SGN2003-00268 C ITY OF TI GARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2003 -00268
c f 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/23/03
PARCEL: 2S 102AC -00201
BUSINESS NAME: MAIN STREET VILLAGE APTS ZONE: CBD
SIGN LOCATION: 12650 SW MAIN ST OFFICE JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON: Y
SIGN DIMENSIONS:
TOTAL SIGN AREA: sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 10 ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of one temporary sign (balloon). Sign #2. Valid from 10/24/03 to
11/02/03.
MATERIALS:
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: .4r. 66 " ecce/
PERMITTEE SIGNATURE: �a� �� "�
DATE: 10/23/03
Ai
%I.l,, SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Nape e of Deuelopme t/Project ,
Site f � i V INS / 1 4 , FOR STAFF USE ON 0 o,,, $
Address/ Street Address Permit No.: S 6 IJ aoo3 -.
Location ( ItP W WiiP/A,61-1R/1 I t/.94 0 3
Sdite/Bldg. # 4y /State Z; E xpiration Date: — �,
/ I' , 11/ I i Receipt #: °�_�' �� "y(o8
Nam 1 , " 'y Approved By: e • (Ct vrt�is)
. / \� ■ t
Date: /a /a3/Z�3
Property its / 'Art - f% / a./ .:�
Owner Mailing Address Suite Map/TL #: dAS /O a A C-"- 00 4010 (
id • /(41/47/(/ G Zoning: C /)
/S to L- Zip �� n • ' UV w Il
},' (l// ,•c /' Electrical Permit Required? El Yes No
Tenant or Na e f �
�
Business � Building Permit Required? El Yes p?f No
Na -Rev. 2/28/2003 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 without the required submittal elements)
copy of all City /State • - Phone
licenses are
required if 0' Completed Application Form
expired in the Orego • •nst. Cont. Board Exp. Date
City of Tigard's Li - e # 2- 2 Copies of Site /Plot Plan, Drawn to Scale
database)
(3 copies, if a building permit is required)
Proposed g Permanent ❑ Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign Temporary ❑ Wall Electronic
(Check all that 1:1 2 copies of elevations, drawn to scale
apply) ❑ Other El Billboard Balloon
(3 copies, if a building permit is required)
❑ New sign? ❑ Alter to exist ng sign? size requirement: 81/2" x 11", to 24" x 36"
Sign Dimensions:
(d C /
.. (
El $307130 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): / 3i, °cl
Et $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): • 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: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes t No building permit.
Type: El Internal El Extern I • 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 ove lap 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 I �i� , 20 6
I ,
/
ignatu g lf:f 'iwner /Agent
P
Con act Person N -'me / Phone No.
,
I l rl l l 1 V l ISIJll 1 I v
1-16 .,
Al Fonno Creek Park
•
12650 S.W. Main Strcct
Tigard. Orcgon 97223
(503) 639 MAIN
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CITY OF TIGARD 10/23/2003
13125 SW Ha11 Blvd. 12:01:40PM
ty �,�u � 1/ Tigard, Oregon 97223
(503) 639 -4171
Receipt #: 27200300000000004688
Date: 10/23/2003
• Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00268 [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 GINA STEPHENS CAC 508 In Person 15.00
Payment Total: $15.00
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