SGN2004-00038 C ITY OF TIGARD SIGN PERMIT
A DEVELOPMENT SERVICES PERMIT #: SGN2004 -00038
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 3/1/04
PARCEL: 25111 DD -00201
BUSINESS NAME: PRIMO ESPRESSO ZONE: C -N
SIGN LOCATION: 15981 SW HALL BLVD JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X4'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one temporary 3'x4' A- frame. Sign must be placed on private
proverty and not in the public right -of -way or visual clearance area. Valid
3/1/04- 3/31/04. Sign #1
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 a s from validity date.
i
APPROVED BY: f
y 1 -
PERMITTEE SIGNATURE: / l
DATE: 3/1 /0
a , SIGN PERMIT APPLICATION
VIII I
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
Address/ Street Address Permit No.: 4$ Lc.)D /_pQ 3-7
Location 1 so, 8 *, Svw 1-FLL RA-
Expiration Date: h lo '1 — 3)3/ /o 50
Suite /Bldg. # City /State Zip
1160029 R9 02_ Q1224- Receipt #: ,2--k-,o `f — t_l 7 7 7
Name Approved By: /- % /,
Property OS�N (U. LN eS+men't Date: 3/i /`s . f
Owner Mailing Address Suite Map/TL #:
Zoo ■ C0= AV C 250 0 Zoning: C .
City /State Zip Phone
w Electrical Permit Required? ❑ Yes D-
Tenant or Name _
Business ,r 1 SAO � ?re SSO Building Permit Required? ❑Yes ❑ No'
Name Rev. 8/7/2003 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
copy a of all City /State Zip Phone q without the required submittal elements)
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard'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 M Temporary ❑ Wall ❑ Electronic
(Check all that Other ❑ Billboard ❑Balloon El 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
rJ New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions:
4 x 3 ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): I 2,,k2$tix 5 2452F- ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft 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): 4' • 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 • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes Iff 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)
. 1
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.
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reverse face
OPEN
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Temporary Freestanding A -Board Sign
12 Square feet per side
Scale 1 " =1'
Site Address: 15981 SW Hall Blvd.
Tenant/Business Name: Primo Espresso
Sign Company: Signs Now
11520 SE 82nd Ave
Portland, Oregon
503- 652 -2072
CITY OF TIGARD • 3/1/2004
13125 SW Hall Blvd. 9:40:51AM
/Ara'M ai\ Tigard, Oregon 97223
c l∎ 6 1.E � (503) 639 -4171 •
Receipt #: 27200400000000000777
Date: 03/01/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00038 [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 NORTHWEST GOURMET KJP 16751 In Person 15.00
COFFEE CO INC
Payment Total: $15.00