SGN2010-00010 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2010 -00010
COMMUNITY DEVELOPMENT • Date Issued: 01/29/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S110AC01700
Jurisdiction: TIG
Name of Business: CHRIST THE KING LUTHERAN CHURCH
Business Address: 11305 SW BULL MOUNTAIN RD
Applicant/Agent:
Work Description: Placement of one (1) temporary freestanding sign (A- frame) 2' X 3' Must be on private
property, not in public right of way. Must meet visual clearance area requirements.
Valid 2/1/10 - 3/2/10 Sign #1
Permanent: No Freestanding: Yes Freeway: No
Temporary: Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 2' X 3'
Total Sign Area: 6
Wall Area:
Wall Face (Direction): E
Sign Height: 3 ft.
Projection From Wall: in.
Illumination: NON
Materials: WOOD
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $19.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. 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: L0 "' l i
Permittee Signature:
0
q SIGN PERMIT APPLICATION
City of Tigard Permit Center 13125 SW Hall Blvd, Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960 •
`TIGA.RD
GENERAL INFORMATION
Name of Development /Project
FOR STAFF USE ONLY
Site � y �'�te (c KJ IeSc� 56A) ,zG10 —10
Address / treet Address // //J/ PermitNo.:
Location i ( 3 05 5Lti ea,/l /Y1 I - ,
Expiration Date:
Suite /Bldg. # City/State Zip ( �3�
7 A'� y . J ( d 1 7 (� Receipt #: / �
Name c 'a1 C°�+(� / Approved By: 1 ri C� / ;
Property c,Vt M ailin g �� Lhq (C(t l � T ei r� Date: i/
Owner
Addr • Suite Map/TL#: ?-S ( , 0 ed � 1'70)
Zoning:
City/State Zip Phone
Name 0t Electrical Permit Required? r] Yes ,�No
Tenant or
Business vi l / ) ` 5+ /�/` 5 Pixof.W.
Building Permit Required? ❑ Yes p, No
Name Rev. 7/1/09
r \curpin \masters \land use applications \sign permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to perm4
issuance, a all City/State REQUIRED SUBMITTAL ELEMENTS
copy of Zip Phone
licenses are (Note: applications will not be accepted
required if without the required submittal elements)
expired in the Oregon Const. Cont. Board License # Exp. Date
City of Tigard's
database) ,❑ Completed Application Form
Proposed ❑ Permanent TZfFreestanding ❑ Freeway n 2 Copies of Site /Plot Plan, Drawn to Scale
Sign A : c Temporary ❑ Wall ❑ Electronic (3 copies, if a building permit is required)
(Check all that Other
apply) ❑ Billboard ❑ Balloon size requirement: 81/2" x 11 ", or 11" x 17"
i Ff New sign? ❑ Alter to existing sign? n 2 copies of elevations, drawn to scale
Sign Dimensions: a v r j (3 copies, if a building permit is required)
u 't` t size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): r
(.(2 ❑ $40.00 Fee (Permanent sign, any size)
• Sign Data Total Wall Area (sq. ft.) ] $19.00 Fee (Temporary sign, any type)
(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): 3 ♦ Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): must include dimensions of wall face and sign
placement.
Copy: ♦ Wall signs do not require site /plot plans.
Materials: t d 6-0,r,
• Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes ❑ No permit.
, Type: ❑ Internal ❑ Extemal • If work authorized under a sign permit has not been
Are there any existing freestanding or wall signs at this location, completed within ninety (90) days after the issuance
including wall signs that overlap a tenant s. ace? of the permit, THE PERMIT WILL BECOME
NULL AND VOID.
❑ Yes El No
If "yes ", a list or diagram of all sign dimensions and square
footage must also be submitted.
(OVER FOR SIGNATURES)
� a
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.
DA FED this day of , 20
Signature of Owner /Agent
Contact Person Name Phone No.
CITY OF TIGARD RECEIPT
Iii 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
Receipt Number: 176735 - 01/29/2010
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2010 -00010 Temp Sign Perm 1003100 -43115 $17.00
SGN2010 -00010 Temp Sign Perm - LRP 1003100 -43117 $2.00
Total: $19.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 1584 DADAMSKI 01/29/2010 $19.00
Payor: Christ The King Preschool
Total Payments: $19.00
Balance Due: $0.00
Page 1 of 1