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SGN2004-00170 C ITY OF TIGARD SIGN PERMIT u°1 I DEVELOPMENT SERVICES PERMIT #: SGN2004 -00170 Ali c�i 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/23/2004 PARCEL: 1 S136AD -04000 BUSINESS NAME: PREGNANCY RESOURCE CENTER ZONE: C -G SIGN LOCATION: 11507 SW PACIFIC HWY D JURISDICTION: TIG APPLICANT /AGENT: BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: Y ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 30" X96" TOTAL SIGN AREA: 20 sq. ft. WALL AREA: 377 sq. ft. WALL FACE (DIRECTION): SIGN HEIGHT: 10 ft. PROJECTION FROM WALL: 10 in. ILLUMINATION: INT DESCRIPTION OF SIGN: Installation of (1) one 20 sq. ft. permanent wall sign. MATERIALS: ALUMINUM EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: Y BUILDING PERMIT REQUIRED: N ADMINISTRATIVE EXCEPTIONS: TOTAL PERMIT FEES: $ 32.00 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 shall expire 10 da s from validity date/ • • APPROVED BY: + % �^^ -� PERMITTEE SIGNATURE: ' I - C DATE: 7 3/2004 „. I 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 FOR STAFF USE ONLY Site pce clover R4Sr a rfn Ic 'S C Address/ Street dress Permit No.: $ 9 iL 'L-c �/ - CO i 7 L'' Location I I SD - 5w PA e A I'' 14 C `( Expiration Date: • Suite /Bldg. # City /State Zip D Iliac-a- o2 5 7,22? Receipt #: Name I Approved By: Property CJ eCyL : rel'ec0 Date: 7/,. 3 cl V Owner Mailing Address Suite Map /TL #: 507 sw P•cX c liw D Zoning: C___C7 City /State Zip Phone Ti fAr o _ c i7a 2 .3- 374 Electrical Permit Required? Ids ❑ No Tenant or Name Business Pity-AO-67 f e � vrce C Building Permit Required? ❑ Yes [I-fdt Name /� ,� Rev. 7/1/04 iAcurpin \masters \revised \sign permit app.doc Sign ,�ly'ro-trl 5,1 (vs L.G.C, Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS (Prior to permit (Note: applications will not be accepted issuance, a a 413 , 44 t Lt iA - g o y-- without the required submittal elements) copy of all City /State Zip jtd Phone licenses are required if Wee MA „J IA /g1,7y 3(00 aas" ❑ Completed Application Form expired in the Oregon Const. Cont. Board Exp. Date City of Tigard's License # Ill 2 Copies of Site /Plot Plan, Drawn to Scale database) I S 7IN (3 copies, if a building permit is required) Proposed El. Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17" Sign ❑ Temporary ® Wall ❑ Electronic (Check all that ❑ Other ❑ Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale apply) (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: -30" X 9` �i ❑ $32.00 Fee (Permanent sign, any size) Total Sign Area (sq. ft.): aO ❑ $15.00 Fee (Temporary sign, any type) Sign Data Total Wall Area (sq. ft 3 . 7 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): /p (o but must include dimensions of wall face and Projection From Wall (inches): /Q '' sign placement. Copy: • Wall signs do not require site /plot plans. Materials: • Freestanding signs over 6 ft. required a Will sign have illumination? ❑ Yes ❑ No building permit. Type: ik 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 III 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) 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 Contact Person Name Phone No. ®YEagiB 96. Your Electrical Sign Source r _ r - ":'°' .RD Approved _ VC) ) SHERWOOD, OREGON Condiiti.. Aror7 ;i. ( ) 603- 720 -6410 For on., • „ , zrk ;; r PERMIT r�t - V �0 17 O b See Letter = . [ ) CUSTOMER Job Add =�.. 501 _ I A..1:14,1 Knowledge Points By: �/ _ . _' ;. _7_2_,/ ADDRESS Lake Oswego, Or 8" JOB FILE NUMBER -' '' "' ;, . K f LAG BOLTS DATE 9 t � . * '� 041404 _ � ° - x r LEXAN FACE LAMPS de DESIGNED BY SOCKETS Designer ` RETAINER — WIREWAY J 8'4 REVISIONS 13 FLEX CONDUIT N Irei e�� aaLLa sr _ ST j $11105 f v CABINET -' 4. 503 - 310-0999 f WALL ...... A l* Iplp. aLl .1 . tik ii. - $ , TO 120 VAC Sign in photo approximate THIS DRAWING IS THE PROPERTY OF YOUR ELECTRICAL SIGN SOURCE, AND IS NOT TO BE REPLICATED OR USED MANUFACTURE AND INSTALL (1) INTERNALLY ILLUMINATED EXTERIOR WALL SIGN IN ANY MANNER WITHOUT EXPRESS WRITTEN CONSENT CABINET FABRICATED FROM ALUMINUM- PAINT Oracale 651 Purple ILLUMINATION - - -- FLUORESCENT LAMPS ATTACHMENT ATTACH TO EXISTING WALL FASCIA CUSTOMER APPROVAL OF LOGO, COLORS, DIMENSIONS REQUIRED BEFORE MANUFACTURING Rev. 1 1