SGN2006-00132 CITY TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2006 -00132
TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/28/2006
PARCEL: 2S102AC - 01704
BUSINESS NAME: TIGARD DENTAL _ ZONE: CBD
SIGN LOCATION: 12720 SW PACIFIC HWY �� - JURISDICTION: TIG
APPLICANT /AGENT: TIGARD DENTAL
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 20" X 21' 6"
TOTAL SIGN AREA: 35 sq. ft.
WALL AREA: 640 sq. ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT: 12 ft.
PROJECTION FROM WALL: 13 in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Installation of one (1) permanent wall sign 20" X 21' 6"
MATERIALS: PLEX/ALUM /GL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 39.00
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. /
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APPROVED BY: � L -
PERMITTEE SIGNATURE: ���� /��/
DATE: 006 /
n
Ill SIGN PERMIT APPLICATION
City (y Tigard Pernit Center 13125 SW Hall Blul, Tigarg OR 97223
Phone 503.639.4171 Fax: 503.598.1960
GENERAL INFORMATION
Name of Development/Project
,f-( aD PO�1A'� FOR STAFF USE ONLY
Site
Address / Street Address Permit No.: (I Y - b0/3..."
Location (X7 5tt 6. 1r ke - AfGatfr st-2
Expiration Date:
Suite /Bldg. # Qty/State Zip
q te. - rwttag a, ? ipi9-3 Receipt # :
Name Approved By - r /k
1 1
Property Date: �1 - %
Owner Mailing Address Suite Map /TL# : P-5 ( DX A C 01 7 0
Zoning: G'S�
City/State Zip Phone
Tenant or Name Electrical Permit Required? ❑ Yes El No
Business pie. f tr - to {4- . .. , Building Permit Required? El Yes El No
Name Rev. 7/5/06
is \curpin \ masters \land use applications \sign permit app.doc
Sign ( t4 # f' 544) £9
Contractor Mailing Address Suite
(Prior to permit g. w �{�� T
issuance, a
copy of all City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
licenses are (Note: applications will not be accepted
require �(1
dif 4 Q q7;.1.3 I��B
3 G^9r� without the required submittal elements)
expired in the Oregon Const. Cont. Board License # Exp. Date
City of Tigard's / '
database) � J 9 2 h ❑ Completed Application Form
Proposed Permanent ❑ Freestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Sign El Temporary [4- ll El Electronic (3 copies, if a building permit is required)
(Check all that
(P ❑ Other ❑ Billboard ❑ Balloon size requirement: 81/2" x 11 ", or 11" x 17"
Rile-W.-sign? ❑ Aker to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: ei • ., (3 copies, if a building permit is required)
'' 9 i • 4 size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.): .zs g 4
❑ $39.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) Ott) /
g ❑ $19.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E �NE NW SE SW
Height to top of sign (feet): t a•' ♦ Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): j' , must include dimensions of wall face and sign
Copy, 1174 e-D 126 placement.
♦ Wall signs do not require site /plot plans.
Materials: y`yL UAW 44145. • Freestanding signs over 6 ft. required a building
Will sign have ill ation? [ es ❑ No permit.
Type: kIntemal ❑ External ♦ If work authorized under a sign permit has not been
Are there any existing freestanding or wall signs at this location, completed within ninety (90) days after the issuance
including wall signs that overl p a tenant space? of the permit, THE PERMIT WILL BECOME
Yes 1:1 No NULL AND VOID.
If "yes ", a list or diagram of all sign dimensions and square i
footage must also be submitted. 5t 9I17 - /)
(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.
DATED this .2 8 day of `?U t '� , 20 d 4
c* g
Signature of Owner /Agent
Contact Person Name Phone No.
CITY OF TIGARD
. • . r. VAd - _ 1
21 Condition�i y _ . _ I j
` � ' For only the work _as � iescri ed in:
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. :' PERMIT NO. t 3 Z --
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ALL. LETTERS MOUNTED T " "
�' C A' E: 1/4"=1* RACEWAY, PAINTED TO MATCH FASCIA SCALE. . NOT LEI i SC DETAIL
\.! SCALE: SIDEWALL_.S PAINTED BLACK. ® SCALE: NOT TO SCALE
Higilliglit PROJECT CONTACT FILE
TIGARD DENTAL This artistic rendering
JAKE WHEELER DDS TIGARD DENTAL.CDR is the exclusive property
S' 0 P1 of HIGHLIGHT SIGN
LOCATION until purchased. Any
12720 SW. PACIFIC HWY ST2 SALESMAN DATE
for an unauthorized repr
STEVE LAWHEAD 07 / 12 / 06 any purpose will mcurr
503 - 620 -8205 TIGARD, OR 97223 legal actlon.Copyright 1997
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TIGARD DENTAL
12720 SW PACIFIC 1-iVV1' .ST. 2
NEW _____y
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TING SIGN
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Highlight TIGARD DENTAL JAKE WHEELER DDS
PROJECT
CONTACT FILE
TIGARD DENTAL.CDR This artistic rendering
is the exclusive property
of HIGHLIGHT SIGN
until purchased. Any
12720 SW. PACIFIC H
S I G N LOCATION
HWY ST2 SALESMAN
STEVE LAWHEAD DATE u
07/12/06 fle go n r ai: n t o p r i uo i z 0 s a c o r e
ig
503-620-8205 TIGARD, OR. 97223
CITY OF TIGARD 7/28/2006
IMI 13125 SW Hall Blvd. 3:12:45PM
Tigard, Oregon 97223
TIGARD (503) 639 -4171
Receipt #: 27200600000000003807
Date: 07/28/2006
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2006 -00132 [SIGN] Sign Permit 100- 0000 - 437000 34.00
SGN2006 -00132 [LRPF] LR Planning Surcharge 100- 0000 - 438050 5.00
ELC2006 -00417 [ELPRMT] ELC Permit 220- 0000 - 431510 53.40
ELC2006 -00417 [TAX] 8% State Surcharge 100 - 0000 - 207020 4.27
Line Item Total: $96.67
Payments:
Method Payer User ID Acct. /Check No. Approval No. How Received Amount Paid
Check HIGHLIGHT SIGN CO ST 5621 In Person 96.67
Payment Total: $96.67
cReceipt.rpt Page 1 of 1