SGN2002-00150 r C. •
CITY TIGARD SIGN PERMIT
, DEVELOPMENT SERVICES PERMIT #: SGN2002 -00150
��'� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/30/02
EXPIRATION DATE:
BUSINESS NAME: CLUB K - INC
SIGN LOCATION: 07360 SW BONITA RD 100 PARCEL: 2S112AC - 0270
APPLICANT /AGENT: ZONE: I -
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X'2
TOTAL SIGN AREA: 6 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of (1) one temporary 3'x 2' A -frame sign. Sign must be placed on
private property and not in the public right -of -way. Valid 9/24/02- 10/24/02. Sign #2
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 OR. Specialty Codes
and all other applicable laws. All work will be done in accordance with approved plans. A sign permit shall expire 90
days from approval date. A temporary sign sh expire 30 days from approval date. A balloon sign shall expire 10
days frnm annrnval riata
APPROVED BY:
PERMITTEE SIGNATURE: al* c~
DATE: 8/30/02
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 iy?(day of �S� 20 .Y Z 0
Signature of Owner /Agent
L) I a. i4C Koq 3 - 6 - 6
Contact Person Name J ���
Phone No.
VAl�A SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Ha11 Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY
Site '71 V VI tiu A e,k.-
Address/ StreetAdbress Permit No.: 6 7 N 2G0 Z "cDalSc,
Location IN0'0 SW : ` I/C. �1' �,�/ II A ' t�
Expiration Date l� /�
Suite /Bldg. # City /State Zip
D q 722i-L Receipt #:
Ti
Name t Approved By: iC y P
Property -r 6' SC Date: Et(Pg
Owner Mailing Address 1 Suite Map /TL #: 1 $ // 2-ac.. - 6
Q O et) t2- . Zoning: 1- L
City/State Zip Phone
'II -
` I] Electrical Permit Required? ❑ Yes [_`lo
Tenant or Nam /
Business jl 0t/' " -�( I� Building Permit Required? ID Yes E_No
I
l
Nam Rev. 01- Jul-02 is \cur•ln \masters \revised \si•n .ermit a•..doc
Sign � 1 IQI Z) 1 i
Contractor Mailing ess Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit Is q:2-7 � 12 A (Note: applications will not be accepted
issuance, a w ithout the required submittal elements) I
copy of all City /State Zip Phone are ✓ �,/ 7 . 62,4 , p- )
required licenses if ( G 2G� D3 ❑ Completed Application Form
expired in the Oreg 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 Er Temporary ❑ Wall ❑ Electronic
drawn to scale
(Check all that ❑ Other ❑ Billboard ❑ Ba [11 2 copies of elevations, a
apply) (3 copies, if a building permit is required)
New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: (
2 ) ❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): / CO 7zitr9;c1s2- 1 $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) him"
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N S E W NE NW SE SW
t • Wall sighs do not need to be drawn to scale,
Height to top of sign (feet): - 3 but must include dimensions of wall face and
Projection From Wall (inches): . sign placement.
Copy: C 7 7 j 't • Wall signs do not require site /plot plans.
Materials:. It,6n.`0 t t.019od . Freestanding signs over 6 ft. required a
building permit.
Will sign h ve illumination? ❑ Yes No . 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 1 No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
Receipt #: 27200200000000003261
Date: 08130 /2002
T I D E M A R K •
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2002 -00149 [SIGN] Temp Sign Perm 100 - 0000 - 437000 $15.00
SGN2002 -00150 [SIGN] Temp Sign Perm 100 - 0000 - 437000 $15.00
SGN2002 -00151 [SIGN] Temp Sign Perm 100 - 0000 - 437000 $15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
• Check CLUB K -9 INC KJP 1017 $45.00
TOTAL AMOUNT PAID: $45.00
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