SGN2009-00185 A ?, 4,. CITY OF - r�GAR® SIGN PERMIT
i Permit #: SGN2009 -00185
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COMMUNITY DEVELOPMENT Date Issued: 08/20/2009
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„ 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 1S135BB00500
Jurisdiction: Tigard
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Name of Business:
Business Address: 15981 SW HALL BLVD
Applicant/Agent:
Work Description: Placement of (1) one temporary 3'x4' A -frame sign. Valid 8/20/09- 9/20/09. Sign #3
Sign must be placed on private prioperty and not in the public right -of -way or visual
clearance area.
Permanent: No Freestanding: No Freeway: No
Temporary: 3 Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: Yes
Sign Dimensions: 3'x4'
Total Sign Area:
Wall Area:
Wall Face (Direction):
Sign Height: 4 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:
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Permittee Signature: 1111 " , t Z— a,-)
P
•-." I N * q SIGN PERMIT APPLICATION
City 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
FOR STAFF USE ONLY
Site / S� 0 lAdb 1' °I 1 3
Address/ Street Address Permit No.:
Location t 5c(g i SW V ilLL t 3t, ' /0 VO-....b Expiration Date: b
Suite /Bldg. # City/State Zip
- -tI(1,1"b C) 12211- Receipt #:
Name Approved By: /1
Property aa,M A(L wO Q 021 t fS Date: 0 i// al
Owner Mailing Address suite Map /TL #: Si 3 566a05,0
S\)J S .W% 11'f Z� 0 Zoning:
City/State Zip Phone
SEATttC ura .
Tenant or Name Electrical Permit Required? ❑ Yes [ 'No
Business Pet MCI C S42t S O Building Permit Required? ❑ Yes 13-
Name Rev. 7/1/09
r \ 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) 12' 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 ❑ Balloon t " 11", 11"
apply) size requirement: 8 /z x 11 , or 11 x 17 "
❑ New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: 3x4 X 25tOf5 (3 copies, if a building permit is required)
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.) 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): 41 ♦ 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 1 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
111 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)
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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 2 -e ) day of NU (& u 5 , 20 b 6 7 -
Si e of ner /Agent
ikkiklc UN ► u-, Avvr 563 - 1 619. 4.2 7
Contact Person Name Phone No.
; M : CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
;TIGAR
Receipt Number: 174934 - 08/20/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00185 Temp Sign Perm 1003100 -43115 $17.00
SGN2009 -00185 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
Check 19966 KPEERMAN 08/20/2009 $19.00
Payor: Northwest Gourmet Coffee Co Inc
Total Payments: $19.00
Balance Due: $0.00
Page 1 of 1
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Sig n Elevation
Primo
E spresso Copy duplicated on
reverse face
OPEN
4'
5:3OAM
WEEKDAYS
6 AM
WEEKENDS
3' 1
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
•
Sig n Elevation
Primo
Espresso Copy duplicated on
reverse face
OPEN
4'
5:3OAM
WEEKDAYS
6 AM
WEEKENDS
1 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