SGN1997-00156 ,
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SIGN PERMIT APPLICATION
A ��Pf.( 13125 SW Hall Blvd., Tigard, OR 97223(503) 639 -4171 FAX: (503) 684 -7297
CITY OF TIGARD
GENERAL INFORMATION {PLEASE PRINT CLEARLY!
Sign Address /Location: ) 3 / 4 C S cal >°i4c i T , a 1-lw ;:: :::: . ,, : ,
/ : FOR ` STA F F USE ONLY'
Name of Tenant/Business: 13 v K , nC
S : / C 1,4e-4) 102 Date Rec eived : : � _ . :
Address: )31 a; S 54 �J c, 714 f-fwy , / 1
Applicant/Agent/Contact Person: 3 m 5 rk
:Received By ,
® Permit: No (s):,(� C7 /s .
Sign Company:srRi�t 5;9 A4 Phone�� �� 696-_,3220
/ Permit Fee
Address: -3 F IQ CP AI.Al Al PO: 41 / H 1�! y - - --
Receip No / ':
City: Cc/ et Ar rr State: o 2 Zip: 72d/5
'approved By- =-=
Sign Company C.C.B. #: t '7`"f � Dat of ; A pproval. 'r a
Expiration Date: —ARV 111:f 1 Expiration Date .
City of Tigard Business Tax #: —,-,: �
(or) Expiration Date: ::Zon ing; : :7 ;
Metro Business License #:_ 7.5'
Expiration Date: C62/qt) - Electrical Perm Y
it Required? es Nd ❑ '
: 1.
Proposed Sign: (check as many as applicable) building, Permit Required ? Yes. 0 ' , : No jj
Permanent Freestanding Freeway Rev.12/2iiss >i \curpiritmaster
Temporary ❑ Wall g Electronic ®.
Other ❑ Billboard ❑ Balloon ❑
Sign Dimensions: y X W
Total Sign Areas (sq. ft.): 1( 5 A f REQUIRED SUBMITTAL ELEMENTS
Total Wall Area (sq. ft.):
Direction Wall Faces: (circle one) N S 0 W NE NW SE SW ❑ Completed Application Form
i,.,51- Height (ft.): 1 D( 1 7 C ' ❑ Site /Plot Plan Drawn to Scale
Projection from Wall: / ' ?Cr- (2 copies, 3 if a building permit is required)
Illumination: Yes ❑ No ❑ Type: Internal ig External ❑ ❑ Elevations Drawn to Scale
(2 copies, 3 if a building permit is required)
U.L. Label #:
❑ Applicant's Statement
Copy:3 l` /2 - K, Al q ❑ Fee (Permanent Sign, any size) $50.00
1 2 y i�� r ❑ Fee (Temporary Sign) $15.00
Materials: 4 I�Y�? � /.r. Li-Al , St
Are there any Existing Signs at this Location? Yes ®... No ❑ I certify that I am the recorded owner of the
[Eyes, a list of all sign dimensions must also be submit/ell property or an agent authorized by the owner. g,erni„x.
NOTE:4 If work authorized under a sign permit has not been ,
completed within ninety days after the issuance of the _ -fi► ,
permit. THE PERMIT SHALL BECOME NULL AND VOID. • Applicant's Signature
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