SGN2002-00067 CITY TIGARD SIGN PERMIT
,, 0p DEVELOPMENT SERVICES PERMIT #: SGN2002 -00067
I DATE ISSUED: 5/3/2002
r 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
EXPIRATION DATE:
BUSINESS NAME: SHADY LANE OFFICES PARCEL: 1S135BD -0110
SIGN LOCATION: 09780 SW SHADY LN
APPLICANT /AGENT: SHADY LANE OFFICES ZONE: C -G
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4'10" X 8'
TOTAL SIGN AREA: 32 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 5 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: EXT •
DESCRIPTION OF SIGN: Permanent placement of (1) externally illuminated freestanding sign. Not to be
placed in visual clearance area or public right -of -way. (Zoned MUC)
MATERIALS: MTL/WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
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 be done in acc rdance with approved plans. A sign permit shall expire 90
days from approval date. A temp ra sign shall expire cy day from approval date. A balloon sign shall expire 10
clays frrm annrnval Hato i
APPROVED BY: ., C ', �
!
PERMITTEE SIGNATURE: -""1"" t_ `!I
DATE: 5/3/2002
•
I P
_.a; 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
Site
SRFfDy t...NNE arrle -r FOR STAFF USE ONLY
Address/ Street Address Permit No.• . 4.0., — 600 i
Location 178"0 SW S11 n D y ,-. R n 6 Expiration Date:
Suite /Bldg. # City /State Zip / /,,
l(�
T16 t) ZD, G l2 q7 7 - .2 - 3 Receipt #: �` �.—
O : ! c
Name Approved By: I,1,4 .'
Property GkcR'ri h EW r S C 7 Ft t--- Date: S
Owner Mailing Address Suite Map/TL #: atimswimmo•
772 D SW W ST&jITE /
vvff Zoning: 11
City /State Zip r Phone
P ogn-Ft NI D, 0 R 9 l .z2.5 3 ) q - / . 8 ' 2 - Z
Tenant or Name Electrical Permit Required? 111 Yes No
Business <S ii-pp/ L R NE 0 FF f CE S Building Permit Required? ❑ Yes Vr<lo
Name Rev. 30 -Jul -01 is \curpin \masters \revised\sign permit app.doc
Sign P. USSE,L/ - � NSTRte7 ; {D)�I
g
Contractor Mailing Address • Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit '12 NW FReNI 2.0 (Note: applications will not be accepted
issuance, a
copy of all City/State Zip Phone without the required submittal elements)
licenses are PORT/it.' D 0 g- `Ilgo9 (5 5) 2'g -3`P1 3
required if I U Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # C to A - 10 - 0. ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) se 9 1 ie (3 copies, if a building permit is required)
Pro Proposed size requirement: 8 x 11 ", or 11" x 17"
p M Permanent 0 Freestanding ❑ Freeway
Sign ❑ Temporary ❑ Wall ❑ Electronic ❑ 2 copies of elevations, drawn to scale
(Check all that ❑ Other ❑ Billboard ❑ Balloon 3 copies, if a building permit is required)
apply) ,' size requirement: 8 x 11 ", to 24" x 36"
❑ New sign? IV Alter to existing sign? $50.00 Fee (Permanent sign, any size)
Sign Dimensions: 4 90 X ?
❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.): 2 2,86€4 FT
NOTES:
Sign Data Total Wall Area (sq. ft.) • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
(Complete all Direction Wall Faces (circle one): • sign placement.
items in this signs do not require site/ lot
section) N S COO NE NW SE SW • Wall si plans.
g q p p
Height to top of sign (feet): - ) • Freestanding signs over 6 ft. required a
building permit.
Projection From Wall (inches): • If work authorized under a sign permit has not
Copy: been completed within ninety (90) days after
Materials:00 6Au6s . o )' 27' a the issuance of the permit, THE PERMIT WILL
Will sign have illumination? Yes ❑ No
BECOME NULL AND VOID.
_ Type: ❑ Internal External
Are there any existing freestanding or wall signs at this Not all jurisdictions accept credit cards, please call jurisdiction for more information.
location, including wall signs that overlap a tenant space? visa ❑Mastercard
Credit card number / /
❑ Yes 0:1 No Expires
If "yes ", a list or diagram of all sign dimensions and Name of cardholder as shown on credit card
square footage must also be submitted. S
Cardholder signature Amount
(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.
DATED this day of /1 fty , 200 2.
Signature of Owner /Agent
(603) gyy — geC
Contact Person Name Phone No.
Receipt #: 27200200000000001622
Date: 05 /03/2002 0.1C, PY
T I D E M A R K
COMPUTER SYSTEMS, I NC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2002 - 00067 [SIGN] Sign Permit 100 - 0000 - 437000 • $50.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check GLORIA M. LEWIS DCP 7378 0 $50.00
TOTAL AMOUNT PAID: $50.00
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