SGN2009-00175 CITY OF TIGARD SIGN PERMIT
Permit#: SGN2009-00175
COMMUNITY DEVELOPMENT Date Issued: 08/11/2009
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.639.4171 Parcel: 2S113AB01201
Jurisdiction: TIGARD
Name of Business:
Business Address: 16505 SW 72ND AVE
Applicant/Agent: Safeco Liberty,
Work Description: Installation of one(1)permanent wall sign 12'X 2'
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions: 12'X 2'
Total Sign Area: 24
Wall Area: 1560
Wall Face(Direction): North
Sign Height: 30 ft.
Projection From Wall: 3 in.
Illumination: No Illumination
Materials: Aluminum
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $40.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. 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.
�W r
Approved By: '
Permittee Signature:
•
f ,
1111• SIGN PERMIT APPLICATION
• � City of Tigard Permit Center 13125 SW Hall Blvd., Tigard, OR1EC"`"' M,,,,
Phone: 503.639.4171 Fax:503.598.1960 i ,
T I GARD ./
AUG 1 1 2009
GENERAL INFORMATION ` j p , r l ,
.s.P,,A,I:.q- 9
Name of Development/Project �sF'y{jp
`r `.l ' FOR STAFF USE ONLY
Site ly
Address/ Street Address Permit No.: S&A) 0- OD 11C
Location n
C Expiration Date:
Suite/Bldg.# iC ty/State Zip l 7' a4
Receipt#: o
Nam Approved By: S' I lee-Fr(
Property 1 (o5-r Date: ail/
Owner Mailing Address Suite Map/TL#: ;S 11 3 P1&o 1 ol-O J
Zoning.
City/State Zip Phone
Tenant or Name Electrical Permit Required? I=1 Yes
Yes No
Business 2cc 0 0 Building Permit Required? ID Yes No
. Rev.7/1/07
nd use applications\sign permit app.doc
Sign Melissa Hayden, Security Signs
Contractor - 2424 SE Holgate Blvd
(Prior to permit Portland, OR 97202
issuance,ll - p: 503 546 7114 f: 503 230 1861 ,UIRED SUBMITTAL ELEMENTS
copy i
licenses are Melissa@pSecuritySigns.com te: applications will not be accepted
required if - CCB: 1 22809 out the required submittal elements) ••
expired in the '
City of Tigard's 26560CLS metro #: 2561
database) ted Application Form
Proposed \ s of Site/Plot Plan,Drawn to Scale
Sign \. !s,if a building permit is required)
(Check all that Other lill boaza
apply) 11LJ u ��� I _-guirement: 8'/z"x 11", or 11"x 17"
New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations,drawn to scale
Sign Dimensions: (3 copies,if a building permit is required)
�x l 7
size requirement: 8'/2"x 11", to 24"x 36"
Total Sign Area(sq. ft.): z1)*
/ ❑ $40.00 Fee (Permanent sign,any size)
SignData Total Wall Area(sq. ft.) ( C III $19.00 Fee (Temporary sign,any type)
(Complete all Direction Wall Faces(circle one):
items in this NOTES:
section) CD S E W NE NW SE SW
Height to top of sign(feet): r ♦ Wall signs do not need to be drawn to scale, but
Projection From Wall(inches): a,” must include dimensions of wall face and sign
Copy: `.''bpd ( iNnet-tf,! placement.
Materials:— V�' ' • Wall signs do not require site/plot plans.
Ly r-n i")11A— • Freestanding signs over 6 ft. required a building
Will sign have illumination? ❑ Yes No permit.
Type: ❑ Internal ❑ Exte al ; • If work authorized under a sign permit has not been
Are there any existing freestanding or wall signs at this location, completed within ninety (90) days after the issuance
including wall signs that overlap a tenant space? of the permit, THE PERMIT WILL BECOME
❑ Yes ] No NULL AND VOID.
If"yes",a list or diagram of all sign dimensions and square
footage must also be submitted. -
(OVER FOR SIGNATURES)
f
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.
DATED this day of f00S .20 QS
dire ner/Agent
L 2 i2 t S '.1/k
Contact Person a - Phone No.
CITY OF TIGARD RECEIPT
g .-; 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 174786 - 08/11/2009
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2009-00175 Sign Permit 1003100-43115 $35.00
SGN2009-00175 Sign Permit-LRP 1003100-43117 $5.00
Total: $40.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 589845 STREAT 08/11/2009 $40.00
Payor: Melissa Hayden
Total Payments: $40.00
Balance Due: $0.00
Page 1 of 1
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VICINITY AERIAL VIEW At.F1ffLIYIEW
Date: 02/10/09 Rev.5: 00/00/00 Rev.10: 00/00/00
Safeco Insurance Address: 165055 W 72nd Avenue Project#:3176 Location#:53 Page:1 I Scale:N.T.S. I Drawn by:MG Rev.1: 00/00/00 Rev.6: 00/00/00 Rev.11: 00/00/00
1418 Elmhurst Rd.
SITE PLAN City/State: Portland,OR Rev.2: 00/00/00 Rev.7: 00/00/00 Rev.12: 00/00/00 •
n Elk Grove Village
Member of Liberty Mutual Group Zip: 97224 File Path:Active\ACCOUNTS\L\Liberty Mutual\Locations Safeco\3176_053_Portland,OR Rev.3: 00/00/00 Rev.8: 00/00/00 Rev.13: 00/00/00 1 c o n Illrnou'60007
Drawings are the exclusive property of Icon Identity Solutions Inc,.Any unauthorized use or duplication is not permitted. Rev.4: 00/00/00 Rev.9: 00/00/00 Rev.14: 00/00/00 Identity Solutions
SIGN E01
Ilium. ❑ " x.... 11'-11 1/2"
t
Non ilium. �n 1 i 5'-2 / 6 4 ,3a°
12 1/4"S/F PAN
Safeco' nsU n;'D/F ❑ 13/4'OUND
H: 2'-0"
q eco nsurancel,,W: 5'-21/4" o1/a•
ePLATE LTRS11,4.
D: N/A
-
OAH: N/A --E Member of Liberty Mutual Group 1/4"Retainer: WA PLATELIPS
V.O.H: N/A CO
M
V.O.W: N/A M
Available H: WA
Available W: N/A EXISTING PROPOSED Non-Illuminated Letters & Logo
QTY:1 SCALE:3/8"=1'-0"
Square Feet: 149
Notes: ?rimyelectric will need to be run for ig to be illuminated.Will need to be approved by PM&
hll'architect.No to exceed 15%01 tof8l\kali area.
CITY OF TIGARD
SIGN E02
Aptsrnver3 .- [--1
Conditiotlr ily Approved [ ]
alum. ❑ For drift the work as described in:
Non mum. PEMMlT NO. SC�,IU ;?-r9 t>c—v-c2 1-1-1
s/F S@@ Letter to: Follow [ ]
D/F ❑ Job Address: Attach
te cUc r A) -73- [ I
H: N/A By: & i�f-=-A-T - Dato: /
lli-
W: N/A
D: N/A tot
M# TO BE DETERMINED
OAH: N/A
Retainer: N/A
V.O.H: N/A TO BE DETERMINED
V.O.W: N/A
Available H: N/A
Available W: N/A PROPOSED
Square Feet: N/A
Notes: Action to be determined.
I
Date: 02/10/09 Rev.5: 00/00/00 Rev.10: 00/00/00
Address: 165055 W 72nd Avenue Project#:3176 I Location#:53 I Page:1 I Scale:N.T.S. I Drawn by:MG Rev.1: 08/06/09 Rev.6: 00/00/00 Rev.11: 00/00/00
Safeco Insurance RECOMMENDATIONS City/State: Portland,OR Rev.2: 00/00/00 Rev.7: 00/00/00 Rev.12: 00/00/00 • IlkGrov418 urst d
y� Elk Grove Village
Vit Member of Liberty Mutual Group Zip: 97224 File Path:Active\ACCOUNTS\L\Liberty Mutual\Locations Safeco\3176_053_Portland,OR Rev.3: 00/00/00 Rev.8: 00/00/00 Rev.13: 00/00/00 !entity C O 11 Illinois 60007
Drawings are the exclusive property of Icon Identity Solutions Inc,.Any unauthorized use or duplication is not permitted. Rev.4: 00/00/00 Rev.9: 00/00/00 Rev.14: 00/00/00 solutions