SGN2002-00006 CITY OF TIGARD SIGN PERMIT
g tfl l rA DEVELOPMENT SERVICES PERMIT #: SGN2002 -00006
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/14/02
EXPIRATION DATE:
BUSINESS NAME: NELSEN'S TIRE & AUTO
SIGN LOCATION: 13880 SW PACIFIC HWY PARCEL: 2S103DD -0120
APPLICANT /AGENT: NELSEN'S TIRE & AUTO ZONE: C -G
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X4'
al 1
TOTAL SIGN AREA: 12 sq. ft. (0
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of Temporary 3'x4' A -frame sign. Not to be placed in visual clearance
area or public right -of -way. Valid 1/11/02- 2/11/02. Sign permit #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 resulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All k I be done in accor• - ce with approved plans. A sign permit shall expire 90
days from approval date. A tem • orary s shall expire 3' da, s from approval date. A balloon sign shall expire 10
days frnm annrnval rlatP y / / /
APPROVED BY: /I " ` � /
PERMITTEE SIGNATURE: \■._ � tiA
DATE: 1/14/02
. a ,,,,
--c,� SIGN PERMIT APPLICATION
,, CI Y OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
kFa s� �9 c7 i-IC. r I q t
Site / ' �' - r , '' F O L ' , i ; �
Address/ Street Address , 1 , f F ;tA.�a t, ct , ? d ,: xS r' t4 1 t
Location /(/Z- it / f /9v i' v ( ' C �?ermi( No'' I ° ;..,f A l7 a ;. t , tg AP:
Suite /Bldg. # City /State Zip �� t> ; " '� I t
/6/.9-z..� d .2 g72,g Expiratio ate: i t ; A , ' cam , iv y ig 4 ‘,-,‘ a'+- �i RF
Name
''
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Property be UD�/1 C / /C LC —� p d D ��qq t ,.:.
' t t : ;' , e� s io,- 1 B �. r r a t
Owner Mailing Address Suite e ' r 3> �, 6 • aim
V , S lu G2c: Eiv %c�I1- D', M ap 1 ii ,, , :.j Y I � tr ' L. '11e
City/State Zip Phone �{ '" r t�
1 r
x 0
� O % . /L7 9724 ° ` 237 7o7cs e .; A k; "x r , s:. °; te A#°° �� ' , r�� ka_, '
Tenant or Name f „ , $ ' , ..5 C 5 , /♦ Y F° s 444t o a pt *is 4 $` 4ra
;Efect1141 { ! f fi A . s •
Business , t� , ! - '
Name TBLtyldif)g Y tye{�(j�'�r'u'{��P � y � ft' 44 e I S' + �� . •
Sign 4/6A/6-- l 2l1 /200 I: ` ir pinlmas(ers rev (in app.doc
Contractor Mailing Address Suite
(Prior to permit
issuance, a
copy of all City /State Zip Phone
licenses are REQUIRED SUBMITTAL ELEMENTS
required if (Note: applications will rig be accepted
expired in the Oregon Const. Cont. Board Exp. Date without the required submittal elements)
City of Tigard's License #
database)
mpleted Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway
Sign 2 Copies of Site /Plot Plan, Drawn to Scale
Temporary El Wall ❑ Electronic
(Check all that (3 copies, if a building permit is required)
apply) Other ❑ Billboard ❑ Balloon ze requirement: 8'/2" x 11 ", or 11" x 17"
❑ New sign? ❑ Alter to existing sign? 2 copies of elevations, drawn to scale
(3 copies, if a building permit is required)
Sign Dimensions: .( V / size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): ,,, s � r--; ❑ s Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft T Er $15.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
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: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? p Yes ❑ No building permit.
Type: ❑internal ❑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
location, including wall signs that overlap a tenant space? the Issuance of the permit, THE PERMIT WILL
BECOME NULL AND VOID.
❑ Yes 2<No
If "yes ", a list or diagram of all sign dimensions and (OVER FOR SIGNATURES) "
square footage must also be submitted.
1
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 . r/ day of J g�YL1._127 , 20 65 2
Signature of Owner /A ent
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Receipt #: 27200200000000000159
_�. Date: 01/11/2002
T I D E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2002 -00006 [SIGN] Temp Sign Perm 100 - 0000 - 437000 $15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check NELSEN TIRE AND AUTOMOTIVE 0 09924 0 $15.00
TOTAL AMOUNT PAID: $15.00