SGN2012-00096 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2012 -00096
COMMUNITY DEVELOPMENT Date Issued: 05/24/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S103DD00600
Jurisdiction: Tigard
Name of Business: Handsberry Stands
Business Address: 13770 SW PACIFIC HWY
Applicant/Agent: Rickard, James
Work Description: Temporary Sign Permit for Handsberry Farm from June 10 - July 9 20120
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: Yes
Sign Dimensions: 3' x 4'
Total Sign Area: 12
Wall Area:
Wall Face (Direction):
Sign Height: ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: Wood
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $52.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. All work will be done in accordance with approved plans. A permanent sign must be placed within
90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon
sign shall expire 10 days from validity date.
Approved By: "/
Permittee Signat i „,
•
City of Tigard
Sign Permit Application
TIGARD
GENERAL INFORMATION
Name of Development /Project
/ G ��� � n ��� FOR STAFF USE ONLY
Site Kl1 (� q /�,,
Address/ Street Address Permit No.: V cNOZOLL - OOO ! 4
6
Location /3 >V j �,$Aeific �"F
Suite /Bldg. # City/State
n Zip /� A pproved By:
I /// �lU A 972.23 Date: 5
Name /f / Receipt #:
Property 7740 GRhIV61 /rd Map /TL #:
Owner Mailing Address Suite Zoning: L=&
Pa & 030152. Allowable Total Area: b
City /State Zip Phone
1/b fi� y � i 5'e3°3i7 tmzi Electrical Permit Required? ❑ Yes L[ o
Tenant or Nam
Business ,J Fl (Yy gS R IGFChg0 Building Permit Required? ❑ Yes Et<o
Name Rev. 7/1/11
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Sign
Contractor Mailing Address Suite
City /State Zip Phone REQUIRED SUBMITTAL ELEMENTS
(Note: applications will not be accepted
Oregon Const. Cont. Board License # Exp. Date without the required submittal elements)
❑ Completed Application Form
❑ Perm
Proposed Permanent ❑ Freestanding ❑ Freeway ❑ 2 copies of site /plot plan, drawn to scale
Sign Er Temporary ❑ Roof ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ wall ❑ Other t
apply) size requirement: 81/2" x 11", or 11 " x 17"
❑ 2 copies of elevations, drawn to scale
❑ New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimensions: size requirement: 8 x 11", to 24" x 36"
Total Sign Area (sq. ft.): /2.. ❑ $165.00 Fee (Permanent sign, any size)
Si Data Total Wall Area (sq. ft _ o ❑ $52.00 Fee (Temporary sign, any type)
gn
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E W NE NW SE SW
Height to top of sign (feet): • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): must include dimensions of wall face and sign
Materials: J cQ placement.
♦ Wall signs do not require site /plot plans.
Will sign have illumination? ❑ Yes ErNo ♦ Freestanding signs over 6 ft. required a building
Type: ❑ Internal ❑ External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenan space?
❑Yes 6 N
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 I 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.
fidd 5 ' m/2_
Ap. ca t ignature Date
Signature of Owner /Agent Date
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
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This agreement is conditional upon renter's obtaining the necessary permits and upon the
renter's providing evidence of the required insurance. If renter fails in either instance, this
contract is void and all rents and deposits paid will be returned to the renter except for the
three days minimum rent which shall be retained by the Grange.
The requirement to sign in and out as described in Section 10 is waived.
An access key has already been furnished.
It is understood that vendors participating in a Tigard Grange Weekend Market may be
offering wares for sale on Saturdays and Sundays from 10:00am to 6:00pm on the other side
of the Grange hall.
This agreement is entered into for each of the respective parties between:
Jessica L Cousineau, for the Tigard Grange No. 148, and kj /S / 9 X /G f RQ , for the
renter.
/ ) Rental Manager
gnature FaTI Position
I. _
"gnature l ate Position
Renter's Mailing Address: /3 / / � v C I /45 OA 97/ ` 3
Renter's Phone Number: 5 ' 3 6. 2 -
Renter's Email Address: ,i . / , , ) i , 4.1 i v
Grange Rental Manager: Jessica Cousineau
Phone: (503) 317 -6694
Email: rentals @tigardgrange.com
Alternate Contact for Grange: Mark Schnetzky
Phone: (503) 807 -7619
Tigard Grange Hall Rental Agreement Page 5 of 5
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
T.1GAR.LD
Receipt Number: 186902 - 05/24/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER' PAID
SGN2012 -00096 Temporary Sign Permit 100 - 0000 -43115 $45.00
SGN2012 -00096 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
Check 0001 JFLOYD 05/24/2012 $52.00
Payor: Cynthia Hand
Total Payments: $52.00
Balance Due: $0.00
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