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SGN1997-00158 SIGN PERMIT APPLICATION yp 41 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297 sre CITY OF TIGARD GENERAL INFORMATION {PLEASE PRINT CLEARLY) Sign Address /Location: /6 � s � 1 -2 el 41;C Tom / j c-i p 7..) 4 FOR STAFF USE ONLY Name of Tenant/Business: J, a 1;4 . h , co .S 7 14,1? t . is Address: � � ° r a ����� :Date Received ' 97 . • /I lJc . Received B Applicant/Agent/Contact Person: C Ii c S ( / y Sign Company: JL Ley-le , Cr G• .Phone: CAD *S/105'0 Permit Na (s r w !/ Address: . > � �C.' • ���, 1-,A(1,-• �c.. Permit Fee '° t Receipt No "' City: t (Ail State: ° Zip: 9 1 Approved By> ' t �, , Sign Company C.C.B. #: 170 (-Li O i y Date ofApproval l/ /5-1:7 Expiration Date: / - 30 ' S Expiration Date '0'7 T 9 7 City of Tigard Business Tax #: Zoning (or) Expiration Date: . Metro Business License #: ©Cc E¢C' Expiration Date: ' 0 ' / • 9/ Electrical :Permit Required? Yes No ❑ Proposed Sign: (check as many as applicable) Building Permit Required? Yes ❑ No Permanent 6 Freestanding ❑ Freeway ❑ Rev. 42 /27/98' a;lcurpin\masters\spa.doc Temporary El Wall L1 Electronic ❑ Other ❑ Billbr -d ❑ , Balloon ❑ El. , e q -0 Sign Dimensions: O K 4..J °, Total Sign Areas (sq. ft • (I pf 1037 . j) REQUIRED SUBMITTAL ELEMENTS Total Wall Area (sq. ft.): - 4 / 6 3 g ( , i i ) Direction Wall Faces: (circle one) N 1, E W NE NW SE SW ❑ Completed Application Form Height (ft.): /cc ❑ Site /Plot Plan Drawn to Scale Projection from Wall: (2 copies, 3 if a building permit is required) Illumination: Yes El No ❑ Type: Internal wr External ❑ ❑ Elevations Drawn to Scale (2 copies, 3 if a building permit is required) U.L. Label #: ❑ Applicant's Statement Copy: — 1 - C. {1t1 1.1CC.1 i tt. r.( Zi Fee (Permanent Sign, any size) $50.00 Materials: tc P,cLA / fie, j(IC 1 li (141.464i0.4 El Fee (Temporary Sign) $15.00 Are there any Existing Signs at this Location? Yes ❑ No ❑ I certify that I am the recorded owner of the if yes, a list of all sign dimensions must also be submitted.) property or,an agent authorized by the owner. NOTE: w If work authorized under a sign permit has not been A completed 7 leted within ninety days after the issuance p ty y ft t o ssuance of the permit. THE PERMIT SHALL BECOME NULL AND VOID. Applicant's Signature 1 List any VARIANCE OR OTHER LAND USE ACTIONS to be considered as part of this application: APPLICANTS: To consider an application complete, you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as described on the front of this application in the "Required Submittal Elements" box. (Detailed Submittal Requirement Information sheets can be obtained, upon request, for all types of Land Use Applications.) THE APPLICANT(S) SHALL CERTIFY THAT: • The above request does not violate any deed restrictions that may be attached to or imposed upon the subject property. • If the application is granted, the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. • All of the above statements and the statements in the plot plan, attachments, and exhibits transmitted herewith, are true; and the applicants so acknowledge that any permit issued, based on this application, may be revoked if it is found that any such statements are false. • The applicant has read the entire contents of the application, including the policies and criteria, and understands the requirements for approving or denying the application. SIGNATURES of each owner of the subject property. DATED this day of , 19 LA// O 'er's Signature Owner's Signature Owner's Signature Owner's Signature 2 • -r ,; `tea-`ptt iTr i.7 ! �/yn�[, f 11 1444-U flat Ifs 1 Ff=17850 ® o Q �F L � nrwoaa ,.M l r � i J 3 '<