SGN2011-00060 IN CITY OF TIGARD SIGN PERMIT
Permit #: SGN2011 -00060
COMMUNITY DEVELOPMENT Date Issued: 05/25/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S113AB00500
Jurisdiction: Tigard
Name of Business: State Farm
Business Address: 16083 SW UPPER BOONES FERRY RD 130
Applicant/Agent: State Farm,
Work Description: Installation of (1) one permanent 31 s.f. wall sign.
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 29" x 154"
Total Sign Area: 31
Wall Area: 2200
Wall Face (Direction): Southeast
Sign Height: 30 ft.
Projection From Wall: 1 in.
Illumination: No Illumination
Materials:
•
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $164.00
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.
Approved By: -8-
Permittee Signature: 671 GiQ ,
RECEIVED
II • City of Tigard MAY 2 4 2011
II
Sign Permit Application CITY OF TIGARD
T I GA R D PLANNiI��/ENGINEF ING
GENERAL INFORMATION
Name of Development /Project
Site St A RPM l 4)15 FOR STAFF USE ONLY
";
Address/ Street Address l 1�, Permit No.: t/ 2 'c> I ( 6 C (0 d
Location , (DO 83 O U. gv1 /1-fit,
Suite /Bldg. # City/State Zip 7 Approved By: f''
/ II V ,, e IKM3 Date: $/• Via
Name � Receipt #: /411056;
Property Map /TL #: 2 S ii) A dD
Owner Mailing Address Suite Zoning: X
Allowable Total Area: IS 7o
City/State Zip Phone
Tenant or Name A Electrical Permit Required? ❑ Yes 6No
Business S`r E Flotoi l 'V <) Building Permit Required? ❑ Yes o
i
Name Rev. 7/1/10
��..y l �N S \curpin \masters \land use applications \sign permit app.doc
Contractor Mailing Address Suite
r Tbz s VO M k t V I6/6'
ty /State y Zip Phone REQUIRED SUBMITTAL ELEMENTS
PD T q �f � 1/ c v - 7 - e f ' (Note: applications will not be accepted
n Const Co nt / B oa ardd tense # Exp. Date
I ' " 7 without the required submittal elements)
L ❑ Completed Application Form
Proposed ❑ Pe anent ❑ Freestanding ❑ Freeway ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Sign ❑ emporarp ❑ Roof ❑ Electronic
(Check all that (3 copies, if a building permit is required)
Wall aPPly) ❑ Other requirement: 8 x 11 ", or 11" x 17"
❑ 2 copies of elevations, drawn to scale
New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimensions: aq r� x 1 5 4 " size requirement: 81/2" x 11", to 24" x 36"
Total Sign Area (sq. ft.): ?1€ /� ` 2 I ❑ $164.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) >� % ❑ $52.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) V� N S E W NE NW E SW
661 �� Height to top of sign (feet): - 30 ♦ Wall signs do not need to be drawn to scale, but .
Projection From Wall (inches): must include dimensions of wall face and sign
I /4 4 PVC, placement.
Materials: ♦ Wall signs do not require site /plot plans. •
Will sign have illumination? ❑ Yes " No • Freestanding signs over 6 ft. required a building
Type: ❑ Internal ❑ External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space?
❑ Yes X No
If "yes ", a list or diagram of all sign dimensions and square (OVER FOR SIGNATURES)
footage must also be submitted.
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503 - 718 - 2421 I www.tigard- or.gov I Page 1 of 2
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 ,/-474-- , 20 / (
Signature of Ow e7ent
-- ) r 3 —47 7- 6 7Y 0
Contact Person Name Phone No.
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 639 -4171 I www.tigard - or.gov I Page 2 of2
•
Malaya Signs sign application for
State Farm Insurance
FRONT DETAIL VIEW 16083 SW Upper Boones Ferry Rd
Part A - 17"x 118"= 14 sq ft
Part B - 7"x 118"= 6 sq ft
Part B - 29"x 30" = 6sq ft
Total = 26 ft
Total 26 sq ft
YOUR N Part A STATE FARM - 1/4" PVC Painted Red
s • 17' ,
ONE. ,- Part B OPERATIONS CENTER - 1/4" PVC Painted Black
I —1111
Part C State Farm Logo - 1/4"PVC
All sign parts attached with a combination of double - sided tape
and construction grade silicon
FRONT FULL VIEW SITE PLAN
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CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 182563 - 05/24/2011
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2011 -00060 Sign Permit 1003100 -43115 $143.00
SGN2011 -00060 Sign Permit - LRP 1003100 -43117 $21.00
Total: $164.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 9627 KPEERMAN 05/24/2011 $164.00
Payor: Malaya Group, LLC
Total Payments: $164.00
Balance Due: $0.00
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