SGN2003-00267 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2003 -00267
4. Al( DATE ISSUED: 10/22/03
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
PARCEL: 25111 DD -00201
BUSINESS NAME: BARGOS PIZZA ZONE: C -N
SIGN LOCATION: 15917 SW HALL BLVD JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2' X 4'
TOTAL SIGN AREA: 16 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of one (1) temporary A -frame sign. Valid from 10/22/03 through
11/22/03. Sign must be placed outside of City right of way.
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: C GL'/
PERMITTEE SIGNATURE:
DATE: 10/22/03
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1V A1I SIGN PERMIT APPLICATION
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CITY OF TIGARD 13125 SW Ha11 Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project
FOR STAFF USE ONLY
Site 8 /1443 ® PI Z
Address/ Street Address
Permit No.: ce,N aoo - DOafo 7
Location / / 7 SW. I 61-VD , 1P3/63
Suite /Bldg. # City/State Zip
Expiration Date:
1 igitRO on 9722-3 Receipt #: e?.. 00.3 - 4( 7(0o
Name Approved By: e .
Property ✓9« KHO/V 5 ftPJ Date: /0 - d 3 - 03
Owner Mailing Address Suite Map /TL #: R s I l I D D -- ooa o I
16-- 7 g 0 WILL- Eby]) . Zoning: C - N
City /State Zip Phone
73 op 06172Z? 5a 3d7e' Zi
Tenant or Name Electrical Permit Required? ❑ Yes ❑ No .
Business Building Permit Required? r=1 Yes ❑ No
Name Rev. 8/7/2003 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 w ithout the required submittal elements)
copy of all City /State Zip Phone q
licenses are
required if
expired in the Oregon Const. Cont. Board Exp. Date El Completed Application Form
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database)
(3 copies, if a building permit is required)
Proposed pr; Permanent ❑ Freestanding ❑ Freeway size requirement: 81/2" x 11", or 11" x 17"
Sign Z Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ 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 . pr. x' It ,) X
(( " ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): 4 9 ,ft. ❑ $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 ft • Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
sign placement.
Co py: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes ❑ No building permit.
Type: ❑ Internal X 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)
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
so-
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Signature of Owner /Agent
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Contact Person Name Phone No.
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CITY OF TIGARD ��
Approved " \
Conditionally Approved [
For only the work Jas described in:
PERMIT NO. S b c - 3 -- ao ato 7
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Attach
Job Addr s s: ((5 °t ('1 St) I-c (( B( tip 1
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CITY OF TIGARD 10/22/2003
13125 SW Hall Blvd. 3:28:42PM
4 1( 1 , Tigard, Oregon 9 72 23
. LI__.. (503) 63 9-4 17 1
Receipt #: 27200300000000004676
Date: 10/22/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00267 [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
Cash BARGOS PIZZA CAC In Person 20.00
Change CITY OF TIGARD CAC In Person (5.00)
Payment Total: $15.00
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