SGN2004-00266 C ITY OF TIGARD SIGN PERMIT
I� DEVELOPMENT SERVICES PERMIT #: SGN2004 -00266
�� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/27/2004
PARCEL: 2S115AB-01900
BUSINESS NAME: TIN TIN BUFFET ZONE: C -G
SIGN LOCATION: 16200 SW PACIFIC HWY A JURISDICTION: TIG
APPLICANT /AGENT: TIN TIN BUFFET
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 3' 10"
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 a temporary A -frame sitn. (3' x 3' 10 ") Sign #2 Valid from 10/29/04
through 11/28/04. Must be placed outside of right of way.
MATERIALS:
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.
C/
APPROVED BY: 4,-� �CLIn��
PERMITTEE SIGNATURE:
DATE: 9/27/2004
li
t�iw , SIGN PERMIT APPLICATION
X111
CITY .OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
Site �� \-t1 5\4(1Q\— FOR STAFF USE ONLY
Address/ Street Address Permit No.: 5 N ?(>04 — 00Aloe
Location 1,1 61� cCCCr- C •}} f,,
`� Expiration Date: I I/a t /o 4
Suite(Bldg. # City /State Zip p
[n � �� io� i . 1• Receipt #: a 0 o 4 - (-1.-./ So
Name �,. Approved By: C • Ca,..„,...,.)
Cl.�SC Date: 9 -.77- o f
Property '- �CZ`C��� °
Owner Mailing Address Suite Map/TL #: a S /ISA 8 — CY 9 0
\\a\, z., 'S(.` m >i,- Zoning: C - G
City /State Zip Phone
,alt)a- %''=1■ 3 (a\`g •A Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name
�,� \�,� - \ -9 �.
Building Permit Required? ❑ Yes El No
Business \
Name
Rev. 7/1/04 is \curpin \masters \revised \siqn permit app.doc
•
Sign
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City/State Zip Phone
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 ❑ 2 copies of elevations, drawn to scale
apply) Other ❑ Billboard El Balloon
(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: 3% )( of ro tk ❑ $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 1‘ , 11 ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: El City ❑ U rb
(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: o Wall signs do not require site /plot plans.
Materials: P\ -- o Freestanding signs over 6 ft. required a
Will sign have illumination? El Yes ❑ No building permit.
Type: El 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
❑ 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)
f
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 g , 20_
gnaureo O
Contact Person Name Phone No.
3
•
\I
■
i
c
I ��
..11 Y UP 1 Ilurli JX J „ _ . , _,, ,, . •
131.25 SW Ha11 Blvd. 2:25:35PM '
tr Tigard, Oregon 97223 -
9 I (503) 63 9-4 17 1
Receipt #: 27200400000000004276
Date: 09/27/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00265 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
SGN2004 -00266 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
SGN2004 -00267 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
Line Item Total: $45.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Cash TIN TIN BUFFET CAC In Person 50.00
Change CITY OF TIGARD CAC In Person (5.00)
Payment Total: $45.00
Page 1 of 1 cReceipt.rpt