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SGN2003-00254 11 7,3 CITY TIGARD SIGN PERMIT i DEVELOPMENT SERVICES PERMIT #: SGN2003 -00254 ,� �,��I ' DATE ISSUED: 10/15/03 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 1S135AB 01003 BUSINESS NAME: GUSTAVS ZONE: C -P SIGN LOCATION: 10350 SW GREENBURG RD CASA JURISDICTION: TIG APPLICANT /AGENT: BUSINESS TAX NO: SIGN PERMANENT: X FREESTANDING: Y FREEWAY: TEMPORARY: WALL: ELECTRONIC: Y OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 8'4" X 4'3" TOTAL SIGN AREA: 29 sq. ft. WALL AREA: sq. ft. WALL FACE (DIRECTION): SIGN HEIGHT: ft. PROJECTION FROM WALL: in. ILLUMINATION: INT DESCRIPTION OF SIGN: Placement of one (1) freestanding sign. Sign placed on existing monument. 8' 4" x 4' 3 ". MATERIALS: ACRYLIC EXISTING SIGNS: 1 ELECTRICAL PERMIT REQUIRED: Y 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: PERMITTEE SIGNATURE: - DATE: 10/15/03 ilk - .'rli • d.. a. 4 �.. ti l h 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 '----ft-"rT7 J I S Address/ Street Address Permit No.: SG N a? Oo 3 - v 0a54 Location Icy -3s Sy.' Ca lera k( 13t.>7 6 .1 2l . Expiration Date: Suite /Bldg. # City /State Zip Receipt #: a 0(7 3 45.45 Name Approved By: C - C • Date: /0 — /5 - 3 Property Owner Mailing Address Suite Map/TL #: /S /35 11$ - V 1 0o3 Zoning: fu-E - 1 City/State Zip Phone Electrical Permit Required? JX( Yes ❑ No Tenant or Name _ Building Permit Required? ❑ Yes No C� � Business Name Rev. 01 -Jul -02 is \curpin \masters \revised\sign permit app.doc Sign 1 �'l 1 (... Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS (Prior to permit �. (Note: applications will not be accepted issuance, a 5 -E� �: 5�. 17- �✓ +— without the required submittal elements) copy of all City/State Zip Phone . licenses are required if c. 17 . c)61.• 4‘172 ( L / 2.3Z. Li /7Z ❑ Completed Application Form expired in the Oregon Const. Cont. Board Exp. Date City of Tigard's License # database) t2 -2-�°t ❑ 2 Copies of Site /Plot Plan, Drawn to Scale (3 copies, if a building permit is required) w Proposed J Permanent /` Freestandin• ❑ Freeway size requirement: 8 x 11", or 11" x 17" Sign ❑ Temporary In Wall ❑ Electronic (Check all that ❑ Other Billboar ❑ Balloon 11] 2 copies of elevations, drawn to scale apply) ( 3 cop if a building permit is required) New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36" S ign Dimensions: ey r �F rr € , 3 �r Fee (Permanent sign, any size . � 8 X 111 $30.00 Fe ( g Y ) Total Sign Area (sq. ft.): aoi a ❑ $15.00 Fee (Temporary sign, any type) Sign Data Total Wall Area (sq. ft.) (Complete all Direction Wall Faces (circle one): NOTES: items in this section) N S E W NE NW SE SW o Wall signs do not need to be drawn to scale, Height to top of sign (feet): but must include dimensions of wall face and Projection From Wall (inches): sign placement. Copy: o Wall signs do not require site /plot plans. Materials: o Freestanding signs over 6 ft. required a building permit. Will sign have illumination? ►' Yes ❑ No o If work authorized under a sign permit has not Type: ❑ Internal i External been completed within ninety (90) days after Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL location, including wall signs that overlap a tenant space? 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 Signature of Owner /Agent . P 't L 181 t AQ • . 'i ZS2..- l 7 ? Contact Person Name Phone No. • l.11 1 Vl' 11V C1..lW ... .....vv� 13125 SW Hall Blvd. 12:27:34PM ilft)i it Tigard, Oregon 9 72 23 r! ►' -I . (503) 63 9-417 1 Receipt #: 27200300000000004545 Date: 10/15/2003 Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2003 -00254 [SIGN] Sign Permit 100- 0000 - 437000 31.00 SGN2003 -00255 [SIGN] Sign Permit 100- 0000 - 437000 31.00 SGN2003 -00256 [SIGN] Sign Permit 100- 0000 - 437000 31.00 SGN2003 -00257 [SIGN] Sign Permit 100 - 0000 - 437000 31.00 SGN2003 -00258 [SIGN] Sign Permit 100 - 0000 - 437000 31.00 ELC2003 -00632 [ELPRMT] ELC Permit 220- 0000 - 431510 267.00 ELC2003 -00632 [TAX] 8% State Tax 100 - 0000 - 207020 21.36 Line Item Total: $443.36 Payments: Method Payer User ID Acct. /Check Approval No. • How Received Amount Paid Check SECURITY SIGNS CAC 010505 In Person 443.36 Payment Total: $443.36 Il � ', t rh o- Z- � . 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Scale: 1/2"= 1' - 0" Scope of Work: Manufacture and install one (1) double- faced, internally illuminated monument sign on existing base. Final graphics to be provided. Cabinet: Painted aluminum construction - 13 1/2" deep cabinet. CIITY OF T9GAD Faces: Ap K Conditionally Approved Lexan face with translucent digital vinyl print applied to the first surface. For only the work..as described in: a PERMIT NO. �� 03 - 00 Illumination: See Letter to Follow Internally illuminated with 800ma high output lamps. lob A/03 5J •ec.r br � B - Addre L' s: �,r.� P� Date _ /o " / -v 3 Installation: Install on existing base (if possible). Base to be painted by others. © Copyright 2003 Sccurity Signs, Inc. DATE 1 O 1 503 � — - � — This original design and specifications are ���� LAN DLORD APPROVAL CLIENT APPROVAL ��`' '`{��� 1 � t � � ) ��� � exclusive property of Security Signs, Inc 03- KS209R5 \`_ (� L✓ ! I `l ITL /7 L (.5 1' i The use of thcsc designs to produce a simila DRAWING # RUB O sign without written authorization from R U B p? G, U IL L QUALITY SINCE 1 925 Sccurity Signs, Inc. Is forbidden. PAGE 5 OF 6 PLEASE SIGN HERE PLEASE SIGN HERE WWW.SECURITYSIGNS.COM PROJECT MANAGER 436 SE 12TH AVE T. 503.232.4172 OR CCB #122809 CUSTOMER AGREES BY 10350 SW GREENBURG RD INITIALING HERE DENNIS BROCKMANN PORTLAND, OR DATE DATE PORTLAND, OR 97214 F. 503.230.1861 WA SECURSIO20CF `7 Sian E Sign C \ Slti GREENBURG RD '�n B \i • • o.. GUSTAV'S t imi t---,_, 8N1b1 J --■____) Sign A 1 # \ \/ [\:\----,„,,,,,,, /--- C ) \ \/ RED \ 4% a \ \ i i i pj o - \ / / ii (J) 0 m ,/ ) ❑ / a —i — 1 1 /, Site Plan N.T.S. © Copyright 2003Sccurity Signs,Inc. DATE Thi l d ifi 101503- LAN DLORD APPROVAL CLIENT APPROVAL ' , ) . ( _ _ %/C---1' � - s original and specifications arc *TY �, ! - exclusive property of Security Signs, Inc. ( ` (51 s i ry The use of these designs to produce a similar D RAW I N G # 03 KS209 R5 sign without written authorization from # 6 OF 6 PUB & GRILL „ T „ QUALITY SINCE 1 92rJ Security Signs, Inc. i s forbidde PAGE Yt PLEASE SIGN HERE PLEASE SIGN HERE WWW.SECURITYSIGNS.COM PROJECT MANAGER 436 SE 12TH AVE T. 503.232.4172 OR CCB #122809 CUSTOMER AGREES BY 10350 SW GREENBURG RD PORTLAND, OR 97214 F. 503.230.1861 WA SECURSl02OCF INITIALING HERE DENNIS BROCKMANN PORTLAND, OR DATE DATE