SGN2000-00029 �- .r,
„__A . SIGN PERMIT APPLICATION
.„., , 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
CITY OF TIGARD
GENERAL INFORMATION {PLEASE PRINT CLEARLY)
Sign Address/Location: /1 4) 1 4 O S - tA.I , fit -i { c_. , � //, -
7 / 6 a r,; °1/4- , , 0 R 9 / 1- )- )) `rer�c.A FOR STAFF USE ONLY
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Name of Tenant/Business: t al( ,(4.eck iii-oltIavicc
Address: I I ( 1 4 o S ..k,.. f) 6 . i. ,F ' ( - i �,
,, / c 6 - Date Rece 02
Applicant/Agent/Contact Person: , j�rry a L 1r0[,\ Received By:
Sign Company: Grec!^p„,,, Nenh Phone: (066 ' '?
Permit � a Q - dc7
Address: d I s---- ) S E S�,� k Permit Fee: I 5 e ',...-'--' .------ 7
City: P�YPSC H State: Oft. Zip: No:: 0 0 32 1 Lo q't
zip: cf 7 3'0
Approved By:
Sign Company C.C.B. #: 7 'Z (' 8 5 Date• of Approval:
Expiration Date: V /7400 c Expiration Date:
City of Tigard Business Tax #: T1
(or) Expiration Date: Zoning: !�
Metro Business License #:
Expiration Date:
Electrical Permit Required? Yes ❑ No
Proposed Sign: (check as many as applicable) Building Permit. Required? Yes ❑ No •
Permanent ❑ Freestanding 21 Freeway ❑ Rev.12/27/96 lAcutpinYnasterskspadoc
Temporary ® Wall
Other ❑ Electronic ❑
ther
❑ Billboard ❑ Balloon ❑
Sign Dimensions: 3 ' x ' A - Fv vi-u.,
Total Sign Areas (sq. ft.): 4 i REQUIRED SUBMITTAL ELEMENTS
Total Wall Area (sq. ft.):
Direction Wall Faces: (circle one) N S (E / W NE NW SE SW Completed Application Form
Height (ft.): Site - • ' : Drawn to Scale
Projection from Wall: (2 copie if a building permit is required)
Illumination: Yes ❑ No Type: Internal ❑ External ❑ Eleva ions Drawn to Scale
U L. Label #: (2 copes 3 if a building permit is required) 1
❑ Applicant's Statement
Copy: hi y t1a1 Lcp.vs ❑ Fee _(Permdnent Sign, any size) 550.00
Materials: LA) t�orl ,4 - Fvo, k. e 0 n ^ i ti Fee porary Si $15.00
Are there any Existing Signs at this Location? Yes ❑ No
ti yes, a list at all sign dimensions must also be submitted.] property certify that I am the recorded owner of the
property or an agent authorized by the owner.
NOTE:* If work authorized under a sign permit has not been --
completed within ninety days after the issuance of the
peLm_Lt, THE PERMIT SHALL BECOME NULL AND VOID. Applicant' ignature
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025/0a /4 4 - 00(000