SGN2010-00097 �� SIGN PERMIT APPLICATION
City of Tigard Permit Center 73725 SW Hall Blvd., Tigard, OA 97223
Phone: 503.639.4771 Fax: 503.598.7960
GENERAL INFORMATION
Name of Development /Project
� � ��� ���� ` FOR STAFF USE ONLY
Site
Address/ SueetAddress PermitNo.: ����1� - lSUUq�
Location (p 77 � � �� >, j }�
Expiration Date:
Suite /Bldg. # CiryJState Zip
1 a �r0/�� � ,�7 q �f a,�� Receipt #:
Name U` � Approved By: S - �' � �
Property �L�G.((�U C��Q, �4$�� l 3 �C. Date: 5I a-,SI� j)
OWller Mailing Address Suite Map /TI. #: o «, � ' �
l �/ �L1.(I�lt�f l�' �� �.�� Zoning: l Ci
Ciry /State Zip Phone
�D Q- 7C -R��j �(Z 9�25� SD3 -�3�- a-�d
Tenant or Name t Electrical Permit Required? ❑Yes � o
Business � � ��� Building Permit Required? ❑Yes [�No
Tom � boa
Name Rev. 7/1 /09
is \curpin \masters \land use applications \sign permit app.doc
Sign l.,u� - j� - �{ t� 1"[ .S{(p
Contractor Mailing Address �j�� Suite
(Prior to permit u � � / `! ,.., , „„ r ��
Issuance, a ( ( i - (J
copy of all City /State Zip Phone REQUIRED SUBMITTAL ELEMENTS
licenses are 4 ��� (Note: applications will not be accepted
re9Uired if 1����(,(.[�� f[i� �� ��°`f�°' �R l y without the required submittal elements)
expired in the Oregon Const. Cont. lioazd License # Exp. Date
City of Tigazd's
database j 1 t l "�(L� ( �' �� ❑ Completed Application Form
Proposed ❑ 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 Billboazd ❑ Bauoon size requirement: 8' /i" x 11 ", or 11" x 17"
aPPIY)
New sign? ❑Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign D ens�gns: (3 copies, if a building permit is required)
���{r.' -1 � � ?' � size requirement: 8' /z" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
,�5, � ❑ $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.)� �!, ,� ❑ $19.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle o
items In this NOTES:
section) N � E W NE NW SE SW
Height to top of sign (feet): �(Q ♦ Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): /a-- must include dimensions of wall face and sign
placement.
Copy: ♦ Wall signs do not require site /plot plans.
Materials: ♦ Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑Yes [�No permit.
Type: ❑Internal ❑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 day of , 20
Signature of Owner /Agent
Contact Person Name Phone No.
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G SIGN PROPOSLIL j�p �� 9 P P 9 P 9 �., G �
I ����� Tenant Space = 99.83' (wide) x 26.5' (tall) = 2,645.49 �
_1_ INTERNATIONAL 15% of 2,645.49 = 396.82 5F MAX 5F ALLOWED BY CODE
SIGN ASSOCIATION. ( ) -•
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Front Illuminated Single Stroke LED Channel Letter " "' - 3/16" Acrylic Faces, 1" Trim Cap, 1 Stroke LED, 5" Deep .040 Returns, .040 White Backs, i_
Pre -wired with 1!4" Riv Nuta, Threaded Rod Letter Height: l6" to 12" (STONE +WOOD OUTLET)
3M Vinyl Graphics - APPLIED TO LETTER FACES LED LOGO BOX 3/16" Acrylic Facee, l" Trim Cap, Grid Pattern LED's, 5" Deep .040 Return5..063 White Backs, Pre -wired with 1/4" �,
A Riv Nuts, Threaded Rod and Paper Pattern. SIZE: 42.3" X 43.41" standard translucent vinyl only A
" " "120V LED TRANSFORMER " "' -FOR LED's, Transformer Boxes are included " "' "U.L. LABEL(5) " "'
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,y-% ! ,r �, � � Thlsdeslgn. manuf aauringtechnlqueandoridealstheproper tyofColumblaSlgns lac. PfO�ect Manage(. Cody KFICII I coc1�- (�'columbiasignscom I I
i and may not be changed published. reproduced or used In any way whhout the wdtten
/��'''�''"" �.+� permissbn and full consent of Columbia Signs. Irx. In addi[bn all designs. bids, drafts.
com contentso( proposalsandarryspecifkatbnscontainedonthislayout may not be used to ❑ Not Approved Please make the changes as indicated above and resubmit for approval I
secure prke comparisons. Redistribution of information contained on this form Is full
acknowledgment and approval of the terms and price listed Vblators will be pn�secvted
4700 Four[h plain Blvd. Vancouver. WA 98f761 to the full ext ent oft he law. IF YOU HAVE ANY QUESTIONS. nSK FIRST. ❑ ApprOVed Signatul Date Qty of Signs i �
Office. zf� - fflb - 1919 ! Fa7c ib0 -(fib -9797
��` ,�����... CITY OF TIGARD RECEIPT
,,
u;' ;• i 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
- �..._�
Receipt Number: 178061 - 05/25/2010
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2010 -00097 Sign Permit 1003100 -43115 $35.00
SGN2010 -00097 Sign Permit - LRP 1003100 -43117 $5.00
Total: $40.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 04509D STREAT 05/25/2010 $40.00
Payor: Cody Reich
Total Payments: $40.00
Balance Due: $0.00
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