SGN2004-00001 CITY TIGARD SIGN PERMIT
n i DEVELOPMENT SERVICES PERMIT #: SGN2004 -00001
c �'l l 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/2/04
PARCEL: 2S103DD - 00800
BUSINESS NAME: JAVA JUICE ZONE: C -
SIGN LOCATION: 13815 SW PACIFIC HWY 80 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: 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 A -frame sign. Sign must be placed on private
property and not in the public right -of -way or visual clearance area. Valid
1/2/04- 2/2/04. 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 da - • .gn permit shall expire. A temporary sign shall expire 30 days from
validity date. A balloon sign shall expire 10 day rom validity -dat .
'----/A.--- _.-Q‘L,
APPROVED BY:
PERMITTEE SIGNATURE: C.____
DATE: DATE: 1 /2/04
•
,
�i'�I° SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW (fall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
ENERAL INFORMATION
Name of Development/Project
Site t AP.4 Lik— l'S141-'4*. FOR STAFF USE ONLY
Address/ Street Address \� � Permit No.: /V 0p --- v U
Location 13 S� `c\C\c� 'ty
Suite City /St Zip
e/ /BBlldg Expiration Date: f / d/0 y — 2 /z /2
p " i ( C c l1 a�� Receipt #: 2-- y
Name
Approved By: r
Property .A4..5.4-■, r t■\S P.�- Date: 1 / 2 p
Dwner Mailing Address Suite Map/TL #: t
12 1S15C Er0 Zoning: C C)
City/State Zip Phone
TLC\ C 1 1 �
Tenant or Name Electrical Permit Required? ❑ Yes D-
3usiness --D-- Building Permit Required? ❑ Yes [1.--No
Name Rev. 8/7/2003 I: \curpin \masters \revised\sign permit app doc
iign
:ontractor Mailing Address Suite
Prior to permit REQUIRED SUBMITTAL ELEMENTS
;nuance, a (Note: applications will not be accepted
opy of all City/State Zip Phone without the required submittal elements)
censes are
squired if
xpired in the Oregon Const. Cont. Board Exp. Date ❑ Completed Application Form
:ity of Tigard's License #
atabase) ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
'ro posed (3 copies, if a building permit is required)
p ❑ P ermanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11", or 1 1 " x 17"
g Check all that Temporary ❑ Wall ❑ Electronic
hec ❑ Other ❑ Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale
❑ New sign? (3 copies, if a building permit is required)
g ❑Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions:
3 x L ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
,z:Di AZ ❑ $15.00 Fee (Temporary sign, any type)
>ign Data Total Wall Area (sq. ft.
Jurisdiction: ❑ City ❑ Urb
Complete all Direction Wall Faces (circle one):
erns in this NOTES:
ection) N S E W NE NW SE SW
Height to top of sign (feet): • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
Copy: sign placement.
• Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes )No building permit.
Type: ❑ Internal ❑ External • If work authorized under a sign permit has not
ire there any existing freestanding or wall signs at this been completed within ninety (90) days after
Dcation, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
❑ Yes gi,\No BECOME NULL AND VOID.
( "yes ", a list or diagram of all sign dimensions and
;quare footage 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.
DATED this J 1a--- day of , 20
Signature of Owner /Agent
(.ate - sops
Contact Person Name Phone No.
-
' t
( ------ G_— _____ or4' ,`
CITY OF TIGARD
L- Approved Il
--- Conditionally Approved
56 ; GC____ For only thew woii as described in
PERMIT NO. 5�'/Z 1 ., i.,?
See Letter to: Follow [ ]
Attach
Job Ad_ _ dress : :/ S � � fJ �:(J
By: ��/ -�°— =` C;at c
..� p y y #
`27 A
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rk.00 O S
pe u r — K..v
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CITY OF TIGARD 1/2/2004
13125 SW Hall Blvd. 10:24:49AM
Au/ , l � ll Tigard, Oregon 9 72 23
(503) 63 9-4 17 1
Receipt #: 27200400000000000002
Date: 01/02/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00001 [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
Cash JAVA JUICE KJP In Person 15.00
Payment Total: $15.00
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