SGN2005-00336 CITY OF TIGARD
SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2005 -00336
.f� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/2/2005
PARCEL: 2 S 103 D D -0060 0
BUSINESS NAME: TRI SQUARE DANCE CLUB ZONE: C -G
SIGN LOCATION: 13770 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 6'
TOTAL SIGN AREA: 18 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 banner sign. 3' x 6' Valid from 12/27/05 through
01/26/06.
MATERIALS: VINYL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 18.00
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:
PERMITTEE SIGNATURE: /-0 ``
DATE: 11/2/2005
r
A lf1, S IGN PERMITAPPLICATIO �!,1.' �I ll 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 FOR STAFF USE ONLY
Address/ Street Add y� ss � �
Location / 3 �4 Permit No.: 4 N 5 '3 3 3
`� ` Expiration Date: I 7- 1 2 -- /.(:3 f/ 2- /ok
Suite /Bldg. # City /State Zip
4( `� 7 Z 2 J Receipt #:
Name
Approved By:
Property Date: /I/
Owner Mailing Address Suite
Map/TL #:
Zoning: ( 4
City/State Zip Phone
Tenant or Name Electrical Permit Required? ❑ Yes 11.-14
Business 'TA-Li S .a�L bCJ-r- (�Q , `+'� Building Permit Required? ❑ Yes 0
Name `- �" Rev. 7/1/05 is \curpin\masters \revised\sign permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to permit REQUIRED SUBMITTAL ELEMENTS
issuance, a (Note: applications will not be accepted
copy of all City/State Zip Phone without the required submittal elements) •
licenses are
required if
expired in the Oregon Const. Cont. Board Exp. Date ❑ Completed Application Form
City of Tigard's License #
database) ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Proposed ❑ Permanent (3 copies, if a building permit is required)
❑ Freestanding ❑ Freeway
Sign 0—' p y ❑ w all size requirement: 81/2" x 11", or 11" x 17"
(Check all that em orar ❑ Electronic
apply) ❑ Other El Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale
(3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign?
Sign Dimensions:
size requirement: 8 x 11 ", to 24" x 36"
3 -743 ❑ $38.00 Fee .(Permanent sign, any size)
Total Sign Area (sq. ft.): •
1 ❑ $18.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.)
Jurisdiction: ❑ City ❑ Urb
(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
Copy: sign placement.
Materials: \iiyl y/ • Wall signs do not require site /plot plans.
• Freestanding signs over 6 ft. required a
-'•n have illumination? ❑ Yes ❑ building permit.
o • If work authorized under a sign permit has not
T Re: ❑ 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.
1C' \ /CD C(10 C1PsA1 A T11TP'•r.\
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 20
e y.t-r - t /
d
Signature of Owner /Agent
0 5' Ll 1 25'
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chsr
D; s 11 61 aVI e3_A - 7 /%/
Contact Person Name Phone No.
Site Plan N
I N
Driveway Gravel and Grass Parking
Tigard Grange
13770 SW Pacific Highway
L.
3'x6' Banner
Driveway Gravel and Grass Parking
J