SGN2003-00229 CITY TIGARD SIGN PERMIT
441 DEVELOPMENT SERVICES PERMIT #: SGN2003 -00229
c ` I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/18/03
PARCEL: 1S135DD-00800
BUSINESS NAME: XENON WEST ZONE: C -G
SIGN LOCATION: 11847 SW PACIFIC HWY JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4'X8'
TOTAL SIGN AREA: 32 sq. ft.
WALL AREA: 1,404 sq. ft.
WALL FACE (DIRECTION): E
SIGN HEIGHT: ft.
PROJECTION FROM WALL: 1 in.
ILLUMINATION:
DESCRIPTION OF SIGN: Installation of (1) one 32 sq ft permanent wall sign.
MATERIALS: WOOD /PLASTIC
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
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 ays from validity date.
APPROVED BY:
PERMITTEE SIGNATURE: '
DATE: 9 / 8/03
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sl SIGN PERMIT APPLICATION
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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 x euoN UveS%
Address/ Street Address Permit No.: Sc j Z..e)d 3 - 00 2-7.—?
Location 11% Su) - PRCi ,c 1-I w.5 Expiration Date:
Suite /Bldg. # City /State Zip �fJ-�3 � "t /
TIC\ ArC9- � OjZcl12.2 -2 Receipt #:
Name Approved By: •
Property Sproo11..ct Date: 9//t3/ 3
Owner Mailing Address Suite Map/TL #: /. ..6 D - oc2C17
Zoning: (,6 .
City /State Zip Phone
155 AVM% WA Electrical Permit Required? ❑ Yes [�No
Tenant or Name AV
M%
XerJOn► WeSk Building Permit Required? ❑ Yes O'1Qo
Name Rev. 8/7/2003 is \curpin \masters \revised \siqn permit app.doc
Sign C.,ee. Sk‘te.S
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit 11911 SW 1 N w � (Note: applications will not be accepted
issuance, a without the required submittal elements
copy of all City /State Zip Phone (S d 3 ) q elements)
licenses are
required if - ,gA+ -J_,O onax3 y43 -3 o ❑ 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 K4 Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11", or 11" x 17"
Sign ❑ Temporary g Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard ❑ Balloon ❑ 2 copies of elevations, drawn to scale
apply)
(3 copies, if a building permit is required)
IN New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: ii i X�/
❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 3� S�,." ❑ $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft ly 0'1 Jurisdiction: ❑ City ❑ Urb
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S () 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: CA%whaalt&e. 1.,t-ier5 • Wall signs do not require site /plot plans.
Materials: We Vrpme / W++' 4;As 1e iers • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes `® 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
❑ Yes ® No BECOME NULL AND VOID.
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
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ti
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 1 day of S e Per' • 20 0
nature of Owner /Agent
&e ,c. # es 15o3) 443 - 3k631,,
Contact Person Name Phone No.
6 fli - k-i_
CITY OF TIGARD
Approved I l
Conditionally Approved [ [
For only the work as described in: ..,
PERMIT NO. --Sc3 t•J t-4--)3 .% — C . NN 7 ja--y .
See Letter to: Follow [ [
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CITY OF TIGARD 9/18/2003
13125 SW Hall Blvd. 10:08:20AM
#4 i t it11 ,1 N� Tigard, Oregon 9 72 23
�- (503) 639 -4171
Receipt #: 27200300000000004173
Date: 09/18/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00229 [SIGN] Sign Permit 100- 0000 - 437000 31.00
Line Item Total: $31.00
Payments: •
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check XENON WEST KJP 1033 In Person 31.00 .
Payment Total: $31.00
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