SGN2005-00370 CITY OF TIGARD SIGN PERMIT
i
4 I DEVELOPMENT SERVICES PERMIT #: SGN2005-00370
A I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/2/2005
PARCEL: 2S 110DC -02300
BUSINESS NAME: BULL MOUNTAIN ORTHODONTIST ZONE: C - G
SIGN LOCATION: 11545 SW DURHAM RD B - JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2'X12'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): N
SIGN HEIGHT: 10 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one 24 sq. ft. temporary banner. valid 12/2/05 - 1/2/06. Sign #1
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 tempo - , - '!n shall expire 30 days from validity date. A balloon sign shall expire 10 days
from validity date.
i
APPROVED BY:
�—
PERMITTEE SIGNATURE: 1, c .
DATE: 12/2/2005
•
Alto
lit 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 ,,/ AT o/i"4....6., in,
Site 0/Vi- t (.J,'ll CO p"0 1is'pc FOR STAFF USE ONLY
Address/ Street Address Permit No.: C- , rs - - ap 3 7 c0
Location //S YS" S‘✓ P 4,-, J "e-6,
Expiration Date: /-1 41-/e 5 — //2._ /(3
Suite /Bldg. # City /State Zip
g"� �€ gr�fO/� 9 ?-22--q Receipt #: 'Lazo j — I 3-b
Name v Approved By:
Property HGI c 4 S A- Date: l2 o �`_
Owner Mailing Address Suite Map/TL #: t
Zoning:
City /State / Zip Phone
' / %
o�'� � 0 94Z0 .S 3- �3°D13 Electrical Permit Required? ❑ Yes Qflo
Tenant or - Name
Business 130i► /ham dam, ()r ed0.44-1u) Building Permit Required? ❑ Yes [i -fd'o
Name Rev. 7/1/05 is \curpin \masters\revised \sign permit app.doc
Sign
Sf •'
P
d- --
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit c033 ay;e1/0 le' (Note: applications will not be accepted
issuance, a
copy of all City /State Zip Phone without the required submittal elements) •
licenses are .� / J 93 (39r tig9C
required if 1 1 �7f� /L ❑ Completed Application Form
expired in the Or on Const. Cont. Board Exp. Date
City of Tigard's License #
database) 1 s---42.10 0 2 Copies of Site /Plot Plan, Drawn to Scale
(3 copies, if a building permit is required)
Proposed
❑ Permanent ❑ Freestanding Freeway Sign ❑ g ❑ Freewa size requirement: 81/2" x 11", or 11" x 17 "
• Si
g g Temporary Wall Electroni
(Check all that ❑ Other Billboard ❑ Balloon El copies of elevations, drawn to scale
apply)
J New sign? (3 copies, if a building permit is required)
g ❑ Alter to existing sign? size requirement: 8 x 11 ", to 24" x 36"
Sign Dimensions: 12' xis
❑ $38.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 2 4`' 2
❑ $18.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft ', I Jurisdiction: ❑ City El Urb
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) VS E W NE NW SE SW
Height to top of sign (feet): 10 • 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: ()ilny / • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes ❑ building permit.
• If work authorized under a sign permit has not
ype: ❑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 1No
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 IL /U2 /a day of V- P«dr -7 ,20 t '?
Sign.. e of Ow. -r/Agent ,.
�� ✓1 --,,� ���� � - 4 0 6 (-
Contact/Person Name Phone No.
BULL ORTHODONT
MOUNTAIN x
FREE EXAM 503 - 620 -462