SGN2014-00128 PPI
II
TIGARD
City of Tigard
December 4, 2014
Ramsay Signs
Attn: Darcy or Nancy
9160 SE 74th Ave.
Portland, OR 97206
Re: Permit No. SGN2014-00127 SGN2014-00128, GN2014-00129
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 10100 SW Washington Square Rd
Project Name: Red Robin
Job No.: N/A
Refund Method: ® Check#215787 in the amount of$460.80.
❑ Credit card"return" receipt in the amount of$ .
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account"deposit" receipt in the amount of$ .
Comment(s): Per applicant's request to withdraw application. Refund 80% of sign
permit application fees: (3) permits @ 153.60 = $460.80 total refund.
If you have any questions please contact me at 503.718.2430.
Sincerely,
;Koh i
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
311 City of Tigard
TIGARD Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the Request for Permit Action form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Ramsay Signs DATE: 11/20/2014
Attn: Darcy or Nancy
9160 SE 74th Ave. REQUESTED BY: Dianna Howse
Portland, OR 97206 AK
TRANSACTION INFORMATION:
Receipt#: 198272 Case#: SGN2014-00128
Date: 11/4/2014 Address/Parcel: 10100 SW Washington Sq Rd
Pay Method: Check Project Name: Red Robin
EXPLANATION: Sign exceeds the allowed 15%of area on front facade. Applicant withdrawing sign
permit application. Refund 80% of application Eees.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Sign permit 100-0000-43113 $133.60
Sign permit-LRP 100-0000-43117 .a3
TOTAL REFUND: S 153.60
APPROVALS: SIGNAT • S DATE:
.� ti
If under$5,000 Professional Staff /Jy"/ef
If under$12,500 Division Manager _
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM`ADMINISTRATION USE ONLY
Case Refund Processed: I Date: I 42/y/j y j By:
1:\Building\Refunds\RefundReyuest.doc x 09/01/2010
City O f Tigard • COMMUNITY DEVELOPMENT DEPARTMENT ! 0 1 1
= q
. " Request Permit Action A2/y//y 1 !: '
lr 1 G A R D 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division Services Supervisor
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2.430 Fax: 503.598.1960 www.tigard-or.gov
FROM: ❑ Owner Nr Applicant ❑ Contractor ❑ City Staff
ci,,ci:.,,
REFUND OR Name: (Mtn'.fliraj INVOICE TO: (Business or Individual) I911 S C On J� inc j Mailing Address: I I i O Ss 4t i � K i wt ''vJ) J
City/State/Zip: Pbf-(e,nej Qv.... oil 2_ap
Phone No.: SO b.-711 _ 4-SS
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
CANCEL/VOID PERMIT APPLICATION.
1 REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
❑ INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
❑ REMOVE/REPLACE CONTRACTOR ON PERMIT do not cancel permit).
Permit#: _.__••-.—a! S 6 I • 0012.+43 ' ;4' • — :- -
Site Address or Parcel #: 1 0 ' t 1 i I -
Project Name: R c I Roi91 v..
Subdivision Name: Lot#:
EXPLANATION: -are,re, 9 ZXCeel 11'11.- t'l1liwee4 159i> Wgir A ikv4.
lIC 1S 1N lAVIAWMVICI 2 L'in-(1 i\Mham SI IS On +-
'VAC . (Se 01-+W te4 'c-t•0
Signature: AINfV) 4 6' Date: 1 11 1
Print Name: /I"a V Qwa c— /t 7.ev — /3 3. 4,0 . 3. YO
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Refund Policy /S.7,( d .372 -4'
1. The Director or Building Official may authorize the refund of:
a) any fee which was erroneously paid or collected.
anot more than 80°o of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 800.of the land use application fee for issued permits.
d) not more than We.of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than son.of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2-4 weeks for processing refunds.
FOR OFFICE: I SE: ONLY
Rte to Sys Admin: Date By Rte to ..Admin: Date/e2/y /y By .i,,
Refund Processed: Date 4,2/y//V By." Invoice Processed: Date By
Permit Canceled: Date///y/j y By 4'4" Parcel Tag Added: , Date By
Receipt# Date Method Amount$
I:\Building\Forms\RegPermit:lction.doc Rev 115/25/2012
Agnes Kowacz
From: Darcy Newton <darcy @ramsaysigns.com>
Sent: Thursday, November 13, 2014 8:43 AM
To: Agnes Kowacz
Cc: Roxie Schwochert
Subject: FW: Red Robin Permits_77 Washington Sq
Agnes -
Per your discussion with Roxie from Priority Signs, please remove E06, Qty 3 Window Vinyls from the scope
of work for the Red Robin location at 10100 SQ Washington Sq Rd. Based on that information, please advise
what is needed to complete the permit process and when they will be available to pick up.
Thank you for your assistance!
Darcy Newton
Ramsay Signs & Heath Northwest
9160 SE 74th Avenue Portland, Oregon 97206
503 777 4555 Fax 503 777 0220
800 613 4555
darcy @ramsaysigns.com
www.ramsaysigns.com
cant ,�,14
. i, ,
ENj.t
Please consider the environment before printing this e-mail.
1
' Fou 6 RECEIVED
V0 1 OCT 13 2014
/�/y i�/ Vin ,
11111 • City of Tigard / CITY OF TIGARD
■ PLANNING/ENGINEERING
Sign Permit Application
TIGARD
GENERAL INFORMATION
Name of Development/Project
r ed ���n /FOR STAFF USE ONLY
Site CC/r���AA''��//ff ((��n�//t���� II�/�/a
Address/ Street Address Permit No.: S6 V2D114^oO t 2
Location lV X00 i J hineton
Suite/Bldg.# City/State Zip • Approved By:
Date: Sr /2
Name Receipt#: I q v A
Property Map/TL#: I S 125 460 102.
Owner Mailing Address Suite Zoning: MuG
Allowable Total Area:
City/State Zip Phone
Tenant or Name
Electrical Permit Required? ❑ Yes Al No
Business red robin Building Permit Required? ❑ Yes \A No
Name Rev.7/1/12
is\curpin\masters\land use applications\sign permit app.doc
Sign rary�t 1 )aq S 1(4flS
Contractor Mailing Address Suite
°MOSSE-1y+h
City/State Zip Phone REOUIRED SUBMITTAL ELEMENTS
(Note: applications will not be accepted
Oregon Const.Cont.Board License# Exp.Date — without the required submittal elements)
()NIL
❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway ❑ 2 copies of site/plot plan,drawn to scale
Sign ❑ Temporary ❑ Roof ❑ Electronic
(Check all that �y (3 copies,if a building permit is required)
apply)
la Wall nSeW V 1 Ay I size requirement 8'/z"x 11",or 11"x 17"
❑ 2 copies of elevations,drawn to scale
At New sign? ❑ Alter to existing sign? (3 copies,if a building permit is required)
t
Sign Dimensions:�•Op 1 x ah +x,o? size requirement 8'/z"x 11",to 24"x 36"
Total Sign Area(sq.ft.): T1�J.1 t A �o6/j ❑ $171.00 Fee (Permanent sign,any size)
Total Wall Area(sq.ft.) .0. ❑ $54.00 Fee (Temporary sign,any type)
Sign Data ,�[ �3
(Complete all Direction Wall Faces(circle one):
items in this NOTES:
section) N 0 E W NE NW SE SW
Height to top of sign(feet): \ • Wall signs do not need to be drawn to scale, but
Projection From Wall(inches): 0 must include dimensions of wall face and sign
��ny placement.
Materials: • Wall signs do not require site/plot plans.
Will sign have illumination? ❑ Yes yi, No • Freestanding signs over 6 ft. required a building
Type: ❑ Internal ❑ External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space?
❑ Yes ❑ No
If"yes",a list or diagram of all sign dimensions and square
(OVER FOR SIGNATURES)
footage must also be submitted.
City of Tigard I 13125 SW Hall Blvd.,Tigard, OR 97223 I 503-718-2421 I www.tigard-or.gov I Page 1 of 2
APPLICANTS:
To consider an application complete,you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as described on the
front of this application in the"Required Submittal Elements"box.
NOTE: Person specified as"Applicant"shall be designated"Permittee"and shall provide financial assurance for work.
* When the owner and the applicant are different people, the applicant must be the purchaser of record or a lessee in possession with
written authorization from the owner or an agent of the owner. The owner(s)must sign this application in the space provided on the back of
this form or submit a written authorization with this application
BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT:
• If the application is granted, the applicant will exercise the rights granted in accordance with the terms and
subject to all the conditions and limitations of the approval.
• All of the above statements and the statements in the plot plan, attachments, and exhibits transmitted
herewith, are true, and the applicants so acknowledge that any permit issued, based on this application, and
may be revoked if it is found that any such statements are false.
• The applicant has read the entire contents of the application, including the policies and criteria, and
understands the requirements for approving and denying the application.
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.
SIGNATURES of each owner of the subject property are required.
t, • f
6 - U)) - 4
- pplicant Signature Date
Signature of Owner/Agent Date
e SS L4 s mQ S Sod -111 MI5 S S
Contact Person Name Phone No.
City of Tigard I 13125 SW Hall Blvd., Tigard,OR 97223 I 503-718-2421 I www.tigard-or.gov I Page 2 of 2
E06 Window Vinyl - RR-WV - (Qty 3) after
Remove any existing vinyl.clean residue from glass. apply new vinyl as shown.
Note:Window mullions and V.O. of windows to be verified.
Application 3M Vinyl Color a7 ______V
#7725SE-314 ♦.
Dusted Crystal i � ' , r
VERIFY ; ,.v
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h 48.00" 39.38"
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VERIFY ; Graphic
1111/11 r...4111 ,
RECEIVED
y � � IP i OCT 132014
Actual surveyed I 4
window V.O.s i CITY OF TIGARD
Approximate logo placement guide
PLANNING/ENGINEERING
with spacing
Scale 1:24
Revisions: Revisions: File Location: Dote: 05.13.14 Location: 10100 SW Washington Square Rd Site ID: 77 C40492
X X ArtDept\Core)Colors
ed�0�,� x x x \Red Robin Designer: TMC City: Portland,OR Name: - E06 pr101 ItySlgn
x