SGN2009-00179 i
CITY OF TIGARD SIGN PERMIT
114 � ,1 Permit #: SGN2009 -00179
COMMUNITY DEVELOPMENT Date Issued: 08/17/2009
I T..,.:.,. 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 Parcel: 2S114AA00100
Jurisdiction: Tigard
Name of Business:
Business Address: 9000 SW DURHAM RD
Applicant/Agent: Bengston, Joanne
Work Description: Placement of (1) one 24 s.f temporary banner. Valid 8/24/09- 9/24/09. Sign #1 Sign
must be placed on private property and not in the public right -of -way or visual clearance.
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 4'x6'
Total Sign Area: 24
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:
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Permittee Signature: ' /�
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SIGN PERMIT APPLICATION
Cit of Tigard Permit Center 13125 SW Had BIuL, Tigad OR 97223
Phone. 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Develo ment/Project •
! �, FOR STAFF USE ONLY
Site ' ' POI ;G1 i'..t e
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Address/ Street Address Permit L �.OD No.: LS ° 1 % - VO
Location p. 8/2.-// 0 7 - 7/ '1( 0/
Expiration Date:
Suite /Bld # Gry /State Zip
Receipt # : `J
P rh T i*
Name � Approved By f q
Pro a — d S �/ f Date: / / 7 / , • Owner Mailin s SSuitee Map /TL# : % o ' v J Zoning: r = e , ,
City/State Zip Phone '
( 5D3 `1 - 't05 Electrical Permit Required? ❑ Yes U--210
Tenant or Na ` [ S r - � c b oI- Building o
Business J y J (i�� g Permit Required? q ❑ Yes �
O Rev. 7 /v07
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Sign C %I�Jl 1 1* . ) `4' +t ' ^' , + •
Contractor' Mailing Address SC O
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(Prior to pemut (% ( KigA) ipa`wi . 3
issuance, a
copy of all City/State zip gqPh��onee /� / REQUIRED SUBMITTAL ELEMENTS
licenses are � � .N J Y q 0 1 (Note: applications will not be accepted
required if without the required submittal elements)
expired in the Oregon Const. t. oard License # Exp. Date
Gry of Tigard's Al tabase) / ❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Sign emporar . Wall [1] Electronic (3 copies, if a building permit is required)
(Check all that Other Billboard ❑ Balloon size requirement: 8 /" x 11 ", or 11" x 17"
apply) �l
tgc New sign? ❑ Aker to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: At )4. 6 (3 copies, if a building permit is required)
size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): 2 ( ,,F
` ❑ $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
Con VY`11yI 1 PAM ILY ri' placement.
I IL • 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: ❑ Intemal ❑ 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)
1
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.
DA'1ED this I day of ; v 20
Sign e of Oa 0 Agent
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Contact Person Name r' tr t
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CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
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Receipt Number: 174863 - 08/17/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009 -00179 Temp Sign Perm 1003100 -43117 $17.00
SGN2009 -00179 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
Credit Card 054154 KPEERMAN 08/17/2009 $19.00
Payor: Joanne Bergston /City of Tigard
Total Payments: $19.00
Balance Due: $0.00
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