SGN2003-00188 , 46
CITY OF TIGARD SIGN PERMIT
i*do4,00 DEVELOPMENT SERVICES PERMIT #: SGN2003 -00188
' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/13/03
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: Y
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3.58' X 22.77'
TOTAL SIGN AREA: 82 sq. ft.
WALL AREA: 1,696 sq. ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Install new sign to replace existing sign for name change. Wall sign (3.5' x 23')
MATERIALS: ACYLIC
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 31.00
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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: ��`Le�(. l� - „
PERMITTEE SIGNATURE: `� ""` `
DATE: 8/13/03
A 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 47/215 "rocu t l X 'rT .t, .
Address/ Street Address Permit No.: ( e % s G NI .c:R - Ie$
Location - J3J dW PttL' l Fie. littei, Expiration Date: ` --
Suite /Bldg. # City /State Zip 00 3 3 Co
71 y21 (n t 9 . 72 2 3 Receipt # a 7
Name Approved By: C - -��
Date: 8 -r3-(3
Property
Owner Mailing Address Suite Map/TL #: °;S /0A CZ--
0 (-2
Zoning: e — 6
City /State Zip Phone •
Electrical Permit Required? KI Yes ❑ No
Tenant or Nam
Business 764 6 �-c Building Permit Required? ❑ Yes X No
Name U" Rev. 2/28/2003 is \curpin\ masters \revised \sign permit app.doc
Sign AA &1 t . c6 OP dy)C
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit �S �� � ,f, , , (Note: applications will not be accepted
issuance, a 75 9`v"
copy of all City /State Zip Phone without the required submittal elements)
licenses are
required if 7/ 1'\ ?722 y D ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # / - 3o oS ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) `Fo (3 copies, if a building permit is required)
Proposed I t Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign ❑ Temporary Z- Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard ❑ Balloon 111 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: $30.00 Fee (Permanent sign, any s ize
36133' k X Z2,771? ' L ❑ $ ( g Y )
Total Sign Area (sq. ft.):
81,412 4 ❑ $15.00 Fee (Temporary sign, any type)
Total Wall Area (sq. ft.) Jurisdiction: ❑ City ❑ Urb
Sign Data / 496 , _So
(Complete all Direction Wall Faces (circle one): NOTES:
items in this •
section) N S E 0 NE NW SE SW
Height to top of sign (feet): 1 q I • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): K but must include dimensions of wall face and
sign placement.
Copy: /.414 Tact x) FFFG-T ��5)
� a Wall signs do not require site /plot plans.
Materials: 4l.unn , A- cp.A-(I • Freestanding signs over 6 ft. required a
Will sign have illumination? 111" Yes ❑ No building permit.
Type: 2 Internal ❑ External • If work authorized under a sign permit has not
Are there any existing freestanding or wall signs at this been completed within ninety (90) days after
location, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
BECOME NULL AND VOID.
No
ra- ¢eS3im .g Yes p ,E] , : r'
Wall If "yes ", a list or diagram a s ,
n dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
I hereby acknowledge that I have read this application, that the information given is
correct, that I am the owner or authorized agent of the owner, and that plans submitted are
in compliance with the City of Tigard.
DATED this day of G- (•�$ , 20 o 3
val
Signature of Owner /Agent Ali
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Contact Person Name Phone o.
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CUSTOMER ORIG. DATE SCALE CUSTOMER APPROVAL ORON00O MN 5S%O �had1 R URNS/ILLE, MN 55737
HOMETOWN DUFFETS C.,72/03 3!£1' = i'-0- PHONE / 507.7•) •2671 Q' PHONE 1 952894-2421
CITY STATE REV. DATE DRAWN BY FAX 1 507 - 367.265] ligns FAX /452- 894 -2748
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CITY OF TIGARD 8/13/2003
13125 SW Hall Blvd. 2:06:13PM
•
iiN., + , t;, (;\ Tigard, Oregon 97223
. I� . M � fi ' � ; � �'.:, A (503) 639 -4171
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
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