SGN2018-00103 CITY OF TIGARD SIGN PERMIT
Permit#: SGN2018-00103
COMMUNITY DEVELOPMENT Date Issued: 10/31/2018
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 1S134BC00300
Jurisdiction: Tigard
Name of Business: Koba Grill
Business Address: 12286 SW SCHOLLS FERRY RD
Applicant/Agent: Younger, Jerry
Work Description: One(1)new 29-square-foot sign on north-facing wall. Sign is made of individual letters,
each less than 20 pounds. Sign will have internal illumination.
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions: 2.33'x 12'
Total Sign Area: 29
Wall Area: 384
Wall Face(Direction): North
Sign Height: ft.
Projection From Wall: 4 in.
Illumination: Internal
Materials: Acrylic and aluminum
Electrical Permit Required: Yes
Building Permit Required: No
Total Permit Fee: $218.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. All work will be done in accordance with approved plans. A permanent sign must be placed within
90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon
sign shall expire 10 days from validity date.
Approved By: 0110■ —ti
Permittee Signature: �`
: ..q
PPI City of TigardRECEIVED
COMMUNITY DEVELOPMENT DEPARTMENT
OCT 31 2018
TIGARD
Sign Permit CITY:OF;; ACJ
fo QL nnlnitnl(tF--Nr;ttyFFRI\I(
SIGN LOCATION REQUIRED SUBMITTAL
,
Address: / ZZ c. fel: chew .-#��Suite#: ELEMENTS
City/state: 75,a Lt/ �'� Zip: `T✓J ) ,3
2 copies of elevations on 8'/2"x 11"
Tenant or business: A.-1170kC= "�' , / r 11"x 17"pages(Wall sign
�/
`
� elevations must include dimensions
of sign and wall face and show the
Property owner name: peoec ilocation of sign on the wall.
Address: 3-i -�'ti l `it C1 "�
�� Freestandingsign elevations must
City/state: trot? OcCiiC v 0 Zip: 0 if be raven to scale.)
' , copies of site/plot plan,drawn
Phone: tc) ' �0 7- i)3 Email: to scale,on 81/2"x 11"or 11"x 17"
• pages(not required for wall signs)
Sign contractor: ie rAfit7 A/ C%A., j r/6,11.1
M.,List or diagram of all existing sign
Address: ?VC) ///7/;9`e 1/ ,V, dimensions and square footage
City/State: (/�eShi, OR Zip: r0/ Application Fee
Phone: 5-0?- _-_1CV Email: 771 efilk- 6 *--7,--,4,„/ cL 1-
NOTES:
CCB License #: 7)6.Qf Expiration date: Ape, ,)0 ,
• Freestanding signs over 6 ft.in height
Contact person: 3r'171 0 L-''-�)L- and walls signs of which any element
L,J
weighs 20 lbs.or more require a
building permit for construction.
SIGN DATA(Complete all items in this section) If any element of a wall sign weighs
70 lbs.or more,plans must be prepared
� TYPE (Check all that apply) by a structural engineer.
6l New sign
❑ Freestanding ❑ Electrical • Building permits require 2 sets of
❑ Alteration to ErVall construction drawings and,if sign is
❑ Freeway
existing sign freestanding,2 copies of site/plot plan
❑ Roof ❑ Other and 2 sets of engineering must be
Sign #: submitted with building permit
application.
'
Sign dimensions: '`' (h) x_(w) = 1 j. sq.ft. sign area
New sign: 27 sq.ft. + Existing sign area Vrsq.ft.=_Total FOR STAFF USE ONLY
Total sign area:__sq.ft. 81./ building face sq.ft. =04%of bldg face Case No.: ��1)'✓)''6l 00
/100
is
Height to top of sign: ft. Projection from wall: 4/ in. Related Case o.(s):
Materials: ky l:G [,i, Ad C\lu m► ; ov'` ' Fee: /6
Application accepted:
Is the sign under 20 lbs.? ❑ Yes ❑ NoBy: Date:
—a--VI-6—b g
(Building Permit required if over 20 lbs.)
Application determined complete:
Direction wall faces (circle one):10 S E W NE NW SE SW /0
Will the sign [l
have illumination? 'Yes [I] No
By: Date:
If yes,what type: [Internal ❑ External (:\Community Development\Land Use Applications\02 Forms and
Templates\Land Use Applications Rev 12/14/2017
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of 2
APPLICANTS
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.
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,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 or 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 required.
'3-errYCCA/1-1e/r-
ic/zili
Applicants signature Print name Date
/0/1/0
Owner's signature Print name Date
Oyrer's si ture Print name Date
SIGN PERMIT APPLICATION
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 2 of 2
12286 SW Scholls Ferry Rd . Tigard OR 97223
L,,,, : , _ ,„„,„ 4
A OCT 31. 2018 Graphic design for :
CITY OF TIGARD
P i NJNG/ENGINEERINGIII Graphic presentation only.
Please see your salesmen for
�� 1( 11 material sample
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28 -c__)i
Stacked Number:
Date of Design .
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Sales person :
<
1 2ft (5"RETURNS) -
General : Set of Individual Channel Letters WHITE IN COLOR
with LED Illuminated _ Bolt hole w/Silicon water tight seal
Disconnect switch will in side of B/D _
Black painted Aluminum Body
Wall
Thur wall wiring ready CI' TIGARD C
All channels built by 040 thickness matching paint aluminum 3/8 Stainless steel Bolt .--7-
(all letters 10Ib or less) Approved y fanning to Wall
.0 All Completed Sign,Design,And Graphics Work
All letters inspect by UL and section label Date: 0 g 120 VOLT LED Belong Pop Sign Until Payment Is Made In Full.
S C POWER SUPPLY
Initials: l This Design Belong Pop Sign.
//Ol/////JI/III//l All Right To Use Altering Or Reproduction Are
Prohibited Without Written Permission.
16.5ft.
G Client Approval :
3/8 Stainless steel Bolt includes colors,spelling,graphics.
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to Wall �� J-BOX AND PRIMARY
�,t �� r j ., ELECTRICAL. POWER TO
e '} SIGN BY OTHERS
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E. fir_r, . \ -`" This sign is intended to be installed in accordance with
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�. ���' - the requirements of Article 600 of the national Electrical
Code and/or other applicable Local Codes.
lr/IFMIIIr i ..... 11--- ' This includes proper grounding and bonding of the Sign.
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