SGN2001-00019 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT#: SGN2001-00019
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 6394171 DATE ISSUED: 1/24/2001
EXPIRATION DATE:
BUSINESS NAME: FAMILY DENTISTRY PARCEL: 1S126C0-00101
SIGN LOCATION: 09225 SW HALL BLVD E
APPLICANT/AGENT: ZONE:
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 18"X 21'
TOTAL SIGN AREA: 31 sq. ft.
WALL AREA: 528 sq.ft.
WALL FACE (DIRECTION): E
SIGN HEIGHT: 14 ft.
PROJECTION FROM WALL: 13 in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Installation of(1) 18" x 21' permanent wall sign.
MATERIALS: ALUM/STEEL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 50.00
This permit is issuedsubject to the regulations contained in the
Tigard Municipal Code State of OR. Specialty Codes
and all other applicablePP P 9 laws. All work will be done in accordance with approved plans. A sign permit shall expire 90
days from approval date. A tempora shall expire 30 days from approval date. A balloon sign shall expire 10
dws fmm annmval data
APPROVED BY:
PERMITTEE SIGNATURE:
DATE: 1/24/2001
A SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SIV Hall Blvd., Tigard, OR 97223(503) 639-4171 FAX: (503) 684-7297
GENERAL INFORMATION
Name of Development/Project
Site ��1 \ (\� fi�
Address/ Street Address FOR STAFF USE ONLY
Location 9o-)QS-
1o-)QS 5,W, WWW• Permit No.: x7 Z o g I `W.o Ct
Suite/Bldg.# City/State Zip
f\ 0!► 9,7;o Expiration Date:
Name d �C I Receipt#:
U f Y11en0.SC�e Approved By:
Property b
Owner Mailing Address 1 Suite Date: t
a I S Ind A clCf Map/TL#: t t ;� C U l C
City/State Zip Phone Zoning: ti
O V�)a 9')a0 S. 10 y
Tenant or Name
Business r qS�1!J� ,� Electrical Permit Required?,;, 1(es ❑' No
Name Building Permit Required? ❑ Y : _ �/No
Rev.12/1/2000 i:lcurpinlmasters\revisedlsi n pe -
rmit app.doc
Sign C S 1(\ co,
Contractor MaiW Add ess Suite
(Prior to permit V i /�z ,tr E FUI 11 n
issuance,a I Y.
copy of all City/State Phon
licenses are 03 ap�_7�a$ REQUIRED SUBMITTAL ELEMENTS
required if d �� 9�a 1 a (3f (Note: applications will n9A be accepted
expired in the Oregon Const.Cont.Board Exp.Date without the required submittal elements)
City of Tigard's License# '
database) r3S1%a 5-7-
DdCompleted Application Form
Proposed Permanent ❑ Freestanding ❑ Freeway
�, wall 1:1 Electronic [�2 Copies of Site/Plot Plan, Drawn to Scale
Sign F] Temporary
(Check all that (3 copies,if a building permit is required)
F]apply) Other ❑ Billboard F] Balloon size requirement: 81/2"x 11",or 11"x 17"
New sign? ❑ Alter to existing sign? Rr'�2 copies of elevations, drawn to scale
1 F (3 s,if a building permit is required)
Sign Dimensions: 1811
X requirement: 81/2"x 11",to 24"x 36"
Total Sign Area(sq. ft.): '31.5 �_ $50.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) 5a8 ❑ $15.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E W NE NW SE SW . Wall signs do not need to be drawn to scale,
Height to top of sign (feet): but must include dimensions of wall face and
Projection From Wall (inches): " sign placement.
Copy: ary P,-A '%3 iy Wall signs do not require site/plot plans.
Materials: A (A,M n K rA S e I Freestanding signs over 6 ft. required a
Will sign have illumination? Yes ❑ No building permit.
Type: K Internal ❑ External • If work authorized under a sign permit has not
Are there any existing freestanding or wall signs at this been completed within ninety (90) days after
location, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
❑. Yes F-] No BECOME NULL AND VOID.
If"yes",a list or diagram of all sign dimensions and (OVER FOR SIGNATURES)
square footage must also be submitted.
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.
DATED this day of . 20
Signature of Owner/Agent
Contact Person Name Phone No.
F k�
Example of Site Plan
3
Parking 3
U
Q
O
U
N
CC3
Driveway
v�
N
Retail
Building �
Parking
J*M
Freestanding
AL Tempora Sign
5' Concrete Walkway
35'
SW Commercial Avenue
Site Address: 13524 SW Business Lane AL
Tenant/Business Name: A Better Office Products Company
Sign Company: ABC Sign Company
680 NE Letter Street
Portland, OR 97200 Scale = 1" = 20'
503-555-4321
*Visual clearance area dimensions are drawn for this example only.
i:\dsts\forms\signexmpi.ptt 01/13/99 For correct dimensions,consult the Community Development Code.
Example of Sign Elevation
A Better Office
Products Copy duplicated
on reverse face
Company
4' .
;S
9'
3'
Temporary Freestanding A-Board Sign
12 square feet
f
Scale: F, = 1'
Site Address: 13524 SW Business Lane
Tenant/Business Name: A Better Office Products Company
Sign Company: ABC Sign Company
680 NE Letter Street
Portland, OR 97200
503-555-4321
iAdsts\fomu\signexmpl.ptt 01/13/99
Receipt #: 27200100000000000317
_..r. Date: 01/24/2001
T I D E M A R K
COMPUTED SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001-00019Sign Permit 100-0000-437000 $50.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Cash LEGACY SIGN CO $50.00
TOTAL AMOUNT PAID: $50.00
FAMILY
DENTISTRY
AV OF.
w77"
SIG
� 9
' N
HALL BLVD.