SGN2012-00018 ill CITY OF TIGARD SIGN PERMIT
v ., Permit #: SGN2012 -00018
- _ , COMMUNITY DEVELOPMENT Date Issued: 02/08/2012
-T1GrARIe 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S113AA00800
Jurisdiction: Tigard
Name of Business: Oregon Business Park
Business Address: 16460 SW 72ND AVE B6
Applicant/Agent: Mohr, Vincent
Work Description: Installation of one (1) permanent wall sign 78" x 36"
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 78" x 36"
Total Sign Area: 19.5
Wall Area: 1344
Wall Face (Direction): West
Sign Height: 18.5 ft.
Projection From Wall: in.
Illumination: No Illumination
Materials:
Electrical Permit Required: No
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.
Approved By: A04...011// 111/ aiMr
Permittee Signature: ✓ L/ LIitLI�(,(,QK--•
RECEIVED
Cit Of Ti and FEB U 8 2012
II :' y PLANNING/ENGINEERING F TIGARD
Si gn Permit Application
,:
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GENERAL INFORMATION
N e of Development /Project
n .N FOR STAFF USE ONLY
Site re f Cl.t(14 /' ),�
Address/ Street Addres Permit No.: "'�� Ll ° a f
Location I (0 Lf 6 0 SUj Z A Vt S p 1 r ,/) 2 �7 `Z,
Suite /Bldg. # City /State Zip AppYOVed By: '��'�M -"l 'p"' / /
/ � a ��I�L
1 i fn r6i O e � 1 77 2Y, Date: /n
Nme ,C �� \vr i � S E Cl�l' �'
R ece i p t # : �� ? 1�
Property 1� "'� C _ s lap /TL #: AS 03 41:1-0 tYdv
Owner Mailing Address SF wA Suite Zoning: I✓
s6 IS
Allowable Total Area:
City/ State Zip Phone
Tenant or
Name
' Electrical Permit Required? ❑ Yes �N
Business
C`1 M� Co �s k (\i c � 0,A i Y 11L Building Permit Required? El Yes No
Name Rev. 7/1/11
` is \curpin \masters \land use applications \sign permit app.doe
�
Sign ;f,1 co0c. 4f4C +f J (viC
Contractor Mailing Address Suite
80 (16 gy /State S Zip
Ci Phone REQUIRED SUBMITTAL ELEMENTS
l ii yG/l , 1 R A l ZJ 2 ��_ (93 t_ zit, (Note: applications will not be accepted
Or€gon Cont. l Cont. V Board License # Exp. Date without the required submittal elements)
CC eii S k 7 9/13/(3 ❑ Completed Application Form
Permanent ❑ Freestanding
Proposed Freeway ❑ y ❑ 2 copies of site /plot plan, drawn to scale
Sign Temporary ❑ Roof ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Wall ❑ Other
apply) size requirement: 8 z » x 11", or 11" x 17"
❑ 2 copies of elevations, drawn to scale
[l]. New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimensions: _ p X �� �� size requirement: 8'/2" x 11", to 24" x 36"
Total Sign Area (sq. ft.): � f ❑ $165.00 Fee (Permanent sign, any size)
Total Wall Area (sq. ft.)
Sign Data
° S 7 0 $52.00 Fee (Temporary sign, any type)
g 13
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E O NE NW SE SW
Height to top of sign (feet): • Wall signs do not need to be drawn to scale, but
' must include dimensions of wall face and sign
Projection From Wall (inches): 37F b
placement.
Materials: p j 4 s fi • Wall signs do not require site /plot plans.
Will sign have illumination? ❑ Yes [A No • Freestanding signs over 6 ft. required a building
Type: ❑ Internal El External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space?
❑ Yes A No
If "yes ", a list or diagram of all sign dimensions and square (OVER FOR SIGNATURES)
footage must also be submitted.
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 718 -2421 I www.tigard - or.gov I Page 1 of 2
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.
(7/ I z
Applicant Signature Date
J■JJ ^ �^,. IA k
Si ture of Owner /Agent Date
V OA CC. A" (1\eokv c °3 - ( C 2 r
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 I Page 2 of 2
GILLESPIE ART PROOF
Building Location: 16460 SW 72ND AVE .
Proof OK as is.
BUILDING 6 , Make changes o in h d a i n c g a e te s d a c n h o a s n e g n e o s a ,
TIGARD, OR 97224
Approved by
Date
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CITY OF TIGARD
1E RECEIPT
: 13125 SW Hall Blvd., Tigard OR 97223
- 503.639.4171
Receipt Number: 185476 - 02/08/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2012 -00018 Sign Permit 100 - 0000 -43115 $144.00
SGN2012 -00018 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
Credit Card 008288 STREAT 02/08/2012 $165.00
Payor: Vincent Mohr
Total Payments: $165.00
Balance Due: $0.00
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