SGN2004-00222 CITY OF TIGARD SIGN PERMIT
l l DEVELOPMENT SERVICES PERMIT #: SGN2004 -00222
k,�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/31/2004
PARCEL: 1S135DD-00800
BUSINESS NAME: SKLAR PEPPLER ZONE: C -G
SIGN LOCATION: 11847 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT: SKLAR PEPPLER
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 20" X 24"
TOTAL SIGN AREA: 3 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 A -frame sign. Sign must be placed outside of
right -of -way. Sign #1. Valid from 8/31/04 - 9/30/04.
MATERIALS: PLASTIC
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: _AAPL
PERMITTEE SIGNATURE: — ! � `•�' 7
DATE: 8/31/2004
41*
AI SIGN PERMIT APPLICATION
44. CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
Site ,Setilg pz pp FOR STAFF USE ONLY
A Address/ Street Address 'J Permit No.:
Location // g 47 ,S A /,Z4L ,46 E xpiration Date: 9 -w -o``�
'1'
Suite /Bldg. # City /State Zip
y4■1 aer 972 z3 Receipt #: a -oar-{ —388 Co
Name Approved By: C_ • Cow -•j
Property IC�i7'/ n— �j0��/Gjj-3— Date: Pa — 3 1 -o '-4
A Owner Mailing Address , Suite Map/TL #: (S t(3 S D p - 00 G 00
//197 S 4114671// Zoning: C — G
City /State Zip Phone
7L77 ,.d ?2T V2Z7 523 6Zv X169 Electrical Permit Required? ❑ Yes K No
Tenant or Name
S /lm 2 ��G �,
Building Permit Required? El Yes [ No
Business
Rev. 7/1/04 is \curpin \masters \revised \sign permit app.doc
Name
Sign
Contractor Mai • Address Suite i REQUIRED SUBMITTAL ELEMENTS
(Prior to permit I (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City /State / Phone
licenses are
required if ❑ Completed Application Form
expired in t Oregon Const. Cont. Board Ex.. 1 -te
City ' ard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
abase) (3 copies, if a building permit is required)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign Temporary El Wall ❑ Electronic
(Check all that Other El 2 copies of elevations, drawn to scale
apply) ❑ Billboard ❑ Balloon (3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
X Sign Dimensions: _i- Zt / /J ❑ $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): x o2 7 ❑ $15.00 Fee (Temporary sign, any type)
Sign Data
Total Wall Area (sq. ft.) Jurisdiction: [11 City ❑ Urb
(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: PL/GS f • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes ❑ No building permit.
Type: ❑ Internal ❑ External 1 • 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
El Yes ❑ No I BECOME NULL AND VOID.
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 day of , 20
Signature of Owner /Agent
Contact Person Name Phone No.
CITY OF TIGARD 8/31 /2004
13125 SW Hall Blvd. 3:27:31 PM
c l � l l, Tigard, Oregon 97223
2 �. W (503) 639 -4171
Receipt #: 27200400000000003886
Date: 08/31/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00222 [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 SKLAR PEPPLER CAC In Person 15.00
Payment Total: $15.00
•
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