SGN2012-00190 •
CITY OF TIGARD SIGN PERMIT
rs Permit #: SGN2012 -00190
COMMUNITY DEVELOPMENT Date Issued: 12/18/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S101AB90131
Jurisdiction: Tigard
Name of Business: C H Physical Therapy
Business Address: 12011 70th AVE
Applicant/Agent: Martzall, Rob
Work Description: Wall sign (3' x 10').
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 3 ft x 10 ft
Total Sign Area: 30
Wall Area: 660
Wall Face (Direction): North
Sign Height: ft.
Projection From Wall: in.
Illumination: No Illumination
•
Materials: Aluminum
Electrical Permit Required: No
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: / 7 /; 0/°°111....
Permittee Signatur . t t
711 CITY OF TIGARD RECEIPT
9 . 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 189556 - 12/18/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2012 -00190 Sign Permit 100-0000 -43115 $149.00
SGN2012 -00190 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 31748 JFLOYD 12/18/2012 $171.00
Payor: Meyer Sign Co. of Oregon Inc.
Total Payments: $171.00
Balance Due: $0.00
Page 1 of 1
City of Tigard
Sign Permit Application
TIGARD
GENERAL INFORMATION
Name of Development /Project
Site T
P /4JSI 71-I6 / FOR STAFF USE ONLY
Address/ S treet Address s GN a a I.? - too f of o
/ Permit No.:
Location /2- I SW 9.0'' -± Ale
Approved By: C. • C. C' i. / I/
Suite /Bldg. # City /State Zip
I I GAab C)10— Date: /..7 - i3 - /a
Name R 2 d R 6 CX �� B..0 `..-less ` 111 , c- LLC..- Receipt #: M 5 -C
Property SAME /' /� tom A-Bt7V e Map /TL #: � 1 S / 0 1 Ala 'TO 3
Owner Mailing Address Suite Zoning: C - ( (PO)
q
' 13° r1
3O / ) Sw Nve u p
; land Allowable Total Area: 1 1 .Se • fi.
City/State Zip Phone V
WI 'San 1 /. 9 7o7 0
Electrical Permit Required? ❑ Yes NI
Tenant or Name
Business C H Ph y S ; C a, � �e c o. P �' Building Permit Required? cif Yes ❑ No
Name Rev. 7 /1 /I1
is \curpin \ masters \land use appbcations \ sign permit app.doc
Sign M SIc,n4 Co. OF °Re&o►J
Contractor Mailing Address Suite
I S7J25 5k/J3-‘411/AVE
City/State Zip ,, 1 Phone REOUIRED SUBMITTAL ELEMENTS
I t G Ai2O Q 9}2Z, 620 _8207 (Note: applications will not be accepted
Oregon Const. Corn. Board License # Lap. D1 to without the required submittal elements)
!0401'4 2.!'f /13
❑' Completed Application Form
Proposed Permanent ❑ F rees ta nding ❑ Freewa y d 2 copies of site /plot plan, drawn to scale
1 _'
0
Sign ❑ Temporary ❑ Roof ❑ Electronic (3 copies, if a building permit is required)
(Check all that Wall ❑ Other
„ 11" 17"
apply) �• er
size requirement: 8t x 11", or 11 x 17
[r 2 copies of elevations, drawn to scale
rg New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimensions: 3' X 10 I size requirement: 81/2" x 11", to 24" x 36"
Total Sign Area (sq. ft.): 30 ❑ $ .Ifr5. tr Fee (Permanent sign, any size)
Si D ata Total Wall (sq. ft.) = �. C io ❑ $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): g must include dimensions of wall face and sign
r�� AL L_v..wt1>J� placement.
Materials: • Wall signs do not require site /plot plans.
Will sign have illumination? ❑ Yes IA 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 pace?
❑ 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 I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 718 -2421 I www.tigard - or.gov I Page 1 of 2
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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:
o 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.
/ )7/ 2, i ?—
Applicant Signature Date
•
^� l
Signature of Owner /Agent Date
t3 MA lit 3 lo goo
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
SCALE: 3/4" = I' -0" DESCRIPTION OF WORK
MANUFACTURE & INSTALL:
NON ILLUMINATED LETTERS WITH
CI OF TIGARD RADIUS SILVER BACKER PANEL
N 0 Approv • _. [ )
• Conditionally Ap .
For only the w or l as esCribe in: [ ] SQ. FT 30 QTY: 2
TOP VIEW PERMIT NO.. 5 N O - 4!e O0) Qv
See Latter to: Follow » [ ] LETTER MATERIAL
10.-0 . Attach . .
Job Ad, dress: l.Aoll ` --7(3w‘ A": w [ I /2" THICK SINTRA
By: 4 �1 eJ ncste N - 13 1 a GREEN= PAINT TM FORREST GREEN
PSV
BLACK = PAINT BLACK
GLOSS FINISH
BACKER PANEL
.RADIUS NON ILLUMINATED CABINET
9 FABRICATED 090 ALUMINUM
En .
4:1A.
PAINT T/M BRUSHED ALUMINUM
FLUSH MOUNT TO WALL
HYSICAL THERAPY
30, - 0 "
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,,rr,, •• ,, - ; t 1 Il REAR ELEVATION FRONT ELEVATION
sales me ersi nco.com C.H. PHYSI THE DATE: BY: �. • Meyer s an original unpublished drawing created for
Y g PRO PROJECT: DATE. j BY: CUSTOMER APPROVAL LANDLORD APPROVAL: Me S n Company's customer and the ea DRAWING #:
1 i � r � per' proi
Ste. terO. 1201 1 SW 70th AVE Ti OR �ISIp++ *I RED #4
planned +ortnetpecrcneees or Meyer sgnCustomers. CH Physical Therapy R6139S
v _ • www.meyersignco.com ADDRESS:
These drawings are not to be shown outside your REV 2
phone: 503 620 - 8200 DESIGNER: JC ACCT MGR JC Nelson REVISION M2 REVISION es organiration copied, reproduced, or exhibited
fax: 503 620 - 7074 DATE: 12 REVISION�Y3 _ REVISION N6 DATE: DATE: in any way Sign C yunles�hori z� inwrin.tgbyan officer of
Meyer SHEET I OF I
- , ' • . e Company o(Or