SGN2010-00021 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2010 -00021
COMMUNITY DEVELOPMENT Date Issued: 02/26/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1 S134BC00300
Jurisdiction: Tigard
Name of Business: Hava Java /Coffee Rush •
•
Business Address: 12210 SW SCHOLLS FERRY RD
Applicant/Agent: Yost, Ron
Work Description: Installation of one (1) permanent wall sign 6' 1 1/4" X 2' 10 3/8"
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 6' 1 1/4" X 2' 10 3/8"
Total Sign Area: 12
Wall Area: 371
Wall Face (Direction): Northwest
Sign Height: 15 ft.
Projection From Wall: 6 in.
Illumination: Internal
Materials: Bik Channel /Plex
Electrical Permit Required: Yes
Building Permit Required: No
Total Permit Fee: $40.00
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:
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Permittee Signature: I
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,„, SIGN PERMIT APPLICATION
111
City of Tigard Permit Center 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960
TIGARD
GENERAL INFORMATION
Na e of D to P mcnt ro J
FOR STAFF USE ONLY
Site / (, // � e �/, � Address / treetA
s : PermitNo.: � 000 al
Location ig /v SU SC /13 Rt � i
Suite /Bldg. # C;cylstace zip Expiration Date:
l / � ' 9 711 7 Receipt #:
( 2N i By: S - 1
Property la vo� Date: I p o` I 0
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Owner Mailing Address Suite Map /TL #: /S / 3 t f F-► t 3
?/) /Vee(') 7. - Zoning:
Sta Zip Phone
M t�hi. £ Pa , ?- g7J - Y g G y Electrical Permit Required? Er<es ❑ No
Tenant or
Business C Building Permit Required? El Yes 2
Name Rev. 7/1/09
SF is \curpin \masters \land use applications \sign permit app.doc
Sign ee ✓ � A
Contractor Mailing Addr - / Suite
(Prior permii
issuance, y / y(
issuancea , a /2V•09 [, L / a JP REQUIRED SUBMITTAL ELEMENTS
copy of all iry /S p Phone
licenses are Q (Note: applications will not be accepted
required if fg 9 -- p7-514.-7//1 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 ❑ Freestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Sign ❑ Temporary ❑ Wall ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other ❑ Billboard ❑ Balloon
apply) size requirement: 81/2" x 11 ", or 11" x 17"
w New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions:6 pi ' l it , q „ (3 copies, if a building permit is required)
/V )b .2 A) /d size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): ; fj ❑ $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) 19.00 Fee (Temporary sign, any e
g ?4v ❑ $ (T P ary gn, y trn )
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E W NE 69 SE SW
Height to top of sign (feet): l • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): (o " must include dimensions of wall face and sign
placement.
Copy: / • Wall signs do not require site /plot plans.
Materials: 11 /l4 (+l /p�h' AO Freestanding signs over 6 ft. required a building
Will sign have illumination? LgrYes ❑ No permit.
Type: ❑ Internal ❑ External • 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 space? of the permit, THE PERMIT WILL BECOME
El Yes 1„ No NULL AND VOID.
If "yes ", a list or diagram of all sign dimensions and square
footage must also be submitted.
(OVER FOR SIGNATURES)
4
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 ,.2% day of / r , 20 �J
Signature of Owner /Agent
12, y
Contact Person Name Phone No.
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Single Faced Wall Sign
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EI bon , rp , r N. Scope of Work:
7 0 Manufacture and install one (1) single face, internally illuminated wall sign.
T GG t f ® [� Sign:
( �1,�i;re�fed [ 8" Deep Gloss Black Channel with a white plex face.
,r-,c work as described d irk Face:
=_
- I =.1 NO. a'AJOt I - D[jUa'
:: I , mot tr.r to Follow [ j 3/16" White Plex with 1" Black Trim Cap. Face to have translucent vinyl graphics
applied to the first surface.
Attach ... "_........_.
1 2_2- /0 S1G) VLLS I Illumination:
— . High output fluorescent lamps.
4647,
A 4 W / e) ci) Copyright 004Security Signs, Inc. DATE 102104 . LANDLORD APPROVAL CLIENT APPROVAL
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.t toil!). Signs. 11,c. is I,rh,n.lin. PAGE # 1 OF 2 G:i, •4_.�.. _.._". , arSW . PLEASE SIGN HERE PLEASE SIGN HERE
WWW.SECURITYSIGNS.COM PROJECT MANAGER
436 SE 12TH AVE 7. 503.232.4772 OR CCB #12-2809 CUSTOMER AGREES BY 12030 SW ALLEN BLVD,
PORTLAND, OR 97214 F. 503.230.7861 WA SECV RStOZOCF INITIALING HERE ToM KEL. BEAVERTON OR DATE DACE
•
1e.
CITY OF TIGARD RECEIPT
-, `•I 1 3125 SW Hall Blvd., Tigard OR 97223
. ' 503,639.4171
Receipt Number: 177038 - 02/26/2010
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2010 -00021 Sign Permit 1003100 -43115 $35.00
SGN2010 -00021 Sign Permit - LRP 1003100 -43117 $5.00
Total: $40.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 8377 LSELLERS 02/26/2010 $40.00
Payor: Ronald E Yost / Lisa S. Yost
Total Payments: $40.00
Balance Due: $0.00
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