SGN2005-00016 C ITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2005 -00016
.111 DATE ISSUED: 1/31/2005
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S102CC 00500
BUSINESS NAME: HOMETOWN BUFFET ZONE: C -G
SIGN LOCATION: 13500 SW PACIFIC HWY 17 HOME TOWN BUFFE JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X8'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one temporary 24 sq ft banner. Valid 1/28/05 thru 2/28/05. Sign
#1
MATERIALS: VINYL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 17.00
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 tempora si n shall expire 30 days from validity date. A balloon sign shall expire 10 days
from validity date.
APPROVED BY:
i l
PERMITTEE SIGNATURE: C am, CL
DATE: 1/31/2005
iii 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 FOR STAFF USE ONLY
Site /''! ® ,6� CJ 1, /�c
Address/ Street Address Permit No.: 5 C-! /JZ,J 3S� a0 Z G� OQ /�
Location /3 f ki �jfe.,yi
Suite /Bldg. # City /State Zip
Expiration Date: A / OS — /---54
—z 74-34p4) alt . ?IZZ Receipt #: 2 ----A- 9 0 c.1)c.
Name Approved By: �C .
Property Date: �z /Q
Owner Mailing Address Suite Map /TL #:
Zoning: C4
City /State Zip Phone
Tenant or Name °Lli(,r, Electrical Permit Required? ❑ Yes [I—No
Business / A? 4A) - /CFrr Building Permit Required? ❑ Yes J_.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
copy of all City /State Zip Phone without the required submittal elements)
licenses are
i I
required if
expired in the Oregon Const. Cont. Board Exp. Date El Completed Application Form
City base of ard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
(3 copies, if a building permit is required)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway 1
Sign y size requirement: 8 /2" x 11 ", or 11" x 17"
Si
g 0-Temporary Wall ❑ Electronic
(Check all that 1:1 Other El Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale
apply)
(3 copies, if a building permit is required)
N ew sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: 7 r i
x- ❑ $37.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
❑ $17.00 Fee (Temporary sign, any type)
Total Wall Area (sq. ft.)
Sign Data Jurisdiction: ❑City ❑ Urb
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E NE NW SE SW
Height to top 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: v �� ut (, • Wall signs do not require site /plot plans.
• 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 1No 1
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
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 4"'-
2 day of -S 1 Y , 20 d
Signature o' er/ ' • - -
6.J e
Contact Person Name hone No.
C yat-- C/
'e
CITY OF TIGARD 1/31/2005
13125 SW Hall Blvd. 1:42:29PM
Tigard, Oregon 97223
�� 1± (503) 63 9-417 1
Receipt #: 27200500000000000379
Date: 01/31/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2005 - 00016 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
SGN2005 -00016 [LRPF] LR Planning Surcharge 100- 0000 - 438050 2.00
Line Item 'l'otal: $17.00
Payments:
Method Payer User ID Acct./Check No.Approval No. How Received Amount Paid
CreditCard MICHAEL L WILDE KJP 556260 In Person 17.00
Payment Total: $17.00
cReceipt.rpt Page 1 of 1
1
CITY OF F TI GARD SIGN PERMIT
BUILDING SERVICES DIVISION
A 13125 SW Hall Blvd., Tigard, OR 97223 PERMIT #.
(503) 639 -4171 DATE ISSUED:
BUSINESS NAME: koyhe / 54--C --� PARCEL #:
SIGN LOCATION: 135Qa S'c.� pa_ p y - � « )y 2--rat ZONING: \_ 1
APPLICANT NAME: k.A t 0... -p3 ee(..., (.,s..) ; I- 0 e, JURISDICTION: —(, : ( ,
BUSINESS TAX NO.: —
This is an interim permit issued during permit system maintenance.
The actual permit will be issued and mailed to the applicant within one week of the date issued above.
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: L — WALL: t ELECTRONIC:
__...... . ............................._.
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3 7c X
TOTAL SIGN AREA: _ 2. u $ CA
WALL AREA:
WALL FACE (DIRECTION): tJ•
SIGN HEIGHT: \ Cit / 2.8 k id I / / _
PROJECTION FROM WALL: o5 IT QS
ILLUMINATION: &J
DESCRIPTION OF SIGN: �ievvtporkiy
MATERIALS: VI k 1 J
EXISTING SIGNS: w/ i} ..
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: th
ADMINISTRATIVE EXCEPTIONS:
........................
TOTAL PERMIT FEES: $
ACKNOWLEDGEMENT:
I understand this Home Occupation Permit is approved for the above described business at the specified
location only, and does not require renewal. Further, I understand that the City of Tigard Business Tax must be
renewed annually in order to maintain permit authorization.
I acknowledge that this Home Occupation Permit approval may be revoked if the conditions and standards of
approval have not been complied with and /or this home occupation is otherwise being conducted in a manner
contrary to the Tigard Community Development Code (18.42). Permit revocation due to a violation of
requirement(s) of this Home Occupation Permit cannot be renewed for a minimum period of one year
(18.142.090). • Issued By:
Permittee Signature: �� / _ _
ManualSGNpermit.doc 09/16/04
1
. ,
CITY OF TIGARD
RECEIPT
DEVELOPMENT DEVELOPMENT SERVICES DATE: // z. ,V5
JURISDICTION.: -
ttlip.jit 13125 SW Hall Blvd., Tigard, OR 97223
RAW 8 1E1I 503-639-4171 CASHIER DATE: rz_e_Ai . 5 —
RECEIPT NO.: '3_.-<Dx2.5-006 c /
LINE ITEMS:
Case No. Fee Description Revenue Acct. No Amount Due
)
sq tu 25 2- 7.—F 7 ! :3 7 O _-
1
I
1 1 I
I
1
1
i
Total Due: $ 3 — 7 c-&--
CI SEE ATTACHED FEE SCHEDULE.
PAYMENTS:
Method Payer Initials Check No. Confirm No. Amount Paid
D,u_) j4e.4.4,9- flAic 4.14A.c., L . t,u, 1 dk_.
1
Total Paid: $ 3 7 c
Tidemark-ManualSystem\ManualReceipt doc 9/13/04