SGN2003-00203 CITY OF TIGARD SIGN PERMIT
,...4.1, 41°71 4111`j`\ DEVELOPMENT Tigard, SERVICES 639 -4171 DATE PERMIT #: ISSUED: 8 28/03 3 00203
PARCEL: 1S135DD-00600
BUSINESS NAME: ZONE: C -G
SIGN LOCATION: 11831 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT: LORETTA GROOM
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 4'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary A -frame sign to advertise property for sale at end of Warner Ave.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES:
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.
APPROVE • • ��• "LcZ�,ir¢_i
PERMITTEE SIGN •41111M 1111 _ .01
DATE: 8/28/03
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A 4,,ti,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 �' ° ��
Address/ Street Address \ Permit No.: S �N a 00 - vo 010 s
Location \ \ ?- J\ S� R�6,& \c.. ``�, 9 _ �' -- 03
Expiration Date:
Suite /Bldg. # City /State Zip
—7\ l cj °(13 Receipt #: ,9 03 - 3 g 7 4
Name Approved By: E._ Ca -Aka)
Property i\S \O.' 'E\ Date: 8 - d $ _ 0 3
Owner Mailing Address Suite Map/TL #: (5/35 0 —00(,9 00
VAW �� 3c Zoning: . C C
City/State Zip Phone •
-Y\\1,N 1 ` -.0:10 Electrical Permit Required? ❑ Yes No
Tenant or Na
Business bk.C3 Mec,\ 5) Building Permit Required? ❑ Yes No
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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 # E" 2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
Proposed ❑Permanent El Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign `Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard ❑ Balloon 1] 2 copies of elevations drawn to scale
apply) (3 copies, if a building permit is required)
Ti New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions:
y y IN V �e ❑ 3 $39-@0 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):,\, 5,�r� El $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: . J'City ❑ Urb
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N S E W NE NW SE SW •
Height to top of sign (feet): ♦ Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
sign placement.
Copy: ♦ Wall signs do not require site /plot plans.
Materials: ♦ Freestanding signs over 6 ft. required a
Will sign have illumination? El Yes ❑ No building permit.
Type: ❑ Internal El 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.
El Yes *No
If "yes ", a list or diagram of all sign 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 a% day of \\N.' , 20 0 3
ZAA-Atv .-1 S- 1 \c)clAsf\
ature of Owner /Agent
_C)3
Contact Person Name Phone No.
CITY OF TIGARD 8/28/200,3
13125 SW Hall Blvd. 1:50:17PM
1041 . Tigard, Oregon 97223
6 11 (503) 639 -4171
Receipt #: 27200300000000003874
Date: 08/28/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00203 [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 LORETTA GROOM CAC 052121 In Person 15.00
Payment Total: $15.00
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