SGN2004-00021 C ITY OF TIGARD SIGN PERMIT
„1� DEVELOPMENT SERVICES PERMIT #: SGN2004 -00021
c �' II 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/6/04
PARCEL: 1 S 135AA -01901
BUSINESS NAME: TIGARD FAMILY CHIROPRACTIC WELLNESS CENTER ZONE: C -N
SIGN LOCATION: 10225 SW HALL BLVD 103 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4'X17' -6"
TOTAL SIGN AREA: 70 sq. ft.
WALL AREA: 2,013 sq. ft.
WALL FACE (DIRECTION): E
SIGN HEIGHT: 14 ft.
PROJECTION FROM WALL: 12 in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Installation of (1) one permanent 70 sq ft wall sign.
MATERIALS: ALUM /NEON /PL
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 ;Lys from validity date.
APPROVED BY:
PERMITTEE SIGNATURE: - - •
DATE: 2/61i 4
i p, . . ,
,,,,,,,l� 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 1 1 6 F # WW j CIA 1i 71L FOR STAFF USE ONLY
Address/ Street Address
Location / 2zS S W , 11 A _. >J
Permit No.: 5C Z 1 - (-1.3c Z-/
Suite /Bldg. # City /State Zip
' D3 116 Aj? _ de. cif 2, Expiration Date:
Name 1'S Receipt #:
Property WAHINE. G kk Approved By:
Owner Mailing Address Suite Date: 2(o /o
10 225 S u) . i 61 Map/TL #:
City /State Zip Phone Zoning: n6€( 7 _,
71G-Ash az 0 /7123 ` -m 1 410
Tenant or Name '/
Business I> a t� T KK t) Electrical Permit Required? ❑ 'Yes ❑ No
Name N Building Permit Required? ❑ Yes No
Sign
C-vgl-tzT 1 , L , L. Rev. 12/1/2000 is \curpin \masters \revised\sign permit app.doc
Contractor Mailing Address Suite
(Prior to permit 1(.?- S ) r�, f W A
issuance, a L�V11�(!� 1/ Y
copy of all City /State . Zip Phone
licenses are SUBMITTAL ELEMENTS
required if m��a1 G ,Z23 t0 ' 1 411 (Note: applications will not be accepted
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License #1 5_J 147 ^ �--CJ i-2-2...-- vL ,( without the required submittal elements)
database)
Pro Proposed ; El Completed Application Form
p Permanent ❑ Freestanding ❑ Freeway
Sign Temporary LWall ❑ Electronic ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
(Check all that ❑ Other [] Billboard ❑ Balloon (3 copies, if a building permit is required)
apply) size requirement: 81/2" x 11 ", or 11" x 17"
New sign? ❑ Alter to existing sign?
❑ 2 copies of elevations, drawn to scale
Sign Dimensions:) >, ( . l 1 (3 copies, if a building permit is required)
size requirement: 81/2" x 11", to 24" x 36"
Total Sign Area (sq. ft.): '—'1 ❑ $�Q OG (Permanent sign, any size)
Sign Data
Total Wall Area (sq. ft.) ❑ $15.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this
section) )
N S E W NE NW SE l SW NOTES:
C , • Wall signs do not need to be drawn to scale,
Height to top of sign (feet): 1 -
but must include dimensions of wall face and
Projection From Wall (inches): / Z"
sign placement.
Copy: L( - CI412cD Pft/tent- WC 14 Nt4 r • Wall signs do not require site /plot plans.
Materials:OILX)01,,J N fvn3 - �t { ck ' � - • Freestanding signs over 6 ft. required a
Will sign have illumination? 2 ❑ 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.
0 Yes ❑ No
If "yes ", a list or diagram of all sign dimensions and fOVER FOR SIGNATURES)
square footage must also be submitted.
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to Ely d- km exiIJG,S / ci\) 1 4 Pr Ii1`
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 day of , 20
Signature of Owner /Agent
Contact Person Name Phone No.
CITY OF TIGARD
Approved X1
Conditionally Approvs,c1 [ 3
p Fo E r n o m n i ll_t t j descriVd in: zi
See Letter to: Follow [ j
Attach 1
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CITY OF TIGARD 2/6/2004
13125 SW Hall Blvd. 10:47:26AM
•
//� ,,
r. � i vi( Tigard, Oregon 97223
. (503) 639 -4171
Receipt #: 27200400000000000451
Date: 02/06/2004
Line Items: •
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00021 [SIGN] Sign Permit 100 - 0000 - 437000 , 31.00
Line Item Total: $31.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check SIGNCRAFT ELECTRICAL KJP 1435 In Person 31.00
ADVERTISING LLC
Payment Total: $31.00