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SGN2003-00238 CITY OF TIGARD SIGN PERMIT DEVELOPMENT SERVICES PERMIT #: SGN2003 -00238 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/30/03 PARCEL: 2S 112 DC -00701 BUSINESS NAME: NW RUGS ZONE: I -P SIGN LOCATION: 15957 SW 72ND AVE BLDG -A JURISDICTION: TIG APPLICANT /AGENT: BUSINESS TAX NO: SIGN PERMANENT: FREESTANDING: FREEWAY: TEMPORARY: X WALL: ELECTRONIC: OTHER: BILLBOARD: BALLOON: Y SIGN DIMENSIONS: 24' X 20 TOTAL SIGN AREA: 480 sq. ft. WALL AREA: sq. ft. WALL FACE (DIRECTION): SIGN HEIGHT: ft. PROJECTION FROM WALL: in. ILLUMINATION: NON DESCRIPTION OF SIGN: Placement of one(1) temporary balloon. 24 feet high and 20 feet wide. Sign #2 Valid from 10/20/03 through 10/20/03 MATERIALS: 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. (f, APPROVED BY: PERMITTEE SIGNATUR . �'i 1 0 1 21 111 1PA r DATE: 9/30/03 / hoi,f, 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 (V+ 1A7 / S Address/ Street Address Permit No.: S6 l) o?D03 - 0d 3 8 / < Location 595 7 Si!1t � / " 1-- e- , Expiration Date: v f 'o - a 0 - 0 3 Suite /Bldg. # City /State Zip 353 7-7) 4y� 0 9 2 f / Receipt #: ?003 — Name J Approved By: e . ea., ,'LPG Property l ""C / 7 ,Ae a dim t /iOY� Date: 9 -3o -03 Owner Mailing Address J Suite Map/TL #: eR S 1 /aD C - 00 76 / 15 S (it/ // .fir >rtc ,,,, Zoning: / - P City/State / Zip (/ Phone 5"4/77 / (mo d / �� 3 306 Electrical Permit Required? ❑ Yes X No Tenant or Nfrte Business 1V OA u6--6, Building Permit Required? ❑ Yes g No Name /(e, 4/2 Rev. 2/28/2003 is \curpin \masters \revised \sign permit app.doc Sign (1 0 17 Old / / t I J Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS (Prior to permit /P© �1 / //,25 � � b - 1(. (Note: applications will not be accepted issuance, a U J n l without the required submittal elements) copy of all City /State Zip Pon j licenses are //// L 9 5 ' 5 1/ - _ ^ required if <7/ // / ❑ 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 ❑ Wall ❑ Electronic (Check all that ❑ ❑ ❑ ❑ 2 copies of elevations, drawn to scale apply) Other Billboard Balloon (3 copies, if a building permit is required) ❑ New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11", to 24" x 36" Sign Dimensions: ❑ $86700 Fee (Permanent sign, any size) Total Sign Area (sq. ft.): Q.20 79 W/ 0 $15.00 Fee (Temporary sign, any type) Sign Data Total Wall Area (sq ft.) Jurisdiction: ❑ City ❑ Urb (Complete all Direction Wall Faces (circle one): items in this NOTES: section) N S E W NE NW SE SW Height to top of sign (feet): S4 • 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. • Wall signs do not require site /plot plans. Materials: • Freestanding signs over 6 ft. required a Will sign have illumination? ❑ Yes ❑ 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 ❑ No If "yes ", a list or diagram of all sign dimensions and squ re foots a must also be submitted. J - (OVER FOR SIGNATURES) (-----8,z_i-oo N° 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. CITY OF TIGARD 13125 SW Hall Blvd. ge Tigard, Tigard, Oregon 97223 (503) 639 -4171 Receipt #: 27200300000000004353 Date: 09/30/2003 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2003 -00238 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00 SGN2003 -00239 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00 Line Item Total: $30.00 Payments: Method Payer. User ID Acct. /Check Approval No. How Received Amount Paid Check MARY/ROBERT MURPHY CAC 3412 In Person 30.00 Payment Total: $30.00 •