SGN2014-00081 CITY OF TIGARD SIGN PERMIT
71 I Permit#: SGN2014-00081
COMMUNITY DEVELOPMENT Date Issued: 06/17/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 2S102AA05500
Jurisdiction: Tigard
Name of Business: LOST PARK SOCIETY KUNG FU ACADEMY
Business Address: 12215 SW MAIN ST
Applicant/Agent: SPAHAN, SHANNON
Work Description: NEW 4'BY 8'WALL SIGN FACING SOUTHEAST ABOVE THE ENTRY DOOR.
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions: 4'X 8'
Total Sign Area: 32
Wall Area: 729
Wall Face(Direction): Southeast
Sign Height: ft.
Projection From Wall: 0.5 in.
Illumination: No Illumination
Materials: ALUMINUM
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $178.00
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 Signatur:./ ,/
i
-77---
Calf OF TIGARD
::::,00veri. _ ..............................__ __1)
c.-,,ait .-.)--4iiy Approved.—.--_—... t I
-c, oniy the work
escriltia_______
?ERMIT NO. 4/ o V-w
See Letter to:Follow..-----------.t x
i
Attack...vr-itz-3,6;e
(.
J-
.__
„HP
- - —
A-- CA .... ....s..............■si \A
.... 6
I ,t. _ _.
-J )
„ Ikk
cr%
F_
t
---1--
74:
--...'
12175 >
,-."-
12215
12215 ,"
12215 12215 /
/
,,
/
:
,
Pc-op 7
•-% 0 c_ ///\''s
SI c1,3
--,
12245
Feet
0 ,..,,
IMI■1
/
114 CITY OF TIGARD RECEIPT
_ ' 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TrG. Fr.o
Receipt Number: 196514 - 06/17/2014
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2014-00081 Sign Permit-LRP 100-0000-43117 $23.00
SGN2014-00081 Sign Permit 100-0000-43115 $155.00
Total: $178.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 1076 JFLOYD 06/17/2014 $178.00
Payor: LOST PARK SOCIETY KUNG FU ACADEMY, LLC
Total Payments: $178.00
Balance Due: $0.00
Page 1 of 1
Atz lb
1N City of Tigard
Sign Permit Application
g pp
TIGARD
GENERAL INFORMATION
Name of Development/Project
Site l,u1Sf Par k S0;4e Kvy,,I1 A.A.Q. FOR STAFF USE ONLY
Address/ Street Address Permit No.:
SGAegei-Qcn /
Location iaa/S i) 51.J 1 s t..(vs 0-
. ``
Suite/Bldg.# City/State Zip Approved By: v
The.:YIA b 1 !a 1'� Date: 7- /Name 1.Crt `-� Fee: j77
Property /} Receipt#: l?(�S-7 4(
Owner Mailing Address Suite Map/TL#:
l 22(S—C SW t"4c,n D Zoning: p UC R L ,
City/State Zip Phone
'alt s ���.�y,, Allowable Total Area: 1 rJ` t7
Tenant or Name/ I �'!�j
Business l ) PGr k Socae. y klnnS.�� k:,k,—.� Electrical Permit Required? ❑ Yes ❑ No
Name / Building Permit Required? ❑ Yes ❑ No
Rev.10/21/2013
Sign I:\CURPLN\Masten\land Use Applications\Sign Permit.doc
Contractor Mailing Address Suite
City/State Zip Phone
REOUIRED SUBMITTAL ELEMENTS
Oregon Const.Cont.Board License# Exp.Date
❑ Completed Application Form
Proposed tS Permanent ❑ Freestanding ❑ Freeway ❑ 2 copies of elevations on 8'/2"x 11"or 11"x 17"
Sign ❑ Temporary ❑ Roof 0 Electronic pages (must be drawn to scale for freestanding sign)
(Check all that
apply) ❑ �� ❑ Other ❑ 2 copies of site/plot plan,drawn to scale,on
81/2"x 11"or 11"x 17"pages (required for
New sign? ❑ Alter to existing sign? freestanding signs only)
Sign Dimensions: Lkr 6 f ❑ Application Fee
Total Sign Area(sq. ft.): 3)11 S b C 4 NOTES:
• Applications will not be accepted without All required
Total Wall Area(sq. ft.)
Sign Data - S submittal elements.
' 72_c-7 5 ck
(Complete all Direction Wall Faces(circle one): ♦ Wall sign elevations must include dimensions of sign
items in this and wall face and show the location of sign on the wall.
section) N S E W NE NW ( SW
Height to top of sign (feet): `A
r to T� • Freestanding signs over 6 ft. in height and walls signs
Projection From Wall(inches): Vii
if of which any element weighs 20 lbs. or more require a
permit from the Building Division for construction. If
Materials: 41'.rn n,„--, any element of a wall sign weighs 70 lbs. or more,
Will sign have illumination? ❑ Yes `® No plans must be prepared by a structural engineer.
Type: ❑ Internal ❑ Exte al • When a Building permit is required, 2 additional
Are there any existing freestanding or wall signs at this location, copies of elevations and, if sign is freestanding,
including wall signs that overlap a tenant space? site/plot plan must be submitted with application.
❑ Yes t4 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 l of 2
l - -
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"Pemuttee"and shall provide financial assurance for work.
*When the owner and the applicant are different people,the applicant must be the purchaser of record,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 below or submit a written i
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.
dG► ATURES of each owner of the subject property are required.
•p cant Signature Date
Signature of Owner/Agent Date
Owner/Agent's Name(Please Print) Title Phone Number
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
'moo C Ver°v`C,
Acs,dam„' <cAv. h o.-,
a,frirg
wt,„, yD1(14 effE4