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SGN2009-00197 _ CITY OF TIGARD SIGN PERMIT Permit #: SGN2009 -00197 COMMUNITY DEVELOPMENT Date Issued: 09/10/2009 TIGARD. 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: Gertz, Donald Work Description: Placement of one (1) 10 s.f temporary banner. Valid 9/14/09 - 10/14/09. Sign #1. Sign must be placed on private property Permanent: No Freestanding: No Freeway: No Temporary: 1 Wall: Yes Electronic: No Billboard: No Balloon: No Banner: No A- Board: No Sign Dimensions: 2'x10' Total Sign Area: 20 Wall Area: Wall Face (Direction): Sign Height: ft. Projection From Wall: in. Illumination: No Illumination Materials: Vinyl Electrical Permit Required: Building Permit Required: 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: Y n 0''�'� v .2 it J 1 SIGN PERMIT APPLICATION 11. j 1 I : Ciy of Tigard Permit Center 13125 SW Hall Blvd., Tigard, OR 97223 Phone: 503.639.4171 Fax: 503.598.1960 GENERAL INFORMATION Name of Development /Project /Q O )' 1. . C O T Y/ $ E( l'o T ` �4 ND .B/Q N c °UNTiF't' fl/f�t� FOR STAFF USE ONLY Site C & / - Address/ Street Address Permit No.: d N ) 2 -tso9 —00/f Location 137 70 S W tY U/ ie F5 ? b I q — to / Y ( Expiration Date: / f o l Suite /Bldg. # City /State Zip 71 9 72. Z- 3 Receipt #: Name Approved By: i Property 77 G A A fi G RN � A � Date: Qfr ieli Owner Mailing Address Suite Map /TL #: S AI M..6 Zoning: C 9 City/State Zip Phone Tenant or Name Electrical Permit Required? ❑ Yes To Business PT L 8 BR ANC y R5 C ®S Building Permit Required? ❑ Yes o Name Rev. 7/1/09 is \curpin \ masters \land use applications \ sign permit app.doc Sign /oNAt D GE i f 7 - - Contractor Mailing Address Suite (Prior to permit 9 cto( 5W City/State .7�1F1 o re issuance, a REQUIRED SUBMITTAL ELEMENTS copy of alCity/State Zip Phone licenses are Li A T o 3 z 5-963 (Note: applications will not be accepted required if A IOU 0 R g 7q6 2 `� without the required submittal elements) expired in the Oregon Const. Cont. Board Incense # Exp. Date Cary tabaa se) Tigazd's database) ❑ Completed Application Form Proposed ❑ Permanent ❑ Freestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale Sign L_l Temporary ❑ Wall ❑ Electronic (3 copies, if a building permit is required) (Check all that Other ❑ Billboard ❑ Balloon apply) size requirement: 81/2" x 11 ", or 11" x 17" JT New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale Sign Dimensions: / X Z / (3 copies, if a building permit is required) size requirement: 81/2" x 11 ", to 24" x 36" Total Sign Area (sq. ft.): l fj ❑ $40.00 Fee (Permanent sign, any size) Sign Data Total Wall Area (sq. ft.) 19.00 Fee (Temporary sign, type) El $ �' P �' �'� any tYP ) (Complete all Direction Wall Faces (circle one): items in this F R p p r OF 1 . 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? ❑ 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 ❑ 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. DATED this C itA'e 5 4 day of S Pr , 20 0 9 D ort.dif Signature of Owner /Agent 1.0)414 So 3 C, r? `Z. 5 963 Contact Person Name Phone No. • MI CITY OF TIGARD RECEIPT 13125 SW Hall Blvd., Tigard OR 97223 • 503.639.4171 T1CaARD Receipt Number: 175159 - 09/10/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SGN2009 -00197 Temp Sign Perm 1003100-43115 $17.00 SGN2009 -00197 Temp Sign Perm - LRP 1003100-43117 $2.00 Total: $19.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Cash KPEERMAN 09/10/2009 $19.00 Payor: Ptld Branch RSCPS Total Payments: $19.00 Balance Due: $0.00 Page 1 of 1