SGN2004-00055 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2004 -00055
° ll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/31/04
PARCEL: 25111 DD -00201
BUSINESS NAME: TONY'S PIZZA ZONE: C -N
SIGN LOCATION: 15917 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'X4' 2 SIDED
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one temporary 3'x4' A -frame sign. Sign must be placed on
private property and not in the public right -of -way or visual clearance area. Valid
4/1/04- 5/1/04. Sign #2
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
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 sh i lays from validity date.
APPROVED BY:
PERMITTEE SIGNATURE: 41 ' G 6 / I"
DATE: 3/31/04
•
f
,,L .il 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 'r 0 K V S r) . 2'2_04 FOR STAFF USE ONLY
Address/ Street Address Permit No.: "_4/ a -- o O 654_
Location , S a ( S w+ Q (l f31 U (A.
Suite /Bldg. # City /State Zip ,c
Expiration Date: . VI/ 0 Y — S7 /04
-�- 025,ar� a cg7-22 — I Receipt #: �Y — 13 1 3
Name Approved By: KV
G11
Property A ( OI4 ,( Date: 3 f 1l o (J 1
Owner Mailing Address Suite Map/TL #: V-,571/ pp— — oo 2 .)(
2a a l S( I4-ve 2? O b Zoning: CA
City /State Zip Phone
<..atf,Lie 6 1 i) y- 'g -Act rS
Tenant or Name Electrical Permit Required? ❑ Yes 12
Business ÷-pvt `3 2 S Building Permit Required? ❑ Yes 0
Name Rev. 8/7/2003 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 w ithout the required submittal elements
copy of all City /State Zip Phone Q elements)
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)
Proposed (3 copies, if a building permit is required)
p ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign ❑ Temporary ❑ Wall
(Check all that 1=1 Electronic
apply) ❑ Other El El
❑ 2 copies of elevations, drawn to scale
. 1( New sign? (3 copies, if a building permit is required)
g ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: 2S 1 S � '
3 — ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 2 Li 4 ,, .
❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft Jurisdiction: ❑ City ❑ urb
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) Ij 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: VtJO 0 GA • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes No No building permit.
Type: ❑ Internal g 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
El Yes VI, 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)
ti
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.
03
DATED this — 3 I - day of , 20
JOI
Signature of Owner /Agent
6 3 g.7a 7 Is
Contact Person Name Phone No.
v / �s
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A CITY OF TIGARD 3/31/2004
13 12 5 SW Hall Blvd. 3:32:23PM
# Tigard, Oregon 97223
AI+ ..41::,,.::,, (503) 63 9-4 17 1
Receipt #: 27200400000000001313 .
Date: 03/31/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00055 [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
Check MEHRI Z. GOLKAR KJP 1037 In Person 15.00
Payment Total: $15.00