SGN2019-00143 CITY OF TIGARD SIGN PERMIT
g Permit#: SGN2019-00143
• COMMUNITY DEVELOPMENT Date Issued: 12/30/2019
T I[,A tZ.D 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 1 S135DA02400
Jurisdiction: Tigard
Name of Business: Brookside Memory Care
Business Address: 11045 SW HALL BLVD
Applicant/Agent: Damian, Benny
Work Description: One (1)24-square-foot banner sign. Permit valid from 12/30/19 to 1/29/20.
Permanent: No Freestanding: No Freeway: No
Temporary: Wall: No Electronic: No
Billboard: No Balloon: No
Banner: Yes A-Board: No
Sign Dimensions:
Total Sign Area: 24
Wall Area:
Wall Face(Direction):
Sign Height: ft.
Projection From Wall: in.
Illumination: No Illumination
Materials:
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $72.00
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: -7i� iii
Ill014,
Permittee Signature: - \�
RECEIVED
City ofTigard DEC 3 0 2019
ilike COMMUNITY DEVELOPMENT DEPARTMENT
1, CITY`U TIG RD
TIGARD
Temporary Sign Permit Applicatio�ANNING/ENGINEERING
SITE INFORMATION / ` q Z
Address: 0y� 5� � \ " City/State: Zip: I
Tenant/business name: P v\ 7\x_cAQ-wk(... C61`•—� Zone:
APPLICANT INFORMATIONN
\
Name: .-\^\'. U e-" vv' ( .—,
Mailing address: ` lc) y S1/4-4 1City/State: l41.e'--e\ Zip: 9' - 723
Phone: C--63 9`.1 (-Aff")1- Email: be.\n\c‘•••(
V"l&k V\C-- (-T\4‘ 0 •C.�w,
Applicant's representative:
Phone: Email:
PROPERTY OWNER INFORMATION Cf-"Same as applicant
Name:
Mailing address: City/State: Zip:
Phone: Email:
SIGN INFORMATION
❑ Balloon Sign Er Banner Sign or ❑ Lawn Sign
Install date: (Valid for 10 days) Install date: I 7-II 3L)//ri (Valid for 30 days)
Sign dimensions: Sign dimensions: ? A
Sign area: Sign area: 2--"A SV•- --
I am the property owner or I am eligible to initiate this application, as provided in the Tigard Community
Development Code. To the best of my knowledge,all the information provided within this application package is
complete and accurate.
Applicant's signature* Print name Date
__CCOite cO R ozones r
Property owner's signature* Print name Date
*The property owner must sign this application or submit a separate written authorization when the owner and
applicant are different people.
STAFF USE ONLY
Case No: •95-XU•,2619—oo/L3 Application fee: '- Received by: L.--C II ate: a 36
Approved by: � Date: 16'- 27-t Expiration date: `2 °----0
City ofTigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of 1