SGN2002-00109 CITY OF TIGARD SIGN PERMIT
j' js e DE VELOPMENT SERVICES PERMIT #: SGN2002 -00109
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/24/2002
EXPIRATION DATE:
BUSINESS NAME: JAVA JUICE PARCEL: 2S103DD -0080
SIGN LOCATION: 13815 SW PACIFIC HWY 80
APPLICANT /AGENT: JAVA JUICE ZONE: C -
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: 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: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: - T4saaperary placement of (1) permanent freestanding framed banner sign. Not to
be placed in visual clearance area or public right -of -way.
MATERIALS: BANNER W /FRM
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 50.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. • ' •rk will be done in a• o dance with approved plans. A sign permit shall expire 90
days from approval date. A t= por. ry sign shall expir- 31 day from approval date. A balloon sign shall expire 10
clays from annrnval data
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APPROVED B
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PERMITTEE SIGNATURE: ,1
DATE: 6/24/2002
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� tic 11 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
FOR STAFF USE ONLY
Site A "5...•e.t �
Address/ Street Address Permit No.: v no 1
Location 13 t l 5 0(4; c E<,
Ex Suite /Bldg. # City /State Date'
1 8 0 _ t t 6,4Y\10 Oil j Cl 7a3 Receipt #: DIU Ow (a
Name Approved By:
Property CA-) ■ L ( t 0.,i► --.... 1 &-i -5 Date: 0 a
Owner Mailing Address Suite Map/TL #:
I )-1& ° 5 ( - k6/1 4, Zoning: _-)
City /State Zip Phone
' G rp 41 ? 2 3 3 � v?DgD Electrical Permit Required? ❑ Yes 13
Tenant or Name
Business 5 I° tier C - Building Permit Required? ❑ Yes No
Name , Rev. 30- Jul-01 i.\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 without the required submittal elements
copy of all City /State Zip Phone 4 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 6. Permanent ❑ Temporary I N . Freestandin g ❑ F reeway
size requirement: 81/2" x 11 ", or 11" x 17"
[J i'-
Sign po I=1 ❑ Electronic 2 copies of elevations, drawn to scale
(Check all that ❑ Other ❑ Bi Wall ID 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?
Sign Dimension t I I ❑ $50.00 Fee (Permanent sign, any size)
(i, ) ❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ): j n
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.
■ et • 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: ` ,(,LO D .. 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 r Not all jurisdictions accept credit cards, please call jurisdiction for more information.
0
location, including wall signs that overlap a tenant space? visa ❑Mastercard
Credit card number / /
❑ Yes ❑ No Expires
If "yes ", a list or diagram of all sign dimensions and Name of cardholder as shown on credit card
square footage must also be submitted. $
Cardholder signature Amount
(OVER FOR SIGNATURES)
1 111,
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 -c., ►-t Qi WI day of , 20 O Z
Vv
Signature of Owner/ ent
Contact Person Name Phone No.
Receipt #: 27200200000000002332
Date: 06/24/2002
T I D E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2002 - 00109 [SIGN] Sign Permit 100 - 0000 - 437000 $50.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check JAVA JUICE /WILLIAM YATES DCP 130 0 $50.00
TOTAL AMOUNT PAID: $50.00
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