SGN2004-00031 r
CITY TIGARD SIGN PERMIT
.I DEVELOPMENT SERVICES PERMIT #: SGN2004 -00031
,�. ,III 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/19/04
PARCEL: 1S135DD-00800
BUSINESS NAME: XENON WEST ZONE: C -G
SIGN LOCATION: 11847 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT: XENON WEST
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 8'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one temporary banner (3' x 8'). Valid from 2/19/04 through 3/20/04.
MATERIALS: VINYL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 0.00
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 10 days from validity date.
APPROVED BY: ` a - ece -a-)
PERMITTEE SIGNATURE: '
DATE: /19/04
• . .
,,,i�� SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY
Site NCet�au We'
Address/ Street Address Permit No.: &N a 00 4 — Cg) v
Location '\ \$ t-,l SW pC, t W Expiration Date: 3 " O -09-
Suite /Bldg. # City /State Zip
Yv2R-19- d ,-� cm Receipt #: a DCA — O(o 3 7
Name Approved By: ( . C twK�y
Property Date: a - /9 _61
Owner Mailing Address Suite Map /TL #: 15 135 OD — OO l av
Zoning: C - C7
City /State Zip Phone
Tenant or Name Electrical Permit Required? ❑ Yes g( No
Business )(eNa W e.$k Building Permit Required'? ❑ Yes 'r No
Name Rev. 8/7/2003 is \curpin \masters\revised \siqn permit app.doc
Sig
Cont ctor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to p rmit (Note: applications will not be accepted
issuance, a w ithout the required submittal elements)
copy of all City /State Zip Phone Q
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database)
(3 copies, if a building permit is required)
Proposed Permanent I=1 Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign Temporary ❑ Wall ❑ Electronic
(Check all that Other 1=1 Billboard El Balloon ❑ 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
01 New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: / 7 i
3 ;� <t ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
a,4 ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft Jurisdiction: ❑ City ❑ Urb
(Complete at Direction Wall Faces (circle one):
items in this NOTES:
section) 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
sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes K 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 overlap 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
I 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 , 20
Signature of Owner /Agent
Contact Person Name Phone No.
3 W 1SeT `
A.coa to Welt- i. Ce C f kk,
Now S etLo c6cer 0.4 [) ' we
1 -3tA,(9 \-4),(V- Pizor
CITY OF TIGARD ............. [�l
Ap proved .....
Conditionally Approved - .- ...... " - "°
For only the work as descr %e , p O
PERMIT NO ,
I. Follow .... ....... .... ........ ...........
See Letter to: .
ttach -------- ---- -��•
Job A dre Date -�
By a 4 S c• 'C4
CITY OF TIGARD 2/19/2004
13125 SW Hall Blvd. 10:11:27AM
/4" i �r� ti Tigard, Oregon 9 72 23
. 4'� �� (503) 63 9-4 17 1
Receipt #: 27200400000000000637
l ate: 02/19/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
BUP2004 -00058 [BUILD] Permit Fee 245- 0000 - 432000 62.50
BUP2004 -00058 [TAX] 8% State Surcharge 100- 0000 - 207020 5.00
BUP2004 -00058 [BUPPLN] Pln Rv 245- 0000 - 433000 40.63
BUP2004 -00058 [FLS] FLS Pln Rv 245- 0000 - 433020 25.00
MEC2004 -00070 [MECH] Permit Fee 245 -0000- 431010 72.50
MEC2004 -00070 [TAX] 8% State Surcharge 100- 0000 - 207020 5.80
SGN2004-0003 1 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
Line Item Total: $226.43
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid .
Check XENON WEST DEB 2096 In Person . 226.43
Payment Total: $226.43