SGN1995-00173 Permit No . S 15;6113
CITY OF TIGARD
SIGN PERMIT APPLICATION
The applicant hereby applies for a permit for the work indicated or as shown in the
accompanying plans and specifications. /I '1
SIGN LOCATION ADDRESS: ( 3 o % �j(,() VAC-1 ` C ( / ZONING: 6 L"
NAME OF BUSINESS: 1:_1 (U (.tom 1 `-U Cmkg .
APPLICANT/AGENT: nLY Vlun --1, MANY: i cam- PHONE: (0 <- 3 o
T h e City of Ti 3 qd (0 C V o , W 194-- i - w (l . C v v it m- , OK `► '7 t i
ty Tigard imposes an annual Business Tax which/ must be kept current on all
persons doing business in the City. Do you presently have a current business tax?
YES ( ) NO ( ) U.L. Label #
PROPOSED SIGN: (Check as many as apply)
PERMANENT ( ) FREESTANDING (>4 FREEWAY ( )
TEMPORARY ( ) WALL ( ) ELECTRONIC ( )
OTHER ( ) BILLBOARD ( ) BALLOON ( )
SIGN DIMENSIONS: 020 0 ) 0 'x 5 `, 5 DMRATION DATE:
I TAL SIGN AREA (Sq. Ft.): ' le)0
Ft.) :
HEIGHT (Ft):
PROJECTION FROM WALL: T`A A
rr.rrg ATION: YES (>6 NO ( ) TYPE:
DOPY: [41,1 R0 5.e/ �� 1
MATERIALS: S: L{ (C.Vti
EXISTING SIGNS:
ADMINISTRATIVE EXCEPTION: N/A ( ) APPROVED ( ) HON MUCH %
AREA ( ) HEIGHT ( )
COMMENTS:
PLANNING DEP . vi * _, All sign permits must be accompanied by a scale
Permit Fee: JIMININII drawing and plot plan. If work authorized under
Recei. No: a sign permit has not been completed within ninety
• = : 1 111., L , days after the issuance of the permit, the permit
Date: 1 Aff shall became null and void.
ELECTRICAL POINA I CERTIFY THAT I AM THE RECORDED OWNER OF THE
REQUIRED: YES o ) NO ( ) PROPERTY OR AN AGENT AUTHORIZED BY THE OWNER.
BUIIDING P �•� 1 j���a REQUIRED: YES 'I C NO ( ) Applicant's Signature
5.14"i) ',% s 4 ti 360 - 1 —oz[�
cP/ • • •• �--�- / Telephone
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