SGN2003-00228 CITY OF TIGARD SIGN PERMIT
i l DEVELOPMENT SERVICES PERMIT #: SGN2003 -00228
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13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/18/03
PARCEL: 2S 102C B -00303
BUSINESS NAME: LONG JOHN SILVER/A &W ZONE: C -G
SIGN LOCATION: 13165 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2'X6' -2'X6'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 2 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one temporary 24 sq ft banner. Sign must be placed on private
property & not in the public right -of -way. Valid 9/22/03- 10- 22 -03. Sign #1
MATERIALS: BANNER
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
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 from validity date.
APPROVED BY: f • A 44,...,4. -
PERMITTEE SIGNATURE: AlliM■W
DAT' : 9/18/03
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ti,. r 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 - -)C `v‘ c
Address/ Street Address Permit No.: 5 En) Z-0aj -C "-L _ . ____
Location / 3 / t s , iJ taC.1' -J'c i /z /
Ex p ir ation Date: 9iLl t I
B C
Suite /Bldg. # City /State Zip
Receipt #: D - c- N ''2 l `f / G g
` /e,iu c - cl 7 Z n
Name 1 Approved By: I-9i" { IJ
Property �k_c - t f'k v , foot im O®t- ✓v`.►/\ Date: UU
Owner Mailing Address Suite Map/TL #:
Zoning: C,
City/State Zip Phone
Electrical Permit Required? ❑ Yes 1q1-1 To
Tenant or Name
Business ,�: , y , it-s � ..)' / Ili - / E. ( ,/
Building Permit Required? 1=1 Yes Z1_146"
Name 4. Rev. 2/28/2003 is \curpin \masters \revised \sign permit app.doc
Sign II,—.,
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 1 manent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign ill emporary ❑ Wall . ❑ Electronic
(Check all that ❑ Other El Billboard ❑ Balloon 111 2 copies of elevations, drawn to scale
apply) (3 copies, if a building permit is required)
pi ew sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
gn Dimensions:
z x co X Z X ❑ $3- 3 6 -60 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): ciq S ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: ❑ 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): L // Z • 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: 6 1 • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes E–No building permit.
Type: ❑ 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.
❑ Yes 12 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 day of , 20
Signature of Owner /Agent
Contact Person Name Phone No.
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CITY OF TIGARD 9/18/2003
13125 SW Hall Blvd. 9:24:55AM
Ap Tigard, Oregon 97223
tip., (503) 639 -4171
Receipt #: 27200360000000004168
Date: 09/18/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00228 [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
Check NATHIR M. NAWRAS KJP 1187 In Person 15.00
Payment Total: $15.00
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