SGN2014-00111 CITY OF TIGARD SIGN PERMIT
III 3 Permit#: SGN2014-00111
COMMUNITY DEVELOPMENT Date Issued: 09/17/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 1S135CA02600
Jurisdiction: Tigard
Name of Business: GOOD NEIGHBOR CENTER
Business Address: 11130 SW GREENBURG RD
Applicant/Agent: ANDERSON, HEIDI
Work Description: APPLICATION TO REPLACE THE EXISTING FREESTANDING SIGN BY MAIN
ENTRANCE WITH A NEW SIGN IN THE SAME LOCATION. NEW SIGN TO STAND
5'6"TALL WITH A SIGN FACE TO MEASURE 42 INCHES WIDE BY 27 INCHES TALL.
Permanent: Freestanding: Yes Freeway: No
Temporary: Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions: 27 INCHES X 42 INCHE:
Total Sign Area: 7.875
Wall Area:
Wall Face(Direction):
Sign Height: ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: WOOD
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $192.00
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: .d
Permittee Signature,/06111111112> '
114 CITY OF TIGARD RECEIPT
j 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 197644 - 09/17/2014
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2014-00111 Sign Permit-LRP 100-0000-43117 $25.00
SGN2014-00111 Sign Permit 100-0000-43115 $167.00
Total: $192.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 863809 JFLOYD 09/17/2014 $192.00
Payor: JESSICA LEVIN
Total Payments: $192.00
Balance Due: $0.00
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I� CITY OF TIGARD
Approved
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PERMIT NO. I .�o"
See Letter to: Follow..,.., [
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Job Address. Att !J O...I __Del[ e]
I �;_ ��-.. CITY OF TIGARD
t��fd° 'Q� �f PLANNING/ENGINEERING
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City of Tigard
•
Sign Permit Application
TIGARD
GENERAL INFORMATION
Name of Development/Project
Site iv4v FOR STAFF USE ONLY
Ic� 'y����
Address/ Street Address `
Permit No.: v /9 w
Location Approved By: )-if
Suite/Bldg.# City/State zip ..� �r
Date• �i/—/I— /-(
Name //yy /y Fee: /7 0.GG
Property L4Yb h/43hi/14r(..Duen- 7 a/44s�//1e. Receipt#: /7 76 1
Owner Mailing Address / Suite'— Map/TL#:
/1i3 G J 11/ 622n.bl i t a Zoning: R a
City/State Zip Kone Allowable Total Area: 30.0
-a t4 %-7-273 Sa3 -0-64V
Tenant or Name
Business fj (sodc/U,e/,h b e;)-- Ce_ l e,t-- Electrical Permit Required? El Yes o
Name Building Permit Required? ❑ Yes i�
Rev.10/21/2013
Sign I:\CURPLN\Masters\Land Use Applications\Sign Permit.doc
Contractor Mailing Address .,11111.
City/State Zip Phone
REQUIRED SUBMITTAL ELEMENTS
Oregon Const.Corn.Board license# Exp.Date
❑ Completed Application Form
Proposed ❑ 2 copies of elevations on 81/2"x 11"or 11"x 17"
P Permanent 'rccstanding ❑ Freeway
Sign 111 Temporary ❑ Roof ❑ Electronic
pages (must be drawn to scale for freestanding sign)
(Check all th.n
El apply) Wall ❑ Other ❑ 2 copies of site/plot pla scale,on
81/2"x11"or 11"x17" t to -ed for" izD
_"New sign? El .Ater to existing sign? freestanding signs only)
Sign Dimensions:,4a b 1 -7// ❑ Application Fee S E P 17 2014
Total Sign Area(sq. ft.): I 750 NOTES: CITY OF TIG ARD `'
u • Applications will not be acRANMNETiout all required
Sign Data Total NJ Area (sq. ft.) =-N-/&-'''' submittal elements.
(Complete all Direction Wall Faces(circle one): ,r/� • Wall sign elevations must include dimensions of sign
items in this i"( and wall face and show the location of sign on the wall.
section) N S E W NE NW SE SW
Height to top of sign(feet): S/�r` • Freestanding signs over 6 ft. in height and walls signs
of which any element weighs 20 lbs. or more require a
Projection From Wall(inches): N/4 permit from the Building Division for construction. If
Materials: 1/1/ioC 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 ❑ Ext rnal • 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 gNo
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 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 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.
Applicant Signature Date 45-7/(-7
saw _..LAL_ /
Si: .17 e of 0. • er gent Date
/-erd i Anclerson V1Il1th, r e 000l in k 3 jog qx 2271
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