SGN2011-00103 CITY OF TIGARD SIGN PERMIT
" ° Permit #: SGN2011 -00103
7- COMMUNITY DEVELOPMENT Date Issued: 09/16/2011
Tii.CirARI!! 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S104BB08100
Jurisdiction: Tigard
Name of Business: Ultimate Tan
Business Address: 14250 SW BARROWS RD 001
Applicant/Agent: Ultimate Tan,
Work Description: Placement of one (1) temporary sign (Banner) 3' x 6' Sign #3 Valid 9/16/11- 10/16/11
Must be placed on private property not in public right of way
Permanent: No Freestanding: No Freeway: No
Temporary: 3 Wall: No Electronic: No
Billboard: No Balloon: No
Banner: Yes A- Board: No
Sign Dimensions: 3' x 8'
Total Sign Area: 24
Wall Area:
Wall Face (Direction):
Sign Height: ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: Vinyl
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $52.00
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: A/ AM,1'
Permittee Signature: Qtit/ GLt_dkUtit--
Sep 15 11 04:06p Debbe 503 -S25 -6190 p.2
,, qc', 7" 11 5 '
IN City of Tigard 6
- -
T Sign Permit Application S E P 15 20
IG BUILDING OF ,GA D
r I FORMATION BUILDING DIVISION
Name of Development /Project FOR STAFF USE ONLY
Site -� 11 'O 0 /v3
Address f - Street Address Permit No.:
Location / 1 A rf'rff V `'s APProved B : S .1 .
Suite /Bldg. CM /State Zip �/ / /
-77., . .9 -7 z-2 Date: I
Name Receipt #:
Property
/ii '° e-- , Map /TL#: J OR/ DI)
Owner Mailing Address Suite Zoning.
Allowable Total Area: /1) (Z
CiniStnte Zip Phone
Electrical Permit Required? ❑ Yes [l(No
Tenant or Name J --
Business U7/// / //.-1-----2 Building Permit Required? ❑Yes T o
Name Rev. 7/1/11
i \curpin \masters \land use applications \sign Permit app.doc
Sign
Contractor \fading Address Suite
City/Sate Zip Phone RE C UI • 1 . : MITTAL ELE 1 NTS
(Note: applications will uQI be accepted
Oregon Const. Cont. Board License # Esp. Date without the required submittal elements)
❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway ❑ 2 copies of site /plot plan, drawn to scale
Sign 2 ❑ Roof ❑ Electronic 0 copies, if a building permit is required)
(Check all that
El apply) wan Other requirement: 81/2" x 11 ", or 11" x 17"
13 hr� ❑ 2 copies of elevations, drawn to scale
❑ New sign? El Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimensions: / f , size requirement: S /z" x 11", to 24" x 36"
Total Sign Area (sq. ft): r 5( 0 x $165.00 Fee (Permanent sign, any size)
Total Wall Area (sq. ft R $52.00 Fee (Temporary sign, any type)
S Data
(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): a Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): must include dimensions of wall face and sign
placement
Materials: 14 n� a Wall signs do not require site/ plot plans.
Will sign have illuminaticbfi? ❑ Yes [3 a Freestanding signs over 6 It required a building
Type: ❑ Internal ❑ External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space?
❑ Yes ❑ No (
If "yes ", a list or diagram of all sign dimensions and square \ OVER FOR SIGN ATLTRES)
footage must also be submitted.
City of Tigard . ... S,. Hall Blvd., — . _ __ .._ . . ...... - ,...... _ . -_ .:, .- . ...., -.. ..
Tigard, OR 97223 1 503 - 718 -2421 1 www.tigard - or.gov 1 Page 1 of 2
Sep 15 11 04:06p Debbe 503- 625 -6190 p.3
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 owuer(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.
e 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.
(.4 '
. •• ant Signature Date
Signature of Owner /Agent Date
Contact Person Name Phone No.
( Fi"
(
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503 - 6394171 1 www.tigard - or.gov Page 2 of 2
- --
IN . CITY OF TIGARD RECEIPT
.1
l ` 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
pgARD:
Receipt Number: 183945 - 09/16/2011
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2011 -00103 Temporary Sign Permit 100 - 0000 -43115 $45.00
SGN2011 -00103 Temporary Sign Permit - LRP 100-0000-43117 $7.00
Total: $52.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 015427 STREAT 09/16/2011 $52.00
Payor: Ultimate Tan
Total Payments: $52.00
Balance Due: $0.00
a
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