SGN2003-00016 CITY TIGARD SIGN PERMIT
j DEVELOPMENT SERVICES PERMIT #: SGN2003 -00016
'` DATE ISSUED: 1/27/2003
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 103DD -00800
BUSINESS NAME: JAVA JUICE ZONE: C -G
SIGN LOCATION: 13815 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 4'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one 12 sq ft temporary sign. Valid 1/27/03 thru 2/26/03. Sign #1
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
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 ex. it ,days from validity date.
r
APPROVED BY: ''
PERMITTEE SIGNATURE: 1
DATE: 1/27/2003
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voy .
., �,j, b,i ;�l fa SIGN PERMIT APPLICATION
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CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 FAX (503) 684 -7297
GENERAL INFORMATION
Name of Developmen Project
FOR STAFF USE ONLY
Site Si V P ra 5 CAARk,e PG.Lc -,..P( �3� G
Address/ Street Address �- �/ Permit No.: s9 A 2.45 3 - (10 , �
Location 1 3 g IC S,w , 9oci riC i iJti
Expiration Date:
S to /Bldg. # City/State Zip
8 6 it.4 ct _ L' 7)3 Receipt #: Q 3j — 00 323
Name lz 1%1 s Approved By: r l' / .
Property A i'l 7 S'( Ve e 5' Date: V2- 7/a3
Owner Mailing Address Suite Map /TL #: Z-S' 0 3 rDD- vtz 9 c
413GSw nogam_N \ 3 \ Zoning: C. c9
City /State Zip Phone
`t -
(9- ►A.� A L
\5 a' _a b8o • Electrical Permit Required? ❑ Yes [g No
Tenant or �� A ��
N- e
[
Business ( ti7e 5 �. Building Permit Required? ❑ Yes 12KNo
Name Rev. 01- Jul -02 is \curpin\masters \revised \sign permit app.doc
Sign •
Contractor Mailing Address 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 Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign ®, Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Othe ❑ ❑ 111 2 copies of elevations, drawn to scale
apply) Billboard Balloon
(3 copies, if a building permit is required)
iiew sign? ❑ Alter to existing sign? size requirement: 8 x 11", ", to 24" x 3
Sign Dimensions: L
x C ❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
la
❑ $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: a Wall signs do not require site /plot plans.
Materials: a Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes No building permit.
. If work authorized under a sign permit has not
Type: ❑ Internal ❑ External
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.
❑ Yes (No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
y {
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 1 c=3 day of , 20 '0
Signature of Owner /Agent
50 - b k ( - q1+
Contact Persoln Name Phone No.
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CITY OF TIGARD 1/27/2003
13125 SW Hall Blvd. 10:18:50AM
t Tigard, Oregon 9 72 23
IL, • (503) 63 9-4 17 1
Receipt #: 27200300000000000323
Date: 01/27/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00016 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check JAVA JUICE /WILLIAM YATES KJP 421 In Person 15.00
Payment Total: $15.00