SGN2004-00134 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2004 -00134
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/15/04
PARCEL: 1 S 134BC -00401
BUSINESS NAME: SCHOLLS IMMEDIATE CARE ZONE: C -N
SIGN LOCATION: 12442 SW SCHOLLS FERRY RD 100 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 36" X 96"
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 24 sq ft banner. Valid 6/15/04 through 7/15/04. Sign
#2.
MATERIALS: BANNER /PLY
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
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: ' 1 AP) cl/
PERMITTEE SIGNATURE: ei4i'�� a C G2 -�'Cbi
DATE: 6/15/04
r Apr 26 04 Ufi:0:9a Kick Alison o u.i - c .I1 i P. c
Rpr 05 04 11:36a Rick Wilson 503 - 231 - 9511 p.2
04/02/2004 13 :12 FAI S035001000 CITY OF T1GARD 41;1O02/004
* .
..�,,..,__ SIGN PERMIT APPLICATION
C Or ti Mad 13Ili Sit fattJhad.. Tigent OR 97223 (503) 639 -4171 FAX: (309) (84-7297
GENERAL INFORMATION
T Warne d DeveksprfrvxeTeoJeet FOR STAFF USE ONLY
sits , P'lW ► w Ps.d■c..l Eavwp- Sam) IS /
Address/ Ss+a1 ndmoas Permit No_ e . l. N a OO ti - 00 1 4
LGCatton Via i. sw Sc is F xr' LA , Expiration mete: ZID
100 T; cyyd,02.. 'i i e,,: DO ( I -
Property , F(DVMusa., V1ca}0, Sys-1/4-k—, Date: (0 -Is- 0 4
Owner *Malang Mews Map(74i: 1 S 13 'BC no , -1-0 /
4'1Q19 ue 61liscf, Zoning. C -N
GRIMM ZO _
PbriVA P 12- g na13. 3- .)5 =13a5 Electrical Permit Required? ❑ Ye; ❑ No
Tenant or ' fire
Business 3fAIol is SI^n ;(1 te BuacGng Permit Required? ❑ Vas 0 No
Menke as. a rrso3 mcu wPIlr+O•KRIVx na+xrl a
Sign c 1 l • . h.6
Contractaef W ague= REQUIRED SUBAAITTAL ELEMENTS
(Priem ®'nit (diets: opplicaboaa wilt r1 b®�tad
e S>r "� �` wEU+euttM required submittal dimwits)
g nu •aye +one
minfinet► }�cL, r�•Z�I"3563q - ■ ❑ Completed Application Form
embed in re mew Goma Corn Mare rte. Date
city d Torre 1''w"'a • (041-0_- Z- a. - 05 ❑ 2 Copies of Site/Plot Plan, Drawn to Scale
(3 copies. if a building perrnit is required)
Propnasd ❑ Penal= ❑ rreeste a mil ❑ "r we requirement 8'/a' x 11", or 11° x 1T
S u rxx Gtr rr g B oars 0 &dem ❑ 2 copies of elevations, drawn to scale
noon
(3 copies. if a building permit is required)
N Newaign7 0 A1/tar to existing slgnT sIze requirement 81h° x 11 to 24° x 36'
Sign Dimensions:
(0 " ,le 96 ❑ $31.00 Fee (Permanent sign, arty size)
Total Sign Area (so. ): a q . L l A $15.00 Fee (Temporary sign. any type)
Sign Ditto Totd Well Area (sg. R) 2_ (2
SQ ��. Jurisdiction: ❑ City ❑ Urb
lC• � (itch - Direction Wall Feces (i one): 1 hIQ $"
lame serilerti OS E W NE PIW SE SW
Height to top 04 sign (Past): ? • Wall signs do not need to be drawn to scale.
Projection From Wall Qndres): ,-t�• but must include dtmenslens of wall hoe end
slim placement
Copy o..:.iict - C".1". ARA lc‘-61z 1 • Wall signs do net require sitorplot plans.
Materials: 'frthj 1 k,. (fizslu - AL" • Freestanding signs ever 6 R faqufrsd a
WW sign have illumination? D yeas L No building permit ,
Type: ❑ Internal External • of work authorised under a sign permit b not
` Are there any e xisting freestanding or wall signs at this been completed within ninety (00) days after
location. Including Wall spns that overlap a tenant space? the issuance of Ova permit. THE PERMIT WILL
BECOME NULL.AN0 VOID.
Yes ❑ No
If - yes", a list or diagram of all sign dimensions and - ---"'--
sq uar e fe! 0° must also be sulSnNttad. •
• (OVER FOR SIGNATURES)
£0/Z0' d 0226 912 MS SIIOH' /JWd ISM 7002 -9e -add
r ripr Cb u-r u o:.7Jd
R 1 l.i l\ W 1 1 �U11
C0 ' d 111101
O4 /U 'YUU1 i.:ii rAL JU:IJ /9LU U u1 £.uenm
1 hereby acknowledge that t have read this application, that the infonmation given is
correct, that 1 am tha owner or authorized agent of the owner, and that pfana submitted are
in compliance with the City of Tigard.
DATED this
E0'E0'd 0226 9i2 £0S
day of - tAal' , 200d-
Contact Person 1 Nilme Phone No.
ST10H. /Jd zS : v i 4002- 90 -8dd
r •
CITY OF TIGARD 6/15/2004-
13125 SW Hall Blvd. 8:05:17AM
Tigard, Oregon 97223
SL, � � (503) 639 -4171
Receipt #: 27200400000000002552
Date: 06/15/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00134 [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
CreditCard ROBYN M LAPLANTE cac 003392 In Person 15.00
Payment Total: $15.00
Page 1 of 1 cReceipt.rpt
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