SGN2004-00286 CITY OF TIGARD SIGN PERMIT
11 DEVELOPMENT SERVICES PERMIT #: SGN2004 -00286
III 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/11/04
PARCEL: 2S 102BD -01700
BUSINESS NAME: JIFFY LUBE ZONE: C -G
SIGN LOCATION: 12860 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 6'X9' -6"
TOTAL SIGN AREA: 57 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 20 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Alteration to existing freestanding sign. Replace old sign with 57 sq ft sign
MATERIALS:
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED:
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 32.00
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:
• PERMITTEE SIGNATURE: 9 7 ` .�'
DATE�1 -0/- 1/0,
r
A
`' "i 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 •
Site
511 - F(/ j L �, FOR STAFF USE ONLY
Address/ Street Address Permit No.: ( y do›-S6
Location 1 2 w . g( 0 S . (F - (G 14 (I -
Suite /Bldg. # City /State Zip Expiration Date:
1-1Al24) 11 pl. Receipt #: :- O 4 —
Name Approved By:
Property Smart "} a.Akv(_ Date: / 8' /
Owner Mailing Address Suite - Map /TL #:
/a et' p CIF lc - / Zoning: c ' C 7
City /State Zip Phone
- 1 4 1 4 0 Cie , .5 57; • (,409 Electrical Permit Required? g -es El No
Tenant or Name
Business 71 r - 1" Li l--v177� Building Permit Required? 7 ❑ Yes ❑ No
Name Rev. 7 /1/04 is \curpin\ masters \revised \sign permit app.doc
Sign
HVCaHi. S kCo J 0-
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit r cicv Flop Z - 1 f tj4, (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City /State Zip Phone
licenses are t
required if ?►�h DR 97x7 GRD "1�t21 ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date I
��
City of Tigard's License # /04, s P. 17 k 1- 111 2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
Proposed Permanent Freestanding ❑ Freeway size requirement: 8 x 11", or 11" x 17"
Sign ❑ Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard ❑ 2 copies of elevations, drawn to scale
apply) ❑ Ballo (3 copies, if a building permit is required)
❑ New sign? ErAqer to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: . �
te % 1.C. , ❑ $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): s 7 $1 ❑ $15.00 Fee (Temporary sign, any type)
Sign Data T sq . ft.) Jurisdiction: ❑ City ❑ Urb
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N S E W NE NW SE SW
Height to top of sign (feet): 2� ' • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
Projection From Wall (inches): sign placement.
Co py : • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? D -s ❑ No building permit.
Type: Internal ❑ External • If work authorized under a sign permit has not
Are there any existing freestanding or wall signs at this been completed within ninety (90) days after
location, including wall signs that overl_ap�a tenant space? the issuance of the permit, THE PERMIT WILL
❑ Yes �No BECOME 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 �° �'�� , 20 v e
na - re of Owner /Agent
Contact Person Name Phone No.
CITY OF TIGARD
Approved I • Xl
c c_ z >•-c 0 ,
Conditionally Approved i 1
For only the wprk as described in:
PERMIT NO. --) )24.10 Si Qo Jo _
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PROJECT CONTACT FILE This artistic rendering
JIFFY LURE TIGARD
SAM TRAKUL JIFFY LUBE TIGARD.CDR is the exclusive property
of HIGHLIGHT SIGN
S 1 G 11 LOCATION
DATE until purchased. Any
HWY 99 SALESMAN DA
unauthorized reproduction
• STEVE LAWHEAD 10 \3 \ 04 for any purpose will incur
TIGARD
503-620-8205 OR. legal action.Copyright 1997