SGN2004-00090 . i CITY OF TIGARD SIGN PERMIT
1 1� DEVELOPMENT SERVICES PERMIT #: SGN2004 -00090
�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/5/04
PARCEL: 2S112DD-01400
BUSINESS NAME: COURTYARD MARRIOTT ZONE: I -P
SIGN LOCATION: 15686 SW SEQUOIA PKWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 5' 1 -1/2" X 2'
TOTAL SIGN AREA: 10 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 0 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Replacement face to existing freestanding sign.
MATERIALS:
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 31.00
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 m validity date.
APPROVED BY: '
PERMITTEE SIGNATURE:
/ -- _
DATE: 5/5/04
Sf ,iint. SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
AA_ FOR STAFF USE ONLY
Site CO URT�IjAP� 1 % orT
Address/ Street Address `l Permit No.:__
Location ls48 Sk( 0 % A kua\/
Suite /Bldg. # City /St v Zip I Expiration Date:
Ti GRRT7 QR- Receipt #: . —
Name Approved By: k-
ro ert Date: 5 / S
Owner y Mailing Address Suite Map/TL #: ,Q ) 1 1 - D % - D ty o
Zoning: Z 7
City /State Zip Phone
Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name
Business Cep,-)17-71-\1 ^ ' .AiZ�iZia�'T' Building Permit Required? ❑ Yes ❑ No
Nam R�Z� /�l
nl am e Rev. 30 -Jul -01 is \curpinUnasters\revised\sign permit app.doc
Sign 1k.JLTl -- LA G-t-cr l4rkk CO ,
Contractor Mailing Address • Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit 8os k � �, (Note: applications will not be accepted
issuance, a
copy of all City/State Zip Phone without the required submittal elements)
licenses are piniz - 4 Z �97 z 6-03 _ � 8 i f ?
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) 6,4(64- (3 copies, if a building permit is required)
El—Permanent size requirement: 81/2" x 11 ", or 11" x 17"
Proposed
emianent Freestanding ❑ Freeway
Sign ❑ Temporary ❑ Wall ❑ Electronic ❑ 2 copies of elevations, drawn to scale
(Check all that ❑Other ❑ Billboard ❑ Balloon (3 copies, if a building permit is required)
apply) size requirement: 81/2" x 11", to 24" x 36"
❑ New sign ? [Alter to existing sign? ❑ $50.00 Fee (Permanent sign, any size)
Sign Dimensions: t�2!• x , 2 • (• ❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.):
10_ g NOTES:
Sign Data Total Wall Area (sq. ft.) • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
(Complete all Direction Wall Faces (circle one): sign placement.
items N S E W NE NW SE SW emi this • Wall signs do not require site /plot plans.
section)
• Freestanding signs over 6 ft. required a
Height to top of sign (feet): 2-' 4, " _ building permit.
Projection From Wall (inches): • If work authorized under a sign permit has not
Copy:E M Ato - 6"$ been completed within ninety (90) days after
Materials: the issuance of the permit, THE PERMIT WILL
Will sign have illumination? Yes ❑ No
BECOME NULL AND VOID.
LW
Type: ['Internal ❑ External / /
Are there any existing freestanding or wall signs at this Not all jurisdictions accept credit cards, please call jurisdiction for more information.
location, including wall signs that overlap a tenant space? 0 visa CI MasterCard
Credit card number l 1
❑ Yes ❑ No Expires
If "yes ", a list or diagram of all sign dimensions and Name of cardholder as shown on credit card
square footage must also be submitted. S
Cardholder signature Amount
(OVER FOR SIGNATURES)
0
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 T<< day of Ivy A , 20
Signature of Owner /Agent
Z$1- 3083
Contact Person Name Phone No.
CITY OF TIGARD 5/5/2004
13125 SW Hall Blvd. 1:46:48PM
Tigard, Oregon 97223
� +�► c1 (503) 639 -4171
Receipt #: 27200400000000001882
Date: 05/05/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00090 [SIGN] Sign Permit 100 - 0000 - 437000 31.00
ELC2004 -00231 [ELPRMT] ELC Permit 220- 0000 - 431510 53.40
ELC2004 -00231 [TAX] 8% State Surcharge 100 - 0000 - 207020 4.27
Line Item Total: $88.67
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check MULTI -LIGHT SIGN CO DEB 37153 In Person 88.67
Payment Total: $88.67
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