SGN2003-00222 CITY OF TIGARD SIGN PERMIT
,,� I DEVELOPMENT SERVICES PERMIT #: SGN2003-00222
` 'IE11 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/15/03
PARCEL: 2S 102CC -00500
BUSINESS NAME: TIGARD FIRESTONE ZONE: C -G
SIGN LOCATION: 13500 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON: Y
SIGN DIMENSIONS: 20 SQ FT TIRE
TOTAL SIGN AREA: 20 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 20 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one temporary balloon. Valid 9/19/03 thru 9/29/03.
MATERIALS: BALLOON
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
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
i p
date. A balloon sign shall expire 10 days • validity dat-
V
APPROVED BY:
PERMITTEE SIGNATURE: X
DATE: 9/15/03
i
I
j „ rl SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Ha11 Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name evelopment/Proi
�/f � FOR STAFF USE ONLY
Site / j 44 rd 1 /e, /1/ c
Address/ Street ad dress J Permit No.: J N 3 (Jo 2 —�- 2 -
Location f 3�Cd . \ (•, l/v f' GrG/ G Expiration Date: 71 / 7/ / 4 3 - 9 / 3
Suite/Bldg. # City/State Zi
9 tY Zip �v.3 '” / v ` S
1 Gr It f,�2 .2�i-J Receipt #:
Name f Approved By: IC
Property Date: 4 /!g o a
Owner Mailing Address Suite Map/TL #:
Zoning: (jc .
City/State Zip Phone
Electrical Permit Required? ❑ Yes 111—No
Tenant or Name e
Business Building Permit Required? ❑ Yeso
Name Rev. 2/28/2003 is \curpin \masters \revised \sign permit app.doc
Sign - l
Contractor Mailing Address '_ Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a n
copy of all City /State Zip Phone without the required submittal elements)
licenses are
required if El 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)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11", or 11" x 17"
Sign `Temporary El Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard Balloon ❑ 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions:
2 v S7 -4 [21 $ 6748 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): Y oo
❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft - Jurisdiction: ❑ City ❑ U,rb
(Complete all Direction Wall Faces (circle one): m
items in this NOTES:
section) N S E W NE NW SE SW
Height to top of sign (feet): 2,D ..(=r; - . Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
sign placement.
Copy: )V d �e- S i'�'' -- T' ♦ Wall signs do not require site /plot plans.
Materials: 10 ((3° rJ o Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes No building permit.
Type: ❑ Internal ❑ Exter al o If work authorized under a sign permit has not
Are there any existing freestanding or wall signs at this been completed within ninety (90) days after
location, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
BECOME NULL AND VOID.
❑ Yes .No
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.
cd
DATED this l day of fi/Ohri �� , 20 1—
,.
Signature of ner /Age
Ot�l roc. ( /-7.14 / 4. / ' �f t
Contact Person Name Phone No.
. tr f r gilaii
13 k b
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CITY OF TIGARD 9/15/2003
13 12 5 SW Hall Blvd. 12:52:00PM
0i l Tigard, Oregon 9 72 23
6 (503) 63 9-4 17 1
Receipt #: 27200300000000004095
Date: 09/15/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00222 [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
Cash TIGARD FIRESTONE KJP In Person 15.00
Payment Total: $15.00
Page 1 of 1 cReceipt.rpt
I`
•
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 4 tf: , 20 ‘
` ,r
Signature o Iner /Age t
IIII
I i'L1 i--7,1 1. P7 a .37'
Contact Person Name Phone No.
7411 i ..
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_ CITY OF TIGARD
Approved — Iy l
Conditionally Approved I I
For only the work as deesari 3 d Inc ZZ
PERMIT NO. .5 v
See Letter to: Follow I l
Attache w I l
fob r, dre / S ✓//(J7y�
- / r, Date: —�r /