SGN2003-00031 CITY OF TIGARD SIGN PERMIT
I, DEVELOPMENT SERVICES PERMIT #: SGN2003 -00031 •
`'` L 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/11/2003
PARCEL: 1S136CD
BUSINESS NAME: CASH AND CARRY ZONE: C -
SIGN LOCATION: 11745 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2' X 12'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): S
SIGN HEIGHT: 12 ft.
PROJECTION FROM WALL: 1 in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Pig cew,el, °C 14 S;0
MATERIALS: VINYL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
3(127
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 10 days fro validity date.
APPROVED BY•
PERMITTEESIGNATURE: F ` l
DATE: 2/11/2003
ir .
�L,r „. SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project n FOR STAFF USE ONLY
Site LfIU IT Oi Ct - l,� f5t ! I rAt lie-4/ X043- C3G03
Address/ Street Address Permit No.:
Location I ‘ALM'5 jotc' - 1 C 1 Expiration Date: 3(1'1/03
Suite /Bldg. # City /State Zip
T\ CitA{ OIL 912-2-; Receipt #:
Name Approved By; 'f3m k
Property N'`O ti AA PI Date: 'D. r l l j(9 3
VHS 0100o Owner Mailing Address Suite Map /TL #: I 1 3 (0C1) -
) rillS PALI i( "'"I Zoning: C. G
City /State Zip Phone
i (G 1i2r) Ov— 11 ZZ Electrical Permit Required? ❑ Yes V No
Tenant or Name Name Building Permit Required? Yes ►5 No
Business Vk in FN 6124 CFiS CAsN 3 Ct .ii-/
Rev. 01- Jul -02 is \curpin \masters \revised \sign permit app.doc
Name
Sign S 0 ea-14e S 6,,, s
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a the required submittal elements)
copy of all City /State Zip Phone
licenses are
required if IF Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # 0 2 Copies o Site /Plot Plan, Drawn to Scale
database) (3 cop' , if a building permit is required)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway s' requirement: 8 x 11", or 11" x 17"
Sign a Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ B illboard ❑ Balloon ❑ 2 copie of elevations, drawn to
apply) (3 co les, if a building permit is required)
Et New sign? ❑ Alter to existing sign? siz requirement: 8 x 11", to 24" x 36"
Sign Dimensions:
0a � / 2- ❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 0 _, / X $15.00 Fee (Temporary sign, any type)
Sign Data
Total Wall Area (sq. ft.) '1
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N 0 E W NE NW SE SW a 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: /0 0 efJa3 a Wall signs do not require site /plot plans.
Materials: I l,) 4t t✓ a Freestanding signs over 6 ft. required a
U building permit.
Will sign have illumination? ❑ Yes Pci No a 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 !j No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted. .
(OVER FOR SIGNATURES)
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 I I ‘t." day of C E i2Utht( , 20 / 3
1
Signature of Owner /Agent
Contact Person m e Phone No.
CITY OF TIGARD 2/11/2003
13125 SW Hall Blvd. 11:08:53AM
Tigard, Oregon 97223
' f J (503) 63 9-4 17 1
Receipt #: 27200300000000000538
Date: 02/11/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003- 00031' [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
CreditCard BRUCE VARNEY BMK 011462 In Person 15.00
Payment Total: $15.00
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