SGN2001-00075 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT#: SGN2001-00075
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 4/23/2001
EXPIRATION DATE:
BUSINESS NAME: PRINT SOURCE INC.
PARCEL: 2S102AC-00101
SIGN LOCATION: 09040 SW BURNHAM ST
APPLICANT/AGENT: PRINT SOURCE INC. ZONE: CBD
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 41"X 69"X 4"
TOTAL SIGN AREA: 20 sq.ft.
WALL AREA: sq.ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 5 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
of one 1 freestanding sign.
DESCRIPTION OF SIGN: Permanent placement ( ) g g
MATERIALS: PLYWOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 50.00
This permit is issued subjefterm
e ulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable lall work will be done in ac rdance with approved plans. A sign permit shall expire 90
days from approval date. poraryign shall expir da7s from approval date. A balloon sign shall expire 10
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APPROVED BY.
PERMITTEE SIGNATURE:
DATE: 4/23/2001
Aw-
;.- SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 S►V Hall Blvd- Tigard, OR 97223 (503) 639-4171 FAX.- (503) 684-7297
GENERAL INFORMATION
Name of Development/Project
Site �'K wSl
FOR STAFF USE ONLY
Address/ Street Address
Location �jp�{� S� (�Ult�l >r/1
Permit No.:
Suite/Bldg.# City/State Zip j
Expiration Date: 1?
Name Receipt#: a� .VIN
�
Property Approved By:
Owner Mailing Address suite Date: on-
peva-�JG-lf" Map/TL#: 5rQca . 06100
City/State Zip Phone ZOrting`.
Tenant or Name
Electrical Permit Required? .- ❑ Yes , ,Pv(No
Business P �c �,-1 S of LCA nJ ,�,�'
Name
Building Permit Required? '_ EJ yes L�" No
Rev.12/1/2000 -i:lcurpinlmasterslrevisefti n permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to permit
issuance,a
copy of iii; City/Sass Zip Phcne REQUIRED SUBMITTAL ELEMENTS
licenses are
required if (Note: applications will not be accepted
expired in the Oregon Const.Cont.Board Exp.Date without the required submittal elements)
City of Tigard's License#
database) 21/
Completed Application Form
Proposed Permanent Freestanding ❑ Freeway
Sign 2 Copies of Site/Plot Plan, Drawn to Scale
9 ❑ Temporary ❑ wall ❑ Electronic (3 copies,if a building permit is required)
(Check all that Other Billboard Balloon
apply) ❑ ❑ ❑ size requirement: 81/2"x 11",or 11"x 17"
New sign? ❑ Alter to existing sign? 2 copies of elevations, drawn to scale
Sign Dimensions: (3 copies,if a building permit is required)
4 X size requirement: 81/2"x 11",to 24"x 36"
Total Sign Area (sq. ft.): 20 [$50.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.J p E] $1 5.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in thisNOTES:
section) N S NE NW SE SW Wall signs do not need to be drawn to scale,
Height to top o sign (feet): (p but must include dimensions of wall face and
Projection From Wall (inches): sign placement.
Copy: SGL- f4-'ChprC • Wall signs do not require site/plot plans.
Materials: • Freestanding signs over 6 ft. required a
building permit.
Will sign have illumination? ❑ Yes A No 4 If work authorized under a sign permit has not
Type: ❑ Internal ❑ External been completed within ninety (90) days after
Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL
location, including wall signs that overlap a tenant space? BECOME NULL AND VOID.
❑. Yes X No
If"yes",a list or diagram of all sign dimensions and COVER 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 2'3 day of '�'� 20 b J
Signature of wner/Agen
J • � tk V �- -/ -�: 3 - 463 -cl 8 3,:S-
Contact
,:S-Contact Person Name Phone No.
Receipt #: 27200100000000001687
�. Date: 04/23/2001
TIDEMARK
COMPUTER SYSTEMS, INC,
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001-00075 [SIGN]gign Permit 100-0000-437000 $50.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check B&B PRINT SOURCE 0 21593 $50.00
TOTAL AMOUNT PAID: $50.00
REMIrrANCE ADVICE 96-8/1232
B & B PRINT SOURCE
URNHAM
TI S.W. OR 97223 21593
TIGARD,OR 97223
503-639-9835
PAY !t --,_,1 DOLLARS
D#TE I TO THE ORDER OF I I GROSSI I N I DISC. MOUNT
.I. A.
PRINT SOURCE,INC.
WEST COAST BANK
11675 SW PACIFIC HWY.,TIGARD,OR 97223
1150 2 L 5 9 311' is L 2 3 2000881: 2 5000 14 L 911'
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