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SGN2011-00066 INI CITY OF TIGARD SIGN PERMIT il . ,. . Permit #: SGN2011 -00066 COMMUNITY DEVELOPMENT Date Issued: 06/08/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S110DCO2300 Jurisdiction: Tigard Name of Business: Blissful Energy Yoga Business Address: 11515 SW DURHAM RD E -7 Applicant/Agent: Blissful Energy Yoga, Work Description: Placement of one (1) temporary sign (A- Board) 2 X 3 Valid 6/9/11 - 7/9/11 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: No A- Board: Yes Sign Dimensions: 2.5 X 3.5 Total Sign Area: 8 Wall Area: Wall Face (Direction): Sign Height: 3 ft. Projection From Wall: in. Illumination: No Illumination Materials: Wood 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: /1(FILA.414,4... 1 V Permittee Signature: � ( 1 Q i C.j2 ,n r ri SIGN PERMIT APPLICATION r City of Tigard Permit Center 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 GENERAL INFORMATION Name of Develo ( ment /Project Site ) S 5 1 I �=- �1..Qdnl\� ( C FOR STAFF USE ONLY -l-'h C Address/ Street Address Permit No.: 544) 2-0 1 / - OC10 (/ Location ' I 5 6 (,) D A 41 ( � Approved By: r....1 49 Suite/Bldg. # City/State I � Zip QQ �� C 1 I ' .__9(A rek ^ 1 (� ^ (2 y Date: & till 1 ( V. Icd 41?Jt/ .? 9/j Name Receipt #: I i7 2 .7 To Property Map /TL #: / (., Owner Mailing Address Suite Zoning: `�`'? Allowable Total Area: ft. /1.4-%, r wee—. City/State Zip Phone N ame Electrical Permit Required? ❑ Yes [4lo Tenant or 1 l 5 I - g Business Building Permit Required? ❑ Yes ['o Name G Rev. 3/3/2011 ll�'Y 1 Q I ' /10( a is \curpin \ masters \land use applications \ sign permit app.doc Sign E-mail: 101 i ,1e )y.0 ©v. Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS (Prior to permit (Note: applications will not be accepted issuance, a copy of all City/State Zip Phone without the required submittal elements) licenses are required if ❑ Completed Application Form expired in the Oregon Const. Cont. Board License # Exp. Date 1 City of Tigard's ❑ 2 Copies of Site /Plot Plan, Drawn to Scale database) (3 copies, if a building permit is required) Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17" Sign '•a°-Temporary ❑ Wall ❑ Electronic (Check all that ❑ Other ❑ Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale apply) (3 copies, if a building permit is required) Er New sign? ❑ Alter to existing sign? size requirement: 8 x 11 ", to 24" x 36" Sign Dimensions: ❑ $164.00 Fee (Permanent sign, any size) • Total Sign Area (sq. ft.): '^� 3 Q ❑ $52.00 Fee (Temporary sign, any type) Sign Data Total Wall Area (sq. ft.) NOTES: (Complete all Direction Wall Faces (circle one): items in this • Wall signs do not need to be drawn to scale, but section) N S E W NE NW SE SW must include dimensions of wall face and sign Height to top of sign (feet): 3 ' placement. Projection From Wall (inches): • Wall signs do not require site /plot plans. Materials: ♦ Freestanding signs over 6 ft. require a building Will sign have illumination? Yes . No permit. ...a Type: ❑ Internal External Are there any existing freestanding or wall signs at this location, including wall signs that overlap a tenant space? ❑ Yes VNo If "yes ", a list or diagram of all sign dimensions and square footage must also be submitted. (OVER FOR SIGNATURES) APPLICANTS: To consider an application complete, you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as described on the front of this application in the "Required Submittal Elements" box. NOTE: Person specified as "Applicant" shall be designated "Permittee" and shall provide financial assurance for work. * When the owner and the applicant are different people, the applicant must be the purchaser of record or a lessee in possession with written authorization from the owner or an agent of the owner. The owner(s) must sign this application in the space provided on the back of this form or submit a written authorization with this application. BY SIGNING BELOW, THE APPLICANT(S) SHALL CERTIFY THAT: ♦ If the application is granted, the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. ♦ All of the above statements and the statements in the plot plan, attachments, and exhibits transmitted herewith, are true; and the applicants so acknowledge that any permit issued, based on this application, may be revoked if it is found that any such statements are false. ♦ The applicant has read the entire contents of the application, including the policies and criteria, and understands the requirements for approving or denying the application. 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. V / Applicant's Si: e Date V ��o g 1 Signature of wner /Agent Date Contact Person Name Phone No. EJ /.SS P Y S � 3 T ies CITY OF TIGARD RECEIPT .1 s g 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 T IGARD Receipt Number: 182790 - 06/08/2011 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SGN2011 -00066 Temporary Sign Permit 1003100 -43115 $45.00 SGN2011 -00066 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 Cash KPEERMAN 06/08/2011 $52.00 Payor: Blissful Energy Yoga Total Payments: $52.00 Balance Due: $0.00 Page 1 of 1