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SGN2004-00387 CITY TIGARD SIGN PERMIT DEVELOPMENT SERVICES PERMIT #: SGN2004 -00387 � JII 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/27/2004 PARCEL: 1S135BD-00300 BUSINESS NAME: HORIZON PEDIATRICS ZONE: C -G SIGN LOCATION: 09735 SW SHADY LN JURISDICTION: TIG APPLICANT /AGENT: BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: Y ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 2' -2 1/2" X 5'- TOTAL SIGN AREA: 12 sq. ft. WALL AREA: 2,700 sq. ft. WALL FACE (DIRECTION): N SIGN HEIGHT: 42 ft. PROJECTION FROM WALL: 1 in. ILLUMINATION: NON DESCRIPTION OF SIGN: Placement of (1) one 12.88 sq ft permanent wall sign. MATERIALS: ALUM EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: N BUILDING PERMIT REQUIRED: N ADMINISTRATIVE EXCEPTIONS: TOTAL PERMIT FEES: $ 32.00 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 dat ign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon sign shall expire om validity date. APPROVED BY: c p PERMITTEE SIGNATURE: DATE: 12/27/2004 U1 /ZO /ZUU4 15 :3u rAA 5U3513e11)t3U Cll OF '1'1(UARD t 1 002 ,..4,,,, `i_,J. SIGN PERMIT APPLICATION CITY OF TIGARD 13125 SW Hall Blvd,, Tigard OR 97223 (503) 639 -4171 FAX; (503) 684 -7297 GENERAL INFORMATION Name of DevelopmenVProlect FOR STAFF USE ONLY Site / OOR/ 43 477 I R I _ Address/ Street Address n h l Loo...- Permit No,:.....) ( J/ ` < 4 ' 7 - ,(_ 's' Location 6/755 JI/,gp y Expiration Date: Suite/Bldg. # CIty /State Zip R eceipt # 2 �`= ` 1 " ? 7 / 500 Iil��l4 � (?64 �17�a3 Name Approved By: Y ./4,4b �'i Date; / 7 . t� `-/ I Property ��� /CDpv (� Owner Mailing Address / ' Suite Map/TL #: 1 7 /3,SI sh4 tai Zoning: State Zip Phone "7;3 l dLOR / 3 /0 Z r Electrical Permit Required? ❑ Yes n-f Tenant or Na Business GR/ ZUA / PEA4TALS Building Permit Required? El Yes ❑kla Name Rev,_8/7 /2003 i :kUrp1nlmestersVevtsed\6ign permit app.doo Sign I 14 )M 3 /4y � ' iC7/US / ,T - , ' contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS (Prior to permit /)' /� 3 t7l t 6 6 I (Note: applications will not be accepted issuance. a `1 iW 7 without the required submittal elements) copy of all ity/State Zip Phone ,v5 licenses are !�Q required if V Q7 o� '7127" C1%3 ❑ Completed Application Form expired in the Oregon Censt. Cont. Board Exp. Date City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale database) ��� 7 �� �� '' (3 copies, if a building permit is required) Proposed ® permanent ❑ Freestanding ❑ Freeway size requirement: 81/2" x 11 ", or 11" x 17" Sign ❑ Temporary ® wail ❑ Electronic (Check an that ❑ other ❑ Billboard ❑ Balloon (71 2 copies of elevations, drawn to scale apply) (3 copies, if a building permit is required) Ni New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11", to 24" x 36" Sign Dimensions: j l .( X 5 ,/ p" ❑ $31.00 Fee (Permanent sign, any size) Total Sign Area (sq. ft.); + a g r3'' ❑ $15,00 Fee (Temporary sign, any type) Sign Data Total Wall Area (sq. ft.) a �� Jurisdiction: ❑ City ❑ Urb - (Complete all Direction Wall Faces (circle one): NOTES: Items in this section) ® S E W NE NW SE SW if • Wall signs do not need to be drawn to scale, Height to top of sign (feet); /t but must include dimensions of wall face and , Projection From Wall (inches): I sign placement. Copy 0 :2_,- ? ,, ., ?t 1;;1 ve.AC. • Wall signs do not require site /plot plans. Materials:.,, „, "w. • Freestanding signs over 6 ft. required a Will sign have illumination? ❑ Yes r i5a! No building permit. Type: nternal ❑ Exte • If work authorized under a sign permit has not I 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. 1Sk If "yes ", a list or diagram of all sign dimensions and square footage must also be submitted. . (OVER FOR SIGNATURES) • 01/26/2004 1530 FAX 5035981960 CITY OF TIGARD 0003 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. 0,11 DATED this i 7 day of . /17 , 2Q C� ri dirn t Za . ._ ... . . ........ ._. .:.._ ...._. . Signature of Owne ' ge L4/61 RA- Lpu -t 573 -77 q s S Contact Person Name Phone No. Letter of Authorization minff" www.ramsaysigns.com 9160 SE 74th Ave Portland, OR 97206 P: (503) 777 -4555 1- 800 - 613-4555 F: (503) 777 -0220 I/We, , represent that I /we are owners/landlords of the following real property: 92-3.5 7 r ,x.9;)- _3 Including the building constructed thereon, which property is presently being rented to: ; ‘ c717 g1 (tenant) 1/We acknowledge that Ramsay Signs, Inc. will be nstalling the following described sign(s) to: (tenant) at •", �i t/. ✓sue /I' (description of sign) Dated this l2 day of z-t , 20 id . jj/c-Q (andlordlOwner or Authorized Agent) (Landlord/Owner or Authorized Agent) 4 MAILING ADDRESS: / APa id� K „L PHONE NO.: Viz F AX NO.: 5 31533 L vc_ a- --te,o i r-. 1�1 -eci∎C 1 rn ( 1 CR C C Ire -eo1Ar 7 jez3 /;" 5 `� N . PortlandMaps Detail Report Page 1 of 1 P 0 I r 0 n d M a ps New Search 1 Mapping 1 Help 9735 SW SHADY LN - TIGARD Explorer 1 Property 1 Maps 1 Crime 1 Census Navigate the area map for this address Aerial Photos Report Long - 122.77637 Lat 45.44240 1 • ' ''.., ' ". ,' if' * 0 ..., `-,,,„ 411,.., r .. ..i .L11 i ' <<..0 4 4t-;Sys . ! • ' 1' .40. ...,-.., te!' • -2 ---,,,.• ..I icv _, .. t t _ h ., r'-' � . i` i::7 �� � � • --.4._.<41. . �7 � T _ ° ■ - _ ` .tom J r - ,?, t T y s - • ,. �,n 1 r m 'Aerial Photos ■ I 0 1 • 1 250 FT City of Portland, Corporate GIS 12/27/2004 1 1 1 1 1 GIS API'I.ICA DONS ACCESSED - I IIROUOII l l 1 I S 10 1 , 1 1 1 1 : PROVIDE: A VISUAL. DISPLAY OF DATA FOR YOUR CONVENIENCE. EVERY REASONAIII.E I:FEUR1 IIAS III:I:N MAUI: T(1 ASSURE 1111: ACCURACY 01' T11E MAYS 0)0)0111011010(11)010 DATA. THE C'11'Y or PON I1 AND MAKES NU WANRAN'I Y. Ri:PR1SF.N I Al ION OR (iIIARAN AS CU TIII: C'ONTI:NI'. SI:0UI:NCI.. ACCURACY. TIMELINESS OR COMPLETENESS OF ANY OF TIII: DATA PROVIDED 11111(IN. I IIF: USER OF II 11S1: APPLICATIONS SHOULD NO RELY ON IIIE DATA PROVIDED I II:REIN FOR ANY REASON. 1110 CITY UI POR (LAND EXPLICI 100 DISCLAIMS ANY REPRI:SEN I A I IONS AND WARRANT II.S, INCLUDING, W I I IIOU'I I.IMI I A DON. '1'111: IMPLIED WARRANTIES OF NII:RI'l1ANlAUII. 1 FY AND Ill NESS FORA PAR 1Il11I AR PURPOSE. 1111: CI I)' UI 1'U111LAN SHAI.I. ASSUME 1101 11 'V FOR ANY ERRORS. OMISSIONS. OR INACCURACIES IN DIE INI'ORMA I ION PROVIDED RICA/MIDI . FSS OF DOW CAUSED. 11(1: CITY OF PORTLAND SHALL A SS' INII, NO I.IAllll.l I'Y FOR ANY DI ('ISIONS MADE OR 01(11)110(0111:11(111110)1011)11111' I III USER OF 1111: AI'PI.ICA IONS IN RI:I.IAN('I: UPON ANY INEORMA PION OR DATA FURNISHED HEREUNDER. 10 BE SARI: OE COMI'I.I:1 I: A('('IIRA('1 PLEASE CHECK WI I II CITY S FAIT FOR 11(1)01011 INIORI.1 ION. Address 1 Mapping 1 Advanced 1 Help 1 About PortlandMaps © 2004 City of Portland http:// www.portlandmaps.com /detail.cfm ?ActiveTheme= Aerial +photos &action = Explorer... 12/27/2004 - - - i - i aNIONNIA- =M. 11•11111. /mom - .. 41 .1. .• ... . • OM dm MS OM MI6 es 4Ib i ' • • • 'tv, n - 7d S • - i ... i - I --- - - - - i_-'_ _ - Qh15 'UAY11Ei . ,41 •+ 1s..-,._ ,r.r . . . ._ . - : _ 1 • t L- I L! t---f- L ' -• • • L�I �T _ • I ,1 _- 4 . F - J EL , h r r _ • I ; , i _ ' , • I _I f- - _ : t 4 i- _ :1 --- - 1 I 1 .-1-Tri - - - -� I i . 1 f N ' [ i ( I ! 1 +_ • - , --�- -- 1 1 _ -[ j ' 1 I l t ' • 1 • 1 1 i -L - I i _ . _i_l i ° _i_.; - - - a __ _._ 1 j _L- ' - -1 - ^' . - -'- -'- j - - - . -. _ _ . �: -_ F± 1 .. 1 !_' -r-1 17 ; ----1-17n---r- ; - r- `_--_... _ � - - ---} 1 - -1 - -- I j ; � - i - - ' i mail Li -- -- L r- -t- - 1 - - - - i • r;_ - ' • -_- `• -- - ; 1 ' i --! 111111111141101 MI Page l of l — — u . 9 - - - T - - - - -- - - - -` - - - 7_ 7 ,, �Q ,,_ ::: , f � i - , . ~` © 1 r N. (7 dpi o o +�J` o n o 1 / !a'Oi1 � A r_____ A_ ?77U ,Li \ U _____ „7,u 1 I 1 0 http: / /www.cgis.ci.portland.or.us/ giswrap / servlet/ GisWrapServlet ?MjIsISp4bBwfCBMcb... 12/27/2004 This sign is intended to be installed in accordance with the requirements of article 600 of the National Electric Code and /or other applicable local codes. This includes proper grounding and bonding of the sign. SAY CITY OF TIGARD lGNS Conditionally Approved.... , ,__ µ F" For only Approved the wgtk as de bed in• ---- F s- lo,, c�J c f' _ 7 •1 PERMIT NO. See Letter to: Foilow..... _. , , ,_ w „ _ ,,, s r A li t t s r ED I 11 tech _ E • • — Job A•. �;. 6y: � 7 c '' Dae D„, Dats :_.f ? - �z1 o x Client PRODUCTION PRINT Horizon Pediactrics 9735 SW Shady Lane #300 N 12.22.04 N Tigard, Oregon ---)--) ii ; 1'Y f r r Account Executive , o „ �,. Diane Amunds„ 1 ACCOUNT EXECUTIVE SIGNATURE Design • • Ross Hilden Approvals in SCALE: I” = I' - 0" Client Date MANUFACTURE AND INSTALL (I) SET INDIVIDUALLY CUT OUT NON - ILLUMINATED LETTERS ON BUILDING WALL Landlord Date LETTERS INDIVIDUALLY CUT OUT FROM .125" THICK ALUMINUM Revisions APPLY HORIZONTAL BRUSHED FINISH 0 Date OPTIONAL v II.6.04 Revision INSTALLATION INSTALL LETTERS BLIND PIN MOUNTED '/z" OFF BUILDING WALL — *I; i� e , DOCTOR' S • © Copyright1004, Ramsay Signs, Inc. 1 These plans are the exclusive Distribution or exhibition of property of Ramsay Signs, Inc. these plans to anyone other And are the result of the than employees of your original work of its design company, or use of these plans I team. to construct a sign similar to the one embodied herein, is \''--) They are submitted to your expressly forbidden. \ `ma x \ company for the sole purpose of your consideration of In the event that such whether to purchase these plans exhibition occurs, Ramsay Signs • or to purchase from Ramsay Inc. expects to be reimbursed 1 • Signs, Inc. a sign manufactured 51000.00 in compensation for ;,-..- , according to these plans. time and effort entailed in creating these plans. I Ramsay Signs 9160 SE 74th Avenue Portland, Oregon 97206 I ( 503 777.4555 C 800 613.4555 C 503 777.0220 1 1of1 0 4 6 5 1 � � F I toin 16/ if i ar�W i