SGN2004-00272 f j
* CITY OF TIGARD SIGN PERMIT
A, DEVELOPMENT SERVICES PERMIT #: SGN2004 -00272
-' I� DATE ISSUED: 9/28/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 110DC -02400
BUSINESS NAME: DR BRANDON ZONE: C -G
SIGN LOCATION: 11565 SW DURHAM RD JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC: Y
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: T X 1'10"
TOTAL SIGN AREA: 13 sq. ft.
WALL AREA: 675 sq. ft.
WALL FACE (DIRECTION): E
SIGN HEIGHT: ft.
PROJECTION FROM WALL: 8 in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Placement of one permanent wall sign. (7' x 1' 10 ")
MATERIALS: ALUM /PLEX
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
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: . �G
PERMITTEE SIGNATURE: ��.
DATE: 9/28/2004
A •
� SIGN PERMIT APPLICATION S
._� - -•!�� CATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
b2 1..Z1/11-k.00/,-/ 1..Z1/11-k.00/,-/ 1..Z1/11-k.00/,-/ FOR STAFF USE ONLY
Site
Address/ Street Address Permit No.: S 6►J �GO — ooa7a,
Location 11 Sw R vIA F-h
Suite/Bldg. # city /state Zip Expiration Date:
P-100 ' I 6 0 1 Rb i OE R"7 ( - { Receipt #: a004 — '/ 0.1„. Name Approved By: C- • CaZrt.Pii--)
Property Vk. L • /400 A \1' Date: rJ — .28 -0`1
Owner Mailing Address Suite Map/TL #: ,..QS 1 / o DC — oca'/ oo _
'Th \ NE I t y pVt Zoning: — G
/�
, Ciity /State Zip Phone
VV co ii 2. �I� 9ti0 14-Da Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name
Business Do_. --\41,1toki Building Permit Required? ❑ Yes ❑ No
Name Rev. 8/7/2003 i:\curpin.mastersvevisedlsign permit app.doc
Sign t`j(.Y1154`f JIG7N5, - -I
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit e I� Q '7V N- ( pP
issuance, a `7 (Note: applications will not be accepted
copy of all City /St Zip Phone sa3 without the required submittal elements)
licenses are
required if p(Q' O*, O Q ?I,00 777 9566- Completed Application Form
expired in the Oregon Const. Cont Board Exp. Date
City of Tigard's License # , / �� / / O p
database ) `T 2 Copies of Site /Plot Plan, Drawn to Scale
Pro osed (3 copies, if a building permit is required)
p Permanent Freestanding El 1h
Freeway size requirement: 8" x 11 ", or 11" x 17"
Sign Temporary , Wall ❑ Electronic
(Check all that ❑ Oth
apply) ❑ Billboard El Balloon 2 copies of elevations, drawn to scale
Igt New sign? (3- copies, if a building permit is required)
g ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions:
/ X 1 t 1 0 pi $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
l �, , ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) r 7 5
4S�is �P Jurisdiction: [7 City ❑ Urb
(Complete all Direction W Faces (circle one):
items in this NOTES:
section) N E NE NW SE SW
Height to top of sign (feet): 19 ' / 0 't • Wall signs do not need to be drawn to scale,
Projection From Wall (inches):. ,, but must include dimensions of wall face and
Copy: D? aP IOoti be- r:—>v Y . i s sign placement.
• Wall signs do not require site /plot plans.
Materials: g b'" -- 14:1 C VWLAft. NI(4t., PGx) • Freestanding signs over 6 ft. required a
Will sign have illumination? ►_ Yes ❑ No building permit.
Type: iga 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
❑ 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)
. Letter of Authorization
• ,
www.ramsaysic ns.com 3 1 1 I. 5
9160 SE 74th Ave Portland, OR 97206 5
P: (503) 777 -4555 1- 800 - 613 -4555 F: (503) 777 -0220
, op,. 1 OA pO4 • , represent that I /we are owners/landlords of the following real property:
0
11565 SW Durham Rd. Bld F Ste 100
Tigard, OR 97224
Washington
Including the building constructed thereon, which property is presently being rented to:
Dr. Brandon SCKco ta9ti
(tenant)
I/We acknowledge that Ramsay Signs, Inc. will be installing the following described sign(s) to:
Dr. Brandon SC rf 42 i Al al
(tenant)
Single face sign on Durham Rd.
Single face sign East elevation
Single face sign on South elev.
(description of sign)
Dated this a,/ day of , .20 6
!"T
(Landlord/Owner or Authori Agent)
(Landlord/Owner or Authorized Agent) •
MAILING ADDRESS: 98/ / /// yam_
c.,4,ar° w A y �Yei 2-
PHONE NO.: 52,3-40-- oz 3 S FAX NO.: 360- 8135-- 727
•
INTERNALLY ILLUMINATED WALL SIGN ..
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CABINET °` 'ANGLE CLIPS INTO
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REMOVABLE _•
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SIGN FACE - -- i
FLUORESCENT — 1 /2" CONDUIT
LAMPS ' ' I THRU WALL
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N CONDUIT
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CITY OF TIGARD 9/29/2004
13125 SW Ha11 Blvd. 11:57:17AM
Tigard, Oregon 97223
ANVIL (503) 639 -4171
Receipt #: 27200400000000004302
Date: 09/28/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00270 [SIGN] Sign Permit 100- 0000 - 437000 32.00
SGN2004 -00271 [SIGN] Sign Permit 100- 0000 - 437000 32.00
SGN2004 -00272 [SIGN] Sign Permit 100 - 0000 - 437000 32.00
ELC2004 -00623 [ELPRMT] ELC Permit 220 - 0000 - 431510 160.20
ELC2004 -00623 [TAX] 8% State Surcharge 100- 0000 - 207020 12.82
Line Item Total: $269.02
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check RAMSAY SIGNS, INC CAC 1725 In Person 269.02
Payment Total: $269.02
Page 1 of 1 cReceipt.rpt
r
a . •
This sign is intended to be installed in accordance with the requirements of article 600 of the National Electric Code andor other applicable local codes. This includes proper grounding and bonding of the sign.
A4TY AF TIC ` ....
p roved • -••
C ?ndt ApP as desor'. o rs :__,
4
Fot o th e w �k Iv y 4 — -
ri ee Let t o. Foll ow..• `Rl PRODUCTION PRINT
lIt 5 ....6t A) 1'--h ' ,AU / t t R t E 5 h
ob Address: �— + 9.23.04
C C / Y Date
1------ O f
9.3.04
DENTIs - R FOR CHILDREN & -rEENS Client
Y ACC E X C U: IVE E SIGNATURE Dr. Brandon
Durham Road
Tigard, Oregon
, L .. ,- ,.: -.',,,.?... Account Executive
SCALE: 3/4" = I' - 0" Doug Ea h D
MANUFACTURE AND INSTALL (I) SINGLE .. `, Design
FACED ILLUMINATED WALL MOUNTED a Ross Hilden
DISPLAY
t
i
CABINET /RETAINERS p r m Approvals
ALUMINUM EXTRUSION . 4
PAINT TO MATCH PREDOMINATE BLUE OF FACE +? Client Date
BACKGROUND COLOR (VERIFY) . . m 1
. landlord Date
FACE ,' N
WHITE LEXAN Ilk ,.,._..,„,,-
- — Revisions
GRAPHICS . ... -4'd' - Date
DIGITALLY PRINTED ON TRANSLUCENT WHITE . ',.
VINYL ..-- .
APPLIED FIRST SURFACE ON LEXAN FACE ''o '"`"'�
ILLUMINATION .. .` , + � '�, _ .. :-, , . INTERNALLY ILLUMINATE WITH FLUORESCENT "� _
LAMPS AS REQUIRED ,:
WITH ENERGY EFFICIENT ELECTRONIC BALLASTS _
INSTALLATION i il
INSTALL DISPLAY FLUSH ON FASCIA - DENTISTRY FOR CHILDREN 4 TEENS
EXACT PLACEMENT TO BE FIELD VERIFIED v - NAeAlillIlltUllik - ''''' ' ' - — "--- —
ss. ' , , ! .. i 0 Copyright 2004, Ramsay Signs, Inc.
These plans are the exclusive Distribution or exhibition of
NOTE TO GENERAL CONTRACTOR /ELECTRICIAN t Ramsay of Raay Sign, Inc these plans to anyone other
- And are the result of the than employee%of your
BRANCH CIRCUIT REQUIREMENTS aigim! work of its design company, or use of these plans
team. to construct a sign similar to
t , -
AU BRANCH CIRCUITS FOR SIGNS the one yforb ed herein, u
MUST BE TOTALLY DEDICATED TO SIGNS, N : ro any the sok purpo se expressly (oridden-
INCLUDING DEDICATED GREEN GROUND, � i ° "° r of your consideration of In the event that such
Vans S,
PER CIRCUIT AND NEURAL PER GRCUiT * �.., '� � i ., whether to purchase these p exhibition occurs, Ramsay s
��'
Of to purchase from Ramsay Inc expects to be reimbursed
Signs, Inc. a sign manufactured SI000.00 in compensation for
SIGN CIRCUITS MUST NOT BE SHARED WITH OTHER LOADS �. "'
SUCH AS LIGHTING, AIR CONDITIONING, AND OTHER `b according to rhea plan. time and effort entailed in
min. ,:. creating these plan
EQUIPMENT
II „ .. ,a Ramsay Signs .4444 PROPERLY SIZED GROUND WIRE THAT CAN BE . , v t � , g low "` 9160 SE 74th Avenue Portland, Ore on 97206
Air TRACED BACK TO THE BREAKER PANEL MUST BE PROVIDED y
x?ss ;e , 503 177.4555 t 800 613.4555 P 503 711.0220
—
NUMBER AND SITE OF CIRCUITS FOR EACH SIGN
°
TO M .
EET RAMSAI SIGNS REQUIREMENT ,
i
3of3 0 4 5 1 8