SGN2010-00177 CITY OF TIGARD SIGN PERMIT
Permit#: SGN2010-00177
COMMUNITY DEVELOPMENT Date Issued: 11/18/2010
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 2S102BD01700
Jurisdiction: Tigard
Name of Business: ""Fri LAE
Business Address: 12860 SW PACIFIC HWY
Applicant/Agent: Mueller,Tim
Work Description: Placement of(1)one 15 s.f temporary banner. Valid 11/19/10-12/19/10 Sign#1 Must
be placed on private property, not in public right of way. Must meet visual clearance
area requirements
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: No Electronic: No
Billboard: No Balloon: No
Banner: Yes A-Board: No
Sign Dimensions: 3x5
Total Sign Area: 15
Wall Area:
Wall Face(Direction): Southwest
Sign Height: ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: Vinyl
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:
Permittee Signature:
it Er
City of Tigard
. .. ,, Sin Permit Application
Sign pP
GENERAL INFORMATION
Name of Development/Project
f� FOR STAFF USE ONLY
Site ....�i N- 1 L L.(4"`z
Address/ Street Address Permit No.: 6 Z 0/O- 00 177
Location / 28(...o S zc:.) cI c_t ,c.. ( K-
_, Approved By:
Suite/Bldg.# City/State Zip /
/ye` 'c7Z23 Date: II/�)e� (iv
Name v L Receipt#: S'S 0 Y(o 5
Property ,S4.ter. /1/-4-k 1...,,i Map/TL#: /
Owner Maihno Address Suite Zoning: (,/(j
„``�— Allowable Total Al rea: S •
City/State Zip Phone
Tenant or Name
Electrical Permit Required? ID Yes 41No
/ _ Building Permit Required? El Yes No
Business `S i
Name / Rev.7/1/10
J 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)
I
❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway E 2 Copies of Site/Plot Plan, Drawn to Scale
Sign Temporary ❑ Roof ❑ Electronic
(Check all that (3 copies,if a building permit is required)
apply) [1] all ❑ Other 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)
'I Sign Dimensions: 3X',.___S---- f/' size requirement: 8'/2"x 11", to 24"x 36"
Total Sign Area(sq. ft.): />.--.__ f / ❑ $164.00 Fee (Permanent sign,any size)
Total Wall Area(sq. ft.) ;''
El $52.00 Fee (Temporary sign, any type)
Sign Data I = °i
(Complete all Direction Wall Faces(circle one):
items in this NOTES:
section) N S E W NE NW SE
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:
• Wall signs do not require site/plot plans.
Will sign have illumination? ❑ YesNo • 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?
❑ Yes
i� (OVER FOR SIGNATURES)
If"yes", a list or diagram of all sign dimensions and square
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.
L
DATED this /Uc� /
day of A/0 Y° . 20 1 0
ignature of Owner/Agent
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Contact Person Name Phone No.
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FOD R C7 F
City of Tigard I 13125 SW Hall Blvd.,Tigard, OR 97223 I 503-639-4171 www.tigard-or.gov I Page 2 of 2
CITY OF TIGARD RECEIPT
•1111 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 180465 - 11/18/2010
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2010-00177 Temporary Sign Permit 1003100-43115 $45.00
SGN2010-00177 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 57012Z 57012Z KPEERMAN 11/18/2010 $52.00
Payor Tim Mueller-Jiffy Lube
Total Payments: $52.00
Balance Due: $0.00
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