SGN2010-00060 CITY OF TIGARD SIGN PERMIT
iE Permit #: SGN2010 -00060
,,..,i4-0,,, ,,i4 COMMUNITY DEVELOPMENT Date Issued: 04/12/2010
;IIGARD 13125 SW H Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S104AD04500
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Jurisdiction: TIG
Name of Business: Tualatin Valley Fire and Rescue
Business Address: 12617 SW WALNUT ST
Applicant/Agent: TUALATIN VALLEY FIRE & RESCUE,
Work Description: Placement of (1) one 28 sq. ft monument sign. Sign must be placed on private property
and not in the public right -of -way or visual clearance areas.
Permanent: Yes Freestanding: Yes Freeway: No
Temporary: Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 7'x4'
Total Sign Area: 28
Wall Area:
Wall Face (Direction):
Sign Height: 4 ft.
Projection From Wall: in.
Illumination: Internal
Materials:
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $40.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. 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.
AP
Approved By: A - W i' O _ _. _ Permittee Signature: 4,
1:1 SIGN PERMIT APPLICATION
City of Tigard Permit Center 13125 SW Hall Blvd., Tigard, OR 97223
...`= Phone: 503.639.4171 Fax :: 503.598.1960
GENERAL INFORMATION
Name of Development /Project
FOR STAFF USE ONLY
Site 'tedet i-in kir, tiel frt re a4 Z?-.5-44 e
Address/ Street Address Permit No.: S4 et) ZO /0 " Cw � (p 0
Location i Z b t T S 1w1 X14, ` n *f' Si" .
Suite /Bldg. # City/State Zip Expiration Date:
73 Receipt #: 1 7 / �1 v
.,...-d. 02 17z -
Name Approved By: // KIP
Property 5f44 e_ Date: y// �/�
Owner Mailing Address Suite Map /TL #:
Zoning: N i./'5
City/State Zip Phone
Tenant or
Name Electrical Permit Required? ❑ Yes r[ 4410
Business Building Permit Required? ❑ Yes [c-Ico
Name Rev. 7/1/09
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Sign .�(,I[; e grIuf?9'I L r. L-`C-
Contractor Mailing Address Suite
(Prior to permit /� /�
P
issuance, a
S. J , J�V�
copy of all City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
c licenses are / (Note: applications will not be accepted
required if r eel ` t , 0� �7� without the required submittal elements)
expired in the Oregon Const. C nt. Board License # Exp. Date
City of 17b
3
Tigard's / 9 ❑
database) 7 f% 7 J Completed Application Form
Proposed ® ® g ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
P Permanent Freestandin Freewa , (
Sign ❑ Temporary p Wall ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other ❑ Billboard p Balloon t " 11", 11"
apply) size requirement: 8 /z x 11 , or 11 x 17 "
New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: (3 copies, if a building permit is required)
liC `f size requirement: 8 x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
2 e $ $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 one):
items in this NOTES:
section) N S E W NE NW SE SW
Height to top of sign (feet): 4/ ' • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): 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? 51 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 1
❑ 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 P day of /u" ,20/c)
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e o Own 1 r /Agent !, / — „� fr4 A
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Contact Person Name Phone No.
( '' OF TIGARD •
Cl:,:,cl:;;c :1 ?y Approved [
For only the work as described in:
PERMIT NO n— or) ac. o
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CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
. ;; ,. ; ,., ;1 0 503.639.4171
LTI IO D
Receipt Number: 177512 - 04/12/2010
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2010 -00060 Sign Permit 1003100 -43115 $35.00
SGN2010 -00060 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 031143 031143 KPEERMAN 04/12/2010 $40.00
Payor: Mike Chapman / TVF & R
Total Payments: $40.00
Balance Due: $0.00
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