SGN2009-00014 :i
. CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2009 -00014
! GARip 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/16/2009
PARCEL: 2S 103DD -00800
BUSINESS NAME: TIGARD DONUT ZONE: C -G
SIGN LOCATION: 13815 SW PACIFIC HWY 80 JURISDICTION: TIG
APPLICANT /AGENT: TIGARD DONUT
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 31" X 47"
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): E
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one (1) temporary sign (A- Frame) Valid 1/16/09- 2/16/09 Sign #1
Must be placed on private property, not in public right of way. Must meet visual
clearance area requirements
MATERIALS: WOOD
EXISTING SIGNS: 1
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 Muniapal Code, State of Oregon Speaalty 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: ° 1-4
PERMITTEE SIGNATURE: ��/ '
DATE: 1/16/2009
SIGN PERMIT APPLICATION
City of Tigard Perrrmt Center 13125 SW Hall Blzd, Tigard, OR 97223
Phone- 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY
Site �q
Address/ Street Address • Permit No.: ' � (_ - V i4
Location 1$ g/rS/// Pa l ch c tY
Suite /Bldg. # City/State Zip Expiration Date:
' $ b 7 GV'd ,U�. i.2.)._ Receipt # : ' Pt - 090 ! oZ0
Name Approved By ' 747
Property Anne. Si 0 `e/r5 Date: 1//40(0`t
Owner Mailing Address Suite Map/ TL# : 10 3 b ip - OAYSO
Zoning: CCP
Oty/State Zip Phone
Tenant or Name Electrical Permit Required? ❑ Yes 2 No
Business — raA rcs loo n v1 f ' Building Permit Required? ❑ Yes ["No
Name Rev. 7/1/07
is \curpin \ masters \land use applications \sign permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to permit,
issuance, a
REQUIRED SUBMITTAL ELEMENTS
copy of all 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 ❑ Permanent Freestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Sign V Temporary ❑ Wall ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other ❑ Billboard p Balloon size requirement: 8 x 11 ", or 11" x 17"
apply) ze re q
❑ New sign? ❑ Aker to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: , )4 , (3 copies, if a building permit is required)
size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): q d
I �C «'7 / ❑ $40.00 Fee (Permanent sign, any size)
Data
Sign Total Wall Area (sq. ft.)
g ❑ $19.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S OW NE NW SE SW
Height to top of sign (feet): ei t • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): must include dimensions of wall face and sign
placement.
Copy • Wall signs do not require site /plot plans.
Materials: Lop-0Z • Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes 1 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.
& — .4
(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 day of GIN" , 20 0
7
-. Signature of Owner /Agent
Pe e k- Vi m ,3 63 - /30
Contact Person Name Phone No.
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Tigard, OR 97223 5113.639.4171
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Receipt #: 27200900000000000120
Date: 01 /16/2009
1.ine Items:
Case NO Iran Code Description Re%enue Account No Am nml Paid
SGN2009 -00014 [SIGN' Temp Si n I'er 100-0000-437000 17.00
SGN2009- 00014 [LRI'F] LR I Iannin Surcltarvc 100-0000-438050 2.00
Line Ilea Total: S19.411)
Payments:
Method Paver User II) acct. /Check No. Approval No. !low Received Amount Paid
Cash TIGARD DONUT ST In Person 20.00
Chan COT ST In Person (1.00)
Payment 'Total: S19.00
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