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SGN2011-00125 CITY OF TIGARD SIGN PERMIT 11 Permit #: SGN2011 -00125 COMMUNITY DEVELOPMENT Date Issued: 01/12/2012 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 1S135BD00900 Jurisdiction: Tigard Name of Business: Vern Fonkl Business Address: 9770 SW SHADY LN Applicant/Agent: Skiles, Tracie Work Description: Installation of one (1) permanent wall sign 1'6" x 11'8" Permanent: Yes Freestanding: No Freeway: No Temporary: Wall: Yes Electronic: No Billboard: No Balloon: No Banner: No A- Board: No Sign Dimensions: 1'6" x 17.4 Total Sign Area: 17.5 Wall Area: 819 Wall Face (Direction): Sign Height: ft. Projection From Wall: in. Illumination: Internal Materials: Electrical Permit Required: Yes Building Permit Required: No Total Permit Fee: $165.00 Conditions: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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: At � Permittee Signature: . 41FALIG, 4' City of Tigard mommom Sign Permit Application GENERAL INFORMATION �.. 1 d I 1 I ` S Name,d D,:.d =,pan_n:; tn,irn FOR STAFF USE ONLY ' ``�, Site 4 � (X l` , ' `/ / ' per `` Address/ S [ a \JJn>s Pe rmit No Z.C � (I C (. I ) - 3 /f ` , r. , v Location St: 1� c�� t� � /I �1 .(.�- ' � / °�/ (� S,:v.)nlJr.tt p, Z , \ Na,,,� Receipt �::_ i 3 i�U K dD � Property • r' `V Q1LIA 't- {-T(4� lap!TI.#: V Owner 1( li `D Rk) ,ii;ry; . \Jilnss i S:, i,o Zoning:,, _,_.... -. (Nat 1 0.,-1.e__ Allowable Total Area: L \Lr(,(lL�t-' 1 W Electrical Permit Required? Id ❑ No Tenant or N . t }- s Business VC 1..-f k —, Building Permit Required? ❑ Yes P'No y_ Naas , l v,' 7!t_ II 1 1, ,,� au m pin uar appinatic ,p p,rm app do Sign Vt�N \�' M)- 1241' --- `•� C Contractor ',bitin Add suiw ts, Zr ; rh. REOUI RED SUBMITTAL ELEMENTS 11� RGt tv t � 1-ZOS^ (Note: applications Trill no be accepted j V or.p , "air:. c.:,,. t6„rJ l.i „,,.,p li>.p. ua,, without the required submittal elements) d r t S 1 ❑ Completed Application Form Proposed p, ❑ D.._;unJn,g ❑ pr,r,,, ❑ 2 copies of site /plot plan, drawn to scale Sign t ❑ Roof ❑ ta. <,'”' (3 copies, if a building permit is required) tr h,ct: all that Vr7p w...„, p r?,h r ' ; � pl ,. y V t size requtremene 8!.i' x l l ", or 11" x l7" _. ,....__...._.._..._..._........ ❑ 2 copies of elevations, drown to scale i Noss' sign? ❑ Alter to existing sign? (3 copies, if a building permit is required) Sign Dimensions: size requirement: 131/2" x 11 ", to 24" x 36" • i' U Total Sign -Area (sq. fc): � ❑ 5165.00 Fee (Permanent sign, any size) Total Fall .1rea (sq. ft) 11-4 e).3 552.00 Fee (Temporary sign, any type) Sign Data �C�1 q{ .<,r p:e a Jl Direction \C a ares (circle one): ' NOTES: '- " " N S E \\- NE NW SE SW Height to top of sign (feet): • Wall signs do not need to be drawn to scale, but Projection From Wall (inches): must include dimensions of wall face and sign placement. Materials: cep f1 \ 4—L..:3 s • W all i do not require site/ 1 t -- Kns lai lans. r p a p Will sign have illumination? Ycs ❑ No • Freestanding signs over 7r - t. re a building a[l, Type: internal p External permit. Are there any existing freestanding or wall signs at this location, including wall signs that overlap a tenant space? ❑ Ycs IVIr No (OVER FOR SIGNATURES) / If "yes ", a list or diagram of all sign mcnsions and square footage must also he submitted. / 1 r f C . City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 1 503 -718 -2421 1 www.tigard- or.gov ) Page 1 of 2 ff " � 7 $• � - Z i APPLICANTS: To consider an application complete, you will need to submit ALL of the REOl11RED SUBMITTAL ELEMENTS as described on the front of this application in the "Required Submittal Elements" box. 1 NOTE: Person specified as "Applicant" shall be designated "Perminee" and shall provide financial assurance for work • When the owner and the applicant are different people, the applicant must be the purchaser of record or a lessee in possession with i written authorization from the owner or an agent of the owner. The owner(s) must sign this application in the space provided on the back of this form or submit a written authorization with this application BY SIGNING BELOW, THE APPLICANT(S) SHALL CERTIFY THAT: I • If the application is granted, the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. • All of the above statements and the statements in the plot plan, attachments, and exhibits transmitted herewith, are true, and the applicants so acknowledge that any permit issued, based on this application, and may be revoked if it is found that any such statements arc false. • The applicant has read the entire contents of the application, including the pollcfes and criteria, and 1 understands the requirements for approving and denying the application. f I hereby acknowledge that I have read this application, that the information given is correct, that I am the 6 owner or authorized agent of the owner, and that plans submitted are in compliance with the City of Tigard. SIGNATURES of each owner of the subject property are required. Applicant Signature Dare 4 Signature of Owner /Agent Date \gi i e SWe'_ 6 /Lc 77( g 3 Contact Person Name Phone No. City of Tigard 1 13125 SW Hall Blvd., Tigard, OR 97223 I 503 - 639 -4171 1 www.tigard- or.gov Page 2 of 2 CONSTRUCTION & MOUNTING DETAIL Minimum 2 on 6' on center 3/13 thread 'Nu bolted with 2n 2' L.bon back R metal studs OF Minimum 2 on 6' on center 3/8' expansion bolts onto concrete Minimum 2 on 6'on center 3/8' lag bolt thru L.Iron to wood structural member or Minimum 2 on 6'on center 3/8'x 6' toggle bolts 11dM 11yM Raceway Flat WaII Routed Face hacked with polycarbonate • 7400 Hardeson Rd Everett. WA 98203 (425) 776.8835 BERRY NEON Fax (425) 774.8221 S I G N S Y S T E M S newpennifs @benyneonsigns Co 1 ii., { 1,6' INSURANCE 503-620 -0230 1 ) VERN FONIC -: 1U COPY :`INSURANCE - 5 1/2• COPY; PHONE NUMBER = 3 1a COPY SP INTERNALLY ELUM5 ATED SIGN ALL #230.33 RED & e 270.12 BLACK VINYL ON WWII LEIAN FACE AS S NOWN = SIGN FRAME PAINTED SA1IN BLACK L.\ )i CITY OF ,r ,�,��?,; TtGARD - 11(T , Approved............ INSIURANaE i If �araily 11� ILI� � • l the iT work � ribed in: w -U Letter � " to: Follow... Attach. � f ... -- Jur, Addres.. '`?7 �r � = „ � . ev 1! - . � D te ErMtawr•�- Z t T 3 t f d PHOTO ELEVATION SCALE: ±3/lbw I. 0 - © Job Name: VERN FONK INSURANCE Scale: 1•m 1• -0 ( NOTED) Designer: MP TY JOHNSON m Berry Neo Sy. Rve ❑ APOVD AS ❑ APPROVED W/ CHANGES AS MARKED Site Address: RGARD OREGON Date: 7/12/2011 Rev. 8/ 15/ 2011 Onao 7: y, m.. n rep,odo nlon, .nd stems, or dle All shall render )ghts Reser me Ino-lnye r CLIENT PR APPROVAL Sales Rep: RON JACOBS Design NO. 071211VERNFONK file Name: VERNIIGD.5011 liable for up to 6150.000 in Statutory Damages, plusattorS.ys fen and costs, voN.rua[ B E R R Y KOTE 155* If.MSbeen.n I.a orf...d is ma 05x.1. NOTE: TIM User W.wlm, a simulation of the prapnee colors aM Maud be verified with atsual materials for each Infringement, under the U. S. Copyright Act ill U. S.C. 412 B 5041 DATE APPROVED: NEON SIGN SYSTEMS O (Jice /Deliveri 7400 Hardeson R oad, Everett, WA 98203 0 (425)776.883 0 1800) 488-2430 r, Fax: (425)774.8221 al E -Mail: info @Berryneonsigns.com - '• „ ' k7 A 4 t ' .,': , •' . 4 , v „ , , ,, „ 4 it 4 ■IGN PERMIT APPLICATION oF " TIGARD *d o • rt . • NI appikted hereby applies for a permit for die work indicated or as shown in Ike . ,, .. ossifications. ' ' . , . '.„;..,,,,•--' 1, 1,,t4t • - . • >4. '. , 4 \p USN LOCATION ADDRESS. 97/0 ,,, ,, 4, J ; o ;AV; • , '' 4 44 tr .%- • , , i.44 4 kloPLICANT: Owner XX Lowe Authorized Repreesntadm . - , - IAME/COMPANY Osamu r ton Insurance Agaacv • a% 4• - 'ROFOSED SIGN: Fresstanthn1 IX W P rosc th ig . 0 i8 , ■ • '4GN DIMENSIONS 3° “ 36 AREA _ HEIGHT ---:........1 . .004; 'ROPER'S FRONTAGE ____ COST -------- ZONING DISTRICT, .4 '4 •., , . , < ... . ibod sATERIAL COLOR ,:. 'soNs *FY --- , ---- • Dcurnso SIGNS: FreanumOrm ..,-,..`-'°% Wall ,,,„„ h 11110.41110 411 *: • . ' . .•■•=as :01AMENTS: , liampozarr %,,N - 60 days • 4 , ,, • e '' , '. .;;,. 1,040 ' , > ' * 141ili i' \ 1 9 ... a I ' A-- .. ' S . .„'■% , • AN dill Permits "St be . • „'.• • oes404 - o w. if work aulkorizad 40,, ..,,,,„*..... B 1.1 baixoull111111 A r. • • ' , .- ./- . , , v4...,, ., •a •..,• • 40tly c 1, Permit Foe 10.00 ,-.--- r?: '1 ..1-k -: .,,, ''' ..r.wo.urnk Nz......................... qui...” ,MWTMF2Mn ■ re • •• • __ P ' . 23183 Tigard neregaIIV.-_. , . t, , • ' , / ,T,.5 ks2-- g 5 "ztilt"." 111 , � 1 CITY OF TIGARD RECEIPT � : 13125 SW Hall Blvd., Tigard OR 97223 ; ' 503.639.4171 TIGARD Receipt Number: 185146 - 01/12/2012 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SGN2011 -00125 Sign Permit 100 - 0000 -43115 $144.00 SGN2011 -00125 Sign Permit - LRP 100 - 0000 -43117 $21.00 Total: $165.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 73579 KPEERMAN 01/12/2012 $165.00 Payor: VANCOUVER SIGN COMPANY, INC. Total Payments: $165.00 Balance Due: $0.00 Page 1 of 1