SGN2001-00127 r
CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT#: SGN2001-00127
jam 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 7/30/2001
EXPIRATION DATE:
BUSINESS NAME: MADDY'S DELI PARCEL: 2S102AA-00491
SIGN LOCATION: 12085 SW HALL BLVD 130
APPLICANT/AGENT: MADDY'S DELI ZONE: CBD
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):
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary placement of(1)A-frame sign. Not to be placed in visual clearance
area or public right-of-way. Sign permit#2-Valid 8/1/01 to 9/1/01.
MATERIALS:
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
This permit is issued subject to th egulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. wok will be done in cordance with approved plans. A sign permit shall expire 90
days from approval date. A t mplprar sign shall exp; a 30 d ys from approval date. A balloon sign shall expire 10
dRvs fmm nnnmval data
APPROVED B {(�
PERMITTEE SIGNATURE:
DATE: 7/30/2001
1 "
SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 FAX.- (503) 684-7297
GENERAL INFORMATION
Name of Development/Project
Site FOR STAFF USE ONLY
Address/ Street Address
Location
2-01 Permit No.:
Suite/Bldg.# City/State Zip
. 164/0 1 � � � Expiration Date: � L �l
Name Receipt#:
Property zi ,'o/ Approved!
Owner Wiling Address Suite Date: MIM
y� �% 9 Map/TL#: 8` ��a — 04QDO
'/State Zip Phone Zoning: C/
poi i �1D
Tenantor Name
Business l 7 S Electrical Permit Required? El Yes o
Name 9 q
Building Permit Required? El Yes No
Rev.12/1/2000 i:\curpinVnasters\revised\sign permita .doc
Sign
Contractor Mailing Address uite
(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 Oreg onst.Cont.Board Exp.Date
City of Tigard's t_i se# without the required submittal elements)
database
-`�7.41"r [� Completed Application Form
Proposed LJ Permanent 2rFreestanding ❑ Freeway
Sign ,Temporary ❑ Wall ❑ Electronic
22 Copies of Site/Plot Plan, Drawn to Scale
(Check all that ❑ Other ❑ Billboard ❑ Balloon (3 copies,if a building permit is required)
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)
�/ /i] size requirement: 8'/2"x 11",to 24"x 36"
Total Sian Area (sq.ft.):
V$-5105.00
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 No building permit.
T e: ❑ 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
the issuance of the permit, THE PERMIT WILL-
location,
ILL
location, including wall signs that overlap a tenant space?
BECOME NULL AND VOID.
❑ Yes ❑ No
If"yes",a list or diagram of all sign dimensions and DOVER FOR SIGNATURES)
square footage must also be submitted.
i
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.
Tfl /
DATED this day of �� 20
i
Sig atu Owner/Agent
Contact Person Name Phone No.
I ,
OD s
I
a
"I \
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Receipt #: 27200100000000003109
AA�0 _.�. Date: 07/30/2001
TCa1M 0T E sMTEA,R� K
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001-00127Temp Sign Perm 100-0000-437000 $15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check C-ZACK VENTURES,LTD. 0 4037 0 $15.00
TOTAL AMOUNT PAID: $15.00
CO-ZACK VENTURES, LTD. tt
4 ynS 7
MADDY'S & SPAGHETTI ALREADI WELLS FARQQ BANK NORTHWEST,N.A
PMB#418 PORTLAND,OR 97201
3 MONROE PARKWAY,SUITE P 24.680-1230
LAKE OSWEGO,OR 97035 7/30/2001
503.244.2142
PAY TO THE CITY OF TIGARD **
ORDER OF 15.00
Fifteen and DOLLARS
CITY OF TIGARD
N
MEMO Ar
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