SGN2004-00154 CITY OF TIGARD SIGN PERMIT
II DEVELOPMENT SERVICES PERMIT #: SGN2004 -00154
. � . � I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/19/04
PARCEL: 2S 110 D C -02300
BUSINESS NAME: RICHARD A WHIPPLE, DDS ZONE: C -G
SIGN LOCATION: 11525 SW DURHAM RD D -1 JURISDICTION: TIG
APPLICANT /AGENT: CURVES FOR WOMEN
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 4'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary sign permit used for Curves for Women. Sign #1. Valid from 10/13/04
through 11/13/04.
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 10 days from validity date.
APPROVED BY: ` / '' e
PERMITTEE SIGNATURE:
DATE: 7/19/04
• ry.
, SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Ha11 Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY •Site (AA 1' 0 iti) It 03 W--)
Address/ Street Address Permit No.:_ SGni a ooy — 00 /.S
Location f 15 2-S s wr,_1 :Ayr i2 ,, — (3 —6tr
Suite /Bldg. # City /State Zip Expiration Date:
- ' l I Ae--fl, j - 7 Z f Receipt #: c9--.0 — 30
Name Approved By: C—� wo
r•
Property k -S Lh — if r i ` W "� -, . • • ' Date: 7— / 9 D
Owner Mi hgpress Suit: — Map /TL #: S/ / U Dc — c).2_3 vo
( /t °7‘-?-7& 6 Zoning:
C —
City/ Zip Phone
� Electrical Permit Required? ❑ Yes ❑ No
'Tenant or Name:
Business R s A r ,ie I) D� Building Permit Required? ❑Yes ❑ No
� c. wt 2- 1h ' J
Name , Rev. 01 -Jul -02 I: \curpin \masters \revised \sign permit app.doc
Sign
Contractor Mailing Address Suite 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 j
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
apply) Other ❑ Billboard ❑ Balloon El 2 copies of elevations, drawn to scale
(3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11", to 24" x 36"
Sign Dimensions:
❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
Z ❑ $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: a Wall signs do not require site /plot plans.
Materials: a Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes El No building permit.
T e: In ternal a If work authorized under a sign permit has not l
yp ❑ ❑External been completed within ninety (90) days after I
Are there any existing freestanding or wall signs at this
location, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL j
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)
N7 P
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 121 day of L ' � , 20 0 `"
Signature of Owner /Age
c i ,(6"/Le, C :;
Contact Person Name Phone No.
CITY OF TIGARD 7/19/2004
13125 SW Hall Blvd. 3:01:19PM
AAA /% ��i y'� i\ Tigard, Oregon 9 72 23
P (50 3) 639 -4171 •
Receipt #: 27200400000000003142
Date: 07/19/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00154 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
SGN2004 -00155 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
SGN2004 -00156 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
SGN2004 -00157 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
SGN2004 -00158 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
Line Item Total: $75.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check CURVES OF TIGARD CAC 1627 In Person 75.00
Payment Total: $75.00