SGN2003-00225 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2003 -00225
c 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/16/03
PARCEL: 1 S135DD -00800
BUSINESS NAME: XENON WEST ZONE: C -G
SIGN LOCATION: 11847 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT/AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4' X 8'
TOTAL SIGN AREA: 32 sq. ft.
WALL AREA: 1,046 sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one (1) permanent wall sign. Non - illuminated, reader board (4' x 8').
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: et
PERMITTEE SIGNATURE: 47 7 ‘ - n - " - - . - 27-1( (
DATE: 9/16/03
.
,,,..,,
,,,,, l,, SIGN 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
FOR STAFF USE ONLY
Site X.e.) n N We.c,+
Address/ Street Address Permit No.: S''AJ 4 a c.3 — D p. ...?S
Location ny'7 5LA? P.A+Ct4,e- \
Expiration Date:
Suite /Bldg. # City /State Zip
t t�Arg Ok e ll a:6 Receipt #:
,Name Approved By:
Property c j A ry d k, e £= Date:
Owner Mailing Address Suite Map/TL #:
3 No 6-t1mflio C— g-d 3 Zoning:
City /State Zip y ? Phone
l SS AW N WO Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name
Business �,UeS\. Building Permit Required? ❑ Yes ❑ No
- Name Rev. 2/28/2003 is \curpin \masters \revised \sign permit app.doc
Sign 17e.NC. ScAe
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit � l�Hl S� �c ,c (Note: applications will not be accepted
issuance, a
copy of all City /State Zip Phone without the required submittal elements)
licenses are
required if ` T
t3Ar9- OZ `V7 343 (503 )443 -3b3L ❑ Completed Application Form
expired in the Oregon Corfst. 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 1 Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard ❑ B a l loon ❑ 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
Zf New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11", to 24" x 36"
Sign Dimensions:
9 X5 ❑ $ Fee (Permanent sign, any size)
voo
Total Sign Area (sq. ft.): 3. 0- 5 52 C4 ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) l G 5 L4 "--/ I Jurisdiction: ❑ City ❑ Urb
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N 0 E W NE NW SE SW
Height to top of sign (feet): • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
Projection From Wall (inches): iii sign placement.
Copy: C., p,M9et61e • Wall signs do not require site /plot plans.
Materials: LJ.)c,c, . 4 , 1 - , - izAkAS },c. wi 5 • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes ■'4 No building permit.
Type: ❑ Internal ❑ External • 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 gf 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.
DATED this day of , 20
Signature of Owner /Agent
Contact Person Name Phone No.
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Painted Wood Frame - Painted Wood Background
6" High, Changable Plastic Letters On Clear Plastic Tracks
CITY OF TIGARD 9116/20C3
13125 SW Ha11 Blvd. 12:17:3 - 3PM
//14 � k , � A Tigard, Oregon 97223
_') L (50 3) 63 9-4 17 1
Receipt #: 27200300000000004107
Date: 09/16/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00225 [SIGN] Sign Permit 100- 0000 - 437000 31.00
Line Item Total: $31.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check XENON WEST CAC 1029 In Person 31.00
Payment Total: $31.00
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