 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 square footage must also be submitted. (OVER FOR SIGNATURES) r 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 t' , 20 c Signature of Owner /Agent S © Gab S °-T Contact Person Name Phone No. , r 6 6,U CITY OF TIGARD Approved _ PS I� Conditionally Approved _ —_ For only the w rk as described in: �6 ; Ce- _ PERMIT NO. 5 F7N Zia y- d°Q l f' See Letter to: Follow I I Attach ■ Job Address: � /S ,� � /.3 Aci ,� o 6y: _ Date:? y / b y 77 litt 7. 9 rk5 20 / . , „.„----"-- --- / ...------' K......, 4 CITY OF TIGARD 2/4/2004 13125 SW Hall Blvd. 9:51:OOAM � � �. Tigard, Oregon 97223 Ali- W (503) 639 -4171 Receipt #: 27200400000000000409 Date: 02/04/2004 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2004 -00019 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00 Line Item Total: $1.5.00 Payments: Method Payer User ID Acct. /Check Approval No. How Received Amount Paid Cash JAVA JUICE KJP In Person 15.00 Payment Total: $15.00 Page 1 of 1 cReceipt.rpt