SGN2004-00353 CITY TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2004 -00353
I'I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/29/2004
PARCEL: 2S 102CC - R - O - W
BUSINESS NAME: ZONE:
SIGN LOCATION: SW NO ADDRESS JURISDICTION: TIG
APPLICANT /AGENT: OBIE MEDIA CORPORATION
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 24" X 84"
TOTAL SIGN AREA: 14 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of one bench with sign within public right -of -way. Approved by Gus
Duenas (City Engineer).
MATERIALS: BENCH
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
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. nn
APPROVED BY: d _ l � ' (a t.n�
PERMITTEE SIGNATURE: Lt ? U `-.—
DATE: 11/29/2004
asto, CC-
411
-44-Ali, SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name f Development/Project
� WS . S / -e / FOR STAFF USE ONLY
Site /� f �J ,r
Address/ Street Address 5L 1 1?/2 .ha/ Permit No.: ,St:. IQ aci) -1 —x:35
Location 5 r L'i c // / P /<
Expiration Date:
Suite /Bldg. # City/State Zip
tia,-- 2 2-7 Receipt #:
Name / m Approved By:
Property / / G L�1 /"l &,"- -erp/4.( Date:
Owner Mailing a Suite Map /TL #:
3 54 Zoning:
�l
City /State Zip Phone
City
/ 7y-6i ( 7 Electrical Permit Required? ❑ Yes ❑ No
Narfie
Business �� S 71-o/ Building Permit Required? ❑ Yes ❑ No
Rev. 7/1/04 i:\curpin\masters\revised\siqn permit app.doc
Name
Sign , a ( e A eci6 Ce2v/
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit ,t2t/ W (/ 7-3 7 ,Lv,' (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City /State Zip Phone
licenses are
required if .e /4 e 7V =2 Completed Application Form
expired in the Ore on Const. Cont. Board Exp. Date
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) 4 - 0 h7 (- --�c44>.^ r owh — (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 El Billboard I=1 Balloon
El 2 copies of elevations, drawn to scale
apply) (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: g q rr K 2/" ❑ $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): / ,/ El $15.00 Fee (Temporary sign, any type)
Sign Data
Total Wall Area (sq. ft.) Jurisdiction: El City ❑ Urb
(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
Will sign have illumination? ❑ Yes No building permit.
Type: ❑ Internal ❑ External o 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
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)
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 P°
v �� / , 20 0 `f
Signature of Owner /Age•-
OPe�4.7 4 7 5
06( " -e e or 3 - 22- 3 - 97
Contact Person Name Phone No.
CITY OF TIGARD 12/6/2004
•
13125 SW Hall Blvd. 11:08:03AM
4p01 I Tigard, Oregon 97223
°'I (503) 63 9-4 17 1
Receipt #: 27200400000000005237
Date: 12/06/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00346 [SIGN] Sign Permit 100 - 0000 - 437000 32.00
SGN2004 -00347 [SIGN] Sign Permit 100 - 0000 - 437000 32.00
SGN2004 -00348 ' [SIGN] Sign Permit 100- 0000 - 437000 32.00
SGN2004 -00349 [SIGN] Sign Permit 100 - 0000 - 437000 32.00
SGN2004 -00350 [SIGN] Sign Permit 100- 0000 - 437000 32.00
SGN2004 -00351 [SIGN] Sign Permit 100 - 0000 - 437000 32.00
SGN2004 -00352 [SIGN] Sign Permit 100 - 0000 - 437000 32.00
SGN2004 -00353 [SIGN] Sign Permit 100- 0000 - 437000 32.00
SGN2004 -00354 [SIGN] Sign Permit 100 - 0000 - 437000 32.00
Line Item Total: $288.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check BANK OF AMERICA CASHIERS CAC 0259789 By Mail 288.00
CK
Payment Total: $288.00
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