SGN2005-00153 I
CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2005 -00153
A sj, DATE ISSUED: 5/24/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S136CD-01600
BUSINESS NAME: STANDARD TV & APPLIANCE ZONE: C -G
SIGN LOCATION: 11674 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT: STANDARD TV & APPLIANCE
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 15' 10" X 5' 10
TOTAL SIGN AREA: 92 sq. ft.
WALL AREA: 1,911 sq. ft.
WALL FACE (DIRECTION): S
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: P
MATERIALS: WOOD FRAME
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: ` _
PERMITTEE SIGNATURE: 1 Or,
DATE: 5 4/20.5
05/23 /2005 15 :08 FAX 5035981960 CITY OF TIGARD 2002
•
1I1.1. 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 FOR STAFF USE ONLY • Site it `�.n'.Lt I b r - ' fie
Address/ Street Address �,. C � . Permit No.: G J aaoS - 0 0 l5 9.
Location Mil 7'1 51 w �/�,
- G"`"1'-1 \'tZ- l () `-' Expiration Date:
Suite /Bldg. # - Clty /Statte� n ZIP .
17t 1I� -t/j Oft- c7 7Z-23 Receipt #: .20 r) 5 - -7330
Name /1 j�j r ,, -ri' Approved By: �
Property .
DMA k ii4' 1 T(LV Date:, 5 -Q q- - o s
Owner Mailing Address Suite Map/T_#: 15 i 3(aC D - 01(00
1010 S �) I st 5 1 - Zoning: C "G
Ciiy /State Zip � Phone
41 ` 60 11,1- Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name
1 - ^ .— /�.,, POI Building Permit Required? 11 Yes 111 No
Business Y 1 �i �lnJ� APO
Name Rev. 1/3/05 I;kurpin \masters \revised \sign permit epp.doc
Sign
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note; applications will not be accepted
Issuance, a
copy of all City /State Zip Phone without the required submittal elements)
licenses are
required if ❑ Completed Application Form
expired In the Oregon Const. Cont. Board Exp. Date
City of Tlgard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
Proposed ❑ Permanent ❑ Freestanding El Freeway ( size requirement: 8 x 11", or 11" x 17"
Sign ❑ Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ Bill ❑ Balloon E] 2 copies of elevations, drawn to scale
apply) - (3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? I size requirement: 81/2" x 11 ", to 24" x 36"
Sign Dimensions: �,, „ , ,
). - /c x _6 /o ❑ $37.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): q ❑ $17.00 Fee (Temporary sign, any type)
Total Wall Area (sq. ft.)
Sign Data / t c /l Jurisdiction: 111 City I:] Urb
(Complete all Direction Wall Faces (circle one): NOTES:
Items in this
section) N 1 0 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)
05/23/2005 15:08 FAX 5035981960 CITY OF TIGARD Ij003
• •
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
Signature of Owner /Agent
Contact Person Name Phone No.
,
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0 = = 1 A
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li
itif OF TIGARD
r'!!iy Approved
• 1 :: • ( ink/ the work as described in: On
„...___ ,,-LI-3Mil- s 1 I
e Letter to: 0 k Follow
Attach [ i
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(CAL 4/1..t. ,',- _ : .-- OS
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MERCHANDISE CONDITION CHECK OFF FORM
WASHER /DRYER
SKU # Model # Serial #
Delivery Whse. Transfer Store Sales- Store Transfer Whse. Delivery
INSPECTED BY Driver Check In NAS Driver Receiver person Cust. Picker Driver Check in Driver
INITIAL
DATE
PARTS (Check box if the parts are present)
FILL HOSES
DRAIN HOSE
KNOBS
LEGS /FEET
OWNERS MANUALS
INSTALL. INSTRUCTIONS
CONDITION (Place letter from below in box and briefly describe approx. position - ie. = D - lower left)
FRONT DAMAGE
RIGHT SIDE DAMAGE
LEFT SIDE DAMAGE
TOP DAMAGE
REAR DAMAGE
OTHER
S = SCRATCH D = DENT R = RUB P = PAINT BLEMISH OR FLAW
CITY OF TIGARD 5/24/2005
13125 SW Hall Blvd. 3:40:15PM
Psolo � I i i ;�� Tigard, Oregon 97 22 3
. `_.. (503) 63 9-4 17 1 '
Receipt #: 27200500000000002330
Date: 05/24/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2005 -00152 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
SGN2005 -00152 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 2.00
SGN2005 -00153 [SIGN] Sign Permit 100- 0000- 437000 32.00
SGN2005 -00153 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 5.00
Line Item Total: $54.00
Payments:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
CreditCard GREG A MALONE CAC 009120 In Person 54.00
Payment Total: $54.00
cReceipt.rpt Page 1 of 1