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SGN2004-00106 ► A CITY TIGARD SIGN PERMIT �� DEVELOPMENT SERVICES PERMIT #: SGN2004 -00106 � 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/13/04 PARCEL: 1 S 136CD -01000 BUSINESS NAME: CROWN CARPET ZONE: C -G SIGN LOCATION: 11745 SW PACIFIC HWY JURISDICTION: TIG APPLICANT /AGENT: BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: Y FREEWAY: TEMPORARY: WALL: ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 4' X 8' TOTAL SIGN AREA: 32 sq. ft. WALL AREA: sq. ft. WALL FACE (DIRECTION): SIGN HEIGHT: ft. PROJECTION FROM WALL: in. ILLUMINATION: NON DESCRIPTION OF SIGN: Placement of one permanent, freestanding sign. Addition of 32 sq ft to existing structure. MATERIALS: PLYWOOD EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: N BUILDING PERMIT REQUIRED: Y 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 siggpermit shall expire. A temporary sign shall expire 30 days from validity date. A balloon sign shal`ezpire,10 d— fro1i dity date. I CL-4.14 APPROVED = PERMITTEE SIGNAT ► ' E: � -A DATE: 5/13/04 ■ la 1 y� c9va /? i3 /44, .1,,, SIGN PERMIT APPLICATION S �,�,�. � I I II CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297 GENERAL INFORMATION Name of Development/Project FOR STAFF USE ONLY Site elf01.0 ✓l - I - S t Twt,. - em47 Address/ Street Address I Permit No.: S& N c oot4 -00/0(0 Location 17 c S W KW Expiration Date: Suite /Bldg. # City /State ( Zip ( TO 73 ct �� . fl 22, Receipt #: 6 v d `{ -- a OA 8 Name Approved By: d. ea- 4-71.(4.) Property M I ' .v-MS Date: 5 - (3 - 0 4 Owner Mailing AckreED Suite MapITL #: i S (C0 C 0 - /0 U a 1412o E , Cvi v,s kv -c,. Zoning: C - G City /State Zip Phone bra ,l� f X00) Electrical Permit Required? ❑ Yes ❑ No Tenant or Name Business 3. ,,,_ ,.,t.- Building Permit Required? ❑Yes ❑ No Name L Rev. 8/7/2003 is \curpin \masters \revised \sign permit app.doc Sign GIST S Contractor Mailing Address ( � Suite REQUIRED SUBMITTAL ELEMENTS (Prior to permit 1 StS � ta�' C �}i � (Note: applications will not be accepted issuance, nI the required submittal elements a wy w ithout th copy of all City/State Zip Phone 4 elements) licenses are G required if (' � oa t1h3 6/3 2 4- Wg m ❑ Completed Application Form expired in the 0 -•. Const. Cont. Board Exp. Date City of Tigard's Lice e # � ❑ 2 Copies of Site /Plot Plan, Drawn to Scale database) � I(] � 1 (— O % (3 copies, if a building permit is required) Proposed Permanent ■ reestanding ❑ Freeway size requirement: 8 x 11", or 11" x 17" Sign Temporary I. Wall ❑ Electronic (Check all that ❑ Other ❑ Billboard El Balloon ❑ 2 copies of elevations, drawn to scale apply) (3 copies, if a building permit is required) ❑ New sign? Z Alter to existing sign? size requirement: 8 x 11", to 24" x 36" Sign Dimension 0 o 2 � x-7.2. - 7Q . ) `l' x7- (x ( ❑ $31.00 Fee (Permanent sign, any size) Total Sign Area (sq. ft. : 3 sc , ❑ $15.00 Fee (Temporary sign, any type) Sign Data Total Wall Area (sq. ft 17004, Jurisdiction: ❑ City ❑ Urb (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, Projection From Wall (inches): " but must include dimensions of wall face and sign placement. Copy: Cft_oU'K) C ckkEtTS • Wall signs do not require site /plot plans. Materials: VI NYL LEmin omPAint>EDit- 41400t) • Freestanding signs over 6 ft. required a Will sign have illumination? ❑ Yes ,sl 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) F L 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. 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A.*. fu {,=',� ♦� II i 1 . d :. y .r` G, •y 1 H I CROWN )lc - CROW,/ CARPET • TILE • VINYL WOOD • LAMINATE CITY OF TIGARD 5/13/2004 13125 SW Hall Blvd. 3:51:S3PM Atoo Tigard, Oregon 97223 ,� : :, (50 3) 63 9-4 17 1 eceipt #: 27200400000000002028 • Date: 05/13/2004 Line Items: Case No Tran Code Description Revenue Account No Amount 'Paid SGN2004 -00106 [SIGN] Sign Permit 100 - 0000 - 437000 31.00 BUP2004 -00218 [BUILD] Permit Fee 245- 0000 - 432000 62.50 BUP2004 -00218 [TAX] 8% State Surcharge 100- 0000 - 207020 5.00 Line Item Total: $98.50 Payments: • Method Payer User ID Acct. /Check Approval No. How Received Amount Paid Check DOUGLAS C LEPPER CAC 6188 In Person 98.50 Payment Total: $98.50