SGN2009-00074 ri • s CITY OF TIGARD SIGN PERMIT
F. Permit #: SGN2009 -00074
COMMUNITY DEVELOPMENT Date Issued: 04/03/2009
1 D 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 25111 DD00201
Jurisdiction: Tigard
Name of Business: Primo Espresso
Business Address: 15981 SW HALL BLVD
Applicant/Agent: Primo Espresso, La,(fd '4/s /Pi ' ICI 3/
Work Description: Placement of one (1) temporary sign 3' X 4' (A- Frame) Sign 10 Must be 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: 3' X 4'
Total Sign Area: 12
Wall Area:
Wall Face (Direction):
Sign Height: 4 ft.
Projection From Wall: in.
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: . J� l.t'J� X -O/ • ( - 4 --
Permittee Signature: 11.1,;,/{.. (,Lkt,
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SIGN PERMIT APPLICATION
City gfTigzniPernit Center 13125 SW Hall Bhd, Tig wZ OR 97223
Pho1e• 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY
Site
Address / Street Address Permit No.: 5 4: 4) - — 01fl7 74f
Location 1 Set 8 1 SW UM A-- ell fl
Suite /Bldg. # City /State Zip Expiration Date:
MC/ ARO oR- ci1034 Receipt # :
Name Approved By: S _I-404=r
Property WIAA A2 92AP Date: `'f/3/0
Owner Mailing Address Suite Map /TL# : a5 l i 1 6 1 OD a1!' )
C A- 2300 Zoning:
Ciry/State Zip Phone
Kate W A Electrical Permit Required? ❑ Yes En"
Tenant or Name
Business Pia MO - C. SPAZ E:SSO 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
copy of all City/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) D Completed Application Form
Proposed ❑ Pemmtent ❑ Freestanding ❑ Freeway 0 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}� q
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: — copies, if a building permit is required)
X 4 K U (CoeS size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
24 ❑ $40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft) []' $19.00 Fee ora sign, an
(Ta mP n' g � y 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): 4' • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): must include dimensions of wall face and sign
placement.
vateate • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes [ l o 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 [,7 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.
DATED this 3 day of tW 1 , 20 b9'
V
Signa of Owner/ ent
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Contact Person Name Phone No.
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CO Approved [ )
For oriy the work as descr inn:
CEWIL`N PERMIT NO. "ti'acp‘ _`"
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Sign Elevation
Primo
Espresso Copy duplicated on
reverse face
OPEN
4'
5:3OAM
WEEKDAYS
6 AM
WEEKENDS
3'
Temporary Freestanding A -Board Sign
12 Square feet per side
Scale 1 " =1'
Site Address: 15981 SW Hall Blvd.
Tenant/Business Name: Primo Espresso
Sign Company: Signs Now
11520 SE 82nd Ave
Portland, Oregon
503- 652 -2072
Sign Elevation
Primo
Espresso Copy duplicated on
reverse face
OPEN
5:3OAM
WEEKDAYS
6 AM
WEEKENDS
3 '
Temporary Freestanding A -Board Sign
12 Square feet per side
Scale 1 " = l'
Site Address: 15981 SW Hall Blvd.
Tenant/Business Name: Primo Espresso
Sign Company: Signs Now
11520 SE 82nd Ave
Portland, Oregon
503- 652 -2072
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CITY OF TIGARD RECEIPT
4
D ^. 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 173073 - 04/03/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00074 Temp Sign Perm 100- 0000 - 438050 $17.00
SGN2009 -00074 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
Check 19805 STREAT 04/03/2009 $19.00
Payor: Northwest Gourmet Coffee Co., Inc.
Total Payments: $19.00
Balance Due: $0.00
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