SGN2012-00093 CITY OF TIGARD SIGN PERMIT
7 Permit #: SGN2012 -00093
COMMUNITY DEVELOPMENT Date Issued: 05/21/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S102BD00701
Jurisdiction: Tigard
Name of Business: Burgerville
Business Address: 12785 SW PACIFIC HWY
Applicant/Agent: Sams, Dave
Work Description: Wall Sign
•
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 19'6 "x20"
Total Sign Area: 32.5
Wall Area: 715
Wall Face (Direction): North
Sign Height: 11.5 ft.
Projection From Wall: 5 in.
Illumination: Internal
Materials: Aluminum /acrylic
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.
I �
Approved By: � I4
Permittee Signature: , /!�
CITY OF TIGARD RECEIPT
I II 11 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 186818 - 05/21/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2012 -00093 Sign Permit 100-0000-43115 $144.00
SGN2012 -00093 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 1087 HWATKINS 05/21/2012 $165.00
Payor: Dave Sams of Advanced Electric Signs
Total Payments: $165.00
Balance Due: $0.00
Page 1 of 1
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tIi' 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 BVa ( E( <Vi l l FORS
• . TAFF U SE L. ,
O
Address/ Street Address
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Location M h > : t` 9-', :
� `� 54.; r,� t��i Nw Permit
Suite /Bldg. # City /State Zip } Y''' "`t ` ',
Expiration Date:.
Name Recei t - ! : f .J�
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II-AI Approv 'd 3y :
Property I
Owner Mailing Address Suite Date:'' (�( av ' r- w ' _.
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City /State Zip Phone 3‘;‘) Z oning r „r'; ' �..( `'r ' y �' ' v' 4`'1'', r
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Tenant or
Name Electrical Permit Required ,'. L '..t,.,_; s...:.,.
:1 ❑: N
Business '� _4 '
_ -- Building Permit Required? "'r ® . :'No
Name
Rev. 1211 /2000' l: \cu . In\ mastersVevised \si.n`.
Sign AbUia,+l 0 iJ C.TI:)i. 5iGNs
Contractor Mailing Address Suite
! (Prior to permit -- ° -�-�
issuance. a Icso .aj..:,,,rn -►L D! I
cop, of sh City /State Zip Phone " 3E , U REQUIRED SUBMITTAL ELEMENTS
: are
requ ;red if 14 Doc con W.671' '5- C6 , 24: (Note: applications will not be accepted
expred in the Oregon Const. Cont. Board Exp. Date without the required submittal elements)
City of T gard's License # I O �I�S -I 1 J _ /Y
database) 7
❑ Completed Application Form
Proposed n Permanent ❑ Freestanding ❑ Freeway
Sign ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Si
g ❑ Temporary ® Wall ❑ Electronic (3 copies, if a building permit is required)
necF, a! that Other B Ball
❑ ❑ size requirement: 81/2" x 11 ", or 11" x 17"
Q New sign? ❑ Alter to existing sign? El 2 copies of elevations, drawn to scale
(3 copies, if a building permit is required)
Sign Dimensions: 1 q / 6 " x . aO )) size requirement: 8' /z" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): 3 j j' El $50.00 Fee (Permanent sign, any size) el
Total Wall Area (sq. ft.) Y ❑ $15.00 Fee (Temporary sign, any type)
Sign Data ��5
lComaiete all Direction Wall Faces (circle one):
items in this NOTES:
5er nr 0 S E W NE NW SE SW . Wall signs do not need to be drawn to scale,
I t,
Height to top of sign (feet): b� . but must include dimensions of wall face and
Projection From Wall (inches): 5 ' I sign placement.
Copy: - ' pcAfb ek,ff„4 I' \.( • Wall signs do not require site /plot plans.
Materials: p1'1Et AI_ • Freestanding signs over 6 ft. required a
r i building permit.
Will sign have illumination? e3 Yes ❑ No , If work authorized under a sign permit has not
Type: gi Internal ❑ External
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 No
If "yes ", a list or diagram of all sign dimensions and (OVER FOR SIGNATURES)
, ..-2
square footage must also be submitted.
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360-225-6826 s I� Company _
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COPYRIGHT 2012 ADVANCED ELECTRIC SIGNS INC. - AS SHOW 4DDE�MCTEED SKETCHn ®ES NOTM LGESORAYUL R TWUs ULAPPRfrifEO
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