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SGN2007-00104 M I CITY OF TIGARD SIGN PERMIT DEVELOPMENT SERVICES PERMIT #: SGN2007 -00104 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 6/5/2007 PARCEL: 2 S 113A D - 01800 BUSINESS NAME: JOHNSTONE SUPPLY ZONE: I - SIGN LOCATION: 16650 SW 72ND AVE B12 JURISDICTION: TIG APPLICANT /AGENT: BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: Y ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 1' 10" X 2' TOTAL SIGN AREA: 3 sq. ft. WALL AREA: 1,000 sq. ft. WALL FACE (DIRECTION): W SIGN HEIGHT: 20 ft. PROJECTION FROM WALL: 1 in. ILLUMINATION: NON DESCRIPTION OF SIGN: placement of one (1) permanent wall sign 1' 10" X 2' MATERIALS: ALUMINUM EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: N BUILDING PERMIT REQUIRED: N ADMINISTRATIVE EXCEPTIONS: TOTAL PERMIT FEES: $ 39.00 This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of Oregon Specialty Codes and all other applicable laws. 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: j1/0 is PERMITTEE SIGNATURE: 1411r1--19-3" / 9-P-*1°'—/ DATE: 6/5/2007 " Er SIGN PERMIT APPLICATION City of Tigard Pert Center 13125 SW Hall Bl'ul, Tigarc4 OR 97223 Phone. 503.639.4171 Fax: 503.598.1960 GENERAL INFORMATION Name of Development/Project FOR STAFF USE ONLY Site 4 ( , k Alo i Address/ St ress Permit No.: A) 0-040 7' 47- o( O C-/' Location /6, G o $1,-) - +z-c.A c L, Expiration Date: Sait2/B1dg. # Qty /State Zip i- S.-.� y - 7 :,� C/ Receipt # : 30 q v Name Approved By. 5 • Tg01- Property C -91-c-- q---- t., ...-r,y r J Date: 49l "'1v7 Owner Mailing Address Suite Map /TL# : .: ( - 4 4 " U l8 Zoning: l L City /State Zip Phone Tenant or Name Electrical Permit Required? ❑ Yes ❑ No Business � A rr r ��� Building Permit Required? ❑ Yes ❑ No Name Rev. 7 /5/06 is \curpin \ masters \land use applications \sign permit app.doc 1 Sign �.w7 S Contractor Mailing Address ✓ U smote (Prior to permit /� / b issuance, a `7 l 0 s-74 14 copy of all Qty /State Zip Phone REQUIRED SUBMITTAL ELEMENTS ' licenses are !') _ A (Note: applications will not be accepted required if �(�C� A 5 '7 7 7 5 expired in the Oregon Const. Cont. Board License # Exp. Date without the required submittal elements) Qty of Tigard's database) (7 3 U J 9.- / 90-0 1 ❑ 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 appl ❑ Other ❑ Billboard ❑ Balloon size requirement: 81/2" x 11 ", or 11" x 17" j New sign? ❑ Aker to existing sign? ❑ 2 copies of elevations, drawn to scale Sign Dimensions: ' _ ' 3 X D - I (3 copies, if a building permit is required) N size requirement: 81/2" x 11 ", to 24" x 36" Total Sign Area (sq. ft.): _ 5 F 3 , / 5 ❑ $39.00 Fee (Permanent sign, any size) Si n Data Total Wall Area (sq. ft.) g Ov. , , /bw s f ❑ $19.00 Fee (Temporary sign, any type) (Complete all Direction Wall Faces (circle one): items in this NOTES: section) N S E NE NW SE SW Height to top of sign (feet): C) / ♦ Wall signs do not need to be drawn to scale, but Projection From Wall (inches): l '' must include dimensions of wall face and sign o . (, p � placement. �' • Wall signs do not require site /plot plans. Materials: „ter ♦ 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 El 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 S day of �, jz _ , , 20 Signa e of Own r Agent Y 11r t , %," 3 - '/ 7 7 45 - Contact person N Phone No. CITY OF TIGARD 6/5/2007 III 131 25 SW Ilan Blvd. 3: 10:46PM • Tigard, OR 97223 503.639.4171 TIGARD Receipt #: 27200700000000002490 Date: 06/05/2007 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2007 -00103 [SIGN] Sign Permit 100- 0000 - 437000 34.00 SGN2007 -00103 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00 SGN2007 -00104 [SIGN] Sign Permit 100- 0000 - 437000 34.00 SGN2007 -00104 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00 SGN2007 -00105 [SIGN] Sign Permit 100- 0000 - 437000 34.00 SGN2007 -00105 [LRPF] LR Planning Surcharge 100 - 0000 - 438050 5.00 ELC2007 -00377 [ELPRMT] ELC Permit 220- 0000 - 431510 53.40 ELC2007 -00377 [TAX] 8% State Surcharge 100- 0000 - 207020 4.27 Line Item Total: $174.67 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid Check RAMSAY SIGNS INC ST 2026 In Person 174.67 Payment Total: $174.67 cReceipt.ipt Page 1 of 1