SGN1998-00174 SIGN PERMIT APPLICATION
� ,,� „����',' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
CITY OF TIGARD
GENERAL INFORMATION {PLEASE PRINT CLEARLY)
Sign Address /Location: 1 11507 �1� ?aca c. #601
-C \ C-A�7 j Q , Q - 7 2:2._ I FOR >STAFF USE ONLY
Name of Tenant/Business: pol?Tl.AN9� S U1. NAi 1,. CP.LoN .) W
Date Recel�ed:
Address: it�z.6 - 1 -5‘.N Ffx r., c- - 1-1-wy , Ti GiAI.D, O C...9 72,2 -
I Received B. / ::>
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A Person: - i-kU & NGrt1 � _ ma y ,
P erm it No.(s): 7`' / : ��
Sign Company: N /6‘.. Phone: 531- 284
Permit Fee:_
Address: Wk.- Q
Receipt :: / - �' .; r
City: is (ice-- State: N /A- Zip: 1.1t/IN .
Approved By: .,
Sign Company.C.C.B.#: 1•1 D to pff A pp r g o v r 7 all _ . : : / r . V c b
Expiration Date: N //a . EP"plrafiorl ae.
City of Tigard Business Tax #: N,” • Zonin 1
(or) Expiration Date: 9 � `
Metro Business License #: I3 %A-
Expiration Date: Electrical Permit Required? Yes ❑ No y
Proposed Sign: (check as many as applicable) B uilding P Required? Ye ❑:! Noj
Permanent ❑ Freestanding Freeway ❑ Rev 1V ll curpin\mast e rosp a;. doc
Temporary Wall 0 Electronic O
Other ❑ Billboard ❑ Balloon' O
Sign Dimensions: 2 T X .FT I
Total Sign Areas (sq. ft.): 51 -FT ,. one S---,::6e( REQUIRED SUBMITTAL ELEMENTS
Total Wall Area (sq. ft.):
Direction Wall Faces: (circle one) S E W NE NW SE SW p Completed Application Form
T
Height (ft.): 3 -i T , p Site /Plot Plan Drawn to Scale
T (2 copies, 3 if a building permit is required)
Projection from Wall:
Elevations Drawn to Scale
Illumination: Yes ❑ No (2 copies 3 if a building Type: Internal ❑ External O ,
( g permit is required)
U.L. Label #: /A
E .-.• kaig=sEttalwriER
Copy: kQ - i\i KI ❑ ee` TPerman�nrt - .Sizm izs) $50.00
Materials:oct
Fee (Temporary Sign) $15.00
Are there any Existing Signs at this Location? Yes ❑ No 7.' I certify that I am the recorded owner of the
If Yes a list of all sign dimensions must also be submitted.] property or an agent authorized by the owner.
NOTE: Q If work authorized under a sign permit has not been -- Yu, within ninety days after the issuance of the
permit, THE PERMIT SHALL BECOME NULL AND VOID. lica 's- Signature
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OF CITY OF TIGARD
Approved
Conditionally Approved ( ��
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By: —}1111. Date: .L ._ '...t
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