SGN2004-00113 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2004 -00113
414. •)111 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 5/19/2004
PARCEL: 2S 110AA -00500
BUSINESS NAME: FARMERS INSURANCE ZONE: C -G
SIGN LOCATION: 10580 SW MCDONALD ST 105 JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X'6
TOTAL SIGN AREA: 18 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): S
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of (1) one 18 sq.ft. temporary banner. Valid 5/19/04 thru 6/19/04.
Sign #1
MATERIALS: CANVAS
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 i n permit shall exp e. A temporary sign shall expire 30 days from validity
date. A balloon sign shall expire 10 d ys ro alidity date.
APPROVED BY: ` °
PERMITTEE SIGNATURE: / ,v / ' / �
DATE: 5/19/2004
05/19/2004 09:47 FAX 5035981960 CITY OF TIGARD Z002
A..
4jF1 SIGN PERMIT APPLICATI ON
CITY OF TIGARD 13125 SW Hall BIvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
ENERAL INFORMATION
Name of Development/Project FOR STAFF USE ONLY
Site _GL Ym ee5 __Z
n< e a ne e
kddress/ Street Address ,, n Permit No.: . 59 AJ Z OO.) L I f co(
Sj
_ ocation /p5'o S�/ %�'uO`� _ Expiration •
Date: ' / ISM 4 `f — /5 '_
Suite /Bldg. # CIty /State Zip _a,
/0 5 T , /f-e • 9, ;. . Receipt #:
Name �� t a—i,
e Approved By: Mr
Date: . 5 i5' o
Property _ --- l/� )a Sc3 y
Owner Mailing Address Suite Map/TL #: / 0
Zoning: C
City/State Zip Phone
Electrical Permit Required'? ❑ Yes Y:I-NO
Tenant or Name
�, Building Permit Required? ❑ Yes o
Business �LLi(/j/La c/f r�
Rev. 8/7/2003 i :1cu Inlmasterstrevised\ei n permit epp.doc
Name / /
Sign Co n tractor Meiling Address Suite REQUIRED SUBMITTAL ELEMENTS
Contractor
(Prior to permit /0S 5 /ff (Note: applications will not be accepted
issuance, a *le A .51/ • without the required submittal elements)
copy of all City/State Zip 9v 4 Phone co)
licenses are
required if T go 6 .�j d 57
El Completed Application Form
expired in the n Const. Cont. Board Exp. Date
City of Tigard's License tr ❑ 2 Copies of Site /Plot Plan, Drawn to Scale •
database) (3 copies, if a building permit is required)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 81/2" x 11", or 11" x 17"
S` Wall Electronic
(Check Te m p orary ❑ ❑
CI copies of elevations, drawn to scale
Other (Check all that ❑j Siliboard ❑ B alloon .
a — (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 X d ' ❑ $31.00 Fee (Permanent sign, any size)
•
Total Sign Area (sq. ft.): /5' ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wail Area (sq. ft.) / ' i Jurisdiction: ❑ City ❑ Urb
(Complete ail Direction Wall Faces (circle one): NOTES:
Items in this
section) N (57E 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: _ 444,,1."a j • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ building permit. Yes a-No • Type: ❑ Internal N-- _ • If work authorized under a sign permit has not
been completed within ninety (90) days after
Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL
location, including wall signs that overlap a tenant space? BECOME NULL AND VOID.
X Yes ❑ No . .
If "yes ", a list or diagram of all sign dimensions and
square footage mu also be sub mitted. •
-- (OVER FOR SIGNATURES)
05/19/2001 09:18 FAX 5035981960 CITY OF TIGARD 003
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.
l9 ° 4
day of . "fiA; ,20
DATED this
— —
Signature of Owner /Agent
OA a Id /e /77 c
Contact Person Name Phone No.
r
3
(Il Y UN I IIJAKU 5/19/2004
13125 SW Hall Blvd. 11:07:02AM
.4r i '4 (II Tigard, Oregon 97223
�J 11. (503) 639 -4171
Receipt #: 27200400000000002126
Date: 05/19/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00 1 1 3 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User 1D Acct. /Check Approval No. How Received Amount Paid
CreditCard DONALD L HELMICK KJP 023162 In Person 15.00
Payment Total: $15.00
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