SGN2013-00102 •
CITY OF TIGARD SIGN PERMIT
E 3 _.. Permit #: SGN2013 -00102
COMMUNITY DEVELOPMENT Date Issued: 08/22/2013
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S103DD00600
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Jurisdiction: Tigard
Name of Business: Tigard Grange
Business Address: 13770 SW PACIFIC HWY
Applicant/Agent: Keeney, George
Work Description: Temporary 4' by 6' banner sign to be locatd on the southeast corner of the existing
structure.
Permanent: No Freestanding: No Freeway: No
Temporary: 2 Wall: No Electronic: No
Billboard: No Balloon: No
Banner: Yes A- Board: No
Sign Dimensions: 4' "x 6'
Total Sign Area: 24
Wall Area:
Wall Face (Direction): South
Sign Height: . ft.
Projectio n From Wall: 'in.
• ,Illumination: No Illumination
Materials: Vinyl
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $56.00
Conditions:
This pen 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 Signature y6 l /
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Site Plan N
Driveway Gravel and Grass Parking
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13770 SW Pacific Highway u II , : !
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Driveway Gravel and Grass Parking
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I I III City of f Tigard
Sign Permit Application
TIGARD •
GENERAL INFORMATION
Name of Development /Project
FOR STAFF USE ONLY
Site 71 ii7 . Je)94/ i;' / r
Address / Street Address Permit No.: 41 � lS ` UO L)
Location 13 770 .C j „--C- )1� 7 Approved By: D F
Suite /131dg. # ` City/State Zip /
/.1� Date: �"a�
Name ` Fee:
Property C A2 5 �,Oy -J Receipt #:
Owner Marlin (19,79
ridress Suite Map /TL #:
Zoning: C C `¢ 16
City/State Zip Phone Allowable Total Area: eZ �
Tenant or Name
Business Te-U 54. lifl¢' °t- S Electrical Permit Required? ❑Yes
Name Building Permit Required? ❑ Yes 0 No
Sign Ter5 / 9r 3 Rev. 6/24/2013
f~ v , "� l: \CURPLN \Masters \Land Use Applications \Sign Permit.doc
Contractor Mailing Address Suite
> LlF 51,t) 079Qhl-fie
City/State Zip Phona�03
/ — n 1 70 Z ' L i 5 .... 9 - 9 76 REQUIRED SUBMITTAL ELEMENTS
Oregon Conn. Cont. Board License # Esp. Date (Note: applications will not be accepted
without the required submittal elements)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway [Completed Application Form
Sign ►i Temporary ❑ Roof ❑ Electronic ,�,/
(Check all that j Wall ❑ Other L� copies of site /plot plan, drawn to scale
apply) (3 copies, if a building permit is required)
,04N/11b"_ size requirement: 81/2” x 11 ", or 11" x 17"
❑ New sign? El Alter to existing sign? E1 copies of elevations, drawn to scale Q
Sign Dimensions: 7 X G (3 copies, if a building permit is required) /VN
Total Sign Area (sq. ft.): size requirement: 8'/2" x 11 ", to 24" x 36"
Si Data Total Wall Area (sq. ft
❑ Application Fee
(Complete all Direction Wall Faces (circle one): NOTES:
items in this /�
section) N S E W NE NW SE6W /
• Wall signs do not need to be drawn to scale, but
Height to top of sign (feet): must include dimensions of wall face and sign
Projection From Wall (inches): placement.
Materials: ,j,q.N/VCyL .9' (00 • Wall signs do not require site /plot plans.
Will sign have illumination? ❑ Yes ®' No • Freestanding signs over 6 ft. and walls signs of
Type: ❑ Internal RI External which any element weighs 20 lbs. or more require a
Are there any existing freestanding or wall signs at this location, building permit.
including wall signs that overlap a tenant space?
p Yes E. No
If "yes ", a list or diagram of all sign dimensions and square
footage must also be submitted. (OVER FOR SIGNATURES)
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
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 fmancial 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.
F it .A. / / ..// 0/z �/l 3
Applicant Signature / Date /
!.wat. .v� E / 2 z h3
Signature of Owner /Aft Date
&WM) / �C��ti 5v3 �'
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 Page 2 of 2
- CITY OF TIGARD ,RECEIPT
Iii I$ 13125 SW Hall Blvd., Tigard OR 97223
- 503.639.4171
T_[GAK:D
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Receipt Number: 192804 - 08/22/2013
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER' PAID
SGN2013 00102 Temporary Sign Permit - LRP 100- 0000 -43117 $7.00
SGN2013 -00102 Temporary Sign Permit 100-0000-4311,5 $49.00
Total: $56.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 4154 JFLOYD 08/22/2013 $56.00
Payor: Gordon L Keeney
Total Payments: $56.00
Balance Due: $0.00
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