SGN2003-00196 ti
CITY TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2003 -00196
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 8/15/03
PARCEL: 2S 111 BC -02800
BUSINESS NAME: CALVIN PRESBYTERIAN ZONE: R -3.5
SIGN LOCATION: 10445 SW CANTERBURY LN JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2'X8'
TOTAL SIGN AREA: 16 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): SW
SIGN HEIGHT: 15 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) 16 sq ft temporary banner. Valid 8/15/03 thru 9/14/03
Sign #2
MATERIALS: VINYL
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED:
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
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 1 a from validity date.
APPROVED BY:
PERMITTEE SIGNATURE:
DATE: 8/15/03
Ir ,,., . .,
4111,
ti ,lam 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
i p FOR STAFF USE ONLY
Site �
Address/ Street Address Permit No.: 5C? � -0 3 - O v 1 i t
Location / 0 V V ,5 Si) 0 - Expiration Date: B '151 6 3 - q ( 14
Suite /Bldg. # City /State ip
0 9 242'Y Receipt #: 3_ 3 c (a 3
Name Approved By:
Property
3 ii Date: 3 (/ S e3
Owner Mailing Address Suite Map/TL #:
Zoning: r 3. .
City /State Zip Phone
Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name
Business Building Permit Required? ❑ Yes ❑ No
Name Rev. 2/28/2003 is \curpin \masters \revised \sign permit app.doc
Sign
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
• issuance, a
copy of all City /State Zip Phone without the required submittal elements)
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
• City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign 'l Temporary ❑ Wall ❑ Electronic
(Check all that II Other ❑ Billboard ❑ Balloon ❑ 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: 2 x EK
0 a9769 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 1/
❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area ( � -:--- �p� Jurisdiction: 111 City ❑ Urb
(Complete all Direc Wall Faces (circle one): NOTES:
items in this
section) NS E W NE NW SE 0
Height to top of sign (feet): /6". • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
Projection From Wall (inches): .2, sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: '/� rf • Freestanding signs over 6 ft. required a
Will sign have illu (nation? ❑ Yes No building permit.
Type: ❑ Internal ❑ Exte al • 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.
❑ Yes -No
If "yes ", a list or diagram of all sign dimensions and —
square footage must also be submitted.
. (OVER FOR SIGNATURES)
4 4,
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 , 20
Signature of Owner /Agent
Uct44 co 3 ' ,43 9 -32 73
Contact Person Name r1 Phone No.
Cm,v /N /3irso k
f=
CITY OF TIGARD
Approved , ( 1
h'rnditionally Approved i J
F x only the work as described in:
PERMIT' NO -5 '2 (o
See Letter to: Follow ( I
Attach ". .... __
Job Address �0 `/ S - (f�G• �f • , � ��
By: – _.'-?' b c —Date: c ll
CITY OF TIGARD 8/15/2003
13125 SW Hall Blvd. 10:02:04AM
AM I % Tigard, Oregon 9 72 23
(503) 63 9-4 17 1
Receipt #: 27200300000000003663
Date: 08/15/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00196 [SIGN] Temp Sign Perm 100- 0000 - 437000 15.00
Line Item Total: $15.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
CreditCard DAVID VANSCHEPEN KJP 009567 In Person 15.00
Payment Total: $15.00
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