SGN2004-00382 CITY TIGARD SIGN PERMIT
T,� I DEVELOPMENT SERVICES PERMIT #: SGN2004 -00382
' 111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 12/15/2004
PARCEL: 2S102AA-00490
BUSINESS NAME: MADDY'S ZONE: CBD
SIGN LOCATION: 12085 SW HALL BLVD 130 JURISDICTION: TIG
APPLICANT /AGENT: MADDY'S
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4' X 2' 8"
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: 0 in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary placement of (1) A -board sign. Not to be placed in visual clearance
area or public right -of -way. Valid 12/15/04 through 1/15/05. Sign #2
MATERIALS: WOOD
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.
APPROVED BY:
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PERMITTEE SIGNATURE: - ial- Q `'
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DATE: 12/15/2004
1
44
44**1i1111'\ 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
ad�y� FOR STAFF USE ONLY
Site
ddress/ Street Address Permit No.: S Co tJ ac,o' -1 - 0038a
Location X20 is S Su) Hal I l l u d • Expiration Date: .��
Suite /Bldg. # City/State Zip
Receipt #: c ,20 o q - 5 9
Hard cart O r 97223
Name Approved By: 0: C
Property Date: /a - / S - o ‘{
\ p ,ner Mailing Address Suite Map /TL #: aS / o 4-A — 00 °/ OCR
,,\( Zoning: C 3 p
City/State Zip Phone
Electrical Permit Required? ❑ Yes ❑ No
enant or Name
Building Permit Required? ❑ Yes El No
Business CO Zc V r eivi.41.&v
Name Rev. 7/1/04 lAcurpin \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 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 NI •- rmanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign at Temporary ❑ Wall
❑ Electronic ❑ 2 copies of elevations drawn to scale
(Check all that • Other ❑ Billboard ❑ Balloon '
apply) (3 copies, if a building permit is required)
❑ New sign? ❑ Alter to existing sign? size requirement: 81/2" x 11", to 24" x 36"
n Dimensions: ❑ $32.00 Fee (Permanent sign, any size)
3 >c ‘-1
Total Sign Area (sq. ft.): ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: II] City El 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: • 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 • 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 1 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 Per:. / S day of PP r , 20 0
k eidtAidalt.V
Signature of Owner /Agent
/'dim C: ��in 5 03- 620 -6 991
Contact Person Nhme Phone No.
CITY OF TIGARD 12/15/2004
13125 SW Hall 131vd. 11:26:24AM
Tigard, Oregon 97223
(503) 63 9-4 17 1
Receipt #: 27200400000000005390
Date: 12/15/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00382 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct. /Check Approval No. H ow Received Amount Paid
Cash MADDYS CAC In Person 15.00
Payment Total: $15.00
cReceipt.rpt Page 1 of 1