SGN2001-00114 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT#: SGN2001-00114
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/6/2001
EXPIRATION DATE:
BUSINESS NAME: HOLLYWOOD VIDEO PARCEL: 2S103DD-0040
SIGN LOCATION: 13727 SW PACIFIC HWY
APPLICANT/AGENT: HOLLYWOOD VIDEO ZONE: C-G
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: TX 4'
TOTAL SIGN AREA: 12 sq.ft.
WALL AREA: sq.ft.
WALL FACE (DIRECTION): SE
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of(1)temporary A-Board sign. Not to be placed in visual clearance
area or public right-of-way. Valid 7/6/01-8/9/01. Sign permit#2
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
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This permit is issued subject to the re ulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All rk 'll be done in accordance with approved plans. A sign permit shall expire 90
days from approval date. A to orary ign shall expire 3 da s from approval date. A balloon sign shall expire 10
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APPROVED BY:
PERMITTEE SIGNATURE:
DA : 7/ 1
SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 6339-4171 FAX.- (503) 684-7297
GENERAL INFORMATION "rLrl*� lx
Name of Development/Project
0a
Site (J \\ t c)
Address/ Stre tAddress I
FOR STAFF USE ONLY
Location Permit No.: 5GW 6 1 " 0-0
Suite/Bldg.# City/State Zip
/'I c 97`7 Expiration Date: 01
Name _ / Receipt#: _ a
Property 5 rKTr tl .� C, Approved Rly
Owner Mailing Address Suite Date:
00 � `J � (910� Map/TL#: of 31�
City/State Zip Phone Zoning:
;g/d
Tenantor IName
Business �} ! v Electrical Permit Required? E] Yes No
Name Building Permit Required? ❑ Yes No
Sign Rev.12/1/2000 i:\curpin\masters\revised\sign permit app.doc
Contractor Mailing Address Suite
(Prior to permit
issuance,a
copy of all City/State. Zip Phone
licenses are REQUIRED SUBMITTAL ELEMENTS
required if (Note: applications will not be accepted
expired in the Oregon Const.Cont.Board Exp.Date
City of Tigard's License# without the required submittal elements)
database
Proposed Permanent Freestanding ❑ Freeway ,Completed Application Form
Sign Temporary
El E] Electronic L. ./2 Copies of Site/Plot Plan, Drawn to Scale
(Check all thatOther ❑ Billboard ❑ Balloon (3 copies,if a building permit is required)
a size requirement: 8'h"x 11",or 11"x 17"
[:1New sign? El Alter to existing sign? W2 copies of elevations,drawn to scale
Sign Dimensions: / / (3 copies,if a building permit is required)
size requirement: 81/2"x 11",to 24"x 36"
Total Sign Area (sq.ft.):
o' V$115.00
50.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq.ft.) Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this
section) N S E W NE NW SE SW NOTES:
Height to top of sign (feet): • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
Projection From Wall (inches): sign placement.
Copy: ♦ Wall signs do not require site/plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes JR No building permit.
Type: El 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
El Yes El No BECOME NULL AND VOID.
If"yes",a list or diagram of all sign dimensions and DOVER FOR SIGNATURES)
square footage must also be submitted.
f
v
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 _
ignat a of r Agent
Contact Person Name Phone No.
Example of Site Plan
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Retail
Building
Parking
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3
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Freestanding h
jjlfti Tentpogg Sign
5'Concrete Walkway
35'
SW Commercial Avenue
IF
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 Scale = 1" = 20'
503-555-4321
*Visual clearance area dimensions are drawn for this example only.
i_dstsvmms\signexmpl.ptt 01/13/99 For correct dimensions,consult the Community Development Code.
i
Receipt #: 27200100000000002815
Date: 07/06/2001
T I D E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001-00114Temp Sign Perm 100-0000-437000 $15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Cash HOLLYWOOD VIDEO 0 0 0 $15.00
TOTAL AMOUNT PAID: $15.00
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