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SGN2012-00021 CITY OF TIGARD SIGN PERMIT Permit #: SGN2012 -00021 COMMUNITY DEVELOPMENT Date Issued: 02/17/2012 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S101AB00100 Jurisdiction: TIGARD Name of Business: Meridian Acupuncture & Wellness Business Address: 12005 SW 70TH AVE Applicant/Agent: Meridian Acupuncture & Wellness, Work Description: Placement of (1) one 24 s.f temporary banner. Valid 2/18/12- 3/19/12. Sign #1. Sign must be on private property and not in the public right -of -way or visual clearance areas. Permanent: No Freestanding: No Freeway: No Temporary: 1 Wall: Yes Electronic: No Billboard: No Balloon: No Banner: No A- Board: No Sign Dimensions: 4'x6' Total Sign Area: 24 Wall Area: Wall Face (Direction): Sign Height: ft. Projection From Wall: in. Illumination: No Illumination Materials: Banner Electrical Permit Required: No Building Permit Required: No Total Permit Fee: $52.00 Conditions: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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: X( Permittee Signature: irk, FEB -17 -2012 09:21 From: To:5035981960 P.2/3 RECE M q I City of Tigard FEB 17 2012 Sign Permit Application RUi D1NG DIGM v SION 1 D GENERAL INFORMATION Namr of l')rvelopmrat /Prnjecl FOR STAFF USE ONLY Site Red RoCY kier ,dinn A( wlei+ -rQ Address/ Si riot Address L'.ltyttt, Permit No.: S HA) 2-4 /t, • COO2I Location 17-005 Su.) 10 = Avt. Approved By: K __ 9u.tn /ntd # City /Stale Zip -- II ' �t ()& t 77223 Date: 1 _ -ha . r 1L4 tf Nante Receipt It: 18 5 . . 71 Property ,Jane )-1. Ike... Map /'1'l #: 2,51 Di 4 0 01 db` _.. _ • _ .._ Owner Madura AddtrAA Suite tontng:_k4 4t. 'e' , 135 S w bev 2J a1. t Kd 2-10 Allowable'1'otal Area: 3 ' 1 1. sA ._.. (city /State. Zip Phony. Tigard I aF� 9`1233 5 c3.672.9b '6O Tenant or e L +icclrical Permit. Required? ❑ Ycs EgiCio Business M p� d i t Ctn A Cu,Qun etiarp at 1 ✓1 t L Building Perron. Required ?. ❑ Yes I No N Rev. 7/1/11 tL r\aupin \umr, �lmnl iac ipptsca n to \sign pen:ut app dor Sign ‘.5'...o 1 , t Y {, e V 7 l A l -t) Contractor MattutgAdt !hate City /gtAre A � Zip Phone REQUIRX,I) SIBMITTAL LLI MF.NTS L ocke 01/40 5 • 63ci • 53 S5 (Note: applications will not be accepted Oregon Corm. (Aneirinircl 1:;enac II FAT. Date without the req aired submittal elements) _. — ❑ Completed Applic Norm Proposed ❑ Pemtanent ❑ Freratanrting ❑ P,ceway ❑ 2 copses of site /plot plan, drawn to scale Sign ErienrpotYCy ❑ unnF ❑ Electronic (Check all that (3 copies, if a building permit is required) I © Wall Other a rr y) size requirement: $ 1/2' x 11 ", or II" a 17" ❑ 2 copies of el(vations, drawn to scale ❑ New sign? ❑ Alter to existing sign? _ (3 copies, if a builtulg permit is required) Sigh Dimensions: uu size requirement: 4 x 11 ", to 24" x 36" . k A e cl 0.1,,1 af(WP(fpd U ic , , Total Si` t Aron (sq. ft.): e „„ + 8, 6 ,r, ❑ $165.00 Pee (Permanent sign, any size) Total Wall Area (sq. ft.) ❑ $52.00 Fee (Temporary sign, any type) Sign Data . (complete all Direction Wall Faces (circle one): Itr n5 in Oa% NO'T'ES: iced ton} N S li W NL NW Sle. SW Height to top of sign (feet): • Wall signs do not need to he drawn to scale, but Projection From Wall (inches): _ must include dimensions of wall face and sign placement. Materials: • Wall signs do not require site /plot plans. Will sign have illumination? ❑ Yes ,®, No • Freestanding signi over 6 ft. required a building Type: ❑ Tnlernal ❑ External permit. Are there any existing freestanding or wall signs at this location, including wall signs I hat overlap a tenant space? ❑ Yes ❑ No If “yes ", a list or diagram of all sign dimensions and square (OVER FOR SIGNATURES) FEB -17 -2012 09:21 From: To:5035981960 P.3'3 APPLICANTS: To consider an application complete, you will need to submit ALL of the REQUI SUURMITTfiL ELEMENTS as described on the front of this application in the "Required Submittal Elements" box. NOTE: Person specified as "Applicant" shall he designated "Pcrmittec" and shall provide financial assurance for work. M When the owner and the applicant are different people, the applicant must he the purchaser of- record or a lessee in possession with written authorisation fmm the owner or an agent of the owner. The owner(s) must sign this application in the space provided on the back of this form or submit a written authorization with this application BY SIGNING BELOW, THE APPLICANT(S) SHALL CERTIFY THAT: o If the application is granted, the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. ♦ All of the above statements and the statements in the plot plan, attachments, and exhibits transmitted . herewith, are true, and the applicants so acknowledge that any permit issued, based on this application, and may be revoked if it is found that any such statements are false. • The applicant has read the entire contents of the application, including the policies and criteria, and understands the requirements for approving and denying the application. 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. SIGNATURES of each owner of the subject property are required. :}.)arm_ )1— JK Q 2 t 17 (2. Applicant Signature Date / 't 1 ' Signature of Owner /Agent Date rs__Javr ) - -ire. 503.6/2. 96, 86 Contact Person Name. Phone No. I. i CA t 4 "- , 1 Pt cLA q.4-t Chi-Q_ ta c--i in i 6 azle.i I A Nrib-L) 36-A . 6'9'1 L t LP • \ . , ; . ) ... ,...- , pn 1 -\ , Ries_ I Approved C1T% Conditionally App i [ )4 r For only the wail as described in: PERMIT NO. Mvaafek2.- es32.1 , \ See Letter to: Follow i \ \ Attach Job Ad rge Ltavea. ae:es sa Avk b y: ______ ------ — -- --- ----- 6v kfy\ o , . CITY OF TIGARD RECEIPT ' 1 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TI'GARD Receipt Number: 185576 - 02/17/2012 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SGN2012 -00021 Temporary Sign Permit 100 - 0000 -43115 $45.00 SGN2012 -00021 Temporary Sign Permit - LRP 100 - 0000 -43117 $7.00 Total: $52.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 34152B KPEERMAN 02/17/2012 $52.00 Payor: JANE T. MCKEE Total Payments: $52.00 Balance Due: $0.00 Page 1 of 1