SGN2019-00017 CITY OF TIGARD SIGN PERMIT
It Permit#: SGN2019-00017
COMMUNITY DEVELOPMENT
Date Issued: 03/07/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 1S135DA02400
Jurisdiction: Tigard
Name of Business: Brookside Memory Care
Business Address: 11045 SW HALL BLVD
Applicant/Agent: Damian, Benny
Work Description: One(1) new 37.5-square-foot wall sign on east-facing wall. Sign weighs less than 20
pounds and 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: 2.5'x 15'
Total Sign Area: 37.5
Wall Area: 1068
Wall Face(Direction): East
Sign Height: 14 ft.
Projection From Wall: 2 in.
Illumination: Internal
Materials: 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:
21.10,40.
Permittee Signature: COW
RECEIVED
City of Tigard
111
1111 - COMMUNITY DEVELOPMENT DEPARTMENT MAR 0 7 2019
SignCITY OF TIGARD
Permit PLANNING/ENGINEERING
tto
SIGN LOCATION i REQUIRED SUBMITTAL
Address: I k 0' S1/4-' \--\---b\\\6!VQ Suite#: ELEMENTS
City/Ci state: `
state: �l ,ice-- c3•, l "1 22-� �copies of elevations on 8'/2"x 11"
Tenant or business: 0 or 11"x 17"pages(Wall sign
elevations must include dimensions
of sign and wall face and show the
V1� 0 \v
Property owner name: , &1/4.---__. of
of si
C �` gn on the wall.
Address: 1�/ SE. Y� h \ Cv • Freestanding sign elevations must
City/state: OA a `k---. 01 t\V C Zip: -27 - be drawn to scale.)
�.5 `V 0 .LZ0
Phone.( � ��(� T Email: 4?a-1nv� � �Y•.,to�ti c�., er,cs,. �c opies of site/plot plan,drawn
to scale,on8'/2"x11"or 11"x17"
ges(not required for wall signs)
Sign contractor: v 5\ (....� (--- -`‘C.• \�
t List or diagram of all existing sign
Address: \}r Lv 7 c7`---.1 1- p\--.._2._ ensions and square footage
City/state: ` `\ -- )' Zip: 1 �� Application Fee
PhonkC'3)6 - !_pu Email: hvv-1 ‘. --7-) v"-` e-1/4e-5 t t•co.(-°`"'•
NOTES:
CCB License#: (0 ‘13k Expiration date:
Contact erson: V'V\(A.3 ----___�` • Freestanding signs over 6 ft.in height
pand walls signs of which any element
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)
[9' New sign by a structural engineer.
❑ Freestanding 0 Electrical • Building permits require 2 sets of
0 Alteration to 0 Wall construction drawings and,if sign is
0 Freeway
existing sign freestanding,2 copies of site/plot plan
❑ Roof El Other and 2 sets of engineering must be
Sign#: submitted with building permit
application.
Sign dimensions: t('! (h) x_(w) = I d' b`� sq.ft. sign area
New sign:,3 t.5 sq.ft.+ Existing sign area sq.ft.=_Total lout tt t:�t t t l. c t.)
Total sign area:375 sq.ft.//O‘oA building face sq.ft. =g-5—°/0-of bldg face Case No.: ''`j A✓ 2119—odn 19""
Height to top p of sign: i 14 ft.Projection from wall: ')-1( in. Related Case No.(s)•
Materials: At/1M/MJM Fee: ie,24 6
Application accepted:
Is the sign under 20 lbs.? 0 Yes A, No By: kDate: -ii
(Building required over 20 lbs.)
g Permit i f
Application determined complet :
Direction wall faces (circle one): N S (10 NE NW SE SW
Will the signhave illumination? Yes I=1 No By: Date:
If yes,what type: Internal 0 External I:\Community Development\Land Use Applications\02 Forms and
Templates\Land Use Applications Rev 12/14/2017
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City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-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.
Applicant's signature Print name Date
Owner's signature Print name Date
Owner's signature Print name Date
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SIGN PERMIT APPLICATION
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 2 of 2
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CITY OF TIGARD
Approved lay?Tanning
Initials: