SGN2003-00239 � R
• CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2003 -00239
e 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/30/03
PARCEL: 2S 112DC -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: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 4'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one (1) temporary A -frame sign. 3 x 4 (Sign #3) Valid from 11/1/03
through 11/30/03.
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: C
PERMITTEE SIGNATURE: ��� I ��
DATE: 9/30/03 /
0: ., N•a V t — N 0 )) 30
Alibt
°� °''lr: ?1±
,,l,, SIGN PERMIT APPLICATION
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CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
Site I Y + IA/ --JR(Lj S FOR STAFF USE ONLY
v0. 3
Address/ Street Address Permit No.: s6 >J . RDa3 8
Location /51S7 Sid 70? /l Ue-
Suite /Bldg. # City /State Zip Expiration Date: 1
H „ Ar � OR 9 • Receipt #: a b o 3 — 4 /353
Name Approved By: L' • eG.)
Property "ma
'Mailing /2(- J Date: ci -3v - 03
Owner Mailing Address Suite i
` Map/TL #: d S/ /a D c Ov 7 C) /
�3SZ S- w, 3 &. ( 7A - 01i Zoning: / - P
City/State Zip / Phone 5' 1 '%" -.
- Ii e/ 6) - l7 Sa3 1 6 300
Tenant or N e i Electrical Permit Required? Li Yes No
Business N. OA f.---)
Business Building Permit Required? ❑ Yes h�J( No
Name 6, ;�l/� Rev. 2/28/2003 is \curpin\masters\revised\sign permit app.doc
Sign (1 / eYcg —
Contractor Mailing Address Suite /) /(� REQUIRED SUBMITTAL ELEMENTS
(Prior to permit -5 (�
issuance, a ,2.45.7.1a---/i44---
` _ { (Note: applications will not be accepted
copy of all City/State Zip p on ( ..�3 without the required submittal elements)
licenses are �' �/ �
required if /'�� X7 ��
CI Com Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date p pp
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 (Check
all that Temporary ❑ Wall ❑ Electronic
apply) Other ❑ Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale
El New sign? (3 copies,. if a building permit is required)
g ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
,s ----(cjil Sign Dimensions: 3
❑ $36:$8 Fee (Permanent sign, any size)
Total Sign Areas . ft.): 3/.00
'!�� c % �'_•y 1=1 $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): aare • 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: 1,300ID • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes It No ! building permit.
Type: ❑ Internal ❑ Exterfial • 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
❑ Yes ❑ No
BECOME NULL AND VOID.
If "yes ", a list or diagram of all sign dimensions and
s • u . re foota • e must also be submitted.
1% ' . , /,.
/.- 1 %,i, ie>e� .: —Air rG: —! (OVER FOR SIGNATURES)
f• � 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 , 20
Signature of Owner /Agent
Contact Person Name Phone No.
CITY OF TIGARD
13125 SW Ha11 Blvd.
/bi Tigard, Oregon 9 72 23
(503) 63 9-4 17 1
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
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