SGN2004-00288 CITY TIGARD SIGN PERMIT
fll DEVELOPMENT SERVICES PERMIT #: SGN2004 -00288
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/8/2004
PARCEL: 2S 110DC -02400
BUSINESS NAME: THE BLITZ ZONE: C -G
SIGN LOCATION: 11565 SW DURHAM RD 110 JURISDICTION: TIG
APPLICANT /AGENT: THE BLITZ
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2.5' X 9'
TOTAL SIGN AREA: 22 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 banner. Sign #1. Valid from 10/11/04 through
11/11/04.
MATERIALS: VINYL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 0.00
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 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: l ^ �- eGc,U t�
PERMITTEE SIGNATURE: -, .PW-4/ o r "j
DATE: 10/8/2004
0 ti � L�
Aek
��1II SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
Site ‘A/j lit) W b�voK FOR STAFF USE ONLY
Address/ Street Address PermitNo.: JC90 07acci — 0083
Location 11665 Sint DU(ham Ro(
Suite/Bldg. # City /State Zip Expiration Date: 1 1 — I 1 - o'
flv F I ll Ccra ( -7a4 Receipt #: °O - 44
Name Approved By: C • c ,.
Property 1) 5RMQ{(a L LC, Date: i 0 - ¢, -�-4
Owner Mailing Address 1 Suite Map/TL #: a i /a DC — vu
/ ) 5 S k) AeA(I e 0 v Zoning: C- cam
City/State Zip Phone
it 5 G (4 D ri7)3 5D -579 ' 4 ° 2 - 43 Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name
Business a j 1 t Building Permit Required? El Yes ❑ No
Name Rev. 7/1/04 is \curpin \masters \revised \sign permit app.doc
Sign
Contractor Mailing Ad.: s Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit
(Note: applications will not be accepted
issuance, a
copy of all City /State Z. Phone without the required submittal elements)
licenses are
required if ❑ Completed Application Form
expired in the Oregon : st. Cont. Board : Date
City of Tigard's Lice -- # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database)
(3 copies, if a building
Proposed ( p� g permit is required)
Pro
p - ermanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11", or 11" x 17"
Sign �:� Temporary ❑ Wall ❑ Electronic
(Check all that ❑ 2 copies of elevations, drawn to scale
apply) ❑ Other El ❑ Balloon
(3 copies, if a building permit is required)
2 New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions:
5/ x °l El $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 0 22, E $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: [11 City 111 Urb
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N S E WO NE NW SE SW
Height to top of sign (feet): • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): 1(9- " but must include dimensions of wall face and
sign placement.
Copy: £ y ./ n/D p PFMNG • Wall signs do not require site /plot plans.
Materials: VilJ)I • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes ® No building permit.
Type: ❑ 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
❑ Yes No BECOME NULL AND VOID.
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
► R
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 g day of , 20 0
id- l o.M49.41..) Matia,
ignatufe of Owner /Agent
S� lxl,1 /.e Ma' /`0, �d 3 - 5 2 9 --P02-63 Conta Name Phone No.
CITY OF TIGARD 10/8/2004 t
13125 SW HallBlvd. 3:29:31PM
cI �. Tigard, Oregon 97223
R21 W (503) 639 -4171
Receipt #: 27200400000000004477
Date: 10/08/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00288 [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 STEPHANIE E MALLOY CAC 035099 In Person 15.00
Payment Total: $15.00
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