SGN2003-00271 h
CITY OF TIGARD SIGN PERMIT
i � DEVELOPMENT SERVICES PERMIT #: SGN2003 -00271
°' c= I 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/30/03
PARCEL: 25111 DD - 00201
BUSINESS NAME: PRIMO ESPRESSO ZONE: C -
SIGN LOCATION: 15981 SW HALL BLVD JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 4'
TOTAL SIGN AREA: 24 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 sign, A- frame. Sign #2. Must be placed outside of
right of way. Valid from 10/30/03 through 11/30/03.
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES:
s
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:
C1AJ Q
PERMITTEE SIGNATURE: - A � J
DATE: 10/ /03
., hl,,, 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
Address/ Street Address Permit No.: 5c,1.1 a oa 3— cD0- - 1
Location 1 S �t 81 5‘1 HA (ii_ fit- -t10 Expiration Date: 11130/o3
Suite /Bldg. # City/State Zip
- Clq(teo 02� cklegg T1 224 Receipt #: 47 (o4
Name e056.H1 ut, I N vestrfn s Approved By: e ,
Property " Date: /d /a5 /o 3
Owner Mailing Address Suite Map /TL #: as /// DD - a°a- a /
2 'O1 SI' T \ it' 2300 Zoning: C '/v
City/State Zip Phone
SeAll>._
Tenant or Name Electrical Permit Required? ❑ Yes No
Business P2itv10 Es P'2� - 50 Building Permit Required? ❑ Yes X No
Name Rev. 8/7/2003 is \curpin \masters \revised \sign permit app.doc
Sign Stc N5 oo' )
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit U 520 Sr 2 ' °
issuance, a g (Note: applications will not be accepted
copy of all City/State Zip Phone without the required submittal elements)
licenses are ) O�LP�0 OR 5 0 3 ( 0 5 Z
2 ` ZD?
required if 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: 8 x 11", or 11" x 17"
Sign O. Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other El Billboard ❑ Balloon 2 copies of elevations, drawn to scale
apply)
(3 copies, if a building permit is required)
❑ New sign? El Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: . 4'
❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): `Z tl. S[ck: . $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 N E N W S E S W •
Height to top of sign (feet): Ai • 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 >J 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
El 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
Signature of Owner /Agent
Contact Person Name Phone No.
Sign Elevation
P rimo
sp'esso Copy duplicated face on
OPEN
4'
5:30AM
WEEKDAYS
CITY OF T�GARD
6AM
Coor nd tied only
Conditional ly work as de Approu °d
scribed in:
ERMIT NO. °1bO3 —c ���
WEEKENDS ee Letter to: Follow
Mi ch S w 44' I I B! J d
Job Address: t 8 l t o aq o 3
3' ._lam Date:
Temporary Freestanding A -Board Sign
12 Square feet per side
Scale l " =1'
Site Address: 15981 SW Hall Blvd.
Tenant/Business Name: Primo Espresso
Sign Company: Signs Now
11520 SE 82nd Ave
Portland, Oregon
503- 652 -2072
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CITY OF TIGARD • 10/30/2003
13125 SW Hall Blvd. 10:26:28AM
t ..
- A,,,�rk ; �� i fl Tigard, Oregon 97223 •
(503) 639 -4171
Receipt #: 27200300000000004769
Date: 10/30/2003
Line Items: •
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00271 [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 NORTHWEST GOURMET CAC 16494 In Person 15.00
COFFEE CO
Payment Total: $15.00
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