SGN2006-00169 , . .
" CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2006 -00169
DATE ISSUED: 9/26/2006
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S 11380 -00500
BUSINESS NAME: SURROUNDINGS ZONE: I -P
SIGN LOCATION: 08184 SW DURHAM RD JURISDICTION: TIG
APPLICANT /AGENT: SURROUNDINGS
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X4'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one 3'x4' temporary A -frame sign. Sign must be placed on
private property and not in the public right -of -way or visual clearance area. Valid
9 -26 -06 &10- 26 -06. Sign #1.
MATERIALS:
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 19.00
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 da s from validity date.
APPROVED BY:
f y
PERMITTEE SIGNATURE: ,h ' - ____
DATE: 9/26/2006 (((
IN .
SIGN PERMIT APPLICATION
• .
City of Tigard Pernit Center 13125 SW Hall Blvd, Tigard' OR 97223
Phone 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development/Project
u (Z FOR STAFF USE ONLY
Site c G /\i - —
Address/ Street Address � � 1 /� /f� Permit No.: � �N� =
Location `Y / Y (.t / /
Expiration D ate. (1b l V / (Z 1
Suite /Bldg. # Zip
— 1 i9 d /2. 9711q Receipt # :
Name Approved By: qq 1
Y( L4
Property i-Pb Date: l a b
Owner Wiling Address i Suite Map /�"L# : Q
/U 66! Y,1ann Zoning: T(
City /State Zip Phone
/ / lei rd O 722
Tenant or Name Electrical Permit Required? El Yes a-No
Business St/0E «h Ch c Building Permit Required? ❑ Yes '
Name Rev. 7/5/06
.---- is \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) ❑ Completed Application Form
Proposed ❑ Permanent Freestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Sign Temporar ❑ Wall El Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other ❑ Billboard ❑ Balloon size requirement: 8' /z" x 11 ", or 11" x 17"
apply) ze re �l
New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: ' , 3' (3 copies, if a building permit is required)
size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
❑ $39.00 Fee (Permanent sign, any size)
Si Sign Data Total Wall Area (sq. ft.)
g ❑ $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
placement.
Copy. • Wall signs do not require site /plot plans.
Materials: ♦ Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes 1Vo 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 ❑ 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 26.---
day ofP be , 20 Dvk
c. 6 -
ent
Signature of Owner/
Cont ct Person Name Phone No.
= - CITY OF TIGARD 9/26/2006
1 11 1 ' � 13125 SW Hall Blvd. 10:26:04AM
Tigard, Oregon 97223
TIGARD (503) 639 -4171
Receipt #: 27200600000000004655
Date: 09/26/2006
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2006 -00169 [SIGN] Temp Sign Perm 100- 0000 - 437000 17.00
SGN2006 -00169 [LRPF] LR Planning Surcharge 100- 0000 - 438050 2.00
Line Item Total: $19.00
Payments:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
Check SURROUNDINGS KJP 2596 In Person 19.00
Payment Total: $19.00
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