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SGN2001-00072 CITY OF TIGARD SIGN PERMIT DEVELOPMENT SERVICES PERMIT#: SGN2001-00072 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 04/17/2001 EXPIRATION DATE: BUSINESS NAME: GENTLE DENTAL PARCEL: 1 S134AA-01901 SIGN LOCATION: 10115 SW NIMBUS AVE 350 APPLICANT/AGENT: GENTLE DENTAL ZONE: C-G BUSINESS TAX NO: JURISDICTION: TIG SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: Y ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 3'X 22'2" TOTAL SIGN AREA: 66 sq.ft. WALL AREA: sq.ft. WALL FACE (DIRECTION): NE SIGN HEIGHT: ft. PROJECTION FROM WALL: 9 in. ILLUMINATION: INT DESCRIPTION OF SIGN: Installation of(1) illuminated wall sign. MATERIALS: STUPLEXI EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: Y BUILDING PERMIT REQUIRED: N ADMINISTRATIVE EXCEPTIONS: TOTAL PERMIT FEES: $ 50.00 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work I be done in acc nce with approved plans. A sign permit shall expire 90 days from approval date. A tempo sin shall expire 0 d ys from approval date. A balloon sign shall expire 10 rtavc from gnnmval rintP APPROVED BY: G(X/NG 1 PERMITTEE SIGNATURE: �\ DATE: 04/17/2001 04/06/01 FRI 09:47 FAX 503 598 1960 CITY OF TIGARD Q002 1GN PERMIT APPLICATION a CITY Of TIO D^UN1�DtrVE��e 13125 SW Hat!Blvd., Tigard, OR 97223(503) 639-4171 FAX(503)684-7297 GENERAL INFORMATION Name of Development/Project Site to E NTL F— D l—W 1-'A L- Address/ street Address Location 16115 SCJ NIM v A�1=. Suite/Bidg.# Gky/State Zip 1,n 4 ARD DP- Name Property Or-fv n E 17 av r,4 L Owner Mailing Address Suitt city/state zip Phoie l c, w'/DR Tenant or Name Business C7�NT1,.� 'DT3htT'p�1.- Name Sign Gi A9.R-'E7-T- 51(4P4 -C ompplt�t Contractor Mailing Address Suitt (Pft to permit g I issuance,a copy ofan city/State Zjpj9fi&0 Phote REQUIREQ SUBMITTAL ELEMENTS seem"aro squired it ANQ> - UA 540 1093 got (Note: applications will if U be accepted expired in ttte oregm Const Cont.Board Exp Date without the required submittal elements) Qty of Tigard's License# tO�p gZfo S.,Z,2..• O database O Completed Application Form Proposed Pf Permanent ❑ Freestanding Q Freeway ®' 2 Copies Of Site/Plot Plan, Drawn to Scale sign. ❑ Ternporaty [Z wan eiecaonle (geek all that � (3 poples,If a building pemtit is required) am [} Other ❑ Billboard E] Saloon size re0rement 8rh`x 11%or 11-x 17" New sign? 0 Auer to ex sting sign? � 2 copies of elevations,drawn to scale Sign Dimensions: 1 / M (3 coples,M a building pwrrdt is regrdred) 3 22-2 , size requirerrrent OW x 1 V.to 24"x 3s" Total Sign Area(sq.ft.): 66.�9 1�1 W.00 Fee (Permanent sign,any size) Sign Data Total Wall Area(sq.ft.) f4UY�S $15.00 Fee (Temporary sign, any type) (complete all Direction Wail Faces (circle ono): • wi' kemt in this NOTES: section) N S E W NE NW SE SW • Wali sgns do not used to be drawn to scale. He' ht to top of sign(feet): but must Include dimensions of wail face and Projection From Wall(inches L. sign placement. COp : QENT1.E PEE T l- • Wall signs do not require sitelplot pians. Materials:$TTe6.L- PL.SIC(CILASS • Freestanding signs over 6 ft, required a Will sign have illumination? ZT Yes ❑ No building permit. T Internal D Extemal • 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 X No BECOME NULL AND VOID. If"yes",a list or diagram of all sign dimens ions and (OVER FOR SIGNATURES) square footage must also be submitted. 04/06/01 FRI 09:49 FAX 503 598 1960 CITY OF TIGARD Qq-0-3 1 hereby acknowledge that I haire read this application, that the information given is correct, that i am the owner or authorized agent of the owner, and that pians submitted are In compliance with the City of Tigelyd. a DATED this day of T �R 2001 Signature of Owner/Agent (oQ�222E-T S' -iA) Gy.MPA�J ; 3�D 6,?s Contact Person Name Phone No. ' METHOD OF ATTACHMENT FOR BUILDING SIGNS FASCIA ( PLEX FACE MODULE ) 1-1/2 X 1-1/2 X 3/16" oe ANGLE IRON PROFILE -- 4'O.C. 0 1/2"X 3" LAG &SHI ELD 0 CHID • G O M F7-7 A 1114Y 811 HARNEY STREET VANCOUVER WASHINGTON 98660 (360)693-9081 FAX(360)693-5948 I Receipt #: 27200100000000001606 -4A� Date: 04/17/2001 ' TIDEMARK COMPUTER SYSTEMS, INC. Line Items: Case No Tran Code Description Revenue Account No. Amount Due SGN2001-00072Sign Permit 100-0000-437000 $50.00 Payments: Method Payer Bank No Acct Check No Confirm No. Amount Paid Check GARRETT SIGN CO.,INC. 0 007350 0 $50.00 TOTAL AMOUNT PAID: $50.00 007350 Garrett Sign Co., Inc. FIRST INDEPENDENT BANK 811 HARNEY ST.VANCOUVER,WA 98660 DOWNTOWN OFFICE (360)693-9081 VANCOUVER,WA 98668 98-537/1233 S DATE CHECK NO. CHECK AMOUNT 04/12/01 007350 *******107 . 67* PAY *ONE HUNDRED SEVEN DOLLARS AND 67 CENTS TO CITY OF TIGARD THE PERMIT ORDER OF be4QL d 11100735011' 1: 1 233053781: 01 00315011'