SGN2009-00121 .
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CITY OF TIGARD SIGN PERMIT
` ' 7 . :l•. Permit #: SGN2009 -00121
COMMUNITY DEVELOPMENT Date Issued: 05/20/2009
TEGARD
13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S136CD01600
Jurisdiction: Tigard
Name of Business:
Business Address: 11674 SW PACIFIC HWY
Applicant/Agent: Malone, Greg
Work Description: Placement of (1) one cluster of balloons. Valid 5/22/09 - 6/1/09. Sign #1 Must be
securely attached and on private property.
• Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: No Electronic: No
Billboard: No Balloon: Yes
Banner: No A- Board: No
Sign Dimensions:
Total Sign Area:
Wall Area:
Wall Face (Direction):
Sign Height: ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: Balloons
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: /13„„..,....,D
,
Permittee Signature: INA----
it SIGN PERMIT APPLICATION
_ • City of Tigard Permit Center 13125 SW Hall Blvd., Tigard, OR 97223
T I G A R U Phone: 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development /Project
� �_�®P 711 Amp //,i FOR STAFF USE ONLY
Site 'DT �I y '� n'�'
Address / Street Address Permit No.: 5'/t- U5'' 0 d) Z,/
Location /
�( 7 Y Z + �/' . Expiration Date: S / —2.1 9 — k' ! / , 4.
Suite/Bldg. # City /State Zip
' i._ keP t 15 g ,7g2 33 Receipt #:
Name C3 � Approved By: cl 4 f�
Property Date: C /7..... /(1,
Owner Mailing Address Suite Map /TL #:
Zoning:
City /State Zip Phone
Tenant or Name Electrical Permit Required? El Yes 12__114
Business 14') L / - r U D A () e t - - Building Permit Required? ❑ Yes E -N44
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"I'igard's
database) ❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway ❑ 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 VI Balloon
apply) size requirement: 81/2" x 11", or 11" x 17"
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: (3 copies, if a building permit is required)
size requirement: 8'/2" x 11", to 24" x 36"
Total Sign Area (sq. ft.):
❑ $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.
Copy:
• Wall signs do not require site /plot plans.
Materials: ♦ Freestanding signs over 6 ft. required a building
Will sign have illumination? El Yes I No permit.
Type: ❑ Internal V 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.
C "I
DA I'ED this I day of Poi , 20 7
c__TR A.,(62.„61
Signature t f Owner /Agent
6ia Perk 53- 60--es
Contact Person Name Phone No.
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111 CITY OF TIGARD RECEIPT
it
1 3125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 173609 - 05/20/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00121 Temp Sign Perm 100 - 0000 - 438050 $17.00
SGN2009 -00121 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
Credit Card 031954 KPEERMAN 05/20/2009 $19.00
Payor: Greg A. Malone
Total Payments: $19.00
Balance Due: $0.00
Page 1 of 1
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