SGN2004-00343 C ITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2004 -00343
��Ill 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/19/2004
PARCEL: 2S102AC -00700
BUSINESS NAME: THAI DELICIOUS ZONE: CBD
SIGN LOCATION: 12540 SW MAIN ST 150 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' -6" X 15'
TOTAL SIGN AREA: 52 sq. ft.
WALL AREA: 720 sq. ft.
WALL FACE (DIRECTION): N
SIGN HEIGHT: 15 ft.
PROJECTION FROM WALL: 14 in.
ILLUMINATION: IND
DESCRIPTION OF SIGN: Installation of (1) one 52.5 sq ft permanent wall.
MATERIALS: PLEX /METAL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 32.00
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 •• n permit shall expire. A temporary sign shall expire 30 days from validity
date. A balloon sign shall expire 10d or validity date.
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APPROVED BY: ���;�
' IF
PERMITTEE SIGNATURE: • � �� ��7�
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DATE: 11/1' 1 I •
A., , 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 - 1441 bMPCI Old S
Address/ Street Address Permit No.: ,..s/A.1 -- - oo -
Location /2S' S(./.J M MN 11 47) Expiration Date:
Suite /Bldg. # City /State Zip
1 9722 Receipt #: o 5
Name Approved By: A- 1P
Property Date: ii (
Owner Mailing Address Suite Map/TL #: /,, /��
Zoning: (-
City /State Zip Phone
Electrical Permit Required? l Yes ❑ No
Tenant or Name
7144_ D 00 Building Permit Required? ❑ Yes B-No
Business
Rev. 7/1/04 is \curpin \masters \revised \sign permit app.doc
Name / 1 ,
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Sign �7(64\)6 �' 1 `VK
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit 10 ;3 /4-}4 (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City /State Zip Phone
licenses are
required if Tk 47 2/3 G 1-C'5 ( 0 .Ef Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # % L'7 .r te ZZ1 �S ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) 17 "I C �� cp' (3 copies, if a building permit is required)
Proposed X Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11", or 11" x 17"
Sign ❑ Temporary l.. Wall ❑ Electronic
(Check all that ❑ Other 2 copies of elevations, drawn to scale
apply) ❑ Billboard ❑ Balloon (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: ■ to x r a $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 52.. _ ❑ $15.00 Fee (Temporary sign, any type)
Total Wall Area (sq. ft.) b t Jurisdiction: O City 111 Urb
Sign Data 24 )( `7
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) Qh S E W NE NW SE SW • Wall signs do not need to be drawn to scale,
t to top of sign (feet): IS 4.0 but must include dimensions of wall face and
Projection From Wall (inches): f' sign placement.
Copy: 7t4( iel4c OU S • Wall signs do not require site /plot plans.
Materials: fc6) 4 4 .4 4 6.7A C-- • Freestanding signs over 6 ft. required a
Will sign have illumination? Yes ❑ No building permit.
,
Type: a 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
❑ 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 � Ti� day of , 20o
Signature of Ow, /Agent
3 nom- 7/( 52. ; 6.51 • !4
Contact Person Name Phone No.
_ __.. _ __________ _
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Approved CITY OF TIGARD [<
Conditionally Approved.._ _ _ [j
For only the work as described in:
lel , I I I PERMIT NO. Y - 00 3`13
See Letter to: Follow [ J
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Project: Thai Delicious Contact: on 5omboon si _„ �,r tt 1
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12540 SW Main St. Approved: - - • .
Tigard, OR 97223 51GNCRAFT ELECTRICAL A WRR1351W i L13a.LC
9033 5W BURNHAM PO BOX 23636 WARD, ODR'. 17222223
503 - 639 -491P 55 *1 499 99
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