SGN2002-00274 CITY OF TIGARD SIGN PERMIT
I 4, DEVELOPMENT SERVICES PERMIT #: SGN2002 -00274
- - ' - 13125 SW H all Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/12/02
PARCEL: 1 S134BC -00300
BUSINESS NAME: THRIFTWAY ZONE: C -
SIGN LOCATION: 12220 SW SCHOLLS FERRY RD JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X8'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): S
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one temporary banner. Valid 12/12/02 thru 1/11/03
MATERIALS: VINYL
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 Oregon Specialty
Codes and all other applicable laws. All work will be done in accordance with approved plans. A permanent sign must
be placed within 90 days from approva4 ate-= : n permit shall expire. A temporary sign shall expire 30 days from
validity date. A balloon sign shall expir • a s om vali ity date.
i
APPROVED BY: `
i c____
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PERMITTEE SIGNATURE:
X G C
DATE: 12/12/02
Iibc;l, +': 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 i KI GT'LJ/t'►, -- ����I
Address/ Street Address CO rmit No.: /./ - Z-c3(\. _
4)
Location (Z Z 2.0 5 C J . O 4 S Expiration Date: (1-64 _ t i I t (
Suite /Bldg. # City /State Zip
CY1G ; O Q. Receipt #: 2�� "t- — -72.4
Name Approved By: f z �-
Property Date: z f uz�
Owner Mailing Address Suite Map /TL #: 15 / 3i/3c -0030o
Zoning: LG 0
City/State Zip Phone
Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name
Business /Zl 4 "71JkY J Ce2Y CIV12iff Building Permit Required? ❑ Yes ❑ No
Name // �� Rev. 01- Ju1-02 is \curpin \masters \revised \sign permit app.doc
Sign - QUeC:C: G-
1, (.0
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
licenses are
required if 0i L J V / ( - L e , 01( 4100 3 3 4 ' € ' b ❑ 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 n ,P ermanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign Temporary ❑ Wall ❑ Electronic
(Check all that Other �❑ Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale
un apply)tu.U' (3 copies, if a building permit is required)
[✓f New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions:
_34413) Z ❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
` - i✓ ❑ $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 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
building permit.
Will sign have illumination? ❑ Yes No • If work authorized under a sign permit has not
Type: ❑ Internal IRE External been completed within ninety (90) days after
Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL
location, including wall signs that overlap a tenant space? BECOME NULL AND VOID.
❑ Yes 12
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
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.
AT- -en DATED this r c day of , 20 eX-
C,1 C'_
Signature of Owner /Agent
(o SoP 6 340 - ette,
Contact Person Name Phone No.
prIFT,
,A6a/k i)20.0\‹_
3
ri" OF ritiAnD
Ap roar: 1
Condi ly Approved.
Fo. only the w91 ii as i;escrikeel
F hriMIT NO. -.S.2^./ 'J 2 - —Oc.) PY___
S Letl to* Follow i
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CITY OF TIGARD 12/12/2002
13125 SW Hall Blvd. 12:10:33PM
a m ill � h c Tigard, Oregon 97223
AA e__.. (503) 63 9-4 17 1
Receipt #: 27200200000000004729
Date: 12/12/2002
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2002 - 00274 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
CreditCard PAUL D COOK KJP 015037 In Person 15.00
Payment Total: $15.00
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