SGN2004-00153 1
C ITY OF TIGARD SIGN PERMIT
. e� iI DEVELOPMENT SERVICES PERMIT #: SGN2004 -00153
ll 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 7/13/2004
PARCEL: 2 S 110AA -01000
BUSINESS NAME: RIPLEY'S FURNITURE ZONE: C -G
SIGN LOCATION: 14170 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 4'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of one temporary A -frame sign. Sign #3. Must be placed outside
public right of way. Valid from 7/13/04 through 8/13/04.
MATERIALS: WOOD
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 vali. ity date.
APPROVED BY: ■�'v �'�-
PERMITTEE SIGNATURE:
DATE: 7/13/2004
_ .41, 0 is 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/Pro'ect
Site R 1 pley S
f Y11-t-.l f FOR STAFF USE ONLY
Address/ Street Address PRCV('‘L- 141 Permit No.: SCE M a004- DO 1.5.3
Location 14n0 S lA) .
Expiration Date: 8 13 0'4
Suite /Bldg. # City /Sta,te Zip ,/
U 04 , 01E 912ZT Receipt #: O 1 3c`
Name Approved Approved By: 0 00.- Li 3
Property _ A Vi A 1? I Date: 9 f 3 U `"{
Owner Mailing Address le — rS (/ o 6 4-1 0 1 O L.)
Zoning: C - G
City /State Zip Phone
Electrical Permit Required? ❑ Yes 0 No
Tenant or Name
Business Building Permit Required? El Yes ] No
Name Rev. 7/1/04 is \curpin \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 ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign - Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard ❑ 2 copies of elevations, drawn to scale
❑ Balloon
apply) (3 copies, if a building ( p' g permit is required)
❑ New sign? N Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: 3 3(4. '
❑ $32.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): ( a ci -c4 ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: ❑ City ❑ Urb
(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
❑ 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.
1
DATED this day of T'1 L `� 20 C 4
I LA
Signature o •wner/ a gent
b(A
► . . go3 -C -4�
� � � I I / Phone No.
Contact Person Nam
CITY OF TIGARD 7/13/2004
13125 SW Hall Blvd. 11:42:09AM
11/4 1I, Tigard, Oregon 97223
(503) 639 -4171
Receipt #: 27200400000000003021
Date: 07/13/2004
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2004 -00153 [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 RIPLEY'S FURNITURE & CAC 4612 In Person 15.00
DESIGN
Payment Total: $15.00