SGN2004-00084 J
CITY OF TI GARD SIGN PERMIT
Ali, 1' • DEVELOPMENT SERVICES PERMIT #: SGN2004 -00084
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 4/29/04
PARCEL: 2 S 102AC -00700
BUSINESS NAME: THAI PRINCESS ZONE: CBD
SIGN LOCATION: 12540 SW MAIN ST 150 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 8'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one temporary banner. Sign #2. (3' x 8') Valid from 4/29/04 through
5/29/04.
MATERIALS: VINYL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
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:
PERMITTEE SIGNATUR
DAT, 4/29/04 mop—
r
A 'P1(16 SIGN PER IT A■ ■ `ICA TIO■
CITY OF TIGARD 13125 SW Kal1 Blvd., Tigard, OR 97223 (503) 639 -417/ FAX: (503) 684 -7297
ENERAL INFORMATION
Name of Development/Project
ite TO A ( Ft /t i (E 5 T�4 - 004 - J T FOR STAFF USE ONLY
.ddress/ Street Address
ocation 12_5 7a _ci,o /1414 — ( s(j Permit No.: �� O o 4 - U d off '
Expiration Date:
Suite /Bldg. # City /State Zip veto /.:% 5 -a9 - v 4
-7 /
6.4 - teb 9k q721.3 Receipt #: a 00 4- - 1 r 7 9 4
Name
` /� Approved By: C , C`r�.�. -,-u2)
roperty vi (Lc, 0
Date: Li. -a 9 0.
'wner Mailing Address Suite Map/TL #: -2 S / 0 ` k OO Lo 7
11 +1 1 t Zoning:
ity/State Zip Phone 0
k7 /.4 4 1 . 72cy 503- • 0 y
enant or Name Electrical Permit Required? ❑ Yes 0 No
usiness 11-{ 0- I PR1 N C jr S 5 L L L, Building Permit Required? ❑ Yes 0 No
Name Rev. 8/7/2003 i:lcurpin\masterslrevisethsign perm app.doc
D
ign TH -( I v11i (ESS P 111
ontractor Mailing Address
iortopermit Suite REQUIRED SUBMITTAL ELEMENTS
uance, a 2 6- y 5 4' /' g ( 5 0
(Note: applications will not be accepted
)y of all j Ci City/State Zip Phone without the required submittal elements)
lured if t I C^A t2 6 7 72Z
)fired in the Oregon Const. Cont. Board Exp. Date ❑ Completed Application Form
y of Tigard's License #
abase) ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
oposed (3 copies, if a building permit is required)
gn 121 Permanent ❑ Freestanding ❑ Freeway size requirement: 81/2" x 11 ", or 11" x 17"
Temporary ❑ Wall
ieck all that ❑ Electronic
❑ Oth B illboard ❑ Balloon
ply? ❑ ❑ 2 copies of elevations, drawn to scale
(3 copies, if a building permit is required)
® New sign? ❑ Alter to existing sign?
Sign Dimensions: size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft): ❑ $31.00 Fee (Permanent sign, any size)
❑ $15.00 Fee (Temporary sign, any type)
gn Data Total Wall Area (sq. ft.)
Jurisdiction: ❑ City ❑ Urb
tmplete all Direction Wall Faces (circle one):
ns in this
lion) .N S 0 W NE NW SE SW NOTES:
Height to top of sign (feet): • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
Copy: sign placement.
Materials: • Wall signs do not require site /plot plans.
• Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes ® No building permit.
Type: ❑ Internal 5E External • If work authorized under a sign permit has not
there any existing freestanding or wall signs at this been completed within ninety (90) days after
:ation, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
11 Yes No BECOME NULL AND VOID.
`yes ", a list or diagram of all sign dimensions and
uare footage must also be submitted.
(OVER FOR SIGNATURES)
hereby acknowledge that I have read this application, that the information given . is
orrect, that I am the owner or authorized agent of the owner, and that plans submitted are
1 compliance with the City of Tigard.
)ATED this 0 "r6 day of A1U40,1 , 20 0 1-1
}
Signature of Owner /Agent V
contact Person Name Phone No.
CITY OF TIGARD 4/29/2004
13125 SW Hall Blvd. 4:03:40PM
Aiti600 Tigard, Oregon 97223
. _I (503) 63 9-4 17 1
Receipt #: 27200400000000001794
Date: 04/29/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00084 [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
Check THAI PRINCESS, LLC cac 108 In Person 15.00
Payment Total: $15.00