SGN2004-00016 Q _,
4 CITY OF TIGARD SIGN PERMIT
i DEVELOPMENT SERVICES PERMIT #: SGN2004 -00016
c= I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/28/04
PARCEL: 2S102DA -00401
BUSINESS NAME: CITY OF TIGARD ZONE: CBD
SIGN LOCATION: 13125 SW HALL BLVD JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 4'
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: Placement of one (1) temporary, two sided, wooden sign. (3 x 4) Valid from
1/30/04 through 2/28/04. Must be placed outside of right of way.
MATERIALS: WOOD
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:
&4-66(31.-- Q , Ca
PERMITTEE SIGNATURE: -P el-p Ca s/L"
DATE: 1/28/04
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I l► � SIGN PERMIT APPLICATION
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CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project FOR STAFF USE ONLY
Site -1(p T F Q�< - 1 - 11- , ��
Address/ Street Address Permit No.: 5G1.1 a DO - 6001(0
Location /2_c LL � 1,1) Expiration Date: °? -as ^ D LI
Suite /Bldg. # City /State Zip
-rig a `d OK 4') Zt3 Receipt #:
Name / / T / Approved By: C • ��
Property C� �/ / -1 / / rn' / Date: / - (260' - 0 4
Owner Mailing Addrel;s S Map/TL #: .1-5/ D A - oo , fo /
Zoning: C.-13p
City /State Zip Phone
Electrical Permit Required? ❑ Yes No
Tenant or Name
Business Building Permit Required? I=1 Yes 4 No
Name Rev. 2/28 /2003 i:\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
copy of all City/State Zip Phone without the required submittal elements)
licenses are
required if T1 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 ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11", or 11" x 17"
Sign Temporary ❑ Wall ❑ Electronic
(Check all that 0 2 copies of elevations, drawn to scale
apply) ❑ Other ❑ Billboar ❑ B al loon
(3 copies, if a building permit is required)
❑v'New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11", to 24" x 36"
Sign Dimensions:
3 1 x , / ,
❑ $6 Fee (Permanent sign, any size)
3130
Total Sign Area (sq. ft.): /2 � ), / ❑ $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
Height to top of sign (feet): • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: V 00 ) • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes 137No 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 [/No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
1
1
.1
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 day of , 20
Signature of Owner /Agent
of,
�I i...4 6.
Con Tr" erson ame Phone No.
09/22/2003 15:59 5032244215 DRAKULICH CARLSDN PAGE 02/02
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