SGN2004-00020 CITY TIGARD SIGN PERMIT
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��I DEVELOPMENT SERVICES PERMIT #: SGN2004 -00020
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/4/04
PARCEL: 2S 104AA -90011
BUSINESS NAME: BELLWOOD TERRACE APTS ZONE: R -12
SIGN LOCATION: 12666 SW KAREN ST LT #1 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 27.5" X 24"
TOTAL SIGN AREA: 5 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 2 ft.
PROJECTION FROM WALL: 0 in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one temporary A -frame sign. (27.5" x 24 ")
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
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 100 ` days from validity date.
APPROVED BY: �(` � �' \ L
PERMITTEE SIGNATURE: l ` -
DATE: 2/4/04
f ,
b . i l l SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
3,e, t L woo b '7 z pi- -A . RP4icl ", FOR STAFF USE ONLY
Site
Address/ Street Address Permit No.: .�C t.J c c o`t — Vo oa o
Location 12 to 5. it €w S�
Expiration Date: .3-5-0%4
Suite /Bldg. # C /State Zip
��j 1� �2 X 72- 7-1
Receipt #: a o0L - O 4d=
Name Approved By: C : LGu
Property C n Z A D C! 5 Date: a- (-1.--04
Owner Mailing Address Suite Map /TL #: 10 `f A- a — 001 (
po r-,,, K is-7 Zoning: B - i-k
City/State Zip Phone
Y/ `" Ad d ( o 03 4 Z -3° ° Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name F /,zs f p- 04 ,e,z , pee p.enf-,e5
Business Building Permit Required? ❑ Yes ❑ No
Name Rev. 01- Jul -02 i:\curpin\masters\revised\sign permit app.doc
Sign
Contractor Mailing Address it REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance. a
copy of all City /State Zip Phone without the required submittal elements)
licenses are
required if ❑ Completed Application Form
expired i e Oregon Const. Cont. Board Exp. Date
Ci : igard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
..tabase) (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
(Check all that ,M ❑ Balloon
❑ El
copies of elevations, drawn to scale
apply) Other Billboard
(3 copies, if a building permit is required)
N New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: . R7 ) �,/ .1/
vc—
� ❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.)
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N S E W NE NW SE SW
• 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: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
building permit.
Will sign have illumination? ❑ Yes ❑ No • 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 [- No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted. _
(OVER FOR SIGNATURES)
4
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 day of , 20
Signatur:*%AOwner /Agent
. - S 0 3 -) a 5- 3 Z it
Contact Person Name Phone No.
g_n y,_
CITY OF TIGARD 2/4/2004
13125 SW Hall Blvd. 1:18:49PM
Tigard, Oregon 97223
II.' 639 -4171
Receipt #: 27200400000000000422
Date: 02/04/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00020 [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 BELLWOOD TERRACE APTS CAC In Person 15.00
Payment Total: $15.00
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