SGN2005-00219 v
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
FOR STAFF USE ONLY
Site �
Address/ Street Address Permit No.: SC CV 2=` L -1- e "247
Location f 'j 2 cw r5tJ t3Q,N.c,JJ GZ Expiration Date:
Suite /Bldg. # City /State Zip
1"r T . J r ? 222 Receipt #:
Name / / Approved By:
Property / Jv 1: 1Z,ca.(k, , G4 t 4. Date:
Owner Mailing Address Suite/ Map /TL #:
L ( 6 k..,) ft? uv&-cs '. Zoning:
Cy /State Zip Phone
li i /s. s F , e Y I 2 X7 - 7(c. v
X Tenant or Name Electrical Permit Required? n Yes ❑ No
Business ( ) l / i(,c.�, r ,c — c Q 5, Building Permit Required? 11) Yes El No
Name Rev. 7/1/05 is \curpin \masters \revised \si permit a pp .doc
Sign
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a t
l
itt
b
d i
w ithout the required submittal elements)
copy of all City /State Zip Phone q )
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # n 2 Copies of Site /Plot Plan, Drawn to Scale
database)
(3 copies, if a building permit is required)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign , Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard ❑ Balloon n 2 copies of elevations, drawn to scale
apply)
(3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? s e requirement: 8 x 11", to 24" x 36"
— Sign Dimensions: ( C
3 ?c , vi $38.00 Fee (Permanent sign, any size)
X: Total Sign Area (sq. ft.): Z r
y ❑ $18.00 Fee (Temporary sign, any type)
Total Wall Area (sq. ft.) Jurisdiction: n City 1 1 Urb
Sign Data 7�i ,- 5 - t , _ l'y
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E W NE NW SE SW
Height to top of sign (feet): • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes ❑ building permit.
No • If work authorized under a sign permit has not
Type: ❑ Internal ❑ External been completed within ninety (90) days after
Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL
location, including wall signs that overlap a tenant space? BECOME NULL AND VOID.
❑ Yes ❑ No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
ti
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 1 day of 3 /7 , 206 s'
Signature of Owner /Agent
Contact Perso Phone No.
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