SGN2004-00117 1
C ITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2004 -00117
..��I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/25/2004
PARCEL: 1 S 136AD -04001
BUSINESS NAME: BURGER KING ZONE: C -G
SIGN LOCATION: 11539 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON: Y
SIGN DIMENSIONS: SHREK
TOTAL SIGN AREA: sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): E
SIGN HEIGHT: 9 ft.
PROJECTION FROM WALL: 24 in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) onttemporary balloon. The size of the balloon shall not exceed 25
feet in height. The balloon shall be secured to a structure and not allowed to float
in the air higher than 25 feet above the nearest building roof line.
MATERIALS: BALLOON
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 date or sign permit shall expire. A temporary sign shall expire 30 days from validity
date. A balloon sign shall expire 10 day • m validity date.
APPROVED BY 4 1111111 d
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PERMITTEE SIGNATURE: ��1�
DATE: 5/25/2004
Ao ,,l, SIGN PERMIT APPLICATION
N �,l: . _.III
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
Site &16 \ (1 ` aS j 1 FOR STAFF USE ONLY
Address/ Street Add+)ess Permit No.: 56,V V ' i /7
Location ) ) 6 39 Sc� Expiration Date: A ' �1 "7 U Y — (e b �'1
Suite /Bldg. # City /State Zip w r T
T tCrU Of-- C1 72Z-5 Receipt #: ow04 -- a... t 5'
Name Approved By:
Property 1 r *A-S 4 J i--,,i R-r.S Date: S7 ay
Owner Mailing Address � Suite Map /TL #: / 3 (o / D '®5`o t
.-z U 3 (o — (I 00 Zoning: C '
City /State Zip q7 Phone
Tenant or Name Electrical Permit Required? El Yes 2
Business <n. r Building Permit Required? ❑ Yes El-No
� . Qf t (- 1 Name ... Rev. 8/7/2003 1: \curpin \masters \revised \sign permit app.doc
Sign S C7/4 ("84 �`r e.i
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a w ithout the required submittal elements
copy of all City/State Zip Phone q )
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database)
(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 ❑ Other ❑ Billboard Balloon ❑ 2 copies of elevations, drawn to scale
apply)
(3 copies, if a building permit is required)
a New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11", to 24" x 36"
Sign Dimensions:
\ \ — 94(1 - 4 - 1 ( -- 1 ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): •
❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft Jurisdiction: ❑ City ❑ Urb
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S O 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): at)' but must include dimensions of wall face and
sign placement.
Co py . • 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
Are there any existing freestanding or wall signs at this been completed within ninety (90) days after
location, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
El Yes No BECOME NULL AND VOID.
If "yes ", a list or diagram of all sign dimensions and
square 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 2-5 day of 1 , 20
d C/
Si... ure of Owner /Agent
1
>-�,� /J 51
Contact Person Name Phone No.
1
CITY OF TIGARD J%2J%2UU4
13125 SW Hall Blvd. 11:17:56AM
Tigard, Oregon 97223
6 1.i (503) 63 9-4 17 1
Receipt #: 27200400000000002219
Date: 05/25/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00117 [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 BURGER KING KJP In Person 15.00
Payment Total: $15.00
Page 1 of 1 cReceipt.rpt
May 24 04 11:50a Denny Willson 503- 234 -9461 p.l
05/24/2004 14:30 3302733212 SQ- RSA It4DUSTRIES PAGE 05
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Conditionally Approved
For only the workas described in:
PERMIT NO. — 61(2.r Vat f 7
See Letter to: Follow
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