SGN2010-00187 CITY OF TIGARD SIGN PERMIT
1111
. Permit#: SGN2010-00187
COMMUNITY DEVELOPMENT Date Issued: 12/28/2010
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 2S112DC00701
Jurisdiction: Tigard
Name of Business: Miller Paint
Business Address: 15951 SW 72ND AVE
Applicant/Agent: Hayden, Melissa
Work Description: Installation of one(1)permanent wall sign 3.1'x 26.6'
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions: 3.1'x 26.6'
Total Sign Area: 84
Wall Area: 1200
Wall Face(Direction): West
Sign Height: 15 ft.
Projection From Wall: 5 in.
Illumination: Internal
Materials:
Electrical Permit Required: Yes
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.
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Approved By: .
Permittee Signature: / ✓
t° SIGN PERMIT APPLICAT 3 :,
itiAi
.,,I. wi ` ' Cid,of'Tigard Permit center 13125 SW HallB/i'd, Tiganl, OR 9 23
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Phone: 503.639.4171 Fax:503.598.1960 Dlr.,' (.
2010
GENERAL INFORMATION
Name of Development/Pr,icct
FOR STAFF USE ONLY
Site -72 1'
Address/ Street Ad rens Permit No.: /.1 a 0( —0 b 18. 7
Location
Suite/Bldg.# City/State Zip Expiration Date:
Receipt#:
Name Approved By: ��4,K
Property Date• ozlf,oho/6
Owner Mailing Address Suite Map/TL#: ?3 //,;.6C.-0010
/c 6C.-0010 I
Zoning: .11 I`6-4?D
City/State Zip Phone
Electrical Permit Required? [r Yes El No
Tenant or Name
Business ]ttek int- Building Permit Required? ❑ Yes dNo
Name Rev.7/1/09
is\curpin\masters\land use applications\sign permit app.doe
Sign Security Signs
Contractor Mailing Address Suite
(Prior t0 permit 2424 SE Holgate Blv I
Issuance,a ,
copy of all City/State Zip Phone REOUIRED SUBMITTAL ELEMENTS
licenses are (Note: applications will not be accepted
required if Portland, OR 97202 503.546.7114 without the required submittal elements)
expired in the Oregon Const.Cont.Board License# Exp.Date
City of Tigard's •
database) 122809 ❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway ❑ 2 Copies of Site/Plot Plan,Drawn to Scale
Sign 0 'Temporary ❑ Wall ❑ Electronic (3 copies,if a building permit is required)
(Check all that ❑ Other ❑ Billboard ❑ Balloon t " "
apply) size requirement: 8/z 11 ,or 11"x 17"
I4New sign? D Alter to existing sign? . ❑ 2 copies of elevations,drawn to scale
Sign D mensions: � _ (3 copies,if a building permit is required)
3 • 1/ )( �/P•6D size requirement: 81/2"x 11", to 24"x 36"
Total Sign Area (sq. ft.):
O ❑ $40.00 Fee (Permanent sign,any size)
Sign Data Total Wall Area(sq. ft.) ',woo
[11 $19.00 Fee (Temporary sign,any type)
(Complete all Direction Wall Faces(circle one):
items in this NOTES:
section) N S B_. C4 NE NW SE SW
Height to top of sign (feet): is • ♦ Wall signs do not need to be drawn to scale, but
Projection From Wall(inches): F,e/ must include dimensions of wall face and sign
placement.
Copy: 0t 1 • Wall signs do not require site/plot plans.
Materials:
• Freestanding signs over 6 ft. required a building
Will sign have illumination? 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 Er 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 ,20
Signature/of Owner/Agent
rr
Melissa Hayden 503.546.7114
Contact Person Name Phone No.
CITY OF TIGARD RECEIPT
lliLI
i
g; 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 180871 - 12/29/2010
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2010-00187 Sign Permit 1003100-43115 $143.00
SGN2010-00187 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 79264S STREAT 12/29/2010 $164.00
Payor: Melissa Hayden
Total Payments: $164.00
Balance Due: $0.00
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