SGN2009-00087 ,,,K
SIGN PERMIT
FA FA _ CITY OF TIGARD
Q . =,,;t , ;, Permit #: SGN2009 -00087
m, ,5. COMMUNITY DEVELOPMENT Date Issued: 04/15/2009
l T1GARD .1 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S110DCO2300
Jurisdiction: Tigard
Name of Business: Blissful Energy Yoga
Business Address: 11515 SW DURHAM RD E -7
Applicant/Agent: Blissful Energy Yoga,
Work Description: Placement of one (1) temporary sign (A- Board) 2.5 X 3.5 Valid 4/15/09 - 5/15/09 Must be S(CO 1 # 1
placed on private property, not in public right of way. Must meet visual clearance area
requirements
Permanent: No Freestanding: Freeway:
Temporary: 1 Wall: Electronic:
Billboard: Balloon:
Banner: A- Board: Yes
Sign Dimensions: 2.5 X 3.5
Total Sign Area: 8
Wall Area:
Wall Face (Direction):
Sign Height: 3 ft.
Projection From Wall: in.
Illumination: No Illumination
Materials:
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $19.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all
other applicable law. 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: .1/1 (// .= „`C. -,, l /oi (,),!, "�
T
1
R SIGN PERMIT APPLICATION
y m City of Tigznl Perntit Center 13125 SW Hall Blzd, Tigard O 97223
Phone 503.639.4171 Fax: 503.598.1960
C67
APR 1 1/ .
GENERAL INFORMATION P � � C / u 20
Name of Development/Project _''/A# 7- IG s
FOR STAFF II"" I. s, _. `
Site Z 1 i ss I l F_ae.e / Y _ A/n,
Address/ Street Address Permit No.: ' (TUB elf
Location 1 1 5( 5 ' ) rk ed
Expiration Date:
Suite /Bldg. H �Gt r /Stare Zip
E--. ) g a trci 00Z- (7 2-Lei Receipt # :
Name / Approved By. S "T
Property ) ) ► nQ Vc iF'JvJ Date: i-01.1'IDq
Owner Mailing ABdress Suite M /TL# :
4575 S te, kj (Zd 2' Zoning:
City/State J Zip Phone C - D"g )
Tenant or
N w
5 `� r0. Dk 9 - 70 - Electrical Permit Required? El Yes EJ Jo
Business j 5. Vii.1 Co Q ` Ni ��0 q Building Permit Required? ❑ Yes ErNo
Name Rev. 7/1/07
is \ cumin \masters \land use applications \sign permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to permit •
issuance, a
copy of all Cry/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
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
Permanent Frees Freeway Proposed ❑ g ❑ y [11 2 Copies of Site /Plot Plan, Drawn to Scale
Sign ❑ 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"
appl) ze re q
a New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: ill f x <Z 1? (3 copies, if a building permit is required)
oDi 2 S_ size requirement: 8 x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
❑ $40.00 Fee (Permanent sign, any size)
S i Sign Data 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 E W NE NW SE SW
Height to top of sign (feet): 3 • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): - must include dimensions of wall face and sign
Copy: k(..l S5iG1L ea-gcov yoca4 placement.
Materials:
O � • Wall signs do not require site /plot plans.
• Freestanding signs over 6 ft. required a building
Will sign have illumination? p 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
El Yes No NULL AND VOID.
If "yes ", a list or diagram of all sign dimensions and square
footage must also be submitted.
41// s" (OVER FOR SIGNATURES)
v
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 D this / day of , 20_0_9_
i
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A,„(j n
Signature * Owner /Agent
Contact Person Name Phone No.
1
I
IIIII CITY OF TIGARD RECEIPT
V
: 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
?JIG A.RP
Receipt Number: 173233 - 04/15/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00087 Temp Sign Perm 100 - 0000 - 438050 $17.00
SGN2009 -00087 Temp Sign Perm - LRP 100 - 0000 - 438050 $2.00
Total: $19.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Cash STREAT 04/15/2009 $19.00
Payor: Blissful Energy Yoga
Total Payments: $19.00
Balance Due: $0.00
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