SGN2002-00202 „
CITY OF TIGARD
SIGN PERMIT
I , DEVELOPMENT SERVICES PERMIT #: SGN2002 -00202
,�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/18/02
EXPIRATION DATE:
BUSINESS NAME: VERIZON WIRELESS PARCEL: 2S112DD 01600
SIGN LOCATION: 15495 SW SEQUOIA PKWY 150
APPLICANT /AGENT: ZONE:
BUSINESS TAX NO: JURISDICTION:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2.5'X 2'
TOTAL SIGN AREA: 5 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): SE
SIGN HEIGHT: 2 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: IND
DESCRIPTION OF SIGN: Placement of (1) one 5 sq ft temporary A -frame sign. Sign must be placed on
private property & not in the public right -of -way. Valid 11/18/02 - 12/18/02. Sign #2
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 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 approval date or sign permit shall expire. A temporary sign shall expire 30 days from
validity date. A balloon sign shall expire 10 •ay from validity date.
APPROVED BY: � � ''=�
PERMITTEE SIGNATURE: 41 %!� " `At
DATE: e/18/02
r -
, o ti SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Ha11 Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
/ i' t oti ) /� II�cG le IT
FOR STAFF USE ONLY
Site V �./ /-
Address/ Street Address ! Permit No.: c /l.� Z Ar. 3-- - 00 - 2 - 0 2.
Location 15 r S Lc re va ict �!�c l ,
Expiration Date:
Suite /Bldg. # Ctat Zip
qu;4e I.�C 1 i ro( OQ 9 72.2. ' Receipt #: Z- 3 7 S',
Name l Approved By: / /,D
Property //7zi Date: 1/ __
U _ M ailin A ddress l c , � G6uit ( a a Ma /TL #: 2 •z)( (
Owner Mailing P S / D
/S Sub ! ti ew f/tot9 #sco Zoning: I L .
City/ate Z Phone (56 3)
POLJit 9 / a d 1 ^ 7 Electrical Permit Required? ❑ Yes ixi No
Tenant or Name /
Business Vey; too (Vt. -Jeff Building Permit Required? ❑ Yes 14 No
Name Rev. 01- Jul-02 is \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
copy of all City/State Zip Phone without the required submittal elements)
licenses are
required if Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # Er 2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
Proposed ❑ Permanent O. Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign ❑ Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ Billb ❑ Balloon 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
JA--New sign? ❑ Alter to existing sign? size requirement: 8 x 11 ", to 24" x 36"
Sign Dimensions: 2 )1 2 f l
❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): l c 7f $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 N E N W O SW
• Wall signs do not need to be drawn to scale,
Height to top of sign (feet): 2_ but must include dimensions of wall face and
Projection From Wall (inches): sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: (.l}`c03 • Freestanding signs over 6 ft. required a
building permit.
Will sign have illumination? ❑ Yes ttl No • If work authorized under a sign permit has not
Type: ❑ Internal ❑ Extern I 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 ❑ No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
r . /
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 i day of (:)( 4 vier , 20 CZ.,
e f iiiiik
Signatur jy Ow, er /Agent
C� L � r03- .?ftr — 4,2 ?‘i
Contact Person Name Phone No.
L11 Y lit 111aAIU)
13125 SW Hall Blvd. 4:04:41PM
eµat ti Tigard, Oregon 9 72 23
- 411, (50 3) 63 9-4 17 1
Receipt #: 27200200000000003999
Date: 10/18/2002
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2002 -00201 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
SGN2002 -00202 [SIGN] Temp Sign Perm 100 -0000- 437000 15.00
SGN2002 -00203 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
SGN2002 -00204 [SIGN] Sign Permit 100 -0000- 437000 30.00
Line Item Total: $75.00
Payments:
Method Payer User ID Check No. Approval No. How Received Amount Paid
CreditCard JIRI KUBIS VERIZON WIRELESS KJP 098637 In Person 75.00
Payment Total: $75.00
Page 1 of 1 cReceipt.rpt
• .\ .
l
-----, .
F., .
, _1 I
„.....;,,
...
R(f('(
c-7,,/
.....f.„.. r% i I
6 \
1‘ 0
, .
_ f f‘oie
: ---, c ______---------
___.................„,„...
2 .
%ITV OF 'IlliAriD .
N( 01A) Apr., roved 1 K
Condi..i:4y Approved._ ..... ............... [ I
1\11 For only the woik as descrnied in:
0 rf\/ r.E.FtMIT NO. - 00 7..A.
See Lett4r tc• Follow i ; c
j 0 l' d S
I I? S
t'al . i . #.
i-vjri. I; : Y 1 tAi ,2e,tAjdt.O/4, i cy c :,,Jy ifir
D.,,. 0 0 if 1 07., 7
. ,