SGN2003-00272 CITY OF TIGARD
SIGN PERMIT
r.i DEVELOPMENT SERVICES PERMIT #: SGN2003 -00272
' c�Jll DATE ISSUED: 10/30/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 1S135BA-00102
BUSINESS NAME: BACKSMART ZONE: C -G
SIGN LOCATION: 10104 SW WASHINGTON SQUARE RD A -2A JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 18" X 16' -9"
TOTAL SIGN AREA: 25 sq. ft.
WALL AREA: 455 sq. ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT: 14 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Placement of (1) one permanent 25 sq ft wall sign.
MATERIALS: ALUM /NEON
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. A I work will be done in accordance with approved plans. A permanent sign must be
placed within 90 days f . approva •.•te or sign permit shall expire. A emporary sign shall expire 30 days from validity
date. A balloon sign : all expire 10 day from :id %ate.
APPROV ! =Y:
�� , , 1_ / ∎ / isaki C, -2-e44 -
PERMITTEE SIGNATURE:
DATE: 10/30/03 l�Jl
i"
4
.CITY OF TIGARD • Sign Permit Application Rec'd By
"( 13125 SW HALL BLVD. Permanent or Temporary Date Recd
TIGARD, OR 97223 Commercial or Residential Permit .
Fe
Permit Fee
(503) 639 -4171 . Receipt No.
Please Print or Type. Called
Incomplete or illegible applications will not be accepted.
Name of Development/Project Are there any existing freestanding or wall signs at this
Site 3r,ic ` location, including wall signs that overlap a tenant space?
• Address/ Street Address ❑ Yes gl No
Location W C If "yes ", a list or diagram of all sign dimensions and
10! O � 1 5 1 y .. id_ square footage must also be submitted.
Suite /Bldg. # City/Stat e a Zip
oc�o-fr . Q? o--4s r
Name V NOTE: If work authorized under a sign permit has not
Property d Q,, 4 . 4 4 been completed within ninety days after the
Owner Mailing Address Suit issuance of the permit, THE PERMIT WILL
BECOME NULL AND VOID.
• City/State } P A 15 Phone I hereby acknowledge that I have read this application, that the
. 1 U- -t-C e 4,z 3 6 31 - vL () 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.
Tenant or Nang
Business Dm& TdrB' Q Signature of Owner /Agent Date
Name ) O - o� s .. O.3
Sign Cont ct Perso N me Phone $'0
M a iling Ad dre Su ite
Contractor Yna r ccr 6767 fr a i ‘ O
Prior to permit ' P o 25/
issuance, a
copy City /State Zip Phone _
g .�
are of required all licenses if �a -.) n 47,2t/ 671:-a/6d Reta Submittal'Elements
expired in - Oregon Const. Cont. Board Exp. Date •.
C.O.T. License # `- -
_ database . q'3 .6 14 -.77- O 4 1 ❑' .Completed'application form .,
:
Proposed .. ❑ 2 copies of-site /plot plan, drawn to scale •
❑ Permanent ❑ Freestanding ❑ Freeway (3 copies If a b uilding permit is required)
Sign ❑ Temporary all ❑ Electronic • .
Check all that
❑ Other ❑ Billboard ❑ Balloon ement: 8 -1/2 x 11 ", or 11 x 17"
apply. Note : signs do not= require site /plot: plans.
[ ✓New sign? ❑ 2 copies of elevations, drawn to scale
1 Alteration to existing sign? (3, copies, if a building permit is required)
Sign Dimensions: , ,, size requirement: 8 -1/2" x 11 ", to 24 "- x 367
)1f " X /‘ _ 9 Note ;Wall signs do not need to. be drawn. to
Total Sign Area (sq. ft.): scale;: -but mustinclude dimensions.
-Sign S f 0 $50,:00.Fee',.;(Permanent sign, any size)
Data • Total Wall Area (sq. ft.) s ❑ $15:0.0 Fee (TeMporary sign, any type) •
Please /7 6, qS 6 ... _
complete Direction Wall Faces (circle o ne): •
each item
in this N S E O NE NW SE SW FOR OFFICE USE ONLY:
section
Map/TL# Zoning:
Height to top of sign (feet): ' -_ •
/ y . Notes
Projection From Wall (inches):
. it Electrical Permit Required? ❑ Yes ❑ No
• Copy: D C Building Permit Required? ❑ Yes ❑ No
Materials: 04,14., �J Approved 6y: Date of Approval:
e HRt.a.n►. i ✓l.a.,_ — .
Will sign have illumination? gl, Yes ❑ No Expiration'Date : .
Type: Er Internal ❑ External
is \dsts \forms\signapp.doc 12/17/98
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n..: BLAZE SIGNS CIF AMERICA, INC.
. P.O. BOX 23910
PORTLAND OR 97281-3910
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s otAmerica
^` s P.O.'BOX 23910 PORTLAND, OR 97281
16'43' p! J TEL 503.639.3262 FAX 503.620.8477
I JOB LO ATION:
BACKSMART
WASHINGTON SQUARE 2
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B A C K S MA Wi .: -
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SPECIFICATIONS:
* MANUFACTURE & INSTALL (1) SET
S/F ILLUMINATED WALL SIGN OF OPEN PAN LETTERS.
SCALE 3/8 " =1' - 0" * 3" RE ALUMINUM RETURNS.
* INSID OF LETTER PAINTED BLACK.
* "THE " '& "STORE" S/T CL RED NEON.
* "BACKSTORE" D/T CL RED NEON.
* ALL TRANSFORMERS MOUNTED
BEHIND; WALL.
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t DESIGN # 20208
1, �I' ± ;,' c FILE NAME: BACKSMART 1.CDR
* SALESPERSON: RON BRENNEMAN
{ SALES APPROVAL DATE
:" -- \ " ," e` W 1 i < DRAWN BY JOSH BROWN DATE 11/28/01
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REVISION: 00/00/00 REVISION: 00 /00 /00
< . , ` �` ' REVISION: 00 /00 /00 REVISION: 00 /00 /00
REVISION: 00 /00 /00 REVISION: 00 /00 /00
FRONT ELEVATION CLIENT APPROVAL DATE
SCALE : APPROXIMATE
LANDLORD APPROVAL DATE
THIS DESIGN AND ENGINEERING IS TO REMAIN THE EXCLUSNB PROPERTY OF BLAZE SIGNS OF AMERICA, INC. UNTIL ACCEPTED AND APPROVED BY PURCHASE. THE USE OF THIS DESIGN, FOR ANY PURPOSE WHATSOEVER, WITHOUTAIRIPIEN APPROVAL Of AN OFFICER OF BLAZE SIGNS OF AMERICA, INC. IS PROHIBITED BY LAW.
CITY OF TIGARD 10/3072003
13125 SW HaII Blvd. 1:39:13PM -
„M.,.. Tigard, Oregon 97223
maltir 6 -1_.. (503) 63 9-4 17 1
Receipt #: 27200300000000004774
Date: 10 /30/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00272 [SIGN] Sign Permit 100- 0000 - 437000 31.00
ELC2003 -00660 [ELPRMT] ELC Permit 220 - 0000 - 431510 53.40
ELC2003 -00660 [ELPRMT] ELC Permit 220 - 0000 - 431510 4.27
•
Line Item Total: $88.67
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check BLAZE SIGNS OF AMERICA INC DEB 1983 In Person 88.67
Payment Total: $88.67
Page 1 of 1 cReceipt.rpt