SGN2004-00192 CITY OF TIGARD
SIGN PERMIT
l DEVELOPMENT SERVICES PERMIT #: SGN2004 -00192
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/3/2004
PARCEL: 2S112DB -00300
BUSINESS NAME: SEARS PARTS AND SERVICE ZONE: I -L
SIGN LOCATION: 07233 SW KABLE LN 500 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 37" X 24.5"
TOTAL SIGN AREA: 6 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one temporary 37" x 24.5" A -frame sign. Sign must be placed on
private property and not in the public right -of -way or visual clearance area. Valid
8/3/04- 9/2/04. Sign #2
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
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 •ay rom alidity date.
APPROVED BY: A 1 ��''��� -'_
PERMITTEE SIGNATURE: A 4 ' .
DATE: 8/3/2114
. ,
.4 11,1% 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
?� 4- FOR STAFF USE ONLY
Site +�✓[ �--
Address/ Street Address Permit No.: $' /V LC d q. - th ( 9 j e_,
Location 7 Z33 St-) 1616 Lt) �-
Expiration Date: / 23 d - -j 1 b
9 Z f uX
Suite /Bldg. # City /State - n Zip //
0 7% �^ Q 71 z 3 Receipt #:
�/ �
Name / ( Approved By: /G
Property S c., -. ?D e- b v � ... 4- Date:
Owner Mailing Address JQ Suite Map /TL #:
2 ( Z G SE /22 Zoning:
C' /State Zip Phone
n- f/ q it b 5b3 2 - - 3 ") 3 / Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name
Business S � -s Su'vre ,e___. Building Permit Required? El Yes ❑ No
Name Rev. 7/1/04 is \curpin \masters \revised\sign permit app.doc
Sign
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City/State Zip Phone
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City ofTigard's License # ❑ 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 ❑ Balloon ❑ 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: ❑ $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (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
• Wall signs do not need to be drawn to scale,
Height to top of sign (feet): but must include dimensions of wall face and
Projection From Wall (inches): sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes Er 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 overlap a tenant space? the issuance of the permit, THE PERMIT WILL
BECOME NULL AND VOID.
El Yes Tir No l — -
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 3 day of 4i , 20 d y
a ,„„„„„,„741Mlb
: ,nature 6 ner /Agent
c11-• " Thp "."7 sz. 3 0 S
Contact Person Name Phone No.
I 1 Y Ul+' 'l IITAKl) 8/3/2004
13125 SW Hall Blvd. 11:12:42AM
iiiho �� Tigard, Oregon 97223
J� (503) 639 -4171
Receipt #: 27200400000000003416
Date: 08/03/2004
Line Iiems:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00192 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
CreditCard JOHN W DENTON /SEARS, KJP 031761 In Person 15.00
ROEBUCK AND COKJP
Payment Total: $15.00
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CITY OF TIGARD
Approved
• Conditionally Approved
For only the worl.as described in:
PERMIT NO. AN —00 i
See Letter to: Follow
Attach
Job Address: /Z-. 1 Zbt
Date
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