SGN2010-00058 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2010 -00058
.:.: „,:',;,; COMMUNITY DEVELOPMENT Date Issued: 04/09/2010
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102AC01101
Jurisdiction: Tigard
Name of Business: Farmers Insurance Group
Business Address: 12562 SW MAIN ST 210 •
Applicant/Agent: Brown, Trent
Work Description: Installation of (1) one 12 s.f permanent wall sign. Sign must be framed.
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 2'x6'
Total Sign Area: 12
Wall Area: 120
Wall Face (Direction): North
Sign Height: ft.
Projection From Wall: 1 in.
Illumination: No Illumination
Materials: Vinyl/Wood
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $40.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. All work will be done in accordance with approved plans. A permanent sign must be placed within
90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon
sign shall expire 10 days from validity date.
Approved By:
Permittee Signature: er C...0.- -cr3
rr SIGN PERMIT APPLICATION
City of Tigard Permit Center 13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development /Project
FOR STAFF USE ONLY
Site I re
S treet Address Sc
A) 2.-Z I U - 0 Otz S$
Address / T Permit No.: cs
Location � (�7S Y•1CLiyVSfi4fl V
O Expiration Date:
Suite /Bldg. # City/State Zip
?- (O - Ti 30 va Ol- C O 223 Receipt #: / 7'75` SO
Name n Approved By: tL P
Property g1,k, s G sd a r'� Date: Y IY / tcs
v1 Owner Mailing Address Suite Map /TL #:
4 * 1 g 15Th rte.$ k — Zoning: M4 C1
M City/State Zip Phone
I J °L Cg Q 0 0 E Electrical Permit Required? 12 Yes [-No
P Tenant or Name U
G \ Business F i 4 A r A C S " ' A S aPIC (. i vDU y� Building Permit Required? El Yes [G]- No
Name Y Rev. 7/1/09
is \curpin \masters \land use applications \sign permit app.doc
Sign A
Ct Contractor Mailing Address Suite
(Prior to permit
issuance, a
copy of all City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
licenses are (Note: applications will not be accepted
required if without the required submittal elements)
expired in the Oregon Const. Cont. Board License # Exp. Date
da ta a Tigard's om leted Application Form
database) ❑ C p pp .
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 ❑ Billboard ❑ Balloon
apply) size requirement: 81/2" x 11 ", or 11" x 17"
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: j� v 6 (3 copies, if a building permit is required)
size requirement: 81/2" x 11", to 24" x 36"
Total Sign Area (sq. ft.):
Z $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) / , _`
� - V ❑ $19.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) S E W NE NW SE SW
Height to top of sign (feet): 2 ♦ Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): / must include dimensions of wall face and sign
Copy: .S 2Pi 7 4h 6�, placement.
ft. Wall signs do not require site /plot plans.
VI PI Materials: y I 'P Be' ♦ Freestanding signs over 6 . required a building
Will sign have ill Lion? ❑ 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 l , 20
Signature of Owner /Agent
50 3 -- 7/9 = 7
Contact Person Name Phone No.
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Approved
Conditionally Approved [ I
For only the work as described in:
PERMIT NO. $ —0o°58
See Letter to: Follow 1
Attach
Job Ad.r- . •
by:
7 S r euL) LiL
NI 111 CITY OF TIGARD RECEIPT
;, 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
:TIGARD
Receipt Number: 177480 - 04/09/2010
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2010 -00058 Sign Permit 1003100-43115 $35.00
SGN2010 -00058 Sign Permit - LRP 1003100 -43117 $5.00
Total: $40.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Cash KPEERMAN 04/09/2010 $40.00
Payor: Farmers Insurance Group
Total Payments: $40.00
Balance Due: $0.00
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