SGN2012-00145 Er
T IGARD
City of Tigard
October 18, 2012
Foress Sign Company
30255 SW Hwy 34
Albany, OR 97321
Re: Permit No. SGN2012 -00145
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 9730 SW Cascade Ave.
Project Name: Shane Co.
Job No.: N/A
Refund Method: ❑ Check # in the amount of $
® Credit card "return" receipt in the amount of $136.80.
Note: Please allow 2 -5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account "deposit" receipt in the amount of $
Comment(s): Refund 80% of application fee as a request for a 2 " freestanding sign
cannot be approved and placed on this parcel per planning staff, Hap Watkins.
If you have any questions please contact me at 503.718.2430.
Sincerely,
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard- or.gov
City of Tigard
TICARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building application
fees. Receipts, documentation and the Request for Permit Ac /ion form (if applicable) must be attached
to this request. Refund requests are due to Accela System Administrator by Wednesday at
5:00 PM for processing by the following Wednesday. Accounts Payable will route refund
checks to Accela System Administrator for distribution. Please allow up to 2 weeks for processing.
PAYABLE TO: Foress Sign Co. DATE: 10/04/2012
30255 SW Hwy 34
Albany, Dr. 97321 REQUESTED BY: Dianna Howse
Hap
TRANSACTION INFORMATION:
Receipt #: 188367 Case #: SGN2012- 00145
Date: 09/13/2012 Address /Parcel: 9730 SW Cascade Ave.
Pay Method: CreditCard Project Name: Shane Co.
EXPLANATION: Refund 80% of application fees as this 2 freestanding sign cannot be approved and
placed on this parcel per Hap Watkins.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000- 43104 $ Amount
Sign Permit 100 - 0000 -43115 $119.20
Sign Permit - LRP 100 - 0000 -43117 17.60
TOTAL REFUND: $136.80
APPROVALS:
If under $5,000 Professional Staff
If under $12,500 Division Manager
I f under $25,500 Department Manager
If under $50,000 City Manager
If over $50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: I Date: I /d/jp //..2-- By I
I:\ Building \Rciunds \RcfundRequcst.dnc x 09/01/2010
City of Tigard • COMMUNITY DEVELOPMENT DEPARTMENT
•
■ Request Permit Act
i , . , l 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard- or.gov
TO: CITY OF TIGARD
Building Division Services Supervisor
13125 SW Hall Blvd., Tigard, OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard - or.gov
FROM: ❑ Owner ❑ Applicant ❑ Contractor Zr City Staff
(check one)
REFUND OR Name:
INVOICE TO: (Business or Individual) �L l 5 /5/7
Mailing Address: �DZ,g� Nikiy
City/State /Zip: 4/440 DR q7.5/
s
Phone No.: ( ¶t// ^ fa ?'97So
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (
CANCEL /VOID PERMIT APPLICATION.
o REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE /REPLACE CONTRACTOR ON PERMIT (do not cancel permit).
Permit #: , 7 ' f / � - v0 A
Site Address or Parcel #: � Se Se
/ ie
Project Name: IvA,te
Subdivision Name: ,� Lot #:
EXPLANATION: /5 �i- �'��2�A ,4.e .// I/� 5111i1 'ri, i ke7 L
y e ppY /i
el 7 9-,° /2-E7// AJ o / r9
Signature: / Date: 4 '� `/ a-
Print Name: j) 1k4'-e # (- ' 4$ Alf#./1 19. a_o 02�r
/ ` I
Refund Policy O °
1. The Director or Building Official may authorize the refund of
a) any fee which was erroneously paid or collected. X34
b) not more than 80% of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80% of the land use application fee for issued permits.
d) not more than 80% of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 80% of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2 -4 weeks for processing refunds.
FOR OI I I :i: l 'I.. O'NII,A
Rte to Sys Admin: Date By Rte to$1dgAdmin: Date 1 /6 /2 By /i v
Refund Processed: Date /0// /Z B (2y Invoice Processed: Date By
Permit Canceled: Date /1) / By 4" Parcel Tag Added: Date By
Receipt # Date Method Amount $
I:\ Building \Forms \RegPer mitAction.doc Rev 05/25/2012
_ cAAk k
71 City of T v „....D
- RECE'
Sign Permit Application SE p 1 2012
TIGARD
CITY OF TIG PBO
GENERAL INFORMATION p�p,NNINGIE , IttFtING
Name of Development /Project
n i FOR STAFF USE ONLY
Site e, n A A 2 C t /�_
Address/ Street Address ) Permit No.: .S V N U � - 0 v 1 (45 Location 17305 C o C- a'& k Approved By:
Suite /Bldg. # j� a City/State /� Zip may?
Name ' i e ��(® t: r ! 72 2 3 Date:
Receipt #: / $ U 3 Co /
Property Map /TL #: M Owner Mailing Address Suite Z on i ng: M U.
Allowable Total Area:
City/State • Zip Phone
Tenant or Name Electrical Permit Required? ED Yes ❑ No
Business Building Permit Required? ❑ Yes ❑ No
Name Rev. 7/1/12
57 is \curPhAmasters \land use applications \sign permit app.doc
i
Sign T 'fJt "e i'- r j2
Contractor Mailing Address Suite
36Z6Ta 140 3V
City /State Zip / Phone REQUIRED SUBMITTAL ELEMENTS
A 4A1A } l'r ?7 Ji / f f L Z „f-Ort6 (Note: applications will not be accepted
Oregon Consr. Cont. Board License # Exp. Date without the required submittal elements)
7[ " Completed Application Form
Permanent Freestanding Freeway 2r2 Pro P
Proposed g ❑ 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
[ ❑ Other t „ „ 11" „
apply) size requirement: 8 /z x 11", or 11 x 1
Zr 2 copies of elevations, drawn to scale
0" New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimension e P u i, ft size requirement: 8'/2' x 11", to 24" x 36"
Total Sign Area (sq. ft.): ✓ Z ❑ $171.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft ❑ $54.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N 6E W NE NW SE SW
Height to top of sign (feet): alsere, ! • Wall signs do not need to be drawn to scale, but .
Projection From Wall (inches): must include dimensions of wall face and sign
Materials: 1/4,...1 d 4,01 placement.
♦ Wall signs do not require site /plot plans.
Will sign have illumination? ❑ Yes ❑ No ♦ 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 tenant space?
e I'es ❑ No
If "yes ", a list or diagram of all sign dimensions and square (OVER FOR SIGNATURES)
footage must also be submitted.
City of Tigard = 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.
J A A A . I.�. .., . d A • ej 611 1 3 / 10`
Apphcan S ature I Date
Signatu e of Owner A _ Date
1140alt, -5817
Contact Person Name Phone No.
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 718 -2421 I www.tigard - or.gov I Page 2 oft
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ENTRANCE SIGN OUT OF i 1!I`, '! A`. •
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LI ATED
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OLD SITE PLAN - BEFORE ENTRY WAS CHANGED AND ROAD WIDENED
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120 FEET
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► °T'° Y ...R._ 1 (1Q (sign associates, inch
N TO BE 36" TALL oR LESS, T'' ' - • : D es i gn D ate: 9 4 12
LOCATED INSIDE SITE DISTANCE Ai - N825176111 Ave N.E Sale 125 Redmond hi, 0 9052
._,. , Tigard, OR 425E85 -e100 FAX 1e251e82 3433
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•18 65"
SPECIFICATIONS:
Remove non- illluminated wood monument sign and posts
S�„ a 'Copy area = 4 sq
I AN W (Max allowed by City) Install (1) non illuminated Monument sign with " DRSP " lower text o°i skartital..
is) co ENTRANCE
nstall (1) non illuminated Directional Entry sign (no lower text).
DIAMONDS• RUBIES. SAPPHIRES• Pk MILS
. -- 3 "x3 "x.125 • - S. -re 3 "x3 "x.125 wall Square
Tube Ste: Support Tube Steel Support
I
I _____-----Footing: 1, " x 18" x 24" deep Y ° 1 Footing: 18" x 18" x 24" deep
TNIS ORIGINAL DRAWING IS THE
PROPERTY OF SIGN ASSOCIATES. INC. ,_____sign
- - - - - - - - - - -�
MID IS PROTECTED TINDER FEDERAL associates, inc LAWS. MA COPYRIGHT
REP O U OF IS DESIGN Customer Approval: Date: Design Date: 9 4 12
CONCEPT OR V825 17 614 Ave N.E. Stile 125 Petlmord. AA o9053
Tigard, OR A25I 995 61 FAX 142519823433
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