SGN2002-00126 CITY TIGARD SIGN PERMIT
A t*Ai DEVELOPMENT SERVICES PERMIT #: SGN2002 -00126
- 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/25/02
EXPIRATION DATE:
BUSINESS NAME: KICKBOXING FOR HEALTH
PARCEL: 2S102AC -0110
SIGN LOCATION: 12568 SW MAIN ST
APPLICANT /AGENT: MICHELLE LOFTUS ZONE: CBD
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 24" X 31"
TOTAL SIGN AREA: sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of (1) one temporary 24" x 31" A -Frame sign. Sign must be place on
private property & not in the public right -of -way. Valid 7/26/02 thru 8/25/02. Sign #1
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 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 sig s :II expire 30 days from approval date. A balloon sign shall expire 10
riays from annrnval Bata
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APPROVED BY: AP-4-7/
PERMITTEE SIGNATURE: X I
7
DATE: 7/25/02
Matthews' Main Street
PAINT COMPANY
Portland's only Rent -a -Quart' program
Dave Matthews
- AINt
Ph: 503.620.
12568 S.W. 72 2 St. Fax: 971.244.0
Tigard, OR 97223
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,4.I.� 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 Development/Project
FOR STAFF USE ONLY
Site P o` \1\11-
Address/ Street Address t Permit No.: S4 /U 2-oO.Z - D 0 / 2.-I
Location I`1 Pc t INA S Leek
Expiration Date: WA (n - VZts / L_
Suite /Bldg. # City /State Zip l
--r ( U f\ D U iC j Receipt #:
Name t Approved By:
Property
" ` v 1 ! I 4 - T 7 f+-Q-`-‘‘.S v ;1 34'44.4 Date: X125/o
Owner Mailing Address Suite Map /TL #:
12,S 6i S LA ni b✓( Zoning: C gp
City/State Zip Phone
x/ '72 23
Tenant or
Name G A 2d t v � 05 - r r f 2 Electrical Permit Required? 1:1 Yes 1:3-
Building Permit Required? El Yes [o
Business
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Na a Rev. 01- Jul -02 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 t Phone
licenses are
required if , El Completed Application Form
expired in the Oregon Coo .. Cont. Board Exp. • . e
City of Tigard's License El 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 tz Temporary [I Wall ❑ Electronic
(Check all that ❑ Other ❑ ❑ ID copies of elevations, drawn to scale
apply) Billboard Balloon
(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: P II
Z' X El $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
$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: �-- /c-X /,jo X ra� ff rt ra II Ai a • Wall signs do not require site /plot plans.
Materials: �(�np • Freestanding signs over 6 ft. required a
Will sign have illumination? El Yes [>(No If
building u tho r i
Type: El Internal CI External • If work authorized under a sign permit has not
Are there any existing freestanding or wall signs at this been completed within ninety (90) days after
the issuance of the permit, THE PERMIT WILL
location, including wall signs that overlap a tenant space?
BECOME NULL AND VOID.
El Yes No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
/htcri Los4 -Lti
1391 -cho cir a `' I C $ (OVER FOR SIGNATURES)
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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 ( L ___ day of 02 3 , 20 0
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Signature of Own/ /Agent
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Contact Person Name Phone No.
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Receipt #: 27200200000000002739
Date: 07/25/2002
T I D E M A R K
COMPUTER SYSTEMS, INC
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2002 -00126 [SIGN] Temp Sign Perm 100 - 0000 - 437000 $15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Cash MICHELLE LOFTUS KJP $15.00
TOTAL AMOUNT PAID: $15.00
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