SGN2012-00007 CITY OF TIGARD SIGN PERMIT
tt Permit #: SGN2012 -00007
COMMUNITY DEVELOPMENT Date Issued: 02/21/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 1S136AD06000
Jurisdiction: Tigard
Name of Business: Carl's HJr.
Business Address: 11437 SW PACIFIC HWY
Applicant/Agent: Carl's Jr.,
Work Description: Installation of (1) one 35 s.f. permanent wall sign.
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 3'6" x 10'
Total Sign Area: 35
Wall Area: 820
Wall Face (Direction): South
Sign Height: 24 ft.
Projection From Wall: 5 in.
Illumination: Internal
Materials: AlumNinyl
Electrical Permit Required: Yes
Building Permit Required: No
Total Permit Fee: $165.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. All work will be done in accordance with approved plans. A permanent sign must be placed within
90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon
sign shall expire 10 days from validity date.
A
Approved By: Ale
Permittee Signature: '%
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t A.
R : SIGN PERMIT APPLICAR$BEIVE[
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
JAN 2 7 2012
GENERAL INFORMATION CITY OFTIGARD
j Name of Development/Project PLANNING /ENGINEERING
Site CARTS 3-Q X ; '� U S EIO NL ' Y i;
Address/ Street Address ; `. t i t ,x x' `
x
Location 114 3 SW Prci IG Hl.../y = ,, ,
Permit fro " ' 3f ,
Suite /Bldg. # City /State Zip 'ta' "•. k „1,00-1,;;4.:4-...,•,.--;;.442._ .'
Expira Date s - _
1 Name 7l6AlkD Oa- R 3.. 1 ' ra (;
Q '?
s' h t a k
Property I,(W LC FaoDS ' Appro > ved Bye � w •
w c x k
Owner Mailing Address Suite Date 1 jA+, � . ` ": ` a K � t?, �` ' - , ° :
Ma p / 1 L # t4 3 4 1r =z = ° ,
City/State Zip Phone k ' nln g � 4"'''''''''''. ' � '..s
Y p Zo t, x�� f � ' j s. x t r
Tenant or Name ^:7-i ii "Lr .. . ,: * .4- ' ' t` � 1 s`
`` Electrical Kean/ �Re ulfed ?. ` I es54 t ®_ No
CHRIS "R ", n ` w r 1 . "1�Y s , = p
Business
Bu llding Permit Requa i , ? ., Q es , N o
Name ..'-r rb'' f's Par xii ,r-.; ti`� .Y. § ' I ' �,j :XF ".4 - ,.' `;
Rev.- 12/1/2000 r, I:lcurpin\ materslrevised\sign perrntfepp:doc '
- . Sign AM takICCn &I FGTn1C S I CPS
Contractor Mailing Address Suite
(Prior to permit
issuance, a 15$0 prp.wrLIVa:A. D,(
copy of at City /State Zip Phone 3Gz REQUIRED SUBMITTAL ELEMENTS
licenses are
required if WOOD(A/40 WA 91 a).5-4,2a‘ (Note: applications will aszt be accepted
expired in the Oregon Const. Cont. Board Exp. Date without the required submittal elements)
City of Tigard's License # 1D5Lo5 7_ /9 -/L4
database) J
❑ Completed Application Form
Proposed Z Permanent .4 Freestanding ❑ Freeway
Sign El Copies of Site /Plot Plan, Drawn to Scale
Si
9 ❑ Temporary ❑ Electronic (3 copies, if a building permit is required)
heck all thai Other Billboard Balloon
apply)
❑ / ❑ size requirement: 81/2" x 11 ", or 11" x 17"
SEE I r New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: �� ) (3 copies, if a building permit is required)
A AG +, - 3 C _ir 10 size requirement: 81/2" x 11 ", to 24" x 36"
J1-76 pIko Total Sign Area (sq. ft.): 1/51/ ill ❑ $ 96 (Permanent sign, any size)
1\1• O' Wall Area (sq. ft.) gea0 W ❑ $15.00 Fee (Temporary sign, any type)
Sign Data
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E W NE NW SE SW . Wall signs do not need to be drawn to scale,
Height to top of sign (feet): 39' but must include dimensions of wall face and
Projection From Wall (inches): $'" sign placement.
Copy: C!p.1\ tip_ Gie,eiv 94140 • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ...1"- Yes ❑ No building permit.
T ype: I ❑ External • If work authorized under a sign permit has not
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 ig1 No
If "yes ", a list or diagram of all sign dimensions and (OVER FOR SIGNATURES)
square footage must also be submitted.
APPLICANTS:
To consider an application complete, you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as described on the
front of this application in the "Required Submittal Elements" box.
NOTE: Person specified as "Applicant" shall be designated "Permittee" and shall provide financial assurance for work.
* When the owner and the applicant are different people, the applicant must be the purchaser of record or a lessee in possession with
written authorization from 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:
♦ 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.
/
Applic. Signature Date
Signature of Owner /Agent Date
bars 3 6es
Contact Person Name Phone No.
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 639 -4171 I www.tigard- or.gov Page 2 of 2
CITY OF TIGAh,
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Cor.ditionally Approved I
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PERMIT NO.
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CITY OF TIGARD RECEIPT
3 1 1 1111: 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 185581 - 02/21/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2012 -00007 Sign Permit 100 - 0000 -43115 $144.00
SGN2012 -00007 Sign Permit - LRP 100-0000-43117 $21.00
Total: $165.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 1074 KPEERMAN 02/21/2012 $165.00
Payor: ADVANCED ELECTRIC SIGNS, INC.
Total Payments: $165.00
Balance Due: $0.00
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