SGN2010-00022 r �
CITY OF TIGARD SIGN PERMIT
" � ; ;.. Permit #: SGN2010 -00022
COMMUNITY DEVELOPMENT Date Issued: 02/26/2010
T1.GARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S134BC00300
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 6' 10 3/8"
Total Sign Area: 12
Wall Area: 371
Wall Face (Direction): Southeast
Sign Height: 15 ft.
Projection From Wall: 6 in.
Illumination: Internal
Materials: Blk Channel /Plexi
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: /. /
0'
Permittee Signature:
SIGN PERMIT APPLICATION
City of Tigard Permit Center 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960
TIGAR.D;
GENERAL INFORMATION
Na a of elopmcnt 74. t
/ FOR STAFF USE ONLY
Site { d CIA { ) 4 • << nn
Address / treet Ad ress � Permit No.: _] 10.i 1 D OD r)a e3'
! 57.11 Jt!
Location M/v 2 0
Expiration Date:
Suite /Bldg. # State Zip
A 7 f71)- 3 Receipt #:
N / V / Approved By: S -
Date: d- f a`�, v Property
Owner Mailing Addre Suite Map /TL #: /5/ 3 q A 6 a .3 "
j ?l, /!0 /.) A Zoning:
ty/Sta Phone q p
, Z 91� 4 ) ^J7 /�a y Electrical Permit Required? [ Yes ❑ No
Tenant or N 1e Kee Business a n, I
usiness !! / `_'t J (-,`(�,'� 1/�f`'� Building Permit Required? ❑Yes dN o
Name Rev. 7/1/09
t \curpin \masters \land use applications \sign permit app.doc
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Sign �/ f A 3
Contractor Mailing A / Suite
(Prior to permit s' /p/
c o py of a G
copy of all Ci /State 1 Zi Phone REQUIRED SUBMITTAL ELEMENTS
licenses are (Note: applications will not be accepted
required if 2 1 /0411) Ylita ) 7 16 7/P 7 without the required submittal elements)
expired in the Oregon Const. Cont. Board License # Exp. Date
City of Tigard's
database) / J , p
/}' 7 01 ❑ Completed Application Form
Proposed Z 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"
or New sign? ❑ Alter to existing sign? 111 2 copies of elevations, drawn to scale
Sign Dimension 0 / i s ) �r q 0 (3 copies, if a building permit is required)
ff�� (/ /V /S size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): t
❑ $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.)? 4v $ ❑ $19.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this � NOTES:
section) N S E W N E N W ( SW
Height to top of sign (feet): /,'" j tt • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): G M must include dimensions of wall face and sign
placement.
Copy: � �' / // • Wall signs do not require site /plot plans.
Materials: / / r r yy `'" • Freestanding signs over 6 ft. required a building
Will sign have illumination? Yes ❑ No permit.
Type: ❑ Internal 11.1 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
❑ Yes No 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 ,2te f� day / , 20 l0
Signature of Owner /Agent
(12% 1/5 S 97u - 14u
Contact Person Name Phone No.
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Manufacture and install ore (1) single face, internally iUuminated wall sign.
Sign:
C '' OF �� | o^ Deep a��o�c c�nne��v~u�p�x�c�
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`- '/}Ap pruved �" � Face:
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work 3/16" White Plex with 1" Blac Trim Cap. Face
• • -- :v/' -- ; NO. /0-01.77- applied to the first surface.
.-:2' ' ctier to: Follow - � [ ] Illumination:
' Attach |
��' '''z J��) | High outpu fluorescent lamps.
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V,I,0 / m Copyright 2004 Security Signs, Inc. DATE ,ou/u* L^wou,no^ppRov^L CLIENT APPROVAL This
endusi, DRAWING o+xyv2o :„.....n,.‘,:;)fit-ryi
,,,„of these &sips to produce a similar
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CITY OF TIGARD RECEIPT
`1
�» • 13125 SW Hall Blvd., Tigard OR 97223
• 503.639.4171
T7 GAR D
Receipt Number: 177039 - 02/26/2010
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2010 -00022 Sign Permit 1003100 -43115 $35.00
SGN2010 -00022 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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