SGN2004-00390 ,. T
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CITY TIGARD SIGN PERMIT
A. i DEVELOPMENT SERVICES PERMIT #: SGN2004 -00390
'E��� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/30/2004
PARCEL: 2S 1028 D -00100
BUSINESS NAME: ST ANTHONY'S SCHOOL ZONE: R -12
SIGN LOCATION: 09905 SW MCKENZIE ST JURISDICTION: TIG
APPLICANT /AGENT: ST ANTHONY'S SCHOOL
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4'X5'
TOTAL SIGN AREA: 20 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): SE
SIGN HEIGHT: 6 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one temporary 20 sq ft banner. Valid 12/30/04- 1/30/05.
MATERIALS: VINYL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 17.00
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 signyer shall expire. A temporary sign shall expire 30 days from validity
date. A balloon sign shall expire 10 days from yali ty date.
APPROVED BY: - - - , / Jl
PERMITTEE SIGNATURE: . G '77'1
DATE: 12/30/2004
4114 . l SIGN PERMIT APPLICATION
CITY` OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of DevelopmenUProject
/�
/ / FOR STAFF USE ONLY
f
Site J S. .44/1 10 -vy S SG 40,
Address/ Street Address / / Permit No.: ?� /J 7 4...A-7C/ 3 - OC. j 7 0
Location 9 f . 5 - 0 ill L- c # ///a/
�� / Expiration Date:_ Z/ �jJ /� y -- 3� Gs
Suite /Bldg. # City/State Zip ^[
T o' _ 2.3 Receipt #: --)-- - 55 - 3
Name n / l Approved By: /<
Property S 7 /4,�/i1O ‘.�/ f Cra T`i�, , ` ,/,,L. Date: I - / ' � + /V
Owner Mailing Address Suite Map/TL #:
9 90 5 1,/rIcke„7_ Zoning:
City/State Zip Phone
r y 0/1-. %7 23 6i -'/ f 77 Electrical Permit Required? ❑ Yes [ IQo
Tenantor Name
Business Building Permit Required? ❑ Yes LINO
Name Rev- 7/1/04 is \curpin \masters\revised\sign permit app.doc
--
Sign - - - - Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City /State Zip Phone
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) - (3 copies, if a building permit is required)
Proposed si requirement: 8 x 11 ", or 11" x 17"
❑ Permanent ❑ Freestanding ❑ Freeway q
Sign Temporary ❑ Wall
(Check all that ❑ Electronic III copies of elevations, drawn to scale
apply) ❑ Other ❑ Billboard El Balloon (3 copies, if a building permit is required)
[4ew sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: U K c / ❑ $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): . 2 0 1 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: [Ity ❑ Urb
(Complete all Direction Wall Faces (circle one): NOTES:
items in this �
section) N S E W NE NW (° 1 SW
• Wall signs do not need to be drawn to scale, 1
Height to top of sign (feet): 6 but must include dimensions of wall face and
Projection From Wall (inches):O 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 building permit.
Type: ❑ Internal E — 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
❑ Yes 127No 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 c)q day of D.12.00AevlbfZr , 20 C
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Aq 4
i•nat - Owner /Agent
_ Of. \ t 53 5 C F - 1/
Contact 'e son Name Phone No.
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Banner designed by Cordelia Norris, 5 Star Signs
Size: 4' x 5'
A ng CITY OF TIGARD 12/30/2004
13125 SW Hall Blvd. 1:55:30PM
a l Ii Tigard, Oregon 97223
(50 3) 63 9-4 17 1
Receipt #: 27200400000000005573
Date: 12/30/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00389 [SIGN] Temp Sign Perm 100 - 0000 - 437000 17.00
SGN2004 -00390 [SIGN] Temp Sign Perm 100 - 0000 - 437000 17.00
SGN2004 -00391 [SIGN] Temp Sign Perm 100- 0000 - 437000 17.00
Line Item Total: $51.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
CreditCard ERIC ROBBINS KJP 030421 In Person 51.00
Payment Total: $51.00
cReceipt.rpt Page 1 of 1