SGN2004-00340 i
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CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2004 -00340
c " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/18/2004
PARCEL: 25101 DC -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.
APPROVED BY:
PERMITTEE SIGNATURE: . . a. ).11"—'
DATE: 11/18/2004
1 4,11a 61: SIGN PERMIT APPLICATION
CTTY.OF TIOARD : 13125 SW Ha11 B14; Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION 0
Nam of Development/Project FOR STAFF USE ONLY
Site �
� W5 C74-0/' � ��G
Address ... 51A) �o,- ^� —,,,,./- � Permit No :: J G1J o� DU`4- OD3`+v
Address/ street A S
Location sw 7 of / Stt/ C-1-1 ee / a,: Expiration Date:
Suite/Bldg # City/State e £ 9 t •
tiff a 77 .7 Receipt #: • Nam /� Approved By:
p
Property
f`i 6�p i -1/ Date:
Owner Mailing A dre , Suite Map /TL #:
Zoning:.
City /State Zip Phone
•
Electrical Permit Required? ❑ Yes ❑ No .
Tenant or Name
Business /l //�� S 57-0, Building Permit Required? ID Yes El No • Rev. O1-Jul -02 1 :1curptrAmasterslrevlsed\slgn permit app.doc
Name
Oh (e ri i ,° l� Coy
Sign
Contractor Mating Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to perm °2` ( it // / k/ ve (Note: applications will not be accepted
issuance. a
/ Zip Phone without the required submittal elements)
copy of alt City/State licenses 5-111_6‘04 �1ir
are � �� �7 t 2 77 '"``'�
req uired if ` Completed Application Form
expired in the of on Const. Cont. Board Exp. Date
City of Tlgard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) orate' l3 o'1/tie-e" (3 copies. if a building permit is required)
Proposed [1 Permanent ❑ Freestanding ❑ Freeway size requirement: 81/2" x11", or 11" x 1T
Sign ❑ Temporary ❑ wait ❑ 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? ❑ Alter to existing sign? size requirement: 8 x11", to 24" x 36"
Sign Dimensions: n i (v i,
0 $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): / ❑ $1 5.00 Fee (T mporary sign, any ty )
Total Wall Area (sq. ft.) 1 / Q e`!
ot�0 Of S /7`e /it Cl
Sign Data (t/ Q S f-
(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 mustinclude dimensions of wall face and
Projection From Wall (inches): • , sign placement.
Copy: 0 • Wall signs do not require site /plot plans.
Materials: a Freestanding signs over 6 ft. required a
building permit.
Will sign have illumination? ❑ Yes I] No 0 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 [4 No
If "yes ", a list or diagram of all sign dimensions and
square footace must also be submitted.
(OVER FOR SIGNATURES)
•
•
• 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.
rtj
i t i efr " / DATED this day of , 20 0
/Lire•
Signature of Owner /Agent
fi r 4P? 5 -e ei'iey 17,9 x S
e_747:9•^ °l& ®p er
DBre edlq S ° 3 - 2 2 3 77
Contact Person Name Phone No.
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CITY OF TIGARD • 11/18/2004 -
13125 SW Hall Blvd. 10:05:O6AM
/ Tigard, Oregon 97223 . ■ di (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