SGN1995-00143 OF TIGARD
CTTY P it No. S6105--01`43 SI PERMIT CATTal
The applicant hereby applies for a permit for the work indicated or as shown in the
accompanying plans arxi specifications.
SIar LOCATION ADDRESS: `- 5 %S &J MA 1 del =VIM: C'‘
NAME OF BUSINESS: I/ " RI-5M c e)P
APPLICANT /AGENT( , //I/ COMPANY: 45 r1.4.10cT PHONE: (�1 '‘(‘‘,
The City of Tigard imposes an annual Business Tax rich must be kept current on all
persons .s doing business in the City. Do you presently have a current business tax?
YES pci NO ( ) U. L. Label # ' 9. g
PROPOS SIGN: (Check as many as apply)
P&L:NAM/IT
P.C) EREESTANDIM FROY ( )
OTHER 3 ( ) WALL .iorc c ELECTRONIC ( )
( ) =BOARD /-82( />. c.' BALLOON
SI DIMENSIONS: ?/ X" 1° ETIRATION DATE:
TL7I�.L SIav AREA (Sq. Ft.) : 24
WAIL AREA (Sq. Ft.) : .4 � o ',z Ada
WAIL FACE: • A / w0h CrL' ' k S / r
HETG� (F•t) : ,r 4f� . ��C.ASe rev /� ' ��' , P r i�.J
PROJECTION FROM WAIL: � ' c.c / FAT' r i �^�� 76/k- o.�
Tr r MI TION: YES ( ) NO , ) TYPE: W o o4 �h < "
(DOPY:
MATERIALS: A ,go R
EXISTING SICK tS : ` `
ADMINISTRATIVE EXCEPTION: N/A ( ) APPROVED ( ) HOW MUCH
COMMENTS: AREA ( ) FIGHT ( )
PLANNING D§PARTMENT All sign permits must be acccupanied by a scale
Permit Fee Z Z) drawing and plot plan. If work authorized under
Receipt No: a sign permit has not been leted within ninety
Approved By: days after the issuance of the permit
Date: permit, the
shall beccue null and void.
ELECTRICAL PERMIT I CEREEFY THAT I AM THE QED OWNER OF THE
RE OIRED: YES ( ) NO PROPERTY OR AN AGENT AUTHORIZED BY THE OWNER.
BUILDING PERMIT - �G>r.Y�> �-
ED: YES ( ) NO Applicant's Signature
/ S:9,7 S &. 4 s ; ‘(;) - eeee
Q/ mp I Address ]'�Grt - Telephone
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