SGN2010-00175 CITY OF TIGARD SIGN PERMIT
7
Permit #: SGN2010 -00175
COMMUNITY DEVELOPMENT Date Issued: 11/09/2010
TMARD;
13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S113AD01900
Jurisdiction: Tigard
Name of Business: XI `u C 44
Business Address: 16600 SW 72ND AVE B10
Applicant/Agent: Gillam, Geogg
Work Description: Installation of (1) one 51.77 s.f permanent wall sign
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 40 "x184"
Total Sign Area: 51.77
Wall Area: 3069
Wall Face (Direction): East
Sign Height: 18 ft.
Projection From Wall: 3069 in.
Illumination: External
Materials: Acrylic
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $164.00
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.
I
Approved By: /`t , . / ./
Permittee Signature: A Agar
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FM- W E-A Y L.. N
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SIGN PERMIT APPLICATION '3 2010
City of Tigard Permit Center 13125 SW Hall Blvd, Tigard, OR 97231 I v or: TIGARD
Phone: 503.639.4171 Fax: 503.598.1960
TIGARD R� P� ,i, r. , • ir• r• i nl c [ R N
GENERAL INFORMATION
Name of Development /Project
(Mws` �� till FOR STAFF USE ONLY
Site
Address/ Street Address hd Permit No.: 5W x010 '. G )
Location (( 6 O o 5v4 77 Expiration Date:
Suite /Bldg. # City /State Zip
I 0 go4l4.+J , OR 9 7z2 Receipt #: ( .F -0 3 `f--
Name ,, 7'6C Approved By:_
Property V (Fd fp7��4
G 1 L41 i4 Date: N -4 -ID
Owner Mailing Address Suite Map /TL #: 5//341, 0? 4DD
15310 OW6 1.5 e zoning. 2-L
City /State Zip Phone
P 0144 4 0 9 2, i T 2 i' 1505.6 7. m. 6 3 O
Tenant or Name Electrical Permit Required? ❑ Yes No
Business l3t.NC 11 CMS eaS t.1 p soil Building Permit Required? ❑ Yes st. No
Name Rev. 7 /1/09
L is \curpin \masters \land use applications \sign permit app.doc
Sign 1'4 A. bi dO t s i 5i14 .S
Contractor Mailing Address Suite
(Prior to permit v 5a 6 1'1 "
issuance, a
copy of all City /State Zip Phone REQUIRED SUBMITTAL ELEMENTS
licenses are (Note: applications will not be accepted
required if �OF!`�l�• t 17 Z06 � 3.9a6, 83T3 without the required submittal elements)
expired in the Oregon Cumt. Cont. Board License # Lap. Date
City of Tigard's
database) 1 8 8 712_ 11 /Z3 / 1 I ❑ Completed Application Form
Proposed ® Permanent ❑ Freestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Sign ❑ Temporary M Wall ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other Billboard ❑ Balloon t » " 11" 17"
apply) size requirement: 8 /2 x 11 , or 11 x 17
® New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: tt X ev ( ( (3 copies, if a building permit is required)
size requirement: 8 x 11", to 24" x 36"
Total Sign Area (sq. ft.
S i 7 Sx ❑ $40.00 Fee (Permanent sign, any size)
Sign Data Total W all Are (sq ft.) -'� $19.00 Fee (Temporary sign, type)
61 3 x. J El $ (T p ry any ryP )
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S Q W NE NW SE SW
Height to top of sign (feet): fit— // " • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): must include dimensions of wall face and sign
Copy: ( .f}(16. /I11 ea1A placement.
Materials: ACM (,� • Wall signs do not require site /plot plans.
�( • Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes CR No permit.
Type: ❑ Internal yi 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.
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.
fiN
DATED this l day of 0 C - 0I'2e f , 20 10
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Signature of Owner /Agent
A .ed Cm"(( ct I A " ro3- Z 14l -2- 77
Contact Person Name Phone No.
Imo.
184 '44 16600 5W 72nd Ave..
O4 �� Portland, Oregon 9721
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I I i. d i 503- 221-0022
503- 221 -9737 FAX
Prepared For.
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Image Media ImageMedl
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Pr otect Manager:
Geoff Gillam
'H N 1 141,1 _ ` 1 ) I o f 01 Image Media
- • ' *t 16600 5W 72nd Ave.,
—� ` Building #10
( r Portland, OR 97224
0 4 . 4 1 0 • ,....
it
a+ PROJEG7 NUMBER IM r.
.:: __ DATE: 10/1
1 ` ,. SCALE:
DRAWN BY: Geoff Gillet
.„. - { Revisions
No. Desrtiptioe
__
'I : Approvals
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Client Spsalure
• 3/8" routed black acrylic letters mounted to concrete facade Color Scheme FCO Wall Display
Non - illuminated FCO letters.
with adhesive. F ace: Manufacture and Install one (1) wall display. Landlord &gnotu e
Approved CITY OF TI G�I Black . Scope of work: Install new signage.
pp AUy
• Upper case letter height (I &M) 18" Conditionally Approved [ j FCO - Non- lluminated
°Copyright 2010 Image Media Material: This original design and specifier
For only the wooa5 describe clip: The use of this design to produc � R outed 3 /8'acryliic exclusive property of Image Med'
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• Lower case letter height (a &e) 12" PERMIT NO 1 sign without written authorbeti
Image Media Is prohibited
See Letter to: Follow [ 3 Installation
• Height from ground 215" d ^ � .w1 __ g........ 1 wa er
J o.t Fides: _.-
/17g_L!L_ Installation:
Adhesive 1
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f ~• , 16600 5W 72nd Ave.,
.. 1? ,0 Portland. Oregon 9722
111.1 s® • #* .: . ...,at •r It • •. a 4 503-221-0022
I . [ t 503- 221-9737 FAX
ill !' a
7 Prepared For.
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! ti :. F1 . "1 w Protect Manager.
• +; Geoff Glllam
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fi ' .h Image Media
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., n.3a ' :: - f� i� .•"I' !il •. a 166005W72nAve. • � . Building #10
1114 Po rtland, OR 97224
• TI 8f[i ‘11 , ° j a PROJECT NUMBER IM • 6 9 la, DATE 7 /13/10
a r SCALE
r E ° DRAWN BY: Geoff 0111arr
_ r. - . • n Im x.
t.
5 Revisions
" ' I No. Description
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A : , r I 1 _ 4 .. . x Approvals
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Client Signature
aF.' , —
iv . 444.:Y
.:.: r landlord Signature
.. ,.. _•x: - A - a r v s c- � This riginal design and speediest
exclusive property of Image Media
The use of this design to produce
' c T r u s t Business Park sign without written authorzatio
Image Media Is prohibited
600 #10 SW 72nd Ave.
rtland, OR 97224 P
2
: CITY OF TIGARD RECEIPT
I. 13125 SW Hall Blvd., Tigard OR 97223
• - 503.639.4171
ztlidi D
Receipt Number: 180343 - 11/09/2010
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2010 -00175 Sign Permit 1003100 -43115 $143.00
SGN2010 -00175 Sign Permit - LRP 1003100 -43117 $21.00
Total: $164.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 719030 STREAT 11/09/2010 $164.00
Payor: Michael Siegelbaum
Total Payments: $164.00
Balance Due: $0.00