SGN2004-00060 C ITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES
PERMIT #: SGN2004 -00060
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 - 4171 DATE ISSUED: 4/6/04
PARCEL: 2 S 110 D C - 01000
BUSINESS NAME: SUMMERFIELD ZONE: R -
SIGN LOCATION: 11175 SW MEADOW BROOK DR OFFIC JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2' X 4'
TOTAL SIGN AREA: 16 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary sign permit for A -frame sign. (2' x 4') Sign #1. Valid from 4/7/04
through 5/7/04.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
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: a
PERMITTEE SIGNATURE:
DATE: 4/6/04
a
0...,,_,1,1, SIGN PERMIT APPLICATION
LICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of DevelopmenUProject
Site FOR STAFF USE ONLY
.• ... .
Address/ Streit Address _
Permit No.: SC. oZad `l ®b ob O
Location 1 /1 75 CAtd)2,
Expiration Date: 5 — '7 — O `t
Suite /Bldg. # City /State Zip
-risc cf ` `7
1 r!� a Receipt #: 2 Oo _
Name ,� Approved By: C. ext,t;✓«,a)
Property 1-1-1: C Date: 4- (v -0 ,f Owner Mailing Address ` Sui Map /TL #: aS / t O DC-6(000
111�� y1>I1 IL Zoning: p -aS'
City /State Zip Phone
A
Tenant or Name Sci 1 Electrical Permit Required? ❑ Yes ❑ No
Business Building Permit Required? ❑ Yes ❑ No
Name Rev. 30 -Jul -01 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 , n CI
expired in the Oregon Const. Cont. Board Exp. Date tJ Completed Application 1 i
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database)
(3 copies, if a building permit is required)
Proposed size requirement: 8 x 11 ", or 11" x 17"
P ❑ Permanent ❑ Freestanding ❑ Freeway
Sign IrTemporary ❑ Wall ❑ Electronic ❑ 2 copies of elevations, drawn to scale
(Check all that ❑ Other 1:1 Billboard El Balloon
(3 copies, if a building permit is required)
apply) size requirement: 8 x 11", to 24" x 36"
❑ New sign? ❑ Alter to existing sign?
❑ $50.00 Fee (Permanent sign, any size)
Sign Dimensions: , 1
❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.):
c NOTES:
Sign Data Total Wall Area (sq. ft.) e Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
(Complete all Direction Wall Faces (circle one): • sign placement.
items in this
section) N S E W NE NW SE SW • Wall signs do not require site /plot plans.
o Freestanding signs over 6 ft. required a
Height to top of sign (feet): building permit.
Projection From Wall (inches): . If work authorized under a sign permit has not
Copy: . been completed within ninety (90) days after
Materials: the issuance of the permit, THE PERMIT WILL
Will sign have illumination? ❑ Yes ❑ No BECOME NULL AND VOID. .
Type: ❑ Internal ❑ External /
: Are there any existing freestanding or wall signs at this ( Not all jurisdictions accept credit cards, please call jurisdiction for more information,
0
location, including wall signs that overlap a tenant space? visa ❑Mastercard
. ❑ Yes No Credit card number / /
Expires
if "yes ", a list or diagram of all sign dimensions and Name of cardholder as shown on credit card
:.square footage must also be submitted.
\ Cardholder signature Amount
(OVER FOR SIGNATURES) \
✓ i
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 U of Q ,c_,(1 20_0g
) � ix
S'igna ure /if Owner /Agent
, � ��- 5 6-Q /
Contact P rson Name Phone No.
CITY OF TIGARD 4/6/2004.,
13125 SW Hall Blvd. 4:04:36PM•
� Tigard, Oregon 97223
(503) 639 -4171
Receipt #: 27200400000000001414
Date: 04/06/2004
Line Items:
Case No Trail Code Description Revenue Account No Amount Paid
SGN2004 -00060 [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
Cash SUMMERFIDLD CAC In Person 15.00
Payment Total: $15.00
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