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SGN2006-10014 C ITY OF TIGARD SIGN PERMIT "11 ` DEVELOPMENT SERVICES PERMIT #: SGN2006 -10014 TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/14/2006 PARCEL: 1S134AA BUSINESS NAME: MY GYM ZONE: C - SIGN LOCATION: 10115 SW NIMBUS AVE 500 JURISDICTION: TIG APPLICANT /AGENT: JEFF MIDDLETON BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: Y ELECTRONIC: Y OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 2' X 12' TOTAL SIGN AREA: 24 sq. ft. WALL AREA: 367 sq. ft. WALL FACE (DIRECTION): E SIGN HEIGHT: 12 ft. PROJECTION FROM WALL: 11 in. ILLUMINATION: INT DESCRIPTION OF SIGN: Placement of one (1) permanent wall sign 24 sq. ft MATERIALS: ALUM EXISTING SIGNS: ELECTRICAL PERMIT REQUIRED: Y BUILDING PERMIT REQUIRED: N ADMINISTRATIVE EXCEPTIONS: TOTAL PERMIT FEES: $ 38.00 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. Cl APPROVED BY: • PERMITTEE SIGNATURE: a W DATE: 3/14/2006 CITY OF TIGARD SIGN PERMIT BUILDING SERVICES DIVISION AI 13125 SW Hall Blvd., Tigard, OR 97223 '! �� 503 -39 -4171 www.tigard- or.gov PERMIT #: 1,t.4 _i oo r DATE ISSUED: al, y1/4 6 BUSINESS NAME: M y Y,(4 PARCEL #: /j- y /, -O /90o SIGN LOCATION: ( <S stk.) M H,bK ZONING: y E - Z _ APPLICANT NAME: M. i c h G ¢/ j.. (fry a._4_____ JURISDICTION: - Gry �_.,, - _.,_ BUSINESS TAX NO.: This is an interim permit issued during computer system maintenance. The actual permit will be issued and mailed to the applicant within one week of the date issued above. PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: \ ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 2 'X 12- / TOTAL SIGN AREA: 21 WALL AREA: 3 (. 7 WALL FACE (DIRECTION): Lc SIGN HEIGHT: apt , PROJECTION FROM WALL: ii I ILLUMINATION: ../ c DESCRIPTION OF SIGN: t *ivL1oJ-`� et t) Y s �. P Q - r . ma..h e,.4 LA04,1 ( s MATERIALS: 4 I.4- EXISTING SIGNS: /vO ELECTRICAL PERMIT REQUIRED: / &.) BUILDING PERMIT REQUIRED: / ADMINISTRATIVE EXCEPTIONS: A.)/4,.. TOTAL PERMIT FEES: $ 3 8 ACKNOWLEDGEMENT: I understand this Hoe Occupation PerOccupation t is appr• ed for the above described business at the specified location only, and does not require renew. Furt er, I understand that the City of Tigard Business Tax must be renewed annually in order to maintain perms - orization. I acknowledge that this Home- OsGupation P. 1 . pproval may be revoked if the conditions and standards of approval have not been complied with and/sr this ' • me occupation is otherwise being conducted in a manner contrary to the Tigard Community DevelofSment Cod 18.42). Permit revocation due to a violation of requirement(s) of this Home Occupation Permit cannot se renewed fora minimum period of one year (18.142.090). Issued By: /1 ' 4 / r�� Permittee Signature: -, , 1:\ Building\ Forms\ ManualPermitForms \ManualSGNpermit.doc 03/06/06 f 1 , CITY OF TIGARD RECEIPT DEVELOPMENT SERVICES R ECEIPT DATE: T r =- ` - j1J� 13125 SW Hall Blvd., Tigard, OR 97223 JURISDICTION - 71, - a G.�b ;G _- I 503- 639 -4171 www.tigard - or.gov CASHIER DATE: CASHIER RECEIPT #: LINE ITEMS: Case No. Fee Description Revenue Acct. No. Amount Due pp ) p [ , a s) L . J (.. Total Due: $ ' G? c 2,- ❑ SEE ATTACHED FEE SCHEDULE. PAYMENTS: Payer: / c_1v-ti,,� E„ c„ —ls .. ss L L Method Initials Check No. Confirm No. Amount Paid Total Paid: $ 3:'' I:\Building\ Forms\ ManualPermitForms \ManualReceipt.doc 03/01/063/10/2006 01/26/2006 10:42 FAX 5035981960 CITY OF TIGARD 141001 A J :u} 6: . S PERMIT APPLICATION CITY OF TIGARD 13125 SW Hall Blvd., llgard, OR 97223 (503;139-4171 FAX (503) 684 - 7297 GENERAL 1NFORMATiON • Name of Development/Project —` -- Site MV &y rn . FPR STAFF USE ONLY Address/ Street address Permit 14o.: Location Q (`S ,-- 1Q' Suite/Bldg. City /State Zip - EXplPati3rl date: 1 RP 0R q -7223. Receipt #: • . 5f50 Name - Approved By: - - Property ;-I . 6(-64 hnflc 13/ Peopa7 Date:_ 3 bgL Owner Meiling address Suite MapI L# / / ci (ao 2q1/`7 Zoning: /4 L C--C- - Z city/state ' Zip Phone f e 9 Oe er/ « g 227- 50 ( 6 , Tenant or Name Electrical Permit Required? - 9-Yes Q. No Business ) Al ,t.4 CAA y X7 0, > Building Permit Required? ❑ Yes Q —No Name Rev, 7 /1/05 Mew • - nnit:••.doc Sign Contractor svtallin9Address Suite REQUIRED SUBMITTAL ELEMENTS ' (Prtar to permit 31% 5w , - fA �l/ (Note; -a lications will not accepted Issuance, a ( pp pte d ' copy of all City/State Zip Phone -- without the tequired submittal elements) ' licenses are rilacs( 'i 6e. cl�, p, 627z-9o-37 - . required H ❑ Completed Application Form expired in the Oregon Corset. Cont. Board Exp. Date City of Tigard's License # i eye 3J 2 , / T? Q • 2 Copies of Site /Plot Plan, Drawn to Scale database) -- (3 copies, if a building permit is required) Proposed ❑ Permanent ❑ Freestanding ❑ Freeway 1 " D s requirement: S /� x 1 �i , aril' x 17 " Sign ❑ Temporary WW Electronic I (�—� (Check all that ❑ Other . 0 Billboard ❑ Balloon 0 . 2 copies of elevations, drawn to scale (3 'copies, if a building permit is required) I'New sign? ❑ Alter to existing sign? sly:® requirement: $ x 11", to 24" x 36" Sign Dimensions: , , l �, - 0 $38.00 Fee .(Permanent sign, any size) Total Sign Area (sq. ft.): —4 0 2 q ❑ $16.00 Fee (Temporary sign, any type) Sign Data Total Wall Area (sq. ft.) 3 (Q---). Jurisdiction: . ❑ City . ❑ Urb (Complete all Direction Wall Faces (circle one): ' items in this lyp'TE.i.: section) N • .S i W NE NW SE SW • Height to top of sign (feet):, 2 r • W :a-H signs do not need to be drawn to scale, Projection From Wall (inches): 11" - . but must include dimensions of wall face and -- - sign placement . Copy • Wa11 signs do not require site /plot plans. Materials: ALL? m • Freestanding signs over 6 ft. required a Will sign have illumination? ► Yes ❑ building permit. No • • If ' ork authorized under a sign permit has not _ Type: 1 Internal ... 1D External been completed within ninety (90) days after Are there any existing freestanding or wali signs at this • the Issuance of the permit, THE PERMIT WILL location, including wall signs that overlap a tenant space? - BECOME NULL AND VOID. ❑ Yes jg No • • 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 1 am the owner or authorized agent of the owner, and that plans submitted are in compliance with the City of Tigard. DATED this 3 -1 k/ ✓® day of , 20 Q( ✓ � Signature •' O wner /Agent MAO O qoL � 7Z- b3 Contact Person Name Phone No. rt --- 81 - AVER - Ti 6 ' - 1V - SIGNS ..,�.� .' T,_QTALatS .a:=r Jan 30, 2006 H Scott Mccartney Properties P.O. Box 2945 Portland, Or 97208 6 03 - 3 - 54E33 Mr. Mccartney, My name Michael Holman owner of Beaverton Signs. I have been hired to provide Jeff Middleton of MY GYM with their new sign at 10115 SW Nimbus in Tigard. I have enclosed a sign layout for your approval. Please call with any questions 503 - 672 -9037 Than i . .i! � ., mo ,t,/p te , M ich.ei Holman � 1,0 Beaverton Signs - . beavorto"nsigns come; a 'rnailsignsbeav @aol com v 3899 S W Hal! Blvd Beaverton, OR 97005 H:os f . 503.672'443 CCB #�1r34942 t 5.03 5T4 47 _ .FAX 03/13/2006 16:03 FAX a1001 E lectrical Permit Avalication ----- ---- 7. - .-------'-- I 0,17■±1 HA - ':i' - ' t -- ---,'- .. . ,, City of Tigard A Received Permit No.: 13125 SW Hall Blvd, Tigard, OR 97223 Plan Review Other Penult: Phone; 503.639.4171 Fax: 503398.1960 o. Inspection Line: 503.639.4175 .... q r_. Date Rcsdy/13y: Itais: SS See Page 2 tor . Internet: wrw.a.tigard.or.us Notified/Method Supplemental Information , ";?4,' „1 ,MN'TpVi,,;: .7,4 0 New construction 0 Addition/alteration/replacement Please check all that apply: ['Service over 225 amps, conarel ElHazardous location 0 Demolition AzOthen CIServicc over 320 amps - rating GiBuildng ova 10,000 sq. ft., . . . _ ,: -,. ... of 1- and 2-family dwellings 4 or more now residential 0 1- and 2-family dwelling Commerciallindustrial 0 Accessory building 7 . °System ova 600 volts nominal units in one structure 0Building over three stories OFeeclers, 400 amps or more ID Multi-family 0 Master builder 0 Other: • DOccupant load over 99 pawns 1:IManu factured stmetures or . , ."-- • - vy:.-. ',if '',' ''',..:": ..', ..Y.' °Egress/4 Plan RV park 0 Health-care facility El Other: Job no.: Job site address: I 01 i S0 iy , 1 ix) 5 Submit 2 50t5 Of Plahg with any of the shove- City/State/ZIP: .-n (,____,. A/Z.0 0 R q 7 2 2 -7-. The above are not applicable to temporary construction service. Suite/bldg/apt. no.: 500 Project name: Etnerip" lige I Q07 Pa. I Tout P l.."' Cross street/directions to job site: /Nil I fyi 1).(f / fi > „7, New residential sink i't " 8 " -famil Y dwelli'l unit. Includes attached garage. 1,000 sq. ft. or less 145.15 4 Subdivision: ' Lot no.: E& addi 500 sq. ft. or portion 33.40 I - Limited energy, residential 75.00 2 Tax map/parcel no.: Limited energy, non-residential 75.00 2 e:f*frYVWi.0 it' .. ' ;V:-.,: ':l*ft i .‘'. 61 0tc:fei't4." , :' ,. :. : •...4 45,4-7 .: ...:." Each IMInufactured or modular ... dwelling, service and/or feeder 90.90 2 C 9 / -4 / t/ 57/1 L 1 Servites or feeders installation, alteration, and/or reloesdon 200 amps or less 80.30 2 0.00 6 . : ".':':f:' ; ':' ,: : ::.- .42 201 aniM 10 40° amps 106.85 2 • ,.. .. 401 amps to 600 amps 160.60 2 Name: 13 ,A(. 5c0.44- rikacAltro turli: 601 amps to 1.000 amps 240.60 2 Address: p. 0 . _ box 21'4 r ic> Over 1,000 amps or volts 454.65 2 - Reconnect only 66.85 2 City/StateiZIP: k--L 0 p_ cr Temporary services or feeders Installation, alteration, audior • relocadoa Phone: (50 ) Z 2 - 5000 Fax: (5cis ) 223 .- i .,..3 200 amps or less 66.85 Owner installation Th : is installation is being made on property that I own which is not 201 anips to 400 amps 100.30 intended for sale, 1 rt. or exchange, according to ORS 447, 449, 670, and701., 401 tunps to 600 amps 133.75 1 2 Owner signature: e: "" - .go Branch circuits - new, alteration, or extension, per panel t!'..5 ,:' .._ .414:4e Vi ';''.•.:.: A. Fee rer branch circuits with service or feeder fee, each Business name: 6atet 6.65 2 5. 5 branch circuit B. Foy for brandt circuits Contact name: Ali fr.c.“,01,. iorh Or"-- without service or feeder fee, 46.85 2 each branch circuit Address: 3g 5 k..) 141411 /!'L. C) Each Weil branch circuit • 6.65 , 2 CitY/SlaterVF: e/...--A-Ityt..7/ o q 7c21..-,- 5 Miscellaneous (service or feeder not ioeladed) Pump or irrigation cir 2 cle 53.40 1 PhOnc: (.....)`, ) • 6..72_ 5--0 3 ' - -7 I Fax: : (5) (50 5 / Sign or outline lighting 1 53.40 2 - E-mail: 54 L4:5. r nErtt14 5'm .s. , 6,e2"-2.-^ Signal eirouit(s) or limited- ' i " - .".':rfs'10::& ; ..40.Z.•' . 7 ) ;t07.4111".ACTOR.f.',:.:'.' '-'4'.;:,.,,.;'!:- ': z'' '''',:',': !.;;;'..,.'",:-T ', , , , ' ' energy Panel. Aeration. or 1 extension. Describe: Page 2 2 Business name: 5 )t. c D p , ( Address: / 6. e',9 .5- ,,,.. o 5 , ir / Each additional inspection over atiosvitbk in an of the above Per inspection 62_50 City/Statc/Z1P: ,,, 2 3 6 investi pa hour (i hr min) 62.50 ... . Phone: (Cr 3 iV6 f476 3 Fax: ( ) Industrial plant per hour 73.75 ' :• j' • , CCB Lk.: /6 I Electrical Lie.: 26 -// .. r'ooduprv. Lic.: 4W5/(:.; Subtotal Suprv. Electrician signature, required: / 40 Plan review (25% of permit fee) Print name: __ -7) . "*„--- /-Z ,e. Date: - State surcharge (S% of permit fee) TOTAL PERNirr FEE Authorized signature: 41/6// .,- -•-• '\ ) i - 11101 permit application aspints if a wok h not obtained withia UM days Ant it hos be accepted es complete Print naxne: 4 A g / ... /1,-.. Date: 07 - de • Fee methodotagy Mg by Tti-Coulny Building Industry Service Bated " Number of inspections pa peonit allowed- IMMIding1Ihreaiat.11LOPeanitApp.do4 12/03 440-4615 10/02/COMAVEB _ - • - BEAVERTON SIGNS Proposal for NEW CHANNEL LETTERS internally illuminated • ■ • • with compact fluorescents with raceway ■ 143 (11.9') Channel letters internally illuminated with compact fluorescents. Alum. returns painted red to match 3M 230-33.Trim cap red to mater 3M 230-33"My Gym" acrylic faces with translucent red vinyl. — Logo can with vinyl image. Logo can and letters to be mounted 24 `� ma y ' on raceway. Logo can return and trim cap to match 3M (2) G�m intense blue 230 -127. Raceway to be painted to match wall (Grey PMS 444c). All UL Approved. 360" (30', 367sq ft ) sign sq ft = 23.8 sq ft 288" (24') 72" (6') Front sq ft = 367 sq ft sign sq ft%= 15 sq ft 37" f .' ' '''''---4-;". MP GY1111 (3.08') 147" (12.25') ,... u "r `. - 1 , + 4 Ili . . f .. FRONT VIEW .' ,, _ ti g M Ayes V Phone: 503-672-9037 3899 SW Hall Blvd. CLIENT APPROVAL: Fax: 503-574-4741 Beaverton, Oregon 97005 e -mail: signsbeav ®aol.com CC B# 134942 LANDLORD APPROVAL: Jan 31, zoos This Original artwork is the property of Beaverton Signs and is protected under Federal Copyright Laws. Make no reproduction of this design concept ,-1 .f, e 1 1 { , T �.. F ,v ' t ""� +# ±e e i ?� for J ! / - B E A% '' r� N Proposal W int illuminated y gi 1 „ „ i ff y : �k� To ". -7-"':1-,i G, ! o t Lu T 4 O N' � r4 . - „, kr with NE compact CHANNEL fluorescents LETTERS with raceway ernall 143” (11.9 ') Channel letters internally illuminated with compact f luorescents. Alum, returns painted red to match 3M 23033 Trim cap red to matct �-4 , 4, r 6 ,,, 3 " 3M 230 33 My Gym" acrylic faces with translucent red vinyl. 24 t, � — �:r� n y� ' s $ =µ ii` + 1 Lo can with vinyl image Logo can and letters to be mounted /2' ',11191,,,„,.T.,„„,\ ,-- ; ' �s „ ': + t ,. " A, �+ on raceway. Logo can return and trim cap to match 3M ( ) , �' s r � r � x"114 m 3 t ' ' I ' h� intense blue 230 -127. . - , , , F , � y , Raceway to be painted to match wall (Grey PMS 444c). A . x1 i ° ' a �° .. All UL Approved. 360 " (30, 367sq ft ) sign sq ft = 23.8 sq ft _ 288" (24') 72 " ( Front S ft 367 S ft "� r � .� a a • ? �v ^ e� of �� Ny. w eY L�1 ' . y ,-,-,3 • .gd q sq t (ty ,> rx -,,...-,,v '� ` ' c° h .. fib ," ; �+* r "',,.,'u ;.1,'''' � " r ` s ,C ,. ,� „r w x' w 4 " 5` , z ,j 1�, J� § `h7 �F. �, r� rY o� "'{ ��, l 5r R � a ' S " C'�u ti ei ,� ��{'''��'' , 37 c'ry' fn .ai� < -",*.'44';'4:` 'x . , rz k I' l , G E. - a�� ` : sign sq ft �0 =15 s ft 37 � �m 4 : 4 0 Vie .. a z � �!� Y sIx k 0. �'. ¢ y et � r f I�� a C xK e eS' «rx h 5 a z , x r r u 147" N b J f q ;�r' }��^�� S � � �'l .y V '��`,� .�M^?`r. �akt 'Y'�i$'��a 5 .,r$� �� s�v�,�w r r�T'� ''°" v or �v - ^ � � 5�! y , . v t a it ^ c� SF � e j ,� I t' c x r i 1 x i, 1 b a. ,, :e ti 47" . , a � i { ., } f i t i 4 t h an s. :,_ , .,..4 ( ) $ � ,. ti } 11--• 1 .� �� 3, i eg tt ] It . 3' ! i r .y' . s ,?�^ x "w' f pl ' f t a 7, 1 k ,4 J r' 7 Y ' i �� g&� r'1" & Y rz a � �) �a,3 � • tc 3Yk „,,,,%,,,,' k u J ■ F., '4 - , .yd j� b t 7 .x .. Fi r , , '£ kr 1 n' Cr H' '1'-4.`,.4';' CV 9 .} , 1t Vi a' Ve w�'tt Kd .�-'�” l r x w YL A ' t0 1 � aagg'4r a 'x i '7fi( 1r y r wktc f4 4 +v 3 x ! `ih Y� ati', , 1 41 ." r_c^yr •.;-; 7^ ` . �P� '1ax'i O ,.} rYz*3 ,fi, t. `' 4 -03�`� Z i k r � w el - � . $,,, '�{ A / W P R 'sir "4. 1 0 >r h / A JI �s i„y Z� i J Z S $ '$^ 1 €� I Js' f•S' { ur ` �f a .. i --:',..r> !�, w' „ sk. e: f , , l + ; � '� r - 4J t•- FRONT VIEW -,_21:.,,,.. , 2 y`� E , a� � � a 3 VAT" � �^ 5, 3 I x t Bi ri 1 h ' -� . • 'p 1 ^�S"+K3 1,4 r j . , e -4, m, '� , 6r 1 3 , " i „. ” : -. '�` -, � ,. r *� R. 3' " C �Ar ➢ 44 j S ` }. } ,-,1 ` b y , d� I' " TE's 1A i I 'E fi C M co La p y� r f r. _ ," i.. ,a .c z ,V i a �4 - 4i x a r W i-m 7 • i - d IA q " „y am � '` }., aZi f , ' � �' S re 1 3 ' . r . ( $ ?4 � • (' :, s \ _ f - is { - . { z r `z tia or� d t �+ j � j � i -.. , ' i f r — . . F J[. — .0 ` 4 i J , -, 4 ..., ' l',., 1 ( I; , I 4 r'7 '' o e �+. ,.. h. , b �I ' ' I t ? F a I �, ..,„ e'e N Phone: 503 - 672 -9037 3899 SW Hall Blvd. CLIENT APPROVAL: CD Fax: 503 Beaverton, Oregon 97005 e -mail. signsbeav@aol.com CCf3# 1349 LANDLORD APPROVA-L N Jan 31, 2005 This Original artwork is the property of Beaverton Signs and is protected under Federal Copyright Laws. Make no reproduction of this design concept 1 - .. 0 - .... ,...0 ,..., ......, C:ri (.1' F TiGARD i- Approved 1 )4 -..1 ----- - — - . - - C r' e 'i • : .... , , ;II ici Apprcived [ -1" _ _ __._ _ __ 1 t.D e..* me work as described in: , =11\4 ■ 10. 0 - / c s'i Ix' ... n otter to: Follow 1 1 i ND Attach • 1 1 44 , 05 Date: _3 A- 17-- 0 I I-, channel letter ilium wt white FLS, 1" red trim, 5" deep channel logo ilium, w/ white FLS, 1 It. blue trim, red return & whlte polycarb. face w/ vinyl overlay w/ _ ___ 5" deep to match — atch 3m vinyl 320-127 Intense blue 3m trans!. vinyl #3630-33 red, 6.5" x 6,5" rcwy. mount return & wht. polycath w/ no graphic . • .- . painted to match pms prey #444c . . / . 143" .., • _ / / .--- . , r ..;;N:1--' 0 :::.,. :. , 41 n .,. _ . . n ..„___, . . 0' ,...`4T:v.iY..-4',e4'.37,.1.;' .,..,,.... It ,,„„ j,.. :43.....; 4 ..:. :c.' *;-.. ! 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'tn.:: -.Q.; •,`,-; try Qt.,..",;:., V r,...1:43%:41 ' ...''9,......4■,,!?i:;i:t2 51';;5 :V11.. ..... 24,11' : “,n:n.:4 ,:p,;, .n.„1-nn-,-.,n _ ., . ..- 't,,Y1n2ti -In, —: , nn nft- al .../cEn n , :ni.nl-fn — :'• ll,;::^2.? '4'4::-.. ';'•'hIq•';‘i '.:4•:"..1;:..Z.:V•,t,'•';'' '''''T,,,I.ii,::;':`,' • .. 1 ,...,,.;:d . ,:T , ;:;,..,,--.:•:,:• •:-.-c.:%,::::',:::•-, ::•:.',,:fze,l : -1 b.,'?;;SV•I'1.i' L. ;"....,?::: ',,•,""_e;••. 114•?:::":•',.., 'f ,.:' • —S,PV' __ .•.:•',..!4 -F,, -..:?:•;:,.!-::::: -Ii.,',..45 ,,_.„......;.„..,,,,,,,,,,..,,...,... ,. ..,•,- • •,:e V 4- ,f,' , 4e• 7)1.: •,•„r•e .4: ,?':.1&:!' ,•••,:.;;,•ye,. .. ti ,' 't...0 ''"Pr'• R;:i1:•4 ''''.::4:0:• - ..,_ SIGN ELEVATION 1" = 1' . . _ — ----t-- Beaverton Signs Dravortg Data: 1/316 10 Plex Color, 6I3 shown I Trlin Juwelltc Calor: as staPan ' C) " risotons carsrame‘twe . • Custamer — - 1- FAX Addaus:_ £18:iir9__Syl Hall Blvd. Customer approyel: Relur.n Color: ' Rcipoy Color: as *Dem loos eNheoh, Stromm, Dalt oth. Tor. r 7Ela..69 --------- -- . _______ (2143mo-ours istooless-lows 121410a2 Cil y, Stale, Zip: Beaverton, Oragan 970051(2ale approval __ __________i____Ilum:,: _ as siimon _ UL.: _______ Jab Location: Cornmeal: ._ Filo # ____ , —... _ _ _. __._ _ ____ _ • i 1 i I 108,0 Siow (Dl\5 M 0 Ebo S-1-\ 011S F--EgCzy CITY OF TIGARD 4/3/2006 - - " 13125 SW Hall Blvd. 6:52:21 PM Tigard, Oregon 97223 TIGARD (503) 639 -4171 Receipt #: 27200600000000001177 Date: 04/03/2006 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2006 -10014 [SIGN] Sign Permit 100- 0000 - 437000 33.00 SGN2006 -10014 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00 Line Item Total: $38.00 Payments: Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid Check HOLMAN ENTERPRISES LLC KJP /DLH 5838 In Person 38.00 Payment Total: $38.00 • cReceipt.rpt Page 1 of 1