SGN2003-00085 1
• CITY OF TIGARD SIGN PERMIT
4 DEVELOPMENT SERVICES PERMIT #: SGN2003 -00085
DATE ISSUED: 4/16/03
`` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 103DD -01201
BUSINESS NAME: NELSEN'S AUTO CARE ZONE: C -G
SIGN LOCATION: 13880 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y 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: Temporary A -frame sign. Valid 4/16/03 to 5/16/03. Sign permit #1. Sign must be
placed out of right -of -way.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
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 expire 10 days from validity date.
APPROVED BY: aLLy Civ (
PERMITTEE SIGNATURE: t� X ,' 4 ' �'`�'
DATE: 4/16/03
i
°tti , I °a- SIGN PERMIT LI °TI
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
4 �UTv 0 26 FOR STAFF USE ONLY
Site
Address/ Street Address Permit No.: S G !v a003-00° 3 S
Location /3 FP J(, c /` /G c,, ,_
Suite /Bldg. # City /State Zip Expiration Date: 51 I(p / 0 3
7 / 4 - 2 / 9 2.2,21 Receipt #: o - v ° 3- i 50 9
Name Approved By: (`,• C!0 j ;!.t �—
• Property qX4 i/ OCf<f7 f� / y Date: 4 4 - RP - 0 �
Owner Mailing Address Suite Map/TL #: 07 S I v 3 Q O — O I � t:s )
720. SO is i Zoning: C. C2
City/State Zip Phone
GQ 8 7339 s`f / 75'300 Electrical Permit Required? ❑ Yes No
Tenant or Name
Business Building Permit Required? ❑ Yes pi No
Name Rev. 30 -Jul -01 is \curpin \masters\revised \sign permit app.doc
Sign Ncrkl� -
Contractor Mailing Address • Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a without th required submittal elements
copy of all City/State Zip Phone q elements)
licenses are
required if EIV Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # [3 2 Copies of Site /Plot Plan, Drawn to Scale
database) ' \ 3 copies, if a building ( p' g permit is required)
Pro Proposed size requirement: 8 x 11 ", or 11" x 17"
p ❑ Permanent ❑ Freestanding ❑ Freeway
Sign ❑ Temporary ❑ Wall ❑ Electronic 2 copies of elevations, drawn to scale
(Check all that ❑ Other ❑ Billboard ❑ Balloon (3 copies, if a building permit is required)
apply) size requirement: 8 x 11 ", to 24" x 36"
❑ New sign? ❑ Alter to existing sign?
❑ $50.00 Fee (Permanent sign, any size)
Sign Dimensions:
3w ,"$15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.):
/a_ (s'q f �' , NOTES:
Sign Data Total Wall Area (sq. ft.) • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
. (Complete all Direction Wall Faces (circle one): sign placement.
items in this
section) N S E W NE NW SE SW • Wall signs do not require site /plot plans.
• Freestanding signs over 6 ft. required a
Height to top of sign (feet): building permit.
Projection From Wall (inches): • If work authorized under a sign permit has not
Copy: been completed within ninety (90) days after
Materials: the issuance of the permit, THE PERMIT WILL
Will sign have illumination? ❑ Yes ❑ No BECOME NULL AND VOID.
Type: ❑ Internal ❑ External \
Are there any existing freestanding or wall signs at this N ot all jurisdictions accept credit cards, please call jurisdiction for more information.
location, including wall signs that overlap a tenant space? visa La MasterCard
Credit card number / /
❑ Yes No Expires
If "yes ", a list or diagram of all ign dimensions and Name of cardholder as shown on credit card
square footage must also be submitted. $
t Cardholder signature Amount
(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 id day of 79)/(-- 2 , 20 03
Signature of Owner /Agent
Contact Person Name Phone No.
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CITY OF TIGARD 4/16/2003
13125 SW Hall Blvd. 2:10:43PM
i��aait oy(t Tigard, Oregon 97223 •
.444 (503) 639 -4171
Receipt #: 27200300000000001509
Date: 04/16/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00085 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
Line Item Total: 515.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check NELSEN TIRE AND CAC 12047 In Person 15.00
AUTOMOTIVE
Payment Total: $15.00