SGN2003-00235 t.
CITY OF TIGARD SIGN PERMIT
l DEVELOPMENT SERVICES PERMIT #: SGN2003 -00235
'�" c7 ' II 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/25/03
PARCEL: 1S135CD-00900
BUSINESS NAME: GLACIER LILY APTS ZONE: R -12
SIGN LOCATION: 11511 SW 98TH AVE JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 2'
TOTAL SIGN AREA: 6 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one (1) temporary A -frame sign. Sign #1. Valid from 9/25/03
through 10/25/03.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
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.
APPROVED BY: / / — e '� J
PERMITTEE SIGNATURE: (` J , j A i� 'i
DATE: 6 '/25/03 /
°i mi 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
Site L t 6R_ Lt Lu IQ Ts FOR STAFF USE ONLY
Address/ Street Address q Permit No.: SG N cac) b ' v 6(..)<g-3 5
Location 5 1k S W 1, 8 T 1�-- A- 1e, -/D /a51 3
Expiration Date: a
Suite /Bldg. # City /State Z aO D 3 - 4.28D
1 l `� 7 Z � Receipt #:
Name /56/9,24A) Approved By: e -
Property j • Cr4t-f d ` lbt-teLc/�t� Date: 9 ZS'D -3
Owner Mailing Address Suite Map/TL #: IS / 35 C(0 - 009 OD
5795 SW C4 L° T Zoning: R. — / .
City /State Zip Phone
36 4I) ;r2%on/ i pR 9 (503)6.77 -0/5.3
Electrical Permit Required? ❑ Yes yj No
Tenant or Name
Business 6 LA-CI � Li Zt i f p I S Building Permit Required? ❑ Yes X No
Name Rev. 2/28/2003 is \curpin \masters \revised \sign permit app.doc
Sign FA-5 % 5 / 9N' 5
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit
issuance, a T/g•1 1 /itq -titt) (Note: applications will not be accepted
copy of all City /State Zip Phone without the required submittal elements)
licenses are
required if w- 97oa 5 ❑ 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: 81/2" x 11", or 11" x 17"
Sign ® Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ID 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:. ' /
X a ❑ $3e7ee Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 1 t
El $15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) Jurisdiction: ❑ City ❑ Urb
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E W NE NW SE SW •
Height to top of sign (feet): 3 ' • 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:.Fi (L rL. G--,t[T • Wall signs do not require site/plot plans.
Materials: ivoob Al /9 -fil • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes [;21 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 ❑ 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 S6/ , 20 03
•
S gnature of Owner /Agent
p-/G/Lgs z r 5o3) 9/7
Contact Person Name Phone No.
E5 ,9983c
CITY OF TIGARD 9/25/2003
13125 SW Hall Blvd. 2:08:14PM
i i ,,,,,,rr i � , Tigard, Oregon 97223
(503) 639 -4171
•
Receipt #: 27200300000000004280
Date: 09/25/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00235 [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 PHYLLIS/PAUL IZATT CAC 900 In Person 15.00
Payment Total: $15.00
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