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SGN2005-00181
CITY OF TIGARD "i DEVELOPMENT SERVICES SIGN PERMIT PERMIT#: SGN2005-00181 140�I� 13125 SW Hall Blvd.,Tigard, OR 97223 (503)639-4171 DATE ISSUED: 6/22/2005 PARCEL: 1 S134AA-02100 BUSINESS NAME: EDI PASSPORT ZONE: I-P SIGN LOCATION: 10450 SW NIMBUS AVE RA JURISDICTION: TIG APPLICANT/AGENT: EID PASSPORT BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: Y FREEWAY: TEMPORARY: WALL: ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 2'X2' TOTAL SIGN AREA: 4 sq.ft. WALL AREA: sq.ft. WALL FACE(DIRECTION): SIGN HEIGHT: 4 ft. PROJECTION FROM WALL: in. ILLUMINATION: NON DESCRIPTION OF SIGN: Placement of(1)one 4 sq ft freestanding sign. MATERIALS: ALUMINUM EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: N BUILDING PERMIT REQUIRED: N ADMINISTRATIVE EXCEPTIONS: TOTAL PERMIT FEES: $ 37.00 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 sh.11 expire 30 days from validity date. A balloon sign shall expire 10 days from validity date. �� • APPROVED BY: t � PERMITTEE SIGNATURE: k± DATE: 6/22/2005 1 , a�'A II SIGN PERMIT APPLICATION CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 FAX: (503) 684-7297 GENERAL INFORMATION Name of Development/Project • - FOR STAFF USE ONLY Site "e0�,6+• -PcjZ C Address/ Street Address A Permit No.: jtJ Zt I n 5 , C)O/g/ Location ( ) e..�W 1.! 1 1,..,‘-&.).s sty Expiration Date: Suit Bldg.# City/State Zip �0-r, or. G-22Z3 Receipt#: , .S 2 7,— Name Approved By: i Property Date: (4/2-2-9:c Owner Mailing Address Suite Map/TL#: /51 3 5'Al( t) Z!Vu • Zoning: p C- 1 City/State Zip ! Phone Electrical Permit Required? El Yes ["No Name Tenant or �No Business 1 1. "�'�SS ( / ❑Building Permit Required? Yes Name Rev.2/28/2003 i:\curpin\masters\revised\sign permit app.doc Sign �_ C (-) --(T' f Th1C3 ski 5 Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS (Prior rmit i436 SC 1"Z�A issuance, aa (Note: applications will not be accepted copy of all City/State Zip Phone without the required submittal elements) licenses are required if --Pp . qZ 47(72 (4 5:53332 417Z- ❑ Completed Application Form expired in the Oregon Const.Cont.Board Exp.Date City of Tigard's License# �ZZ ❑ 2 Copies of Site/Plot Plan, Drawn to Scale database) (3 copies, if a building permit is required) Proposed ❑ Permanent Freestanding El Freeway1 size requirement: 8/z" x 11", or 11" x 17" Sign ❑ Temporary Wall El Electronic (Check all that (Chet ❑ Other ❑ Billboard El Balloon El 2 copies of elevations, drawn to scale apply) (3 copies, if a building permit is required) New sign? Alter to existing sign? size requirement: 81/2"x 11", to 24" x 36" Sign Dimensions: Z x Z sftee 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.) Jurisdiction: ❑ City ❑ Urb (Complete all Direction Wall Faces (circle one): ; NOTES: items in this section) N S E W NE NW SE SW ` Height to top of sign (feet): , • Wall signs do not need to be drawn to scale, Projection From Wall (inches): but must include dimensions of wall face and sign placement. Copy: • Wall signs do not require site/plot plans. Materials: Aq, L.V,-, A.t 0 A ; • Freestanding signs over 6 ft. required a Will sign have illumination? El Yes a No building permit. Type: El Internal El 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 BECOME NULL AND VOID. 12 Yes ❑ No 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 day of ,. , 20 Signature of Owner/Agent Z7r ILL.,-,-,zgi2414Q10 M Z3 Z. IR Contact Person Name Phone No. 4 j 4 # is 'qL "f ' * e. ,`M1 ie"111.. ,t `\' ' '' mrd ) ''':::,'„ (2---- .—kil ',--, • i 44! :c2 'CA: li 1 , E•1`1 7 Mk/1 r �' -3 a o o I � istz >_ N o > F .1--• p o -a O J d ` LC ao owm Q >. QUu CL U-) -) m M doAdt• Dr Ma Po 5 $ 4E.-. SIq Kr Robinson 4841 a Scope of Work: .� ,DrBeaverton , Washington Square Crescent v a, a. ` Fl tTeenayPoi k � VCemetery 3 4 Grove a Manufacture and install one (1) 4'x5' double-faced, non- SW CA '"' F. 217 10450 SW Nimbus Ave, g illuminated monument sign. Includes aluminum construction, 210 Portland, OR 97223 t • „ Lt �s polyurethane paint and dimensional copy (0.5" & 0.25"). SW dor SW Oak St mod{ 5W Ironnvaati n', Greenburg 217 5 Tigard a SW Anton Dr SW North Dakota St a N Dr trS SW Tigard s Groton � Kj,P 02005 MiCIOSO4 ory 92004 NAV1EQ,anO/orGOT,inc. I'1 ©Copyright 2005 Security Signs,Inc. R i DATE 052505 • LANDLORD APPROVAL CLIENT APPROVAL IN�TERN'A 091. This original design and specifications are f N SIGN ASSOCIATION T SEC Ii R l SIG■ 7 exclusive property of Security Signs, Inc The use of these designs to produce a similar DRAWING 4i. 05 KK446 INS_____ZAI sign without written authorization from -0, PASSPOR,'C11)111111111) s, QUALITY SINCE t 925 Security Signs, Inc. is forbidden. PAGE OF 2 PLEASE SIGN HERE PLEASE SIGN HERE WWW.SECURITYSIGNS.COM PROJECT MANAGER 10450 SW NIMBUS 436 SE 12TH AVE T. 503.232.4172 CUSTOMER AGREES BY OR CCB #122809 INITIALING HERE KEVIN KELJO SUITE A PORTLAND, OR 97214 F. 503.230.1861 WA SECURSIO2OCF "w TIGARD, OREGON DATE DATE CITY OF TIGARD 6/22/2005 13 12 5 SW Hall Blvd. 12:03:48PM lit,,,, 0,14,iiesi\ Tigard,Oregon 97223 (503) 63 9-4 17 1 Receipt #: 27200500000000002875 Date: 06/22/2005 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2005-00181 [SIGN] Sign Permit 100-0000-437000 32.00 SGN2005-00181 [LRPF]LR Planning Surcharge 100-0000-438050 5.00 Line Item Total: $37.00 . Payments: Method Payer User ID Acct./Check No.Approval No. How Received Amount Paid Check SECURITY SIGNS INCKJP KJP 013665 In Person 37.00 Payment Total: $37.00 -a WEST COAST BANK -10". 500 East Broadway,Suite 100 SECU Rf tY SIGNS, INC. Vancouver,WA 98660 013665 96-8/1232 436 S.E.12TH AVENUE c® PORTLAND,OREGON 97214 CHECK NO. DATE ,ZZ . tMOUNT7 ----� 0 PHONE(503)232-4172 AU 0 PAY-rn tc: / cic.41/4....1 y ,) 1 TO THE - ORDER • • ` ltion i •�■ OF C—'' C * '-4C1 &24411W C 0 , IA II • i v0 L366 " is L 2 3 2000881:00 200 L8 3 4 70i' cReceipt.rpt Page 1 of 1