SGN2004-00028 CITY OF TIGARD SIGN PERMIT
i DEVELOPMENT SERVICES PERMIT #: SGN2004 -00028
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/13/04
PARCEL: 2S 102CC - 00500
BUSINESS NAME: FIRESTONE ZONE: C -
SIGN LOCATION: 13500 SW PACIFIC HWY 80 FIRESTONE JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2'X8'
TOTAL SIGN AREA: 16 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 6 ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of (1) one temporary 16 sq ft banner. Valid 2/13/04 - 3/14/04. Sign #1
MATERIALS: BANNER
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
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 1 da from valid date.
APPROVED BY:
PERMITTEE SIGNATURE: ef-7-V �
DATE: 2/13/04
v4.1!1'i SIGN PERMIT APPLICATION
ilk
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
Site
FOR STAFF USE ONLY
Address/ Street Adqress
Location / T /ll S W g iii4, j Permit No.: S /J �- e�Z (( — ( }J C7
suite/Bld # cites state Zip Expiration Date: a- //,3 f 0(-1 — 3 f / y Qy
i ! Ti Receipt #: oL� o ()p 5 (
Name Approved By:
Property Date: / V
Owner Mailing Address Suite Map/TL #: .5 / C) d. CC — �.Sc) u
Zoning:
C
2
ity/State Zip Phone
Tenant or Nam ______,... Electrical Permit Required? ❑Yes [l� —rQo'
Business / 1 �rf y ,-,t /7ratipere Building Permit Required? ❑ Yes Q No
Name `/ Rev 8/7/2003 i:\curpin\masterslrevisedlsign permit app.doc
Sign
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit
issuance, a (Note: applications will not be accepted
copy of all City/State Zip Phone without the required submittal elements)
licenses are
required if
expired in the Oregon Const. Cont. Board . Exp. Date EJ Completed Application Form
City of Tigard's License #
database) E] 2 Copies of Site /Plot Plan, Drawn to Scale
(3 copies, if a building permit is required)
Proposed
PI n ❑ Permanent ❑ Freestanding El Freeway size requirement: 8 x 11 ", or 11" x 17"
Sig :-' e all that ' .emporary El Wall ❑ Electronic
apply) ❑ Other ❑ Billboard ❑ Balloon El copies of elevations, drawn to scale
New sign? (3 copies, if a building permit is required)
g ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions:
- 1L Ad ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): / L
�! ❑ $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/7 SW
Height to top of sign (feet): 6 f^� • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
Co sign placement.
py • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes 21 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
❑ Yes ❑ No BECOME NULL AND VOID.
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted. 1
(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.
+' L
DATED this to day of / _1 , 20
Signature of Owner/Agent
/ / ry wiik4 6,2g
Contact Person Name Phone No.
CITY OF TIGARD 2/13/2004
13125 SW Hal1 Blvd. 12:48:24PM
A Tigard, Oregon 97223
_P c'� (503) 639 -4171
Receipt #: 27200400000000000568
Date: 02/13/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00028 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct /Check Approval No. How Received Amount Paid
Cash FIRESTONE KJP In Person 20.00
Change CITY OF TIGARD KJP In Person (5.00)
Payment Total: $15.00
Page 1 of 1 cReceipt.rpt
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Attach I
Job Address:13 AID f(- P
Date