SGN2005-00017 I
CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2005 -00017
� DATE ISSUED: 2/3/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136DB-00201
BUSINESS NAME: BIG TOWN HERO ZONE: C -G
SIGN LOCATION: 11571 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT: BIG TOWN HERO
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 18" X 24"
TOTAL SIGN AREA: 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 lawn sign. (18" x 24 ")
MATERIALS:
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
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: // /()/(----K..1—. ii
PERMITTEE SIGNATURE:
DATE: 2/3/. 005
# .0 , ,I,, SIGN PERMIT APPLICATION
A. #
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
N of Development/Project
6
Site `-'/
�- 76 FOR STAFF USE ONLY
l Address / S;re`Act�r /S � J f, Permit No.: ,G1\) Qo05 -- t- O ) 7 . f
Y Location V
Suite /Bldg. # City /State z Expiration Date: 3-11 0 S
77w 9 13 Receipt #: o 005 - 043 v
NaV Approved By: O 0 /1..c./ntAJ
/ Property �f ���✓Y1/] Date: .,q - 3- v S
7, Owner i gAllfarW Z/ Suite Map/TL #: 1513 - pOao 1
Zoning: c - C
ty /St Ly 7L f� hone
7 [� ❑
N
Tenant or '�� I Electrical Permit Req Yes No
Business e��� 6.:„ Building Permit Required? El Yes ❑ No
Name Rev. 1/3/05 is \curpin\ masters \revised \sign permit app.doc
Sign
Contractor Mailing Address Suite . - REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a 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 # ❑ 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 „RI Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard El Balloon 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
A Sign Dimensions: a C9 0
❑ $37.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): ❑ $17.00 Fee (Temporary sign, any type)
Si n Data Total Wall Area (sq. ft.) Jurisdiction: ❑ City ❑ Urb
9
(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 1
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted. I
(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 F , 20 ®6
Signat r e of Owner /Agent
Altit‘hd o ,q Thti 3 f 10 C I ZJ
Contact Person Name Phone No.
CITY OF TIGARD 2/3/2005
13125 SW Ha11 Blvd. 11:30:24AM
..., 4 ellii i� � Tig Oregon 97223
1- (503) 63 9-4 17 1
Receipt #: 27200500000000000438
Date: 02/03/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2005 -00017 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
SGN2005 -00017 [LRPF] LR Planning Surcharge 100- 0000 - 438050 2.00
Line Item Total: $17.00
Payments:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
Cash BIG TOWN HERO CAC In Person 22.00
Change CITY OF TIGARD CAC In Person (5.00)
Payment Total: $17.00
cReceipt.rpt Page 1 of 1