SGN2012-00186 CITY OF TIGARD SIGN PERMIT
III Permit #: SGN2012 -00186
COMMUNITY DEVELOPMENT Date Issued: 12/05/2012
T I G ARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S112AC00100
Jurisdiction: Tigard
Name of Business: Save on Tires
Business Address: 14529 SW 72ND AVE
Applicant/Agent: Paulus, Jaylene
Work Description: New 3'x12' illuminated wall sign on east - facing wall.
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 3' x 12'
Total Sign Area: 36
Wall Area: 882
Wall Face (Direction): East
Sign Height: 10 ft.
Projection From Wall: 6 in.
Illumination: Internal
Materials:
Electrical Permit Required: Yes
Building Permit Required: Yes
Total Permit Fee: $171.00
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: ,. /..4.11
Permittee Signature: dr/ / /T /
7
IN CITY OF TIGARD RECEIPT
. 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 189372 - 12/05/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2012 -00186 Sign Permit 100 - 0000 -43115 $149.00
SGN2012 -00186 Sign Permit - LRP 100 - 0000 -43117 $22.00
Total: $171.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 4368 TLEHRBACH 12/05/2012 $171.00
Payor: Integrity Signs Oregon
Total Payments: $171.00
Balance Due: $0.00
Page 1 of 1
M I City of Tigard ,
• Sign Permit Application
TIGARD ��
GENERAL INFORMATION
Name of Development /Project _
' FOR STAFF USE ONLY
Site 'Tres /r � es 1
Address/ eet Address Permit No.: S tI L 2- 001%6 %
Location /1/5a 7 Sai . " ' Rte- t la
Approved By: t'
kelp # City/State Zip
// /Cb Date: 1115416 t2.
Name J v � Receipt #: 1% 31 / �
Property Map /TL #: 2.6 6 112AC.00100
Owner Mailing Address Suite Zoning: I - L.
Allowable Total Area: % 64
City /State Zip Phone
Tenant or Name Electrical Permit Required? "Yes ❑ No
Business ,iawe Oh / fee S Building Permit Required? [Q Yes ❑ No
Name Rev. 7/1/12
� ',^ c U /l�
is \curpin \ masters \land use apphcauons \sign permit app.doc
Sign 'f '� h V 191 S
Contractor Mailing Address V ki Suite
City /State Zip Phone REQUIRED SUBMITTAL ELEMENTS
111 1 13)( clam 7) 3 3 (Note: applications will not be accepted
Oregon CConst. Cont. Board License # Exp. Date without the required submittal elements)
1q415 / )`3 Completed Application Form
Proposed Permanent ❑ Freestanding ❑ Freeway 2 copies of site /plot plan, drawn to scale
Sign ❑ Temporary ❑ Roof ❑ Electronic (3 copies, if a building permit is required)
(Check all that 2. Wall ❑ Other
appl)) / size requirement: 81/2" x 11 ", or 11" x 17"
2 copies of elevations, drawn to scale
[ ✓7 New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimensions: 3 X is I size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): s � i $171.00 Fee (Permanent sign, any size)
Total Wall � a a(sq ft.) ❑ $54.00 Fee (Temporary sign, arty type)
Sign Data _ f , ,,011/ i,
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S OW NE NW SE SW
Height to top of sign (feet): /0 , • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): / must include dimensions of wall face and sign
Materials: ' placement.
�o2 ° � Ot f ^ ' • Wall signs do not require site /plot plans.
Will sign have ill ination? 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?
2 Yes ❑ No
If "yes ", a list or diagram of all sign dimensions and square
(OVER FOR SIGNATURES)
footage must also be submitted.
City of Tigard 1 13125 SW Hall Blvd., Tigard, OR 97223 1 503- 718 -2421 1 www.tigard - or.gov 1 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 APPLICANTS) 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.
A J pp lica rft S ignature Date
/ Signature of ner /Agent Date
(!i Cr /t (i'_5 K.J I _343/
Cgnttact 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 of 2
I; 3F,,,i 4I Dualite Sales & Service, Inc. CUSTOMER NAME: _ _ Form
WIL Lt ANISBURG, OHIO • CEDAR HILL, rExA$ CITY / LOCATION:
lA
1 Dualite Ln. - Williamsburg, OH 45176
(513) 724 -7100 - Fax: (513) 724 -6437 Site or Store No.: —___ _____
SITE
Li SITE PLAN - Survey
Indicate below: Street Names (major Cross Streets), Location of the Building (show entrances and parking)
Mark Locations of Exist'g or Proposed Signage, Property Lines & Setback Dimensions from the Property Lines
and Provide Compass, if appropriate.
Please note Traffic Patterns; heavy, light, dead -end, alleys, interstate hwys, etc.
If Possible, Key Photos, to the Direction from which they were taken.
NORTH
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For only the work as described in:
PERMIT NO
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