SGN2011-00044 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2011 -00044
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COMMUNITY DEVELOPMENT Date Issued: 03/25/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S102CC00500
Jurisdiction: Tigard
Name of Business: DD THAI FUSION
Business Address: 13600 SW PACIFIC HWY
Applicant/Agent: Ley, Charles
Work Description: Placement of one (1) temporary sign (Banner) 6' x 4' Valid 3/26/11 - 4/26/11 Must be
placed on private property not in public right of way. Must meet visual clearance area
requirements Sign #1
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: No Electronic: No
Billboard: No Balloon: No
Banner: Yes A- Board: No
Sign Dimensions: 6' x 4'
Total Sign Area: 24
Wall Area:
Wall Face (Direction): North
Sign Height: 12 ft.
Projection From Wall: in.
Illumination: No Illumination
Materials:
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: . � , 'WLC �! CJU
Permittee Signature: 1 /1
I • City of Tigard and RECEIVED
rr MAR 2 5 20
Sign Permit Application "
TIGARD
�hlG /ENGINEERING
GENERAL INFORMATION
Name of Development /Project
FOR STAFF USE ONLY
Site ./
Address / Street Address Permit No.: X V �(1 ^ 6°° 'f-
Location /34,0c) 50) fi T / liz-j �/
Suite /Bldg. # City /State [ / Approved By: S - l �T
i ( 1/ 2 "D 9"7,a5 Date: 3 I a-SI (l
Name / Receipt #: ( (ci 3
Property ASR , VJ 4e/ Map /TL #: � 0, D D S _ D�
e
Owner Mailing Address Q !'/ DA' Zoning:
l tu A'
/i4,35 SA) All owable Total Area:
ri State Zip Phone
/�/9z 9V. )5 5),3 a 85'7 ; Electrical Permit Required? p Yes g No
Tenant or
Business /J.i) 7hA f K/,ti. /41) Building Permit Required? ❑ Yes ONo
Name Rev. 7/1/10
�� nR/ c \curpin \ masters \land use applications \ sign permit app.doc
Sign `/+'
Contractor Mai ft Address Suite
eCola 9 50 NALL BLvh
City /State Zip Phone REQUIRED SUBMITTAL ELEMENTS
86A R7 A) (3/Z g O (Note: applications will not be accepted
Oregon Const. Cont. Board License # Exp. Date without the required submittal elements)
❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway
Sign �, Temporary 1=I Roof El Electronic III Copies of Site /Plot Plan, Drawn to Scale
(Check all that (3 copies, if a building permit is required)
Wall El Other
apply) size requirement: 81/2" x 11", or 11" x 17"
❑ 2 copies of elevations, drawn to scale
New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimensions: / l , size requirement: 81/2" x 11", to 24" x 36"
Total Sign Area (sq. ft.): 4;,.e./ ❑ $164.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft _ K $52.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) 0 S E W NE NW SE SW
Height to top of sign (feet): , /, / • 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: &ANiIJe,e / ` S4g tfjlJ�/L
/ • Wall signs do not require site /plot plans.
Will sign have illumination? ❑ Yes No • 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? - 3 /AllI _ 1 (l l 0
El Yes g No
If "yes ", a list or diagram of all sign dimensions and square
(OVER FOR SIGNATURES)
footage must also be submitted.
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 718 -2421 I www.tigard - or.gov I 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.
DAIED this aJ day of 4/C4 ,20/I
Signature of Owner /Agent
L� AIRL-E5 L-Ey 3 S' �.�
Contact Person Name Phone No.
-11)
, ( ,t,6 6 IN
City of Tigard ( 13125 SW Hall Blvd., Tigard, OR 97223 ( 503- 639 -4171 ( www.tigard- or.gov ( Page 2 of 2
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 181935 - 03/25/2011
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2011 -00044 Temporary Sign Permit 1003100 -43115 $45.00
SGN2011 -00044 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 02575A STREAT 03/25/2011 $52.00
Payor: Charles L Ley
Total Payments: $52.00
Balance Due: $0.00
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