SGN2003-00186 C.
CITY OF TIGARD SIGN PERMIT
l DEVELOPMENT SERVICES PERMIT #: SGN2003 -00186
" � DATE ISSUED: 8/13/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 2S102CC -00500
BUSINESS NAME: HOME TOWN BUFFET ZONE: C -G
SIGN LOCATION: 13500 SW PACIFIC HWY 17 OLD CNTRY BUF JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4.08' X 13.83'
TOTAL SIGN AREA: 56 sq. ft.
WALL AREA: 2,965 sq. ft.
WALL FACE (DIRECTION): S
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Install new sign to replace existing after name change. Wall sign 4' x 14'.
MATERIALS: ACRYLIC
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 31.00
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 validity date.
APPROVED BY: (r(i /
- 6 • ` (
PERMITTEE SIGNATURE:
DATE: 8/13/03
,, A
A *Iiiiiik, . 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/Project FOR STAFF USE ONLY
Site ///i/nA �otuAl / -7—
Address/ Street Address _ Permit No.: saki a 003 — Do i8 c • Location •--i ; „0/ 1 i FIC l Y , Expiration Date:
Suite /Bldg. # City /State Zip
..---- .0. ( ,11
f i c -fz t dl? ? 722 3 R eceipt #: 0? O 3 — 3� ( 7
Name Approved By: C • ea,-,......)
•
Date: 8- t3 -03.
Property 00,500 Owner Mailing Address Suite Map/TL #: 'Si" . CC
Zoning: . C " G
City /State Zip Phone
Electrical' Permit Required? .. ❑ Yes - ❑ No '.
Tenant or Nam
Business , Building Permit Required? ❑Yes ❑ No
Name Rev. 2/28/2003 is \curpin\masters \revised\sign permit app.doc
Sign /IA 6`1 Gl■J a c8 62 (ly)C •
Contractor Mailing Address Suite RE SUBMITTAL ELEMENTS
(Prior to permit ( Note: applications will not be accepted
issuance, a 75 2os � 7 y - withoutthe required submittal elements)
copy of all City /State • Zip Phone •
licenses are .
required if 71fL I\ 972 Z ❑ Completed Application Form
. expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # / _3D o s- El Copies of Site /Plot Plan, Drawn to Scale
database) 40 (3 copies, if a building permit is required)
Proposed 2 Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign ❑ Temporary [- Wall ❑ Electronic •
(Check all that ❑ Other ❑ Billboar ❑ Balloon ❑ 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
Le New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36" •
Sign Dimensions:
, v.0,93 h x / 3.J'3 1 - ❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 56 , y go 0 ❑ $15.00 Fee (Temporary sign, any type)
Total Wall Area (sq. ft.)
Sign Data z 9,S /4' Jurisdiction: ❑ City ❑ Urb
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N E W NE NW SE SW •
Height to top of sign (feet): q ` • Wall signs do not need to be drawn to scale,
511 but must include dimensions of wall face and
Projection From Wall (inches): ,S sign placement.
Copy: ��
/,q,y — (o/ ) • Wall signs do not require site /plot plans.
Materia ( ue -fwrt
: ��e�1�YJ " " l �C ' • Freestanding signs over 6 ft. required a
Will sign have illumination? 8 --Yes ❑ No building permit.
Type: t® tnternal ❑ External • If work authorized under a sign permit has not
been completed within ninety (90) days after
Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL
location, including wall signs that overlap a tenant space? BECOME NULL AND VOID.
F 3-zi EL Yes mho P a , No
G„�,L+.•r'
If "yes ", a list or diagram of II sl n 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.
DATED this j`' day of , 20 o
Irata,..
Signature of Owner /Agent
Contact Person Name Phone o.
I I
CITY OF TIGARD
ir k- 1
Approved
• • '-- inditionally Approved t 1
For only the work as described in:
PERMIT NO. ---511M-111) — poi a ( 0
See Letter to: Follow 1 1
Attach • -- 4 1
Job Address: ...135.11--4
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PROJECT DRAWING / REVISION SALES REP. FILE HAMS
THIS DRAWING IS THE PROPERTY Of
I • CHANNEL LETTERS 211 MIKE F
MF-00174-4
325 MINNESOTA AVE. N.
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1 • cusiomER ORic. DATE SCALE CUSTOMER *PPR AIN 5516° OVAL ORONOCO BURNSVILLE, MN 55337
HCMETOWN 81.JF PET CAP/22iO3 Ia. r T.0" PHONE t 5137.367 .2631 • PHONE i 9W-8944421
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FAX 1 502-267.2633 S1 FAX / 952,9942M
CITY
TIGARD STATE REV. DATE
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CITY OF TIGARD 8/13/2003
13125 SW Ha11 Blvd. 2:06:13PM
i��� � ( Tigard, Oregon 97223
�� (503) 639 -4171
4
Receipt #: 27200300000000003617
Date: 08/13/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00185 [SIGN] Sign Permit 100 - 0000 - 437000 31.00
SGN2003 -00186 [SIGN] Sign Permit 100- 0000 - 437000 31.00
SGN2003 -00188 [SIGN] Sign Permit 100 - 0000 - 437000 31.00
SGN2003 -00189 [SIGN] Sign Permit 100- 0000 - 437000 31.00
• Line Item Total: $124.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check MEYER SIGN CO OF OREGON CAC 8309 In Person 124.00
Payment Total: $124.00