SGN2009-00212 CITY OF TIGARD SIGN PERMIT
Permit #: SGN2009 -00212
COMMUNITY DEVELOPMENT Date Issued: 10/14/2009
?]LisARD. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S103DD00600
Jurisdiction: Tigard
Name of Business:
Business Address: 13770 SW PACIFIC HWY
Applicant/Agent: Bartels, Gregory
Work Description: Installation of (1) permanent 12 s.f wall sign
Framed and wall mounted
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 12x1
Total Sign Area: 12
Wall Area:
Wall Face (Direction): North
Sign Height: ft.
Projection From Wall: 1 in.
Illumination:
Materials: Vinyl/Wood
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $40.00
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: 7e- P-'
Permittee Signature: Bn
SIGN PERMIT APPLICATION
City of Tigard Permit Center 13125 SW Hall Blvd, Tigard, OR 97223
Phone: 503.639.4171 Fax: 503.598.1960
TI AR
GENERAL INFORMATION
Name of Devel pment1 Project
FOR STAFF USE ONLY
Site 1), L a -west
Address/ Street Address Permit No.: c.C`j /J - (3° LI Z
Location ( 3` 0 S (,U o _ (L (IA (IA Expiration Date:
Suite /Bldg. g. # # City/State �� "Lip
-pcp e( o- - Q 1 22> Receipt #: yy t
Name Approved By: /� J
Property C � ' V �
P q ailAJ Date: '7 /64
M ailing ddress Suite Map/TL#:
Owner r � d $ (Las. Zoning: Ck
City/State > Zip Phone
It 04114/ de_ Q7Th 5-035-Qom-0 Electrical Permit Required? ❑ Yes [ 4 o
Tenant or Name
Business CO■Avc , GO Building Permit Required? ❑ Yes MAO
Name Rev. 7/1/09 permit use applications peut app.doc
Sign e
Contractor Mailing Address Suite
(Prior to permit -PO &d 5
issuance, a �`
copy of all City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
licenses are ?C � ct - t0 62 S . v• 6156 (Note: applications will not be accepted
required if f ��( ��''(VV��`' - ' without the required submittal elements)
expired in the Oregon Coast. Cont. Board License # Exp. Date
City of Tigard's
database) Vf Completed Application Form
Proposed X.:1 Permanent ❑ Freestanding ❑ Freeway j{ 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
apply) size requirement: 8t /z" x 11", or 11" x 17"
,n New sign? ❑ Alter to existing sign? 1 2 copies of elevations, drawn to scale
Sign Dimensions: ( i\ i 2 (3 copies, if a building permit is required)
size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): fl
Z 40.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft) I Z $19.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) 0 S E W NE NW SE SW
Height to top of sign (feet): S' • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): Is 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? ❑ Yes ] No permit.
Type: ❑ Internal yl 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•
•
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 1 day of C-- , 20 0
„foAc, 6 I
Signature of Owner /Agent
Contact Person Name Phone No.
� Z
C j!'i r( S 1 -YvN 3 -�e- S
•
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
?IGARD
•
Receipt Number: 175624 - 10/13/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00212 Sign Permit 1003100 -43115 $35.00
SGN2009 -00212 Sign Permit - LRP 1003100 -43117 $5.00
Total: $40.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 2494 KPEERMAN 10/13/2009 $40.00
Payor: The Christmas Tree Company, LLC
Total Payments: $40.00
Balance Due: $0.00
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