SGN2003-00264 CITY TIGARD SIGN PERMIT
.���6 DEVELOPMENT SERVICES PERMIT #: SGN2003 -00264
'` c� - •'' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
DATE ISSUED: 10/21/03
PARCEL: 1S136CD-01401
BUSINESS NAME: AMERICAN BOOT CO. ZONE: C -G
SIGN LOCATION: 11652 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'X10'
TOTAL SIGN AREA: 40 sq. ft.
WALL AREA: 840 sq. ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT: 16 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one permanent 40 sq ft wall sign. Banner to be enclosed with a
frame.
MATERIALS: BANNER /FRAME
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 31.00
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 date. A balloon sign shall expire 1 ...'ys from validity date.
APPROVED BY:
PERMITTEE SIGNATURE: 4.101 .
DATE: 10/21/03
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14,,°il,,,v SIGN PERMIT APPLICATION
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CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
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GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY
Site .
Address/ ' Street Address Permit No.: 5 e2/•- 7 - 1 -3 3 3 - Oo Z to
Location 11652 S(.J pae; -P C H uJ J
Suite /Bldg. # City /State Zip
Expiration Date:
ft rd b R. q r zz 3 Receipt #: 2c303 — `f ce yea
Name Approved By: W Property IV k S ,poper +''e5 t_ I-C Date: /c/ /z r l -
Owner Mailing Address Suite Map/TL #: /S/ 3 co CD - O) 4 D /
Z$50 Cea {{gills 4 t - al Z Zoning: ei C .
City /State Zip Phone
Bea Verfrari oR- grIDOS Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name •
Business evt Ca, . 1 cr5+ C D , Building Permit Required? ❑ Yes ❑ No
Name Rev. 2/28/2003 is \curpin\masters\revised \sign permit app.doc
Sign
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted '
issuance, a
copy of all City /State Zip Phone without the required submittal elements)
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)
Proposed AEr Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign ❑ Temporary "Wall ❑ Electronic •
(Check all that ❑ Other El Billboard El Balloon ❑ 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
Er New sign? ❑ Alter to existing sign? size requirement: 8 x 11 ", to 24" x 36"
Sign Dimensions: '
LOX 4 ❑ $ Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
40 ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft Q�1 _� Jurisdiction: ❑ City ❑ Urb
vT
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E 0 NE NW SE SW
Height to top of sign (feet): .16 • 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: $U v► vier • • 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
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 0 , 20 0 3
i
Sign ure of Ow►er /Agent
SR nclra (Ppfr /CS 6503) 6ZO -2-2-6
Contact Person Name Phone No.
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Cal Cu (oc n 1 5 T o ± o d Wa l I Area. : Ne.3 i4 (zo'J x (,04-I-1, (4z') = 840 59uate
Cal Cu.Iafin tofu -. s-19r+ Area, : fk jk+ (4 00') = 40 s940+•e-
Approved CITY OF TIGARD
Conditionally Approved _ [
F d cribed in:
PER MIT only NO. the wor � —U3' 00 2 .. ( O `f
See Letter to: Follow [
Attach
Job Addre : i I b52 5"`J P �<< 14
B )(. 1 Q „eJ Date:4 0 zi
WORK BOOTS
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TOES la
Site Address: 11652 SW Pacific HWY
Tenant/Business Name: American Boot CO.
Sign Company: Sign Scope
13185 SW Pacific Hwy
Tigard, OR 97223
CITY OF TIGARD 10/21/2003
13125 SW Hall Blvd. 10:00:04AM
�ia,.Nr Tigard, Oregon 97223
(503) 63 9-4 17 1
Receipt #: 27200300000000004640
Date: 10/21/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00264 [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 AMERICAN BOOT COMPANY KJP 4253 In Person 31.00
Payment Total: $31.00
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