SGN2004-00156 a �t
CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2004 -00156
c 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/19/04
PARCEL: 2S 110 D C -02300
BUSINESS NAME: DR. BRAD MCALLISTER ZONE: C -G
SIGN LOCATION: 11525 SW DURHAM RD D -6 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X 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: Placement of one temporary, A -frame sign. Sign #3. (Curves) Valid from
10/13/04 through 11/14/04.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
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 days from validity date.
APPROVED BY: � / (1/
PERMITTEE SIGNATURE: egroryor
DATE: 7/19/04
4i
•
vi, 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
FOR STAFF USE ONLY
Site f
. etu ei :9
Address/ Street Address Permit No.: :, y i ; L. / ; ` CC l -'
Location , //t li2`j .Sir�Jit��i t ,),-&
Suite /Bldg. # City /State zip Expiration Date: 11—/c7-0
- l net 1 g D Receipt #: c2004 — 3/4a.
Name Approved By: C • ��
1 JN -:r") 7- /9 -0�(
Property 14 PAS 6
sJ7 c. 3 / Date:
Owner Mailing Address Suite Map /TL #: ,,..S Ito () c — Oa 3 o o
iciJ ,D 70 Zoning: C - G
City /State Zip Phone
•
i , n,; . q 7 ? a .53' `/ 73 -6; f i
l Permit Required?
Tenant or Name q ❑ Yes xi No
Business l / 7 / / / 1 Building Permit Required? ❑ Yes No
Name Rev. 8/7/2003 is \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
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 El Temporary ❑ Wall
(Check all that ❑ Electronic
apply) ❑ Other ❑ Billboard Iii Balloon ❑ 2 copies of elevations, drawn to scale
(3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24 x 36"
Sign Dimensions: 5'
❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): r
/421 n 111 $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 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
• sign placement.
Copy: • 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 El 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
❑ Yes I=1 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 day of , � , 20 b
7 7
Sig 7 nature of 9vner /Agerit
3/e-' t1-J (Oa A I reg..(4.4 ct S733 D-F67
Contact Person Name Phone No.
CITY OF TIGARD 7/19/2004
13125 SW Hall Blvd. 3:01:19PM
,s,,,t Tigard, Oregon 97223
- li..ii (503) 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