SGN2003-00001 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2003 -00001
6 ' ll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/3/03
PARCEL: 2S102AD -02800
BUSINESS NAME: PUBLIC WORKS ANNEX ZONE: CBD
SIGN LOCATION: 09020 SW BURNHAM ST JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4X6'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 6 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one 24 sq ft permanent freestanding sign. Sign must be placed
on private property and not in the public right -of -way.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 30.00
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 expir 1 • d. s from validity date.
APPROVED BY:
PERMITTEE SIGNATURE: 6 — /
DATE: 1/3/03
7 .- /oa- (olk- 7Soac .)-
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tw Ire SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Nam? of Development/Project
pF -r �1A, FOR STAFF USE ONLY
Site $u c. / o1e K.s A-Aw
Address/ Street Address Permit No.: C 11.1 2- b 3— Or (
Location ' ®o20 S(,i ZukiAlt,Aiti ApE
Expiration Date:
Suite /Bldg. # City/State Zip -� Receipt #: - v C . 44 "
74 /9 � t . ? 3
Name Approved By: r_-
� Date: I Jz/a3
Property a Uf l,- gff-1..-(7 Owner Mailing Addre s , / Suite Map /TL #: %-S /0 L /.� p_O ? c7
• 131025 StJ` r 1t j U1) Zoning: (' ,3i
City /State Zip Phone
L `ci `' Bee 3 563 - 637 - gni g' ? Electrical Permit Required? ❑ Yes Air No
m
Tenant or Na
Business Pat I'L Ohs 4/010 c Building Permit Required? ❑ Yes ,1N No
Name Rev. 01- Jul -02 is \curpin \masters \revised \sign permit app.doc
Sign C; or - rc
Contractor Mailing A ress `l 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 �ermanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign 1❑ Temporary ❑ Wall ❑ Electronic
(Check all that 111 2 copies of elevations, drawn to scale
apply) ❑ Other ❑ Billboard ❑ Balloon
(3 copies, if a building permit is required)
E New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: : r
H ,Y(ti ❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): a q i 1111 $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.)
(Complete all Direction Wall Faces (circle one): ' NOTES:
items in this
section) N S E W NE NW SE SW
• Wall signs do not need to be drawn to scale,
Height to top of sign (feet): ! .." but must include dimensions of wall face and
Projection From Wall (inches): sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: t,,3 • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes X No building permit.
• If work authorized under a sign permit has not
Type: ❑ Internal `_►`�� been completed within ninety (90) days after
Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL -
location, including wall signs that overlap a tenant space? BECOME NULL AND VOID.
El Yes [N3 No
If "yes ", a list or diagram of all sign dimensions and j
square footage must also be submitted.
(OVER FOR SIGNATURES)
1
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 6/004 , 2003
I P
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Signat 4 of Owner /Agen'
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"' ,—.A... ' Phone No.
Contac "Jerson Name
. _ .._
Fees Associated With 9:06:05AM
Tt
11' Ill'.'-, Case #: SGN2003-00001
City of Tigard
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PRMT 1/1/90 12/31/05 [SIGN] Sign Permit 100-0000-437000 1/2/03 30.00 0.00
Total: $0.00
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