SGN2014-00113 Npq CITY OF TIGARD SIGN PERMIT
gi
Permit#: SGN2014-00113
COMMUNITY DEVELOPMENT Date Issued: 09/22/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 2S113AB00500
Jurisdiction: TIGARD
Name of Business: Bridgeport Family Medicine
Business Address: 16083 SW UPPER BOONES FERRY RD 320
Applicant/Agent: Bridgeport Family Medicine,Arianna
Work Description: Temporary sign permit for a 6'x 2.5'banner located at 16083 SW Upper Boones Ferry
Road.
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: Yes A-Board: No
Sign Dimensions: 6'x 2.5'
Total Sign Area: 15
Wall Area:
Wall Face(Direction):
Sign Height: ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: Vinyl
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $61.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. All work will be done in accordance with approved plans. A permanent sign must be placed within
90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon
sign shall expire 10 days from validity date.
Approved By: f 4
Permittee Signature: C' pr-eg-c4-
a O�Sep. 17._ 2014: 2:40PM 35981960 CITY OF TIGARD No. 7722 FP: _2 01/92
RECEIVED
. •
... el City of Tigard •SEP 17 2014
11141 - Sign Permit Application CITY OF TIGARD
PLANNING/ENGINEERING
.... D.
(-YENS$AL INFORMA'X IO
' Name ofDevdnpment/'0$ T F E O Nig
r Cr«k �( 00113
Site F /ddc « l�
Address/ Street Address Permit No.:� '�
Location 1(44A1 SW UP," bus FGrr� }a/
Approved By:_ A'1C
Suite/Bldg City/Stale Zip l/�
320 -�i yaroI g722 y Date: 14
Name
Fee:_ r
5 ) nii7fael Receipt#:.
Property Map/TL#: �MA-
(1200S-VC)
Owner % ;Ii, d e suirc� a u P P 4"Ba a s
..{i i ,_
*aril 12,8(. _ 'W !ZO Zoning:
cky/sun Gp phone Allowable Total Atea:� •
Tr /�p/Z. q4=1.4- -43) 631-08 K
Tenant of "'t'c Electrical permit Required? ❑ Yes ,❑�No
Business f5 t tag t..ro/4' Palm l bl ed t CtvElectrical ta
Name Building Permit Required? ❑ Yes ,erNo
n r� Pr.'/l Rcc.3o/2]/2D13
Sign I (i(I k 61 b) \J i (4l R1CUO/Z/2Dtaslon\�^e Use Applications\$�T Peirnicdoc
Contractor Meiling Address Suite
City/Slate !.i[) Phone
REQUIRED SUBMITTAL ELEMENTS
Q, n Comet t:ont•Board lieente# l3ep.Dacc
❑ Completed Application Form
s�recwa ❑ 2 copies of elevations on 81/2"x 11"or 11"x 17"
Proposed 0 namenud ❑ Roof ❑ r pages(roust be drawn to scale for freestanding sign)
Sign ® 7'cn^Pn�Y ❑ Roof ❑ A-,1e�trrn,ic
(flee&all that ❑ Wall [] Other ❑ 2 copies of site/plot plan,drawn to scale,on
aPPIY) _ 81/2" x 11"or 11"x 17"pages (rcyuircd.for
NI New sign? ❑ Alter to existing sign? freestanding signs only)
Sign Dimensions: - 3 z 5 1 ❑ Application Pee ‘if(X)
Total Sign Area(sq.ft.): 15 41,l NOTES;
• • Applications will not be accepted without all required
Sign Data Total Wall Area(sq. ft) _ i submittal elements.
(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.
rettion) N S E W NEE NW SE SW
♦ Freestanding signs over 6 ft. in height and walls signs
Height to top of sign(feet): 2.t f-" of which any element weighs 20 Lbs. or more require a
Projection From Wall(ruches): .F��(1 permit from the Building Division for construction. If
Materials: \twill any element of a wall sign weighs 70 lbs. or mote,
J sign have illumination? ❑ Yes it plans must be prepared by a structural engineer.
Will
Type: ❑ Internal ❑ External • 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.
0Yes 1p No
If"yea", a list or diagram ol all sign dimensions and square (OVER FOR SIGNATURES)
footage must also be submitted._ .
-- _... .. ..,. . , . r 7 .rte
Sep. 17. 2014 2:40PM No, 7722 P. 3
09/17/2014 00:08 5035981960 CITY OF TIGARD PP.t.it 02/02
APPLICANTS: —To considet an application complete,you will need to submit ALL of the ILEOUIRMEM3 as described on the
front of this application in the"Required Submittal Elements"box.
NOTE: Person specified as"Applicant"shall be designated"Pet-mince"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 ownet(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 eac tl owner of the subject property ace requited.
Applicant Signature Date
ty
Signature of Owner/Agent Date
Owner/Agent's Name(Please Print)
Tide Phone Number
(i f o Tioard 1 13125 SW Hall Blvd, Tigard,OR 91223 ( 503-718-2421 I www.tigard-or.gov 1 Page 2 of 2
Sep. 17. 2014 2:40PM No. 7722 P. 4
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Sep. 17. 2014 2:41PM No. 7722 P. 5
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