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SGN2004-00338 CITY TIGARD SIGN PERMIT l DEVELOPMENT SERVICES PERMIT #: SGN2004-00338 ll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/17/2004 PARCEL: 25101 DD -R -O -W BUSINESS NAME: ZONE: SIGN LOCATION: SW NO ADDRESS JURISDICTION: TIG • APPLICANT /AGENT: OBIE MEDIA CORPORATION BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: FREEWAY: TEMPORARY: WALL: ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 24" X 84" TOTAL SIGN AREA: 14 sq. ft. WALL AREA: sq. ft. WALL FACE (DIRECTION): SIGN HEIGHT: ft. PROJECTION FROM WALL: in. ILLUMINATION: DESCRIPTION OF SIGN: Placement of one bench with sign within public right -of -way. Approved by Gus Duenas (City Engineer). MATERIALS: BENCH 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. jj APPROVED BY: ` I/ PERMITTEE SIGNATURE: G z 05 DATE: 11/17/2004 �t. ,�, { . SIGN PERMIT- t PPLI ATI N CITY.OF TIGARD • . 13125 SYYHall B1vdd Tigard, OR 97223 (503)639 -4171 FAX: (503) 684 -7297 • GENERAL INFORMATION - • Name of Development/Project / FOR STAFF USE ONLY Site t/ i S S 7 � o i � 7 L 4 L 4 Address/ street Address 5 occ 4 J( d''t- a`tn ' Permit No:: SfoNa vor-► - ov 33 R Location SI'✓ 7, @ / 3%5 Expiration Date: Suite/Bldg # City/State • ZIP tlla OIZ ?7 .223 Receipt #: • Namen Approved By: Property Pk b��G- /� lac "L ��fl47 Date: Owner Haling A dre 9 suite Map/TL #: Zoning: City /State Zip Phone • Electrical Permit Required? ❑ Yes ❑ No • Tenant or Name • • /> / S i Building Permit Required? ❑ Yes ❑ No Business /,� / Rev. 01-.10-02 1;lcurptn�nasterstrevlsedlstgn permit app.doc Name Sign O h r e )`►i e lot Cod , ,--- Contractor Mailing Address � Suite REQUIRED SUBMITTAL ELEMENTS (Prior to permit 21/ 11/ 1P-- live (Note: applications will not be accepted issuance, a • wi thout the required submittal elements) i copy of all City/State Zip Phone a � ���/ licenses are f e�� ?7 7'2 5-11-_6 G req uired it Completed Application Form expired in the Ot on Const Cont. Board Exp. Date ❑ 2 Copies of Site /Plot Plan, Drawn to Scale City of Ttgard's on t c - / F o 'vvt �` 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 DI 2 copies of elevations, drawn to scale (Check all that Other CS ❑ Billboard ❑ Balloon a.. (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: , i f if 0 $30.00 Fee (Permanent sign, any size) Total Sign Area (sq. ft.): f CI tit ❑ $15.00 Fee (T n5 rra sign, C a(y tyge) Total Wall Area (sq. ft.) fi o 7`D O � Sign Data � (Complete all Direction Wall Faces (circle one): NOTES: Items in this section) N S E W NE NW SE SW o 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: • o Wall signs do not require site /plot plans. Materials: • Freestanding signs over 6 ft. required a building permit. Will sign have illumination? ❑ Yes [LNo • If work authorized under a sign permit has not Type: ❑ Internal ❑ External been completed within ninety (90) days after Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL location, including wall signs that overlap a tenant space? BECOME NULL AND VOID. • ❑ Yes cg( No If "yes ", a list or diagram of all sign dimensions and s • uare footage must also be submitted. ;r,1etva//C -- (5 Ir . (OVER FOR SIGNATURES) • • 0 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. n 47 � DATED this day of 20 q Signature of Owner /Agent 0, - 140 � D Y7ov7 S Ogr i e / Contact Person Name • Phone No. • • • • 'V #. 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Method Payer User ID Acct. /Check Approval No. How Received Amount Paid Check OBIE MEDIA CORPORATION CAC 67864 In Person 300.00 Payment Total: $300.00 cReceipt.rpt Page 1 of 1