SGN2005-00338 CITY TIGARD SIGN PERMIT
•; i DEVELOPMENT SERVICES PERMIT #: SGN2005-00338
�I DATE ISSUED: 11 /4/2005
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 112AC - 02600
BUSINESS NAME: CLUB K - ZONE: I -
SIGN LOCATION: 07320 SW BONITA RD JURISDICTION: TIG
APPLICANT /AGENT: CLUB K -
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 5' X 4'
TOTAL SIGN AREA: 40 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 12 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Installation of one permanent freestanding sign.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: Y
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 38.00
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. tp / / f AP PROVED BY: (/• 4' PERM SIGNATURE: •
DATE: 11/4/2005
7% . 00
Allho
_. 'ilia 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
,C� FOR STAFF USE ONLY
Site Fp',/re 4 JP, / rr° 5, ,2 NG
Address/ Street Address Permit No.: 5 6 N a Dos "- 00 33 8
Location 73 ,20 56) r ►jat
Expiration Date:
Suite /Bldg. # Citt' /State Zip
7 i:0I ?7- --'V Receipt #: ',. 60S - -5u, 81.
Name Approved By: c_ � c
Property G iryi" ffenes ire. Date: / / - `I - 0S
Owner Mailing Address Suite Map /TL #: .75 / )- i1 C " UaIo 0 `-'
/J,5 -23?‘-?. Zoning: I - i--
City /State Zip Phone
� A 7rn £72 t 39 -Szri
� rq0 �� 9 Electrical Permit Required? ❑ Yes VI No
Tenant or N e
Business v t 1 k- t y,<__,
Building Permit Required? X Yes ❑ No
Name Rev. 7/1/05 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 /S to zip Phone without the required submittal elements)
licenses are -
required if NI Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # L.. 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 ❑ Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ Billb ❑ Balloon 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
,Q New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: x 9 i
❑ $38.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): LI Ley ❑ $18.00 Fee (Temporary sign, any type)
Si n Data Total Wall Area (sq. ft.) Jurisdiction: ❑ Cit El Urb
g
(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): W ' • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
sign placement.
Co py : • Wall signs do not require site /plot plans.
Materials: ') ptxt gPs-) I)y,� c • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes 0 Nu building permit.
No • If work authorized under a sign permit has not
Type: ❑ Internal 4Rt 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 ANo
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 day of , 20
i
:11;
S' • natur' of Owner /Agent
.5-2) _7-3
Contact Person Name Phone No.
L J '5,1v I
1 \ - --e-----------7- kig r "
ix Li ,
. •
. . /
L Op Vret C- ' 6
:) 1 .4* g■
0 ,
6 6
•
9
e 0
-,..--Z- 6 - ;t 1 • - ° V . •
.: 013
dic. 1 1 . 0 0 0 .nsa : 11:0
CITY OF TIGARD
;
Approved A
ieri
Conditionally Approved [ 1
For only the wojicas described in: ".• '
PERMIT NO •-••-7A.) eROL)5 — 00338 „
See Letter to: Follow [ ] - , \ •,f i 0
s _....,
Attach [ ] , ' ■Illr . - *
,,,, - . . 7-77: C :.• - '/''.
Job Addres§: 7. (Sted
By: a • C6u. q..1-0--- Date: /I -y- 05
' -- ' : - c!0 5.
_rnisib:. le ; 5
Va. r;„-,,,
It lj- O FFICE COPY
,
--=
. ,
1 ,
f
4 I .
1 4) ,4 1'
1 -iielV
3
f L -
1 ................--..-:
st '
CITY of TIGARD
GEOGRAPHIC INFORMATION SYSTEM
VICINITY MAP
BoN
'' l oc1C mac. , .
,..,
..4,_
�‘ F 1
1 cue R.-t f ( .
( yR5 FERR
', T ___
„
•• 9 %
l / BUII ? QP
!G R =
O _
Tigard Area Map
N
( 0 25 50 Feet
1'= 40 feet
4'
City of Tigard
., Information on this map is for general location only and
should be verified with the Development Services Division.
,L 13125 SW Hall Blvd
Tigard, OR 97223
(503) 639 -4171
http://www.ci.tigard.or.us
Community Development Plot date: Oct 6, 2005; C: \magic \MAGICO3.APR
I. -
CITY OF TIGARD 11/4/2005 ''
13125 SW Ha11 Blvd. 10:18:46AM •
A Oregon 97223 -
:-_4- ' (503) 639 -4171
Receipt #: 27200500000000005686
Date: 11/04/2005
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2005 - 00338 [SIGN] Sign Permit 100- 0000 - 437000 33.00
SGN2005 -00338 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00
Line Item Total: $38.00
Payments:
Method Payer User ID AcctJCheck No. Approval No. How Received Amount Paid
Check CLUB K -9, INC CAC 1847 In Person 38.00
Payment Total: $38.00
cReceipt.rpt Page 1 of 1