SGN2001-00143 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT#: SGN2001-00143
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 8/17/2001
EXPIRATION DATE:
BUSINESS NAME: CARROW'S PARCEL: 1S136AD-0650
SIGN LOCATION: 10900 SW 69TH AVE
APPLICANT/AGENT: CARROWS ZONE: C-G
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 30"X 30"
TOTAL SIGN AREA: 6 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 18 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Permanent placement of(1) illuminated lottery sign to be attached to existing
freestanding sign. Meets 8'clearance requirement and does not exceed the
square footage requirements for C-G zone.
MATERIALS: PLXGLAS
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 will be done in accordance with approved plans. A sign permit shall expire 90
days from approval date. A temporary si shall expire 30 days from approval date. A balloon sign shall expire 10
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APPROVED BY.
PERMITTEE SIGNATURE.
DATE: 8/17/2001
Receipt #: 27200100000000003408
�Ak� Date: 08/17/2001
T I D E M R K
COMPUTER SYSTEMS, INC,
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001-00143Sign Permit 100-0000-437000 $50.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check DS CARRICK ELECTRIC 0 1644 $50.00
TOTAL AMOUNT PAID: $50.00
DS CARRICK ELECTRIC BANK OF THE WEST
1644
15832 NW CLEARY COURT
BEAVERTON, OR 97006 90-78/1211
(503)645.3761 8/17/2001
a
TO THE d
ORDER OF city of Tigard $ *'50.00
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Fifty and 00/100*************s*********************************s**s******************************************** '•
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city of Tigard
8
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MEMO AUTHORIZED SIGNATURE AOP
• CarroVs restuarant lottery sign
11'0016►, 411' 1: 121, 1007`8211: iSS00292611'
02100/2001 12:19 F.kl 50568.47297 City of Tisard Q002
o w ~ ' SIGN PERMIT APPLICATION
4 O OITY Of TIOARD 1312S SYl`Ile!!131�d.. T/grsyl.OR 17]? {50.7)j.39-41 7l FAX {J07!(8 1.7317
LbNERAL INFORMATION
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Q Site S7FOR STAFF USE ONLY
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Sheet Addeo Address! Ct /�tsU�
Location 1® DC) S W , t Perm it No.* I —
9uite/840ty! tete zip 1
' 7,L� Expiration Dtate:
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Name Receipt#
Property �(V✓p I,c) Approved By:
P Y
Owner Malfing Aldrets (site Date:
10 9 00 S-j 614-i4o, MaprrL#:
j715y/state zip Phone Zonino,
Tenant orNama I Electrical Permit Required? Y s o
Business V✓
Building.Permlt Required?
Name _J
/� " I Rsv.121/2000
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copy of al Gtyfsato Zip Pnone gEQUIRED SUBMITTAL ELEMENTS
j`conoot are ' �`f S-t'c' l (Note: application$will pp=be accepted
required if 1r"
exptwd In ft Oregon al ont Doard V.Dow without the required submittal elements)
1 City of Nerd's License* a
drubea°) _4 ❑ Completed Application Form
Proposed Parmanent FrseslandingFreeway (� 2 Copies of Site/Not Plan,Drawn.to Scale
1 Sign a Temporary Wag Lj Elec4 4 (g oopba•if a bulleing permit is required)
(Check al!the( S Other ❑ ailward ❑ Balloon siza requirement: M'x 11",or 11"x".
apply)
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations,drawn to scale
S n Dimensions.,. (3 cop*@.If a building permit is required)
19 p a¢e reputrrment: 8W x 11',to 24"x 36`
Total Sign Area(sq.R.): 5� $50.00 Fee (Permanent sign,any size)
� r •
Total Wall Area(sq.ft_) ❑ S15.00 Fee (Temporary sign,any type)
Sign Data
(Ccmplete all Direction Wall Faces(circle one):
Gtmi in this NOTES:
section) N S E W NE NW SE SW , Wall signs do not need to be drawn to scale,
Hei ht to top of sign fast): ' but must Include_-dimensions of wall face and
Projection From Wag(inches): sign placement.
G : + Wall signs do not require site/plot pians.
Freestanding signs over 6 ft. required a
Materials:
Will sign have ilium nation? Yes ❑ No building permit..
T
Will
s internal Eztemal • If work authorized under a sign permit has not
been Completed within ninety 190) days after
Are there any existing freasthiniding or well signs at this the issuance of the permit, THE PERMIT WILL
i location.including well signs that overlap a tenant space? BECOME NULL AND VOID.
OS No
If"yes",a list or gram of all sign dimensions and !OVER FOR SIGNATURES)
ta
square footage must also be submitted.
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Merchandise Presite ` t
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P.O. Box 12649 Z
Salem OR 97309-0649 2Z��
Retailer Name: Retailer ID:
Address: �—�
city: �! Y State: Zip:
Countr�114227t>�J Contact: Phone:a:?)
Preferred Hours of Installation: Mon - Thurs: Fri: "�'416 Sat:8-'CO dSun: CSD
X NEW INSTALLATION Sign Type: WInterior ❑ Exterior Wall Mount ole 72�-'P ❑ End Projection Mount
❑ RELOCATION Dispenser Model: ❑ 412 ❑ 412 FW [:1416 'I'VO 416 Ultimate '22-3
❑ UPGRADE ❑ Overhead Dispenser ❑ Other(please specify)
LOTTERY SIGN (Complete this section for all exterior sign installations.)
❑ Photo(s)Attached(Draw a square on the photo identifying sign placement.)
Note: For the permit process, it is important the photo(s)capture all exterior signs at that location.This may require two photos,
orae of the store front and ore of the pole. Be sure photo is taken straight in from of object, not at an angle.
Dimensions of store front x (measure across building front and from ground to point where the roof meets the wall.)
Is there wiring or an outlet within six feet of where the Lottery sign will be mounted? ❑ Yes ❑ No
Narrative: (Provide additional information or details such as nearest cross street,special instructions,electrical issues,etc.)
Is there is a pole sign? ❑Yes ❑No
If yes,pick one sign on the pole and provide a rough estimate of its dimensions.
What sign are you providing dimensions for? Dimensions of sign chosen x
(Complete this section for all interior sign installations.)
;( Photo Attached(Draw a square on the photo identifying sign placement.)
Is there wiring or an outlet within six feet of where the Lottery sign will be mounted? X Yes ❑ No
Narrative: (Provide additional information or details such as nearest cross street,special instructions,electrical issues,etc.)
S.
IN-COUNTER DISPENSER
Photos Attached(Provide view of front and back of counter•draw a square on one of the photos identifying dispenser placement.)
Is there an electrical outlet within six feet? X Yes ❑ No
Is there electrical wiring or an electrical outlet that may impact dispenser installation? ❑Yes X No
Does the installation require cutting into storage space? Yes ❑ No
Narrative: (Provide additional information or details such as nearest cross street, special instructions,electrical issues,etc.)
OVERHEAD DISPENSER
❑ Photo Attached(Draw a square on the photo identifying dispenser placement.)
Quantity of Scratch its to be displayed (i.e., 10 games, 16 games, etc.):
Configuration of dispenser games wide x games high
Ceiling Type: ❑Hard ceiling ❑ False ceiling/Drop ceiling
Distance from ground to ceiling? feet
Is there electrical wiring or an electrical outlet that may impact dispenser installation? ❑Yes ❑ No
Narrative: (Provide additional information or details such as nearest cross street,special instructions,electrical issues,etc.)
Retailer Signa re Date /' — oz__
FR Signatu Route# ��_( Date,?02 O/
Oregon Lottery Sign Attachment Methods
Sign dimensions
301/2"X 301/2"X 6"
Weight
48 Lbs w/o face or back plates
51 Lbs w/(2)face plates
52 Lbs w/(1)face plate (1) back plate
Sign construction
1/8"extruded aluminum, welded comers
with (2)two captive face plate channels.Aluminum
back plate(when required)30"X 30"X 1/8"
is inserted in place of one face plate
all mount
In rt aluminum back plate into the approp . to channel.
Drill )four 5/16"holes in the comers o back plate
Alter a attachment method:Attach ) Simpson Strong-tie A-21 or equal, angle
bracke o the four comers of the n with(4) 5/16"X1"self tapping screws.
Locate gn box at the desir wall location and attach with the appropriate
screws list below.
Surface type
Wood (4) 0X2" Pan head screws W/1/4"X1"fender washers
Concrete or (4) #10 1/2" Pan head screws W/ 1/4"X1" fender washers
Concrete bl
Stucco (4) 3"X1/4"t e bolts W/1/4"X1"fender washers
Mesh b ck
She t steel (4) 3"X114"toggle w/ 1/4"X1"fender washers
Oregon Lottery Sign
301 X 30 1/2"X 6"Sign box
O O
Drill(4)5/16"mounting holes
in back Plate
Alternate support bracket
(4)ea.Required per sign
Attach to sign w/5/16"
self tapping screws
rill(2)5/16-holes
Pole Sign Attachment Information:
The signs we are mounting are onto existing poles with existing signs using
the appropriate of the following methods.
Pole signs will be attached by 3/8" x 1 %2" bolts with fender washers tapped
into hole in pole and also bolted to other existing sign.
Alternatively the will be mounted using 5/16" self tapping screws into the
pole and again bolting to the other existing sign