SGN2002-00012 C
CITY OF TIGARD ' SIGN PERMIT
PER
.i DEVELOPMENT SERVICES
PERMIT #: SGN2002 -00012
I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/22/2002
EXPIRATION DATE:
BUSINESS NAME: 20/20 EYECARE PARCEL: 1S135AA-0190
SIGN LOCATION: 10225 SW HALL BLVD
APPLICANT /AGENT: ZONE: C -
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS:
TOTAL SIGN AREA: sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Installation of (1) 3'9" x 22' permanent wall sign.
MATERIALS:
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
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. All work will beslone in accordance with approved plans. A sign permit shall expire 90
days from approval date. A temporary si• • sh expire 30 days from approval date. A balloon sign shall expire 10
ria■c from annrnval ciatP
#11( • -
APPROVED BY: ; ' !
PERMITTEE SIGNATURE: -- ��A a IP
DATE: 1/22/200
„,,di, Ali SIGN PERMIT APPLICATION
CITY OF TIGARD 13121 .SIU' Hall 13lyd., Tigard. 0/? 97223 (503) 639 -417/ FAX: (503) 684 -7297
GENERAL INFORMATION
Name of DevelopmenUProject
Site ee wcob «11�T -
FOR STAFF USE ONLY
Address/ Street Address
Location Permit No.: 5C7 Al 2-<..o• -dt c 1 L
Suite /Bldg. # City /State n Z�i
rt tt� C�1� Ps Expiration Date:
Name W ,, ff Receipt #: c}-t..,..- Z
Property AMNE. gl.'&' Approved By: /L� 4
Owner Mailing Address Suite Date: 1 /a g_ I -
0 14), /41 Map/TL #:
City /State Zip Phone Zoning: OA)
7/674t qi 2 b SS/ ' I- o
Na me
Business / Tenant
2 420 NO � Electrical Permit Required? n Yes ❑ No
Busi
Building Permit Required? E Yes ❑ No
Name �
( .) Nu N IX/ S(C . Nc.f2 1i T/��'►' , 1 /'')` . Rev. 12/1/2000 is \curpin\masters \revised \sign permit app.doc
Sign
Contractor Mailing Address � Suite
(Prior to permit g03; Sw.):31/'2 AA —
issuance, a
copy of all City /State Zip Phone REQUIRED SUBMITTAL ELEMENTS
licenses are �p0 I\ al q.1� —I t D
required if C917Y1/ v+rC., CO lV (Note: applications will net be accepted
expired in the Oregon Const. Cont. oard Exp. Date without the required submittal elements)
City of Tigard's License # l 1( Cl e •g ^ y
database)
❑ Completed Application Form
Proposed Permanent U Freestanding ❑ Freeway
Si n ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
g Temporary Wall ❑ E
Check all that (3 copies, if a building permit is required)
apply) ❑ Other 111 Billboard ❑ Balloon size requirement: 81/2” x 11 ", or 11" x 17"
Li New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Di enSIOnS: , (3 copies, if a building permit is required)
3 c1 x 2-2- size requirement: 8'/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): .S / ❑ $50.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) Sue) U $15.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) it S E W NE NW SE SW • Wall signs do not need to be drawn to scale,
Height to top of sign (feet): ( ";`..Cc but must include dimensions of wall face and
Projection From Wall (inches): 12, sign placement.
Copy: 242o C- .y,t..C.A- • Wall signs do not require site /plot plans.
Materials: PLE)r0A. rfiflive(� • Freestanding signs over 6 ft. required a
Will sign have illumination M.. Yes El 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.
1 ❑ Yes No
If "yes ", a list or diagram of all sign dimensions and (OVER FOR SIGNATURES)
L square footage must also be submitted.
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 day of , 20
Signature of Owner /Agent
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Contac a rson . e Phone No.
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Receipt #: 27200200000000000252
.�. Date: 01/22/2002
TIDEMARK
COMPUTER SYSTEMS, INC
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2002 - 00012 [SIGN] Sign Permit 100 - 0000 - 437000 $50.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check LUMINITE SIGN CRAFT INC 0 7693 $50.00
TOTAL AMOUNT PAID: $50.00