SGN2009-00024 CITY OF TIGARD
SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2009 - 00024
DATE ISSUED: 2/6/2009
T,19:0.9. 13125 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 1028 D - 02600
BUSINESS NAME: KIM1 ZONE: C -
SIGN LOCATION: 12957 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X8'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one 24 s.f. temporary banner. Valid 2/6/09 - 3/9/09. Sign #1
Wall mounted
MATERIALS: VINYL BANNER
EXISTING SIGNS:
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 19.00
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.
APPROVED BY. / s
PERMITTEE SIGNATURE: X./
� ��y'
DATE: / /2009
IN
SIGN PERMIT APPLICATION
IMI
1
City Tigard Pernt Center 13125 SW Hail Blul, Tigairl OR 97223
Phone. 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development /Project
FOR STAFF USE ONLY
Site
Address/ Street Address Permit No.: 5 Ai t 2 4 ) 5' - O `
Location / .Lg 5 J tit pQC( L P (nr a / 6 /O 9 3 / q j US
Y Expiration Date:
Suite/Bldg. # City /State ,/ Zip
TT? i Sl e on 94 Z2-3 Receipt # : "---o o 5 1 - (Y2—if y.
Name Approved By k- 3 P
Property ) Fit1 Al - 1<I 04 Date: 'Z /So A S
Owner Mai g Address / Suite A Map /TL# :
e f � /\/‘ .. � IA/ 1k I Uel�adC O 9k- Zoning: 4
City/State Zip Phone pa, 3
G te 'v tff71 ' ?I ---‘' 7 u o Electrical Permit Required? ❑ Yes [-No
Tenant or Name
Business Building Permit Required? ❑ Yes ❑
Name Rev. 7/1/07
is \curpin \ masters \land use applications \sign permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to pernut
issuance, all a REQUIRED SUBMITTAL ELEMENTS
copy of City/State Zip Phone
licenses are (Note: applications will not be accepted
required if without the required submittal elements)
expired in the Oregon Const. Cont. Board License # Exp. Date
City of Tigard's
database) ❑ Completed Application Form
Proposed ❑ Freestanding ❑ Freeway 111 2 Copies of Site /Plot Plan, Drawn to Scale
p
Sign Permanen Temporary ❑ Wall ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other ❑ Billboard ❑ Balloon size requirement: 8 x 11 ", or 11" x 17"
apply) q
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: .3 X �, (3 copies, if a building permit is required)
size requirement: 8 x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): 2 y
❑ $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) ❑ $19.00 Fee (Temporary sign, any type)
(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, but
Projection From Wall (inches): must include dimensions of wall face and sign
placement.
Co p y ' • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes ❑ No permit.
Type: ❑ Internal ❑ External • If work authorized under a sign permit has not been
Are there any existing freestanding or wall signs at this location, completed within ninety (90) days after the issuance
including wall signs that overlap a tenant space? of the permit, THE PERMIT WILL BECOME
❑ Yes ❑ No NULL AND VOID.
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.
DA 1 ED this 6 fh day of (- b , 20 0 /
Signa e of Own /Age
Contact Person Name Phone No.
r CITY OF TIGARD 2/6/7009
, e
"� € 1 s« hall Iilcd. 9:00:IOAM
m
''''' Tigard, OR 97223 503.639.4171
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Receipt #: 27200900000000000284
Date: 02 /06/2009
Line Items:
Case No "Iran Code Description Revenue Account No Amount Paid
SG N 2009-00024 [SIGN] Temp Sign Perm 100- 0000 - 437000 17.00
SG N2009-00024 [LRPF] LR Planninw Surcharge 1 00-0000-43S050 2 .00
Line Item Total: $19.00
Payments:
Method Payer User ID Acct. /Check No. Approval No. I -low Received Amount Paid
Check PENNEY KIM /VOGET BUILDING kjp 1618 In Person 19.00
Payment Total:. $19.00
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