SGN2005-00350 f
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CIT� ®� TI��RD SIGN PERMIT
I� DEVELOPMENT SERVICES PERMIT #: SGN2005 -00350
''� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/14/2005
PARCEL: 2S 112 DD -01600
BUSINESS NAME: DENTAL PROFESSIONALS ZONE: I -P
SIGN LOCATION: 15495 SW SEQUOIA PKWY 120 JURISDICTION: TIG
APPLICANT /AGENT: SECURITY SIGNS
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC: Y
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: SEE ABOVE
TOTAL SIGN AREA: 66 sq. ft.
WALL AREA: 525 sq. ft.
WALL FACE (DIRECTION): E
SIGN HEIGHT: ft.
PROJECTION FROM WALL: 5 in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Install one new wall sign. (21' 10.75" x 3')
MATERIALS: ALUM /PLASTIC
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 38.00
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 days from validity date.
��� �� .
APPROVED BY:
PERMITTEE SIGNATURE: ��
DATE: 11/14/2005
�'
�: ;•1 i!
CITY OF TIOARD !3/2S SW Hall Blvd., Tigard, OR 97223 (S03) 639 -4/7/ FAX: (S03) 684 -7297
GENERAL INFORMATION
Name of DevelopmenVProject
FOR STAFF USE ONLY
Site � �.l'C�_ �Zd'�= S�In/../�t -.S
Address/ Street Address Permit No.: � (� 1J ,� �S � � � � >35 t�
Location (�'- e.�.p � S� I � �
Suite /Bldg. # Ciry /State Zip
I� �� Expiration Date:
Receipt #: ,;� CUS �- ��' ��
Name Approved By: C ~ ��
Property Date: jl - l4 -c,5
Owner Mailing Address site Map/TL #: � S 1 / �?l� /) �° � l (o �
Zoning : / - i�
City /State Zip Phone
Tenant or
Name Electrical Permit Required? �] Yes ❑ No
Business Building Permit Required? ❑Yes (�j No
Name Rev. 8/7/2003 is \curpinlmastersuevised\sign permit app.doc
Sign �J�'c U6Z [ I � �SI[�,6. C S
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permic (Note:. applications will not be accepted
issuance, a Z�ct�t 5� 4�- OL [�Q�, �
copy of all Ciry/$tate Zip Pnone without the required submittal elements)
licenses are
required if �� �,� �fZ"7�7 Sb323 Z �( 1"�L ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License #
database) )�ZZ� ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
- (3 copies, if a building permit is required)
Proposed ❑ permanent ❑ Freestanding ❑ Freeway size requirement: 8' /z X 11 ", Of 11" X 17"
Sign ❑ Temporary Wall ❑ Electronic
(Check all that Other ❑ ❑ 2 copies of elevations, drawn to scale
apply) ❑ ❑ Billboard Balloon
(3 copies, if a building permit is required)
[� New sign? ❑Alter to existing sign? size requirement: 8' /z" x 11 ", to 24" x 36"
Sign Dimensions: i „ r
Z l -- (C� r� 3 ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): � � � ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) � ��� Jurisdiction: ❑City ❑ Urb
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S � W NE NW SE SW
Height to top of sign (feet): I -� � e Wall signs do not need to be drawn to scale,
Projection From Wall (inches): �'r but must include dimensions of wall face and
sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: �kZ,,�V11 AIIJV"1 ��L/9S�) � , • Freestanding signs over 6 ft: required a
Will sign have illumination? Yes ❑ No building permit.
Type: � 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)
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
- -- - -:
Signat. - : : �� er /Agent •
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S�- T3� �� � � � �
Contact Person Name Phone No.
Day ,k� i Scope of Work: Night
Permit, manufacture and install one (1) Set of internally illuminated
35' I�ever5e Channel Letters and one (1) Set of Flat Cut Out letters.
"DP" Letters:
KETUIZNS Five inch (5 ") painted aluminum (to match
:, �, _
PM5 2995c)
���" ` BACKS Clear Plex backs .�� °�'�� �`�iV �� r 1.
Snooze0entist.com ` . a ._ .».� '.
,��
- FACES White Alex w /digitally printed translucent
� � vinyl (to match PM5 2995c) .`
` TRIM CAP Black
- - - ILLUMINATION EGL White Neon �r�"' -
_�,� .. � , en a Professionals" Letters: � *, � ' � _,;;.
__
"D t I
_ • .-
- f ��"` ` RETURNS Five inch 5" ainted aluminum to match '` •� - �"'� � � �`t' =- �-° �� • � "ice ��='" - � -�
_ r
( ) p ( x�. ,,��
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-- �-- �- --.- -e ;_ -�
BACKS Clear Plex backs "� "`• •° "�`{ -_ -�
�"' °° ` ='" '� FACES White Alex w/ digitally printed translucent
•� � - - -� '� vinyl (to match PM5 361c)
-- R�- T1zIM CAP Black
ILLUMINATION EGL White Neon �
"5noozeDentiSt.com" Letters: ,
(15 x 35) x .15 = 78.75 Allowable 5c�uare Feet of 5ignage ' /z" Black 5intra w/ Bruehed Aluminum WriSCO applied to the faces. � �
65.7 Square Feet of Signage Proposed Install F.C.O. Letters flush to wall Surface. �, �- __ --` "" Typical Channel Letter Detail �
Installation: A'' ' -� �
Install letters 2" ofP wall to allow "halo" lighting using remote , S� -'� 3/8" x 4-" Shielded
transformers. �` � gag BoItS
1° Trim Cap
3/16" Acrylic face
21' -10 3/4"
__�I 30 MA Neon Tube �
10' - 21/4" I
. -� ���II
F���I11II GIa55 HOU51ng5
T � —i�� 30 MA Transformer
�� � with disconnect switch ��
� ��� � � UL approved GIa55
�� `. �� Stands
� � �. '.� A roved ��� �� ��� � �''�Y Walleturn5 N.T.9.
PP P _
I Con • I Iona y Approved ,
For only the work as described in: [ �
Reverse Channel Letters - 65.7 5c�. Ft. PERMIT NO. e�e�S oQ v
Scale:' /2 "- 1 ' - 0" See Letter to: Follow � ^ -�
_ Attach � 1
Job Addres _: GJ ,�- -
� ��: ►� O Copyright 2005 Security Signs, >�t�. - nat . _ _i� -i�-v s
r i DATE 1 02505 LANDLORD APPROVAL L7ENT APPROVAL
��1ExH.11D�.� This original design and specifications arc
SIGU ASSDCI4I�ON
exclusive property of Security Signs, Inc.
SE � U F� � � SIGN The use of these designs to produce a similar DRAWING # 05- KS 83 5 R 1
_ � sign without written authorization from
QUALITY SINCE 1 925 � Security Signs, Inc. is forbidden. PAGE # 1 OF 1 dental professionals PLEASE SIGN HERE PLEASE SIGN HERE
_ _.
WWW.SECURITYSIGNS.COM PROJECT MANAGER 15495 SEQUOIA PKWY.
CUSTOMER AGREES BY
436 SE 12TH AVE T. 503.232.4172 OR CCB #122809 � SUITE 1 20
PORTLAND OR 97214 F. 503.230.1861 WA SECU RS1020CF INITIALING HERE MATT MCCLEAN TIGAR D, OR DATE DATE
CITY OF TIGARD 11 / 14/2005 . >.
13125 SW Hall Blvd. 2:59:38PM '
�,�,�m,� � � Tigard, Oregon 97223
�L��'� (503) 639 -4171
Receipt #: 27200500000000005830
Date: 11/14/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2005 -00350 [SIGN] Sign Permit 100 - 0000 - 437000 33.00
SGN2005 -00350 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 5.00
SGN2005 -0035I [SIGN] Sign Permit 100- 0000 - 437000 33.00
SGN2005 -00351 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 5.00
ELC2005 -00892 [ELPRMT] ELC Permit 220 - 0000 - 431510 53.40
ELC2005 -00892 [TAX] 8% State Surcharge 100 - 0000 - 207020 4.27
ELC2005 -00893 � [ELPRMT] ELC Permit 220 - 0000 - 431510 53.40
ELC2005 -00893 [TAX] 8 %State Surcharge 100- 0000 - 207020 4.27
Line Item Total: $191.34
Payments:
Method Payer User ID Acct. /Check No.Approval No. How Received Amount Paid
Check SECURITY SIGNS, INC CAC 014413 In Person 191.34
Payment Total: $191.34
cReceipt.rpt Page 1 of 1