SGN2004-00082 CITY OF TIGARD SIGN PERMIT
l DEVELOPMENT SERVICES PERMIT #: SGN2004 -00082
^' �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4128/04
PARCEL: 1 S 136AD -06504
BUSINESS NAME: VACANT ZONE: C -G
SIGN LOCATION: SW NO ADDRESS JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 32" X 48"
TOTAL SIGN AREA: 10 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one temporary lawn sign. (48" x 32 ") Must be placed outside of right
of way.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES:
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: eke- . C�
PERMITTEE SIGNATURE:
DATE: 4/28/04
04/19/2004 08:52 FAX 5035981960 CITY OF TIGARD 1ij002
A •
; a . SIGN PERMIT APPLICATION
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CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Developmend�ro ec m ��. FOR STAFF USE ONLY
Site #/ 5 ! 3 (7/
Address/ SveetAdd s e Permit No.: S(,N a eo-4 -- c�oo'2 a
t
Location )'7' (o d., , 0 0 Expiration Date: 5 "a ` 04
Sulte/Bldg. City /State Zip g72 Z3
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7 C9A-e10 02 Receipt #: a 004 - l r 7(o 3
Name / Approved By C • & ,r,a,>
Date: 4-01i3,04
Property
MA-4K. 3
Owner Mailing Address Suite Map/TL#: • /513(94P U6� `>`
1437-0 SV-1 t 64 ;ble • Zoning: L' G
Cary /State Zip Phone
77 6freS 0 . c 7 z Z4- Electrical Permit Required? ❑ Yes Z No
Tenant or Name
/ Building Permit Required? ❑ Yes No
Business N f�
•
Rev, 8/7/2003 i :lcurpinlrnastere'revieedlsign permit app.doc
Name
Sign iVO" ]p N 8 .._
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
r equired are Completed App
Form
required if ❑ p pp
expired
A of Tlgard's License # red in the License ConsL Cont. Board Exp. Date
Ci 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 ❑ B illboard ❑ Balloon 2 copies of elevations, drawn to scale
MIA (3 copies, if a building permit is required)
New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11 ", to 24" x 36"
Sign Dimensions: 32 // u ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 0,6 5 F izt $15.00 Fee (Temporary sign, any type)
Total Wall Area (sq. ft.)
Sign Data � • Jurisdiction: 1`/ City ❑ Urb
�
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N $ E W NE NW SE SW
Height to top of sign (feet): P7' 0 Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
Projection From Wall (inches): -- sign placement.
Copy = :,: _ - all signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes VI 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.
❑ Yes ❑ No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted. .
(OVER FOR SIGNATURES) •
•
Apr •52pm ; ; P 003/01.15 F-668
I hereby acknowledge that have read this application, that the information given is
correct, that am the owner or autho 'zed agent of the owner, and that plans submitted are
in compliance with the City of Tigard
2• - 4'
DATED this day of • 4 , 20 (9 4- -
Ct.4
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(Or 4iclYN
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Signature of Owner/Agent
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4,44,6
Contact Person Name Phone No.
options for the 48" x 32" lawn sign
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REPRESENTATIVE - FOR STATE
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S T AMER,
4\ . I. f ti First American Title Insurance Company of Oregon
An assumed business name of TITLE INSURANCE COMPANY OF OREGON -
' : p 1700 SW Fourth Avenue Portland, OR 97201 -5512
Phone: (503) 222 -3651
This map is provided as a convenience in locating property
First American Title Insurance Company assumes no liability for any variations as may be disclosed by an actual survey
Reference Parcel Number 1 S 136AD 06504
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EA5EMEf{T-
CITY OF TIGARD 4/28/2004
13125 SW Hall Blvd. 4:21:32PM
A¢ab,di :� I� Tigard, Oregon 9 72 23
Aill■ �'� (503) 63 9-4 17 1
Receipt #: 27200400000000001763
Date: 04/28/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00082 [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
Check JOHN /SUZANNE GALLAGHER CAC 289 In Person 15.00
Payment Total: $15.00
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