SGN2001-00175 CITY OF TIGARD SIGN PERMIT
mirk DEVELOPMENT SERVICES PERMIT #: SGN2001 -00175
• - '�' 1 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/24/2001
EXPIRATION DATE:
BUSINESS NAME: SKIPPERS
SIGN LOCATION: 11685 SW PACIFIC HY PARCEL: 1S136CD -0010
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APPLICANT /AGENT: SKIPPERS ZONE: C -G
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 8'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: 704 sq. ft.
WALL FACE (DIRECTION): SW
SIGN HEIGHT: ft.
PROJECTION FROM WALL: 1 in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary Placement of (1) banner sign. Not to be placed in visual clearance
area or public right -of -way. Valid 8/8/01 - 9/8/01. (Sign #1)
MATERIALS: BANNER
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. I s k will be done i . ccordance with approved plans. A sign permit shall expire 90
days from approval date. A - mpora, sign shall e pir 30 days from approval date. A balloon sign shall expire 10
days from annrnval data
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APPROVED B / /et th
PERMITTEE SIGNATURE: �'
DATE: 9/24/2001
li s
a,T:V'C':i SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of k _ pee Development/Project
Site �
Address/ Street Addre s FOR STAFF USE ONLY
Location II(o8'S A. -efc- r i� Oa Permit No.:.. 00 1
Suite /Bldg. # � i City/State ip 0
1 cek O 97(g a 3 Expiration Date: 015 01 , CO 0
Name Receipt #: 4.4,11
Property FR �-ee L j ,— / be G Approved By:
Owner M li Address Suit Date: , g 6
I g 3,v).S+et re_
Ps v c. Map/TL #: 3 % C,D — aill 10.
City/State Zip Phone 5'0 3 — `'
Zoning:
p
o f1 J , o L 97,05" ads
or Name
Business ) Electrical Permit Required? ❑ Yes [YNo
Name � „t1 Building Permit Required? El Yes III/No
Sign
LA k G Z1 �/ � A4 Rev. 12/1/2000 is \curpin\ masters \revised\sign permit app.doc
Contractor Mailing Address cap U /7 Suite
(Prior to permit 76 ft A ye_ Sp cc, +h
issuance, a
copy of all City /State . Zip Phone 3)
licenses are REQUIRED SUBMITTAL ELEMENTS
required if y_en)-1- I' A- g W 3 ? g 7� - 7( I"7
1 f (Note: applications will not be accepted
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # without the required submittal elements)
database) ,_,,/
Proposed Permanent DI Completed Application Form
❑ Freestanding ❑ Freeway .
Sign Temporary ❑ wall ❑ Electronic eg/ 2 Copies of Site /Plot Plan, Drawn to Scale '
(Check all that Other ❑ Billboard ❑ Balloon (3 copies, if a building permit is required)
apply) size requirement: 8 x 11 ", or 11" x 17"
New sign? ❑ Alter to existing sign? 4 2 copies of elevations, drawn to scale
/Sign Dimensions: (3 copies, if a building permit is required)
size requirement: 81 x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): 3 x ❑ ee (Permanent sign, any size)
Sign Data To Wall A (sq. ft.) /( /, f fiti-I t $15.00 Fee Temporary sign, any type)
(Complete all Direc Wall Faces (circle one):
items in this
section) N S E W NE NW SE SW NOTES:
Height to top of sign (feet): 3 • Wall signs do not need to be drawn to scale,
Projection From Wall (inches):,, but must include dimensions of wall face and
sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes No building permit.
Type: ❑Internal 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 0 N
If "yes ", a list or iagram of all sign dimensions and (OVER FOR SIGNATURES)
square footage must also be submitted.
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
Signatur of Owner /Agent
Contact Person Name Phone No.
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Receipt #:27200.10
r' �� w �/ Date: 09/24/2001
T C I D T E ';B M A R I NC .
Line Items:
Case No Tran Code Description Revenue Account No Amount Due
SGN2001 -00175 [SIGN] Temp Sign Perm 100- 0000 - 437000 $15 "00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Cash SKIPPERS 0 0 0 $20.00
Change SKIPPERS 0 0 0 . , ($5.00)
TOTAL AMOUNT PAID: $15.00
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