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SGN2004-00339 C ITY OF TIGARD SIGN PERMIT Ave DEVELOPMENT SERVICES PERMIT #: SGN2004-00339 I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/17/2004 PARCEL: 25101 DB -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: $ 30.00 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 days from validity date. APPROVED BY: PERMITTEE SIGNATURE: Le _ C'e7`-/ DATE: 11/17/2004 A .i. . 4.a l lr : SIGN PERMIT APPLICATION • CITY.OF TIOARb • • 13125 SW Hall Blvd: Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297 • GENERAL INFORMATION al-S/ D I - Na e of Development/Project FOR STAFF USE ONLY C '/� `1 Site l�5 J ��r ��� oo33 � Address/ Street Address st,✓ e...h u- - 0�- 7-1.2oeltio( Permit No:: 3 CAN a oo - oc: 30 3 Location s f-( 72 , Sk/ v'S Expiration Date: Suite/Bldg. # City/State Di ?7 7 Zip ,� Receipt #: Nam 66 �� Approved By: Property / (,( b ! /G- k 6f O -.4/4/ Date: Owner Mailing Addr suite . Map/TL #: Zoning: City /State Zip Phone • Electrical Permit Required? ❑ Yes ❑ No Tenant or Name Business il //�� s 57-P/"' Building Permit Required? ❑Yes ❑ No Rev. 01 -Jul -02 lAcurpin\maslerstrevlseaskgn permit app.doc Name Sign t'b r11 ,° /o? (0/--,: 9r /' Contractor Mailing Address suite REQUIRED SUBMITTAL ELEMENTS (Prior to permit t 2// h 00- , Ave (Note: applications will not be accepted issuance. a • without the required submittal elements) copy of all City /state Zip Phone a � / /�� licenses are f eta � R 7 r 7 S'�� _ A �f required if L Completed Application Form expired in the Oc on Const Cont. Board Exp. Rate City of a Tlgard's License ❑ 2 Copies of Site /Plot Plan, Drawn to Scale _ /.f D Minn database) • 0.1 copies. if a building permit is required) Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 81/2" x 11 ", or 11" x 17" Sign ❑ Temporary ❑ wall ❑ Electronic (Check all that ❑ Other ❑ eiuboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale apps) (3 (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: L i ic //7 it $30.00 Fee (Permanent sign, any size) �7 . Total Sign Area (sq. ft.): / • f- ❑ $15.00 Fee (Temporary sign, any ty ) Total Wall Area (sq. ft.) / f'//(r) ra of 5 7`e /'z C( Sign Data (V (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): • j . sign placement, Copy: • o Wall signs do not require site /plot plans. Materials: o Freestanding signs over 6 ft. required a building permit. Will sign have illumination? ❑ Yes 0_ No o 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 17( No I i If "yes ", a list or diagram of all sign dimensions and I ,guare footage must also be submitted. (OVER FOR SIGNATURES) • • • B hereby acknowledge that l 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. a rj • DATED this d ay of / / . 20 Signature of Owner /Agent fir/ 41'i StAi e o T ® S per ® l � « Cv� 5 3 - 2- 2.3 _.'7 77 Contact Person Name • Phone No. • • • • d { rr ! z irr. y rl 4 f s • t r J f f t I 1 f� + 7 Y .. r • T r, . 1 { ( J � . - e�a?r- - ,t ., ° ,r v• • i 7 1,44'/ ��" t ! ? r 1 r ,( "J L -'Y 'y 9,9},2 • -rl ' , CI rJ ti fr n L4 a„ i t ,� " - t / � 1`'r' rj A.1, "t a J i/ • - i-tr h s' �3 r t•\ 7 Ji45 rr r�tt 7 tW•; a " E. rs „ ,-- -.. - -1.' r • rr { h 4 t'. 0,-", 7 t ' `` +fctY1yt'j° rt t <1 „„ k : ' ` c ' rir:7i t y.rjif rf r l .� 1 • 1 , J �'" ` ,. 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J.-- ,,, ,..,-,. -.t#4 .ffis,;):74,'Yl.:7,:t.„..,,• '...--,,-- f ..1. : ,, .. :.-7),,., ',; f ' - •'' - 'is..:'= , :lj.,5;.-Ti.: . ,'.it i ti'lt c i•' 4. ` - '(.; ,. ,..4. .;:s, AI 2' • ' , ,ci• .f.,-, _•• ■,*_..."......-- 6, . $ bi/ 7 ,2 k2Y 1 Ya-v K2 5 ( / p) a f AI --) • CITY OF TIGARD 11/18/2004 13125 SW Hall Blvd. 10:05:06AM U' Tigard, Oregon 97223 . u c'� (50 3) 63 9-4 17 1 Receipt #: 27200400000000005009 Date: 11/18/2004 • Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2004 -00332 [SIGN] Sign Permit 100 - 0000 - 437000 30.00 SGN2004 -00333 [SIGN] Sign Permit 100- 0000 - 437000 30.00 SGN2004 -00334 [SIGN] Sign Permit 100 - 0000 - 437000 30.00 SGN2004 -00335 [SIGN] Sign Permit 100 - 0000 - 437000 30.00 SGN2004 -00336 [SIGN] Sign Permit 100 - 0000 - 437000 30.00 SGN2004 -00337 [SIGN] Sign Permit 100- 0000 - 437000 30.00 SGN2004 -00338 [SIGN] Sign Permit 100- 0000 - 437000 30.00 SGN2004 -00339 [SIGN] Sign Permit 100 - 0000 - 437000 30.00 SGN2004 -00340 [SIGN] Sign Permit 100 - 0000 - 437000 30.00 SGN2004 -00341 [SIGN] Sign Permit 100- 0000 - 437000 30.00 Line Item Total: $300.00 Payments: 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