SGN2003-00273 CITY TIGARD SIGN PERMIT
�i DEVELOPMENT SERVICES PERMIT #: SGN2003-00273
A �� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/30/03
PARCEL: 2S 102AA -05500
BUSINESS NAME: TIGARD FITNESS ZONE: CBD
SIGN LOCATION: 12215 SW MAIN ST JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4' X 18"
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 banner. (4' x 18 ") Valid from 10/30/2003 through
11/30/2003.
MATERIALS: PLASTIC
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: a L
PERMITTEE SIGNATURE:
DATE: 10/30/03
i ,,
A,.
1. SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
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GENERAL INFORMATION
Name of Development/Project
77 ,1 O 4' es r FOR STAFF USE ONLY
Site
Address/ Street Address Permit No.: SAN 4900 3 - QO , 3
Location a(�.sw mask SA sa /Bldg. # City /State Zip Expiration Date: 1 �� 3003
Receipt #: 4:00 3 —
Name / Approved By: a. C-!
Property ze /r Date: 1 0 1 30/0 3
Owner Mailing Address Suite Map /TL #: 2,5 I ID A- A- - O5500
/ a-, i,S ti lf- Zoning: a (3n
City /State Zip Phone
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6,f' 7 .5-n639-/4,35-
- n 63 9 -/63 Electrical Permit Required? ❑ Yes )Z No
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Tenant or Name
Business Building Permit Required? ❑ Yes No
Name Rev. 8/7/2003 is \curpin \masters \revised \sign permit appp.doc
Sign
Contractor Mailing Address - Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a
copy of all City /State Zip Phone without the required submittal elements)
licenses are
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 ®. Temporary ❑ Wall ❑ Electronic
(Check all that ❑ Other ❑ Billboard El Balloon 111 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: /1- 'T/AO/kJ
24, /ex y' - fLts h -- ❑ $31.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.):
1Z 5'1., )Lf ❑ $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 0 E p NE NW SE SW
Height to top o 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 [I 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.
IZr Yes ito
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(OVER FOR SIGNATURES)
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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.
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CITY OF TIGARD 10/30/2003
13125 SW Hall Blvd. 3:13:22PM
Am0664 -, 0\ Tigard, Oregon 97223
(503) 639 -4171
Receipt #: 27200300000000004783
Date: 10 /30/2003 Q.
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00273 [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 TIGARD FITNESS INC CAC 1023 In Person 15.00
Payment Total: $15.00
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