SGN2004-00053 1
CITY TIGARD SIGN PERMIT
-1 , I DEVELOPMENT SERVICES PERMIT #: SGN2004 -00053
, c � Ill 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/19/04
PARCEL: 2S 110AA -01000
BUSINESS NAME: RIPLEY'S FURNITURE ZONE: C -G
SIGN LOCATION: 14170 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4' X 3'
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 A -frame sign. Valid from 3/20/04 through 4/20/04. Must be
placed outside of right of way.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES:
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(--
PERMITTEE SIGNATURE: CI
DATE: 3/19/04
i
„,,,*
SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Ha11 Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
Site - R, p l etr S Fu r i -fu re- FOR STAFF USE ONLY
Address/ Street Address Permit No.: 3 V n1 ( )bL1 000 5 3
Location I l 7(3 c /
Suite /Bldg. # City/State (� C Zip Expiration Date: /��y o 4
- Ii ciGrJ i DR 47 `f' Receipt #: a do-i - 1) 05
Name Approved By: C — u,-i
Property Toh r+ l7c(o ,cl p I CI Date: 3 - oy
Owner Mailing Address Suite Map /TL #: a S 11 0 (4 A °- 0 1 ob u
I' 1 70 3 L) Poe Ow Zoning: G - C'
City /State Zip Phone
I (Card 9 7aa 4
Electrical Permit Required? ❑Yes tR] No
Tenant or Nam
Business liple4 ` 5 fro ; - - - u , Q Building Permit Required? ❑Yes [ No
ame Rev. 8/7/2003 is \curpin \masters \revised \sign permit app.doc
Sign
Contractor Mailing Addre Su' : REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a w ithout the required submittal elements)
copy of all City /State Phone q
licenses are
required if ❑ Completed Application Form
expired in the Oregon . •nst. Cont. Board Exp. D. -
City of Tigard's Lic- • e # 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 I=1 Billboard E1 Balloon III copies of elevations, drawn to scale
apply)
(3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: � � i
(� . -- x ` - f 1 ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): i
o? 0 $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft Jurisdiction: ❑ City ❑ Urb
(Complete all Direction Wall Faces (circle one):
items in this 1 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: 1,0c),_6_,, • 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
Are there any existing freestanding or wall signs at this I 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
square footage must also be submitted.
(OVER FOR SIGNATURES)
r t
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.
C r DATED this V — day of (ri, C H , 20 0 C A
Signat - of Owner /Ag - nt
Contact Person Name Phone No.
CITY OF TIGARD 3/19/2004:
13125 SW Hall Blvd. 3:42:22PM
�'llAi Tigard, Oregon 97223 #,
41. (503) 639 -4171
Receipt #: 27200400000000001105
Date: 03/19/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00053 [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 JOHN RIPLEY CAC In Person 20.00
Change CITY OF TIGARD CAC In Person (5.00)
Payment Total: $15.00
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