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SGN2004-00347 CITY OF TIGARD SIGN PERMIT PERMIT #: SGN2004 -00347 11�) DEVELOPMENT Tigard, SERVICES O ) 639 -4171 DATE ISSUED: 11/29/2004 PARCEL: 1S136DB-R-O-W BUSINESS NAME: ZONE: SIGN LOCATION: SW NO ADDRESS JURISDICTION: TIG APPLICANT /AGENT: OBIE MEDIA CORPORATION BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 24" X 84" TOTAL SIGN AREA: 14 sq. ft. WALL AREA: sq. ft. WALL FACE (DIRECTION): SIGN HEIGHT: ft. PROJECTION FROM WALL: in. ILLUMINATION: DESCRIPTION OF SIGN: Placement of one bench with sign within public right -of -way. Approved by Gus Duenas (City Engineer). MATERIALS: BENCH 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: o wl( 2 PERMITTEE SIGNATURE: DATE: 11/29/2004 )S13Co 011 dik, 14 ittmo A, x.14► SIGN PERMIT APPLICATION CITY OF TIGARD 13/25 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297 GENERAL INFORMATION Name of Development/Project �p Site 6 � 5 5 �,f� h � �G l.i FOR STAFF USE ONLY Address/ Street Address $W Gvrh Lr — Qr�tynu,A, Permit No.: S6K)„Roay ' 00347 Location 5i12 ACrA l' k../ 7 / 57 Expiration Date: Suite /Bldg. # City /State Zip l ,pe�� I 7;2.2--..) Receipt #: c C6 Name Approved By: C. = CO- i —'1-a� Property 5 74r f e D) 0/2 ®k Date: 11 Owner Mailing Address 09Pt 44 sure Map /TL #: ) S 13(9 D 6 - RO LA) 5 yp SG✓ ii/e5Y 3s Zoning: 'C7 Zip Pone 4,- h T 7024 as it -s Electrical Permit Required? ❑ Yes ❑ No Tenant or Name J� Business ilk 5 S 7-0,.. Building Permit Required? ❑ Yes ❑ No Rev. 7/1/04 is \curpin \masters \revised \sign permit app.doc Name Sign d b "e / - e-,64 (z,v-, Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS (Prior to (Note: applications will not be accepted issuance, a / �vQ without the required submittal elements) copy of all City /State Zip Phone licenses are required if Z G ei;t e f 71.-/©a p Completed Application Form expired in the Ore n Const. Cont. Board Exp. Date City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale database) 69kttwr'1" is 4) 4}17ci (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 ❑ 2 copies of elevations, drawn to scale (Check all that 0 Other ❑ Billboard ❑ Balloon apply) (3 copies, if a building permit is required) 0 New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36" Sign Dimensions: 02 y , ,67 / 6 III $32.00 Fee (Permanent sign, any size) Total Sign Area (sq. ft.): / q ❑ $15.00 Fee (Temporary sign, any type) Si n Data Total Wall Area (sq. ft.) ^ //A Jurisdiction: ❑ City III Urb g l'i (Complete all Direction Wall Faces (circle one): NOTES: items in this section) N S E W NE NW SE SW o 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: o Wall signs do not require site /plot plans. Materials: o 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 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 [g 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 ( 7 day of 1 " v , 20 ®'y Signature of Owner /Age SIA) eh -1 CV c f-� O 1 e2Pe. --4. teo h 5 1261 e e 3 2 97 Contact Person Name Phone No. • CITY OF TIGARD 12/6/2004 13125 SW Hall Blvd. 11:08:03AM /_ ,,, / „ „ L i i , Tigard, Oregon 97223 6' l (503) 63 9-417 1 Receipt #: 27200400000000005237 Date: 12/06/2004 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2004 -00346 [SIGN] Sign Permit 100 - 0000 - 437000 32.00 SGN2004 -00347 [SIGN] Sign Permit 100- 0000 - 437000 32.00 SGN2004 -00348 ' [SIGN] Sign Permit 100 - 0000 - 437000 32.00 SGN2004 -00349 [SIGN] Sign Permit 100 - 0000 - 437000 32.00 SGN2004 -00350 [SIGN] Sign Permit 100 - 0000 - 437000 32.00 SGN2004 -00351 [SIGN] Sign Permit 100- 0000 - 437000 32.00 SGN2004 -00352 [SIGN] Sign Permit 100- 0000 - 437000 32.00 SGN2004 -00353 [SIGN] Sign Permit 100 - 0000 - 437000 32.00 SGN2004 -00354 [SIGN] Sign Permit 100- 0000 - 437000 32.00 Line Item Total: $288.00 Payments: Method Payer User ID Acct. /Check Approval No. How Received Amount Paid Check BANK OF AMERICA CASHIERS CAC 0259789 By Mail 288.00 CK Payment Total: $288.00 cReceipt.rpt Page 1 of 1