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SGN2011-00081 lig ., CITY OF TIGARD SIGN PERMIT . .. Permit #: SGN2011 00081 COMMUNITY DEVELOPMENT Date Issued: 08/03/2011 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S113AB00300 Jurisdiction: Tigard Name of Business: Lasik -Joffe Medical Business Address: 16037 SW UPPER BOONES FERRY RD 150 Applicant/Agent: Paulus, Jaylene Work Description: Installation of one (1) permanent wall sign 3' 6" x 8' Permanent: Yes Freestanding: No Freeway: No Temporary: Wall: Yes Electronic: No Billboard: No Balloon: No Banner: No A- Board: No Sign Dimensions: 3' 6" x 8' Total Sign Area: 28 Wall Area: 1575 Wall Face (Direction): South Sign Height: 43 ft. Projection From Wall: 7.5 in. Illumination: Internal Materials: Aluminum /LexanNinyl Electrical Permit Required: Yes Building Permit Required: No Total Permit Fee: $165.00 Conditions: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. 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: ra Permittee Signature: / A9- Tki..) IL .. City of Tigard RECEIVED :, JUL 2 8 2011 Sign Permit Application j 6 AR. CITY OF TIGARD -+ F :�„ r , 1 t t t GENERAL INFORMATION Name of Development /Project Las 1n - t (� FOR STAFF USE ONLY Site Las `A 1l�idt:r00L. 'p����''C�d &� Address / Street Address , �, Permit No.: Location 1 003 5) � µ�Wor kd I suite /Bl . # City /State Zip Approved By: — r(35 1f C , Date: -1 /A8/1/ Name Receipt #: lk 3 T 2 2 - Property S l •1iit- --) Map /TL #: ..15 11 a 8 v o 3 a-0 Owner Mailing Address Suite Zoning: P S-r2- Allowable Total Area: t 5 /c) City /State Zip Phon, Q SU3 4 131 • /° 3/ 3 Electrical Permit Required? Vi Yes ❑ No Tenant or Name Business kA 5 j k. Building Permit Required? ❑ Yes IdNo Name Rev. 7/1/11 ,, �, is \curpin \ masters \land use applications \ sign permit app.doc Sign \D►W �3rl 5 0riS 0/ 4K-J , Contractor Mailing Address Suite p_b . Uu $ F) City /State Zip Phone REOUIRED SUBMITTAL ELEMENTS 44 I a 97(31553-981,3/13 (Note: applications will not be accepted gon coast. Cont Board License # Exp. Date without the required submittal elements) 1 9 4 IS-S- to It, 1/3 ❑ Completed Application Form Proposed ©permanent ❑ Freestanding ❑ Freeway ❑ 2 copies of site /plot plan, drawn to scale Sign ❑ Temporary ❑ Roof ❑ Electronic (3 copies, if a building permit is required) (Check all that Fall ❑ Other t » apply) size requirement: 8 /Z x 11", or 11" x 17" ❑ 2 copies of elevations, drawn to scale [,New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required) Sign Dimensions: size requirement: 8t /z" x 11", to 24" x 36" 3'-t•' X 8 _ o tt Total Sign Area (sq. ft.): , ❑ $165.00 Fee (Permanent sign, any size) Total Wall Area (sq. ft.) El $52.00 Fee (Temporary sign, any type) Sign Data , 5 ., 75 = D• A % (Complete all Direction Wall Faces (circle one): items in this NOTES: section) N © E W NE NW SE SW Height to top of sign (feet): 151 • Wall signs do not need to be drawn to scale, but Projection From Wall (inches): -7. S " must include dimensions of wall face and sign placement. Materials: awn i lullr+ . ' Y 1 ^ L • Wall signs do not require site /plot plans. Will sign have illumination? ErCes ❑ No • Freestanding signs over 6 ft. required a building Type: [4nternal ❑ External permit. Are there any existing freestanding or wall signs at this location, including wall signs that overlap a tenant space? zp I ..r�w�D /aa Yes ❑ No If "yes ", a list or diagram of all sign dimensions and square (OVER FOR SIGNATURES) footage must also be submitted. City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 718 -2421 I www.tigard - or.gov I Page 1 of 2 APPLICANTS: To consider an application complete, you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as described on the front of this application in the "Required Submittal Elements" box. NOTE: Person specified as "Applicant" shall be designated "Permittee" and shall provide financial assurance for work. * When the owner and the applicant are different people, the applicant must be the purchaser of record or a lessee in possession with written authorization from the owner or an agent of the owner. The owner(s) must sign this application in the space provided on the back of this form or submit a written authorization with this application BY SIGNING BELOW, THE APPLICANT(S) SHALL CERTIFY THAT: • If the application is granted, the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. • All of the above statements and the statements in the plot plan, attachments, and exhibits transmitted herewith, are true, and the applicants so acknowledge that any permit issued, based on this application, and may be revoked if it is found that any such statements are false. • The applicant has read the entire contents of the application, including the policies and criteria, and understands the requirements for approving and denying the application. 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. SIGNATURES of each owner of the subject property are required. 7 / / i f A plic nt Signature Date —a_c4.t Signature of Owner /Agent Date Ja q 1 f 57)3 - I - 37 Contact Person Name Phone No. • City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 639 -4171 I www.tigard - or.gov I Page 2 of 2 Phone 503- 981 -3743 Fax 503 - 982 -8153 2830 INDUSTRIAL AVE. ; P.O. BOX 88 HUBBARD, OREGON 97032 vONIIY ELECTRONIC MESSAGE BOARDS ' ILLUMINATED SIGNS LETTERS BANNERS ' LED / NEON / CUSTOM DESIGN / INSTALLATION ; SERVICE LANDLORD APPROVAL I /We, k// ym A1'1 lI represent that I /we are owners /landlords of the following real property including the building constructed thereon and Hereby give Integrity Signs Oregon the right to enter my property to erect and service the sign(s) as we have agreed upon, and to connect the power that has been provided to the sign location(s). Dated this 1 i day of lw , 20 / f n'" (Lands d /Owner or Authorized Agent) ( / Owner or Authorized Agent) Phone Number: fl S' 6 A0' 0,17 - Fax Number: —( ° J 9r- a 1l NI VIEW 715" a o. I 14" II _ _ W ALL _-._ \\ 1 SPADE O O II 215" DEEP REVERSE PAN Lti I tRE L L LAS1K m hl MEDI - CENTER 4 4" DEEP BACKER PANEL Ci O FFE ' - SIN FACE ILLUI" 11NATED WALL SIGN SPEGiFICA.TIONS w..-w : : SCALE - 3/4".1' - • SO. 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MEDI - CENTER SINGLE PAGE ILLUMINATE W .L -L SIGN y � 5 „ M SCALE 3 _ T - O N ° T YN .i r . X4..1. FT. 2 fO .*..,.v...,!..,,, ' ...„.....r., t t•'" % r3 ,:, BACKER PANEL I Aluminum Fabricated, Painted to match building fascia. Jaffee P'ledl- Center • logo routed out of face 8 backed with white 'exam . Copy colors printed on translucent vinyl with lamination I , ,�, REVERSE PAN CHANNEL L 1 I tRS I MIE , Faces: 3' Aluminum, Painted Blue e RetururrLS.s: . 040' Aluminum, 215' Deep, Painted Blue Letterbacks: Clear Lexan 1 L - 'Mounted 1' from Backer Panel for Halo Illumination 1 1 1 h ILLUMINATION BEFORE —_ AFTER White LED's „elllierw PPROVED/FOR PRODUCTION �'I 11 -1092 2830 INDUSTRIAL AVE. d� (Y% / SKETCH R: P.O.BOX 88 NAME �l'Vh 1 SStE JOB NAME: Lasik HUBBARD 97032 91GNAtURE • r " � ' / � // � IDAIEI /1 1 —���� Tigard. Oregon - J 1 �Jf � i ' ° Phone 503 - 981.3743 1 /) f �{ / � l ! 7 /. i' I , ,' LOCATION: ' ^�' ' ` R I r j ` ) Fax 503-982-8153 N L , A t E I — / —! I, -°. ^ .. a I� �I � - LANDLORD SIGNAIUR`e- SALESPERSON: R Br6aZ1Ie _ - - - ED ® Certified original artwork is dlbcted tinder federal copyright lows. DRAWN B Y: D A T E 5/31!11 \�� , Make no reproduction of design concepts by IRO without permission. Colas on print may may sighlty horn actual specified calouts for finished sgNs �nxat a awt 44..0 pza azio j ° u10 Daum o60 .au,sO -pi,.. r `oosc_ 61.1= c .c�u of a.Z ...% ' u+!,d h t�Jt��a - 7'TVAN 31$".1I£eS a s.Cra" au,yh roµouu.at! oza- at arc aaxg a y i aa. ,no. . arm ca..ac 'fit r♦ L ' utY A40 ang crawled wry _MC' MCC,. -3..ne-o ' Nde aszeinaa 751tiveci C330 _9 !vZda aStanae eSSO.V. C 3?da6 » s "99M .9 .ri4 L 4 .0 — .9 ilk' - to Q Il (--a a c)) £ Ls x� ' V ) l .,.7 a 4 e 1 "d 1 CITY OF TIGARD RECEIPT 13125 SW Hall Blvd., Tigard OR 97223 • 503.639.4171 TIGARD Receipt Number: 183482 - 07/28/2011 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SGN2011 -00081 Sign Permit 100 - 0000 -43115 $144.00 SGN2011 -00081 Sign Permit - LRP 100 - 0000 -43117 $21.00 Total: $165.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 3163 STREAT 07/28/2011 $165.00 Payor: Integrity Signs Oregon Total Payments: $165.00 Balance Due: $0.00 Page 1 of 1 CITY OF TIGARD RECEIPT 1111 1I 2 131 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 183486 - 07/28/2011 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID ELC2011 -00427 Sign or Outline Lighting 220 - 0000 -43103 $67.84 ELC2011 -00427 12% State Surcharge - Electrical 100 - 0000 -24001 $8 14 Total: $75.98 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Check 3163 BTAGGART 07/28/2011 $75.98 Payor: Integrity Signs Oregon Total Payments: $75.98 Balance Due: $0.00 • • Page 1 of 1