SGN2011-00022 1, , CITY OF TIGARD SIGN PERMIT
Ir .. Permit #: SGN2011 -00022
COMMUNITY DEVELOPMENT Date Issued: 02/09/2011
TIGARD 13125 SW HaII Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S102BD01700
Jurisdiction: Tigard
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Name of Business: Jiffy Lube
Business Address: 12860 SW PACIFIC HWY
ApplicantlAgent: Mueller, Tim
Work Description: Placement of one (1) temporary sign (A- Board) 2' x 6' Must be placed on private
property, not in public right of way. Must meet visual clearance area requirements.
Valid 2/10/11- 3/12/11 Sign #1
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: Yes
Sign Dimensions: 2' x 6'
Total Sign Area: 12
Wall Area:
Wall Face (Direction): Southwest
Sign Height: 6 ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: Plastic
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $52.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. All work will be done in accordance with approved plans. A permanent sign must be placed within
90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon
sign shall expire 10 days from validity date.
Approved By: ,
/i cLt
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Permittee Signature:
I
City of Tigard
Sign Permit Application
GENERAL INFORMATION
Name of Development /Project
� - j e.._ FOR STAFF USE ONLY
Site 1::‘,... /,, �
Address/ Street Address / w
Permit No.: - "" N dv t i - Udd�t —
7 f C, J f c� k-,c, �
Location ,/ S • i2
Suite /Bldg. # City/State Zip 7 Approved By:
T c -J 0 iL 17Z?$ Date: 9 ' I
Name r Receipt #: ig rq/ Y0
Property J 4vt.. b..t. C Map /TL #: nn ; - 5(oc� -13 B01`) 0
Owner Mailin ddress Suite Zoning: c
"--.-- Allowable Total Area:
City/State Zip Phone
Tenant or Name Electrical Permit Required? E] Yes Er No
Business J c 1('] (c-L 19.--- Building Permit Required? ❑ Yes ,VNo
Name Rev.7 /1 /10
is \curpin \masters \land use applications \ sign permit app.doc
Sign •
Contractor Mailing Address Suite
City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
(Note: applications will not be accepted
Oregon Const. Cont. Board License # Exp. Date without the required submittal elements)
1 El Completed Application Form
Proposed ❑ Permanent ❑ Freestanding Freeway El 2 Copies of Site /Plot Plan, Drawn to Scale
Sign _ mporary El Roof ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ wall ❑ Other
apply) size requirement: 8 /2 " x 11", or 11" x 17"
❑ 2 copies of elevations, drawn to scale
4 ew sign? ❑ Alter to exis (3 copies, if a building permit is required)
Sign Dimensions t ,,,v art size requirement: 8' /z" x 11 ", to 24" x 36"
'
Total Sign Area (sq. ft.): /
.. y 7' III $164.00 Fee (Permanent sign, any size)
Total Wall Area (sq. ft.) �L ❑ $52.00 Fee (Temporary sign, any type)
Sign Data = % I
(Complete all Direction Wall Faces (circle one):
items in this 1 NOTES:
section) N S E d E NW SE SW
Height to top of sign (feet): C • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): must include dimensions of wall face and sign
placement.
Materials:
• Wall signs do not require site /plot plans.
Will sign have illumination? ❑ Yeses e- ♦ Freestanding signs over 6 ft. required a building
Type: ❑ Internal ❑ External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space?
El Yes
If "yes ", a list or diagram of all sign dimensions and square (OVER FOR SIGNATURES)
foota . e must also be submitted. - 0 1 - 31,E
City of Tigard 1 13125 SW Hall Blvd., Tigard, OR 97223 1 503- 718 -2421 1 www.tigard - or.gov 1 Page 1 of 2
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 re 6 , 20 / /
Sign. e of Owne /Agent
M t X6 c - 7 Z d
Contact Person Name Phone No.
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City of Tigard 1 13125 SW Hall Blvd., Tigard, OR 97223 1 503- 639 -4171 1 www.tigard - or.gov 1 Page 2 of 2
ili CITY OF TIGARD RECEIPT
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5 g _ . 13125 SW Hall Blvd., Tigard OR 97223
• 503.639.4171
TIGARD
Receipt Number: 181416 - 02/09/2011
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2011 -00022 Temporary Sign Permit 1003100 -43115 $45.00
SGN2011 -00022 Temporary Sign Permit - LRP 1003100 -43117 $7.00
Total: $52.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 406552 STREAT 02/09/2011 $52.00
Payor: Jiffy Lube
Total Payments: $52.00
Balance Due: $0.00
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