SGN2004-00035 r
CITY OF TIGARD SIGN PERMIT
I`I'k DEVELOPMENT SERVICES PERMIT #: SGN2004 -00035
el 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/24/04
PARCEL: 1 S135BC -00900
BUSINESS NAME: JAZZERCISE ZONE: C -G
SIGN LOCATION: 10855 SW CASCADE AVE JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2'X3'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Proposal for a temporary A -board sign. This is the first sign this year.
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 10 days rom validity date.
APPROVED BY: `fi
PERMITTEE SIGNATURE: / 5 Y1/\j
DATE: 2/24/04
r
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uwrdb,, . SIGN PERMIT APPLICATION
CI TY O F T I 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 V 22P.((CAV/ �C �C�Oy - O JS
Address/ Street Address Permit No.:
Location X0 3 ' LO cVsrad;i Avv Expiration Date: 3/70 ^ 1/4/0
Suite /Bldg. # City /State Zip
A a C) '7 3 Receipt #: a � —
q
Name Approved By: an7,t
Property P U��ld)� + Jt� I I (� _ Date: - D/',2 r0 4 1
Owner ner Mailing Addre �,` Suite Map /TL #: iii
3S - 00 90O -C
�� 8 ) ^ 0C �1W 6 Zoning: pi cC
City/StatteZii - e Ph � 333 one
11 90.44 (y 1d�3 H '2D' a1 Electrical Permit Required? ❑ Yes L! o
Tenant or Nam
Business Jl..� % e fl /� /2 5 Building Permit Required? El Yes A No
iA
Name Rev. 01- Jul-02 is \curpin \masters \revised\sign permit app.doc
Sign i `
Q�
Contractor Mailing Addr ss Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City /State Zip Phone
licenses are
required if Q • Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # 0 2 Copies of Site /Plot Plan, Drawn to Scale
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 all that ❑ Other ❑ Billboar ❑ Balloon 0 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
New sign? ❑ Alter to a lsting sig ? size requirement: 8 x 11", to 24" x 36"
lgn imen io s: Sa� l bef)r°
vote-04th 2 x 3 _ ❑ $30.00 Fee (Permanent sign, any size)
Iota; Sign Area (sq. ii.): 4 p,_ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.)
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N S E W NE NW SE SW
• 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: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
building permit.
Will sign have illumination? ❑ Yes 4 No • If work authorized under a sign permit has not
Type: ❑ 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 10 No
If "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 9 day of l hua/l , 20 04
yr
Signatu J of Owner /Agent
ftflLH 6 503" X3 9'7733
Contact P rson Name Phone No.
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226CCA
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CITY OF TIGARD 2/24/2004
13125 SW Hall Blvd. 1:36:35PM
Tigard, Oregon 97223
°I (503) 63 9-4 171
Receipt #: 27200400000000000707
Date: 02/24/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00035 [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
Check AMY SIM BMK 1 100 In Person 15.00
Payment Total: $15.00
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