SGN2004-00365 CITY TIGARD SIGN PERMIT
q■i� DEVELOPMENT SERVICES PERMIT #: SGN2004 -00365
c'111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/1/2004
PARCEL: 2S 110AC -01400
BUSINESS NAME: BULL MTN HEIGHTS ZONE: R -25
SIGN LOCATION: 11430 SW BULL MOUNTAIN RD JURISDICTION: TIG
APPLICANT /AGENT: BULL MTN HEIGTS
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON: Y
SIGN DIMENSIONS:
TOTAL SIGN AREA: sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of balloon cluster.
MATERIALS: BALLOONS
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: 2 a . (GC - ti" c_
PERMITTEE SIGNATURE: \j J` -
DATE: 12/1/2004
. S
.1, ,;.,_`' 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
11 FOR STAFF USE ONLY
Site v 1M - 4\el �-
Address/ Street Address J Permit No.:
Location 1)14 SLA) j011 _ 4(1
Expiration Date:
Suite /Bldg. # City/State Zip
G rk Of— ')--).-.1 Receipt #:
Name Approved By:
V
Property Ctrd ✓Q ujs Y ncq hiu ri (- Date:
Owner Mailing Address Q r' Suite Map/TL #:
1 ? _3.5 ) SO all O 41 & Zoning:
City/State Zip Phone •553
,Yc 6f- Tw..1 u''4 - l fi 1 11 Electrical Permit Required? ❑ Yes ❑ No
Tenant or Na
Business a.)(l��Pvos w),3-1-- Building Permit Required? Yes ❑ No
111
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 Phone
licenses are
•
required if ❑ Completed Application Form
expired in the regon Const. Cont. Board Exp. Date
Cit�y o T rd's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
d5rabase)
(3 copies, if a building p� g permit is required)
Proposed ❑ Permanent ❑ Freestanding III Freeway size requirement: 8 x 11", or 11" x 17"
Sign Temporary ❑ Wall
(Check all that ❑ Electronic ❑ 2 copies of elevations, drawn to scale
apply) Other ❑ Billboard E1 Balloon (3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: ❑ $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: ❑ 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.
7. Materials: 11rnk> • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes ❑ "No building permit.
Type: Internal El • 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 At 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)
I hereby acknowledge that 1 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 J ,e CQ AALer , 20
Signature of Owner /Agent
VavusSa_ 46SP) , OS') (z � h -01 '
Contact Person Name Phone No.
•
CITY OF TIGARD 12/1/2004
13125 SW Hall Blvd. 2:33:59PM
Tigard, Oregon 97223
(503) 63 9-4 17 1
Receipt #: 27200400000000005180
Date: 12/01/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00365 [USIGN] Temp Sign Perm 255- 0000 - 437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
CreditCard VANESSA PUGLIESI CAC 023334 In Person 15.00
Payment Total: $15.00
cReceipt.rpt Page 1 of 1