SGN1997-00095 SIGN PERMIT APPLICATION
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imvoi � iAA 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX.' (503) 684-7297
CITY OF TIGARD
GENERAL I FORMATION (PLEASE PRINT CLEARLY)
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Sign Addre i s/Location: S . i.L) W rLIUU s % - '5—
STAFF USE ONLY.
SCi Fou._S F-ei y mil- > : : FOR ' :
Name of Tenant/Business:
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Na enant/Busines N
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Address: �/�cvvt e
> Date R : . ;
'`Received'B . `; ::_
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Applicant/Agent/Contact Person: � 1G,L GV� 1 Le.F� i
Sign Company: U/'r1Vr u e2 5/6 ev - Phone: aVoD �o 9 9 3 - y7 ?3
Permit ` No : s i< <.. . ;: C1 . . _ .
Address: (06e) /3 /4.0%1 q 9 Permit ,F �
City: Vi'tA)CDLU e2 State: 4- Zip: 9g(0
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»Date of`:A ': <r_<:::'': ' '` ' > � `: ? ::.: :.: >': ; . : .c., ..::..•:. Sin Company C.C.B. #: C X957 .f.. pp oval...
Expiration Dat
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City of Tigard Business Tax #: / 8
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or ira ion D Z-n ng »: »> >> >'. ._ - /V
( ) Exp t ate: : >:: s:::::;: ::..:.
Metro Business License #:
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Me ess L e se ,2-o
Expiration Date:
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Elecfricaf >'Permif: Required ., Yes ,t ;_ : N ❑,
'Build Permit :Required? Yes � "No
Proposed Sign: (check as many as applicable) : g ... �;;< <.; p::..:.:: ::: : 0 •
Permanent � Freestanding E:3 Freeway ❑ :.: ::::: ::.. . .•. "`
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Temporary ❑ Wall ❑ Electronic ❑
Other ❑ Billboard ❑ Balloon ❑
Sign Dimensions: 1P Ci ,6 137m Goa. I ?. a
Total Sign Areas (sq. ft.): S" /o 70 FT pQ 5� c' REQUIRED SUBMITTAL ELEMENTS
Total Wall Area (sq. ft.): iv / A T ,/
Direction Wall Faces: (circle one) N S E W NE NW SE SW I� Completed Application Form
Height (ft.): C ig Site /Plot Plan Drawn to Scale
Projection from Wall: /WA' (2 copies, 3 if a bu permit i s requ
Illumination: Yes IA No ❑ Type: Internal (tj External ❑ €evations Drawn to Scale
(2 copies, 3 if a bu perm i s required)
U.L. Label #: L j S El>;
❑ Applicant's Statement
Copy: /\ L-1 E. 2TSof3S �� ❑ Fee (Permanent Sign, any size) $50.00
Materials: i(y\' -TA (-- 1 L i \ST
- co- l G ❑ Fee (Temporary Sign) $15.00
Are there any Existing Signs at this Location? Yes ❑ No cif
I certify that I am the recorded owner of the
If yes, a list of all sign dimensions must also be su prope or an -gent auth • zed by the owner.
NOTE: 4 If work authorized under a sign permit has • not been ;, / 4
completed within ninety days after the issuance of the L J � �°
permit. THE PERMIT SHALL BECOME NULL AND VOID. Applicant's Signature
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