SGN2003-00195 4'
CITY TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2003 -00195
I I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/14/03
PARCEL: 2S 102B D -01700
BUSINESS NAME: TIGARD PLAYSCHOOL ZONE: C -G
SIGN LOCATION: 12860 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2.5' X 2'
TOTAL SIGN AREA: 5 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary A -frame sign for preschool.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: •
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes
and all other applicable laws. 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: /f .14
PERMITTEE SIGNATURE:
DATE: 8/14/03
rte= °.�,i S IGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project i' FOR STAFF USE ONLY
Site Address/ sl reet l A� � I � � � � �SC � v v � �� � ,
Add Permit No.: ,EG NI .- ^ Op ` S Location )2.5 Q 3u) P AC 1 FIG f J ,1
4 Expiration Date: `t /iY`
Suite /Bldg. # City /State Zip a 003 3�P S 7
r I 6A-12D �,p Receipt #:
Name J t\ Approved By: C. e..a.
Property �
Ti &AK) P / c L 1AZ . Date: "lcf Owner Mailing Address Suite Map/TL #: ,;?..5/0.. BO -0/700
98146 5 W UluIY 19), Zoning: C G
City /State Zip Phone
TIg a O . c17,223 � ' 6 81)0 Electrical Permit Required? ❑ Yes No
Tenant or Na Building Permit Required? 111 Yes No
Business - I GARD P o'05C I }0a (,
Name Rev: 30 -Jul -01 is \curpin\masters\revised\sign permit app.doc
Sign J IP
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a the required submittal elements)
copy of all City/State Zip Phone
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
size requirement: 81/2" x 11 ", or 11" x 17"
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway
Sign Q Temporary ❑ Wall ❑ Electronic ❑ 2 copies of elevations, drawn to scale
(Check all that (3 copies, if a building permit is required)
apply) • Other ❑ Bi ❑ Balloon size requirement 8 x 11", to 24" x 36"
❑ New sign? ❑ Alter to existing sign? ❑ $50.00 Fee (Permanent sign, any size)
Sign Dimensions: t � x ❑ $15.00 Fee (Temporary sign, any type)
. Total Sign Area (sq. ft.): 5 ('�
1 "v NOTES:
Total Wall Area (sq. ft.) ♦ Wall signs do not need to be drawn to scale, .
Sign Data but must include dimensions of wall face and
(Complete all Direction Wall Faces (circle one): sign placement.
items in this signs do not require site /plot plans. •
section) N S - E W NE NW SE SW • Freestanding signs over 6 ft. required a
Height to top of sign (feet): building permit.
Projection From Wall (inches): ♦ If work authorized under a sign permit has not
Copy: been completed within ninety (90) days after
Materials: WOOD the issuance of the permit, THE PERMIT WILL
BECOME NULL AND VOID.
Will sign have illumination? ❑ Yes g,. No
Type: ❑ Internal ❑ External
Are there any existing freestanding or wall signs at this Not all jurisdictions accept credit cards, please call jurisdiction for more information.
❑ Visa ❑ MasterCard
location, including wall signs that overlap a tenant space? / /
❑ Credit card numbe
Yes K No Expires
If "yes ", a list or diagram of all sign dimensions and Name of cardholder as shown on credit card
square footage must also be submitted. 3
Cardholder signature Amount
(OVER FOR SIGNATURES)
f
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 1 day of Atij GO ° , 20 0
/, kW/WC
Signature o Owner /Agent
4 "6, 1� Rtit,t4Alo G �1 60 .� �I -I k3o
Contact Person Name Phone No.
CITY OF TIGARD 8/14/2003
13125 SW Hall Blvd. 3:25:53PM
timpki������ Tigard, Oregon 9 72 23
(503) 63 9-4 17 1
Receipt #: 27200300000000003657
•
Date: 08/14/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 - 00195 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check SCOTT /KATHARINE CAC 8609 In Person 15.00
RUMBAUGH
Payment Total: $15.00
•