SGN2003-00100 CITY TIGARD SIGN PERMIT
ik DEVELOPMENT SERVICES PERMIT #: SGN2003 -00100
-'�' - � I II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/5/03
PARCEL: 1S135DD-00800
BUSINESS NAME: XENON WEST ZONE: C -G
SIGN LOCATION: 11847 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4'6" X 6'6"
TOTAL SIGN AREA: 2,925 sq. ft.
WALL AREA: 1,680 sq. ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Wall sign for new tenant.
MATERIALS: NEON TUBING
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 30.00
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 days from validity date.
APPROVED BY:
PERMITTEE SIGNATURE: � ��� `
DATE: 5/5/03 �,
1
�I .11 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 '04-J 1. .
Address/ Street Address Permit No.: _ iV a 003 -. cx o9 ei
Location 1I $ 47 Sim. PA-op1e-
deseleit
Suite /Bldg. # City/State Zip Expiration Date: i-
Receipt #: G° a 3 -- o o i o 0
Name Approved By: C- ca....( 7,-Li.
(r -/rr- 5 /i -ri-S Date: S' -S- 0 3
Property
Owner Mailing Address Suite Map /TL #: 15 13S D D 0 CSvo
i l gs4- - 1 5u). pAci rr'
/-re•k', Zoning: G V
City/State Zip Phone (So))
"nVfren e2. I 7?a 3 `f(og -4: t Electrical Permit Required? Yes ❑ No
Tenant or Name
Business X r fl/0 wri 57. Building Permit Required? ❑ Yes No
Name N 1 y h. i-t? P/ - t, C
Sign / ��7 Rev. 2/28/2003 is \curpin \masters \revised \sign permit app.doc
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit g-,y S te, H t _12 /Kfur (Note: applications will not be accepted
issuance, a
copy of all City/State Zip Phone without the required submittal elements)
licenses are r1� W
required if 9g� �' 9 3 696 Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # /04+1-1 `
1 2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
Proposed Permanent ❑ Freestanding ❑ Freeway size equirement: 8 x 11 ", or 11" x 17"
Sign ❑ Temporary IMNall ❑ Electronic
(Check all that ❑ Other ❑ Billboard ❑Balloon 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
R- 1Cre sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: cf.`, G /, X 4. , 'G It
$30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): • , j I ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) go Jurisdiction: ❑ C ity ❑ Urb
(Complete all Direction Wall Faces (circle one): NOTES:
items in this �
section) N ®E (3 NE NW SE SW
Height to top of sign (feet): I 3' • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): cE'� but must include dimensions of wall face and l
sign placement.
Copy: 5(f - , ..ic J W( --e-,'t • Wall signs do not require site /plot plans.
Materials: 04,01 1---, P 6-o{-J • Freestanding signs over 6 ft. required a
Will sign have illu nation? 12-1 ❑ No building permit.
Type: 2internal ❑ 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 LI No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
ti
"Nie. -
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 0 3
i/4 /4aL
": 'ure wner /Agent
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CITY OF TIGARD 5/5/200:i
13125 SW TIall Blvd. 10:52:41 AM
.600 � t, Tigard, Oregon 97223
�'� (503) 63 9-4 17 1
Receipt #: 27200300000000001786
Date: 05/05/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
ELC2003 -00249 [ELPRMT] ELC Permit 220 -0000- 431510 106.80
ELC2003 -00249 [TAX] 8% State Tax 100 -0000- 207020 8.55
SGN2003 -00099 [SIGN] Sign Permit 100- 0000 - 437000 30.00
SGN2003 -00100 [SIGN] Sign Permit 100- 0000 - 437000 30.00
Line Item Total: $175.35
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check HIGHLIGHT SIGN CORP DEB 3877 In Person 175.35
Payment Total: $175.35