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SGN2009-00156 4 1 CITY OF TIGARD SIGN PERMIT a Permit #: SGN2009 -00156 COMMUNITY DEVELOPMENT Date Issued: 06/26/2009 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S102AC01100 Jurisdiction: Tigard Name of Business: Business Address: 12568 SW MAIN ST Applicant/Agent: Cleaning Green, Work Description: Placement of one (1) temporary sign (Balloon) Valid 6/27/09 - 7/6/09 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: Electrical Permit Required: No Building Permit Required: No Total Permit Fee: $19.00 Conditions: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. A permanent sign must be placed within 90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon sign shall expire 10 days from validity date. Approved By: ALLeby d Permittee Signature: ' # G i Ju 26 09 10:01a FOREST CLEANING INC 503-624-1425 p.1 I • • RI SIGN PERMIT APPLICATION G of Tigard Permit Center 13125 SW' Hal 1.Blvd., Ziiard, OR 97223 11,c3A Phone: 503.639.4/71 Fax: 503.598.1,960 GENERAL INFORMATION ¶m :. oCDcvclo /t' o I i : t ! ' 1, 1 — - ` FOR STAFF USE ONLY Site v 4'.' i. l -I(.'; .l` n Address/ Sret r � '� r t � '\' ,\ f1 , c . 2 N o.: . �1 3rd , 0 (5( Location '� . '�; .4iC> t, )' i \ \ )1;1;1 It " suite f31d # ci - F cation Date: /MA-. y/S [C • Li 1 p 1 1 C1i, �t CI)i L / �- Receipt #: — Narnc l � 1' • S 1-12-'04 I "— Approved By: Property Date: Gila-40(01 Owner Maihr g Ad dress Suite A.4ap /TT.#: 615103_111., 0 t • Zoning: City /State Zip Phone Tenant or ;dam Electrical Permit Required? ❑ Ycs �No Business : i/ k 1. '1 '� ^� (/. ti ' ; 1: Building Permit Required? ❑ Yes )J ilcIo Nagle Rev. 7 11/(17 • `,✓ L \clfphL\ masters \land use applications \sit7l permit app.doc Sign Contractor laihng \ddress Suite (Prior to petrlit issuance,a -_ _- cony of all City /State Zip Phone REQUIRED SUBMITTAL ELEMENTS tlCe'n$CS arc n:yuircd if (Note: applications will not be accepted expired in the oregr�n t:,n.c. Goa[. Hoard License rt ,ap- Hate without the required submittal elements) • City of'figard's database.) ❑ Completed _Application Form Proposed ❑ Pemclnent ❑ Freestanding ❑ Sig,,, Freeway III Copies of Site/Plot Plan, Drawn to Scale Temporary ❑ Fall Llev.mnic (check :IL that (3 copies, if a building permit is required) apply' ❑ Other ❑ Billboard Balloon size requirement: 8Y-2" x 11", or 11" x 17" ❑ New sign? ❑ 2 to existing sign? ❑ 2 copies of elevations, drawn to scale Sign Dimensions: (3 copies, if a building permit is requited) Total Sign Area (sq. ft.): size requirement: 81/2" x 11 ", to 24" x 36" ❑ $40.00 Fee Permanent sign, any size) Sign Data Total Wall Area (sq. ft.) , .-2( ,.i 9.00 Fee (Fetnpora-ry sign, any type) (Completc all Direction Wall Faces circle one): items in thi., section) N S E W NE NW SE SW NOTES: - Height to top of sign (feet): : • Wall signs do not need to be drawn to scale, but Projection From Wail (inches): I must include dimensions of wall face and sign Copy: placement. Materials: • Wall signs do not require site /plot plans. - • Freestanding signs over 6 ft_ required a building Will sign have illumination? ❑ Yes ❑ No permit. Type: ❑ Internal U External • If work authorized under a sign permit has not been Are these 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 subtttitted. (OVER FOR SIGNATURES) (e/'-1 JP� 26 09 10:01a FOREST CLEANING INC 503 -624 -1425 p2 j- 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 \ (i___ ( �� r G ? 1y of \ 1 } . 20 0 r' t il 1 .+1 (_) Signature of Owner /Agent ' T A, + Contact Person Name i Phone No. :,1)("1-\_J /11 ; ' � C . \ u C\ \ l � , C , \ l 1 l `u 6. � `(C C- C i 1 C � "� -C J � i , „ �. � ,. ; - ; -_ j� \�~ r I \C )/ C ` A () , CC .. CITY OF TIGARD RECEIPT 1 13125 SW Hall Blvd., Tigard OR 97223 • 503.639.4171 TIGARD Receipt Number: 174159 - 06/26/2009 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SGN2009 -00156 Temp Sign Perm 100- 0000 - 438050 $17.00 SGN2009 -00156 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 009762 STREAT 06/26/2009 $19.00 Payor: Moira Smith Total Payments: $19.00 Balance Due: $0.00 Page 1 of 1