SGN2004-00363 . •
CITY OF TIGARD SIGN PERMIT
i DEVELOPMENT SERVICES PERMIT #: SGN2004 -00363
A 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/1/2004
PARCEL: 2S104BB -08000
BUSINESS NAME: ULTIMATE TAN ZONE: C -N
SIGN LOCATION: 14250 SW BARROWS RD 001 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 6'
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: Install one banner. (3' x 6') Sign #2 Valid from 12/2/04 through 12/31/04.
MATERIALS: VINYL
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: �' z ye a Ca-4
PERMITTEE SIGNATURE:
DATE: 12/1/2004
, Nov 30 04 01: 08p p- 1
RECEIVED
v:Li SIGN PERMIT APPLICATION � 30 2004
CITY OF flGARD 13125 SW Hall Blvd., Tigard OR 97223 (503) 639 -4171 FAX (503) 684 -7297
CITY OF TIGARD
GENERAL INFORMATION BU /LDJNr nfyigi0
Name of Development/Project
�
"��`i/ 7 /,f/ t � FOR STAFF USE ONLY
Site s rf'o✓% ��
Address/ Street Addrass .J Permit No.: S CN a° 0 — co 3
Location / . e/r/!th/ Expiration Date: /D-3i-o4- Suite/Bldg. # State Zip 2 00 �} - J`�1l a
j i('�A /d Receipt #: _
Name // Approved By. e- (
Date: /�- .2- D
Property S 1 U x /38 D ar7
Owner Mailing Address Suite Map /TL#: a
Zoning: - Al
Cil.y/State Zip Phone
. Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name /(1. / Building Permit Required? ❑Yes CI No
Business u`��/ ?✓
Rov.7ftlot f: laurpinlmectrarclrovisodtstgn permit spp .doc
Nam ti •
Sign 1P3 I'rC: ` 0 5 % " s\
Contractor Malting Address Suite i REQ UIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will DA be accepted
issuance, a without the required submittal elements)
copy of alr State Zip Phone
r eq u ired W / tit ��y� 0 Com feted Application Form are
required W ,J ' ` r ____. L-I p Pp
expired in the Oregon Coast. Cont. Board Exp. Date
City of Tigard'a License # ❑ 2 Copies of Site/Plot Plan, Drawn to Scale • database) (3 copies, if a building permit is required)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 81/2" x 11 ", or 11" X 17"
Sign Temporary El Wan ❑ Electronic ❑ 2 copies of elevations, drawn to scale
(Check a ll that Other ❑ Billb ❑ Balloon
app (3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 8t x 11 ", to 24" x 3E'
X/ �_' S D A 3 ❑ $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 1:1 $15.00 Fee (Temporary sign, any type)
Total Wall Area (sq. ft.) ' Jurisdiction: ❑ City ❑ Urb
Sign Data _
(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
Will sign have illumination? ❑ Yes ❑ No P building permit.
TyLe: ° Internal El 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.
it Yes ❑ No
If "yes ", a list or dt gram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
Nov 30 04 01:09p p. 3
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 ,.//0 day of J j Vz / 7 ' , 20 G ,
A
Sig ftire of aGner /Agent
/c\k/z? i 3°3:6-
Contact Person Name Phone No.
. 6'ev) /9/t-e)
, Noy 30 04 01:09p p.2
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CITY OF TIGARD
13125 SW Hall Blvd.
•
;, i it Tigard, Oregon 97223
A �� (503) 63 9-4 171
Receipt #: 27200400000000005170
Date: 12/01/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00363 [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 DEBRA NASS CAC 022139 In Person 15.00
Payment Total: $15.00
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