SGN2004-00287 CITY OF TIGARD SIGN PERMIT
i t DEVELOPMENT SERVICES PERMIT #: SGN2004 -00287
°°�' ISSUED: 10/8/2004
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S102CB -03101
BUSINESS NAME: THE POTTER'S HOUSE ZONE: C -G
SIGN LOCATION: 12950 SW PACIFIC HWY 125 JURISDICTION: TIG
APPLICANT /AGENT: THE POTTER'S HOUSE
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2' X 3'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one temporary A -frame sign. (2' x 3') Must be out of right -of -way.
Sign #1. Valid from 10/9/04 through 11/9/04.
MATERIALS: METAL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes
and all other applicable laws. 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: 0, o JL'
PERMITTEE SIGNATURE: / 14
DATE: 10/8/2004
1
, . ..
��� SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
Site 1St ON/ SO StAl Pat e NwY FOR STAFF USE ONLY
X Address/ - Street Address
Permit No.: S61Ja0 0(4 -Uaa8 7
Location
Expiration Date: 1 1 f q/ o `r Suite /Bldg. # City /State Zip
-
1'25 11 9'1 - 4 OP' Ri 1422; Receipt #: aoo4 -
Name Approved By: C ea;-�
\, Property Mkt( lienvielZ On. Date: / 0 8 - -04
'C Owner Mailing Address Suite Map/TL #: 025 1 oa e-#3 - 0 3 i ° /
P -950 Qati 'Cic VwY .i5 Zoning: C -6
City /State Zip Phone
'( A/A d- '1223
Tenant or Name Ele Permit Required? ❑ Yes ] No
A Business '(�e Q�, A'e -{ '� " pt,�5 6, Building Permit Required? ❑Yes No
Name Rev. 7/1/04 is \curpin \masters \revised \sign permit app.doc
Sign
Contractor Mailing Address ite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City/State Zip Phone
licenses are
required if ❑ Completed Application Form
expired in th Oregon Const. Cont. Board Exp. Date
City of ' rd's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
ase)
(3 copies, if a building ( p� g permit is required)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17" n ( Sag e k all that T emporary ❑ Wall ID Electronic El copies of elevations, drawn to scale
apply) ❑ Other ❑ Billboard ❑ Balloon
(3 copies, if a building permit is required)
I . irn (0, 0- ❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11 ", to 24" x 36"
40 ( st A S Dimensions: 2^ 2->z 3 ❑ $32.00 Fee (Permanent sign, any size)
p( / XTotal Sign Area (sq. ft.): rimii lx3 ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: ❑ City 111 Urb
(Complete ail Direction WaII Faces (circle one): NOTES:
items in this -
section) N S E W NE NW SE SW
• Wall signs do not need to be drawn to scale,
Height to top of sign (feet): but must include dimensions of wall face and
Projection From Wall (inches): sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: $'41,,,i /yretIl r • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes ❑ No building permit.
Type: ❑ Internal ❑ External • If work authorized under a sign permit has not
Are there any existing freestanding or wall signs at this been completed within ninety (90) days after
location, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
❑ Yes ❑ No BECOME NULL AND VOID.
- --
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
,
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.
DATED this day of ` ' 4 ° 1,a)( , 20 09
I A rio,
1
Signature of O' ner /Agent
1) ' A t (3.334)3 71,
Contact Person Name Phone No.
B PD %4es
'sT, , p ,� avert
/a
y_ 104
v
1, i