SGN2004-00118 ir
CITY T SIGN PERMIT
rr, l DEVELOPMENT SERVICES PERMIT #: SGN2004 -00118
�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/26/04
PARCEL: 2 S 104 B B -08000
BUSINESS NAME: ULTIMATE TAN ZONE: C -N
SIGN LOCATION: 14250 SW BARROWS RD 001 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 6'
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: Install one banner. (3' x 6') Sign #1 Valid from 6/1/04 through 7/1/04.
MATERIALS: VINYL
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: (li a .
PERMITTEE SIGNATURE: EEE7L
DATE: 5/26/04
. ,
SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Ha11 Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
/ FOR STAFF USE ONLY
Site Ja /"/p14 l ,- .5i
Address/ Street Address J p mit
P er No.: J GtJ c U) (-/ " 00 t / 8
Location /17/0 ,a/7 7 . C Suite /Bld # Ci /stat Zip Exp Date: 7 - i - d T
Tl 2 eceipt #: c?oog -
Name _ Approved By: C
Property (1/W/ * .5 -d 4 Date: 5- a ?-0
Owner Mailing Address _ Suite Map /TL #: c26 / O 4 4 (3 l3 — 0D
C0 s64/ /fiL Zoning: C - /v
,ci Zip Phone
i .e Ma 716i o 00! — (41/ Electrical Permit Required? ❑ Yes j No
Tenant or Name f--'
Business `)e t M Ar .1 Building Permit Required? ❑Yes No
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. C. . 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 Other El copies of elevations, drawn to scale
apply) i--1 ❑ Bil lboard ❑ Balloon
(3 copies, if a building permit is required)
New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11", to 24" x 36"
Sign Dimensions:
3 g /'g ' ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
ft' g f ❑ $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) 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: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes t No building permit.
Type: ❑ Internal 14 External I • 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)
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 rn , 20�
/ 41IP
Signature of Owner /Agent
/41002
Contact Person Name Phone No.
i\l6 ° °\/ V
71/: vsn
0/06
CITY OF TIGARD 5126/20C4
13125 SW Hall Blvd. 3:02:48PM
Ai��,,,i Tigard, Oregon 97223
_=_L.;t (503) 639 -4171
Receipt #: 27200400000000002258
ate: 05/26/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00 1 1 8 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
Line item Total: $15.00
Payments:
Method Payer User 1D Acct. /Check Approval No. How Received . Amount Paid
Check DEBRA NASS /ULTIMATE TAN CAC 5261 In Person 15.00
Payment Total: $15.00