SGN2003-00053 TIGARD PERMIT
mat l DEVELOPMENT SERVICES PERMIT #: SGN2003 - 00053
— -- - I � `` 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 2/28/03
PARCEL: 2S 101 AB -01608
BUSINESS NAME: WESTERN PSYCHOLOGICAL & COUNSELING SERVICE; ZONE: MUE
SIGN LOCATION: 07455 SW BEVELAND RD JURISDICTION: TIG
APPLICANT /AGENT:
BUSINESS TAX NO:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X 6'
TOTAL SIGN AREA: 18 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION): SE
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one permanent freestanding sign. Sign must be placed on private
property & not in the public right -of -way.
MATERIALS:
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 30.00
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. /...._,_____
– �� ~1 .'
APPROVED BY'
PERMITTEE SIGNATURE: -' ' • ; C � ( M
DAT E 2/28/9.3'
ir , ,
,: �,, ,, SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of DevelopmenUProject FOR STAFF USE ONLY
Site 1�0- 5-m.,� Q tO c (..0-04.% n
Address/ Street Address Permit No.: .SC7rt) 2-0° 3— Okzo 5 3
Location 4"-5. 51 3s.)e-tr_ock .5 Expiration Date:
Suite /Bldg. # City/State Zip , p 03 — (JO 7 cJ 7
Receipt #:
{fie �rMd 61 1i Z23 Approved By;
Name
212,9 �$r
e-eA,.1 a c�Ad -1-1,ek�t4►c.0 L. LC D ate: ° 3
o/ /60
Owner�y Mailing Address Suite Map /TL #: Z,5j ,3- O
?O �01. Z'-1L ' Zoning: /JILL E
City /State Zip Phone
Q.xitA- ,rva OL Electrical Permit Required? ❑ Yes ca. No
'Tenant or Name
Building Permit Required? ❑ Yes R No
Business a e,,, Q.„,3 93 t u. , c C„,),JQ „v,
Rev. 01- Jul -02 is \curpin \masters \revised \sign permit app.doc
Name
‘,11.0. Cba:r'NC. - 'G , .
Sign i � i )A n c,, , 0
C axi-)1.,‘\ €A L&. i • 1
Jt <,�o t
Contractor Mailing Address Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a IJ 3 1n° without the required submittal elements)
copy of all City/State Zip Phone
required are �j71- 1Z3(5o3) lo (i 63 ❑ Completed Application Form
required if �,. I'l.��i�t
expired in the Oregon Const. Cont. Board Exp. Date �- El Copies of Site /Plot Plan, Drawn to Scale
City of Tigard's License # (no3-i C O I ?.(e l O
database) T J (3 copies, if a building permit is requ
Proposed jj Permanent Ef Freestanding ❑ Freeway size requirement: 8 x 11 ", or 11" x 17"
Sign '❑ Temporary ❑ Wall ❑ Electronic'
(Check all that ❑ Other ❑ Bi llboard ❑ Balloon [1] 2 copies of elevations, drawn to scale
apply) ! (3 copies, if a building permit is required)
in New sign? ❑ Alter to existing sign? size requirement: 8 x 11", to 24" x 36"
Sign Dimensions: R 2 (4 7 7 11•c44 C tt ❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): t 0 $15.00 Fee (Temporary sign, any type)
• Sign Data
Total W all Area (sq. ft.)
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N S E W NE NW ( SW • Wall signs do not need to be drawn to scale,
Height to top of sign (feet): 3 but must include dimensions of wall face and
Projection From Wall (inches): . sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
building permit.
Will sign have illumination? ❑ Yes Er No • If work authorized under a sign permit has not
Type: El Internal ❑ Extern I been completed within ninety (90) days after
Are there any existing freestanding or wall signs at this the issuance of the permit, THE PERMIT WILL
location, including wall signs that overlap a tenant space? BECOME NULL AND VOID.
❑ Yes ❑ No
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 0.3
4 MI
Aignature of Owner /Agent
oe i, CS 3) -� a Li
Contact Person Name Phone No.
CITY OF TIGARD 2/28/2003
13125 SW Hall Blvd. 2:32:55PM
A// m,�vp��ll�"�,I Tigard, Oregon 97223
;;'�� (503) 63 9-4 17 1
Receipt #: 27200300000000000797
Date: 02/28/2003
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2003 -00053 [SIGN] Sign Permit 100- 0000 - 437000 30.00
Line Item Total: $30.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check GEORGE HUBER CAC 1374 In Person 30.00
Payment Total: $30.00
P . 2
Feb 24 03 09:43a
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February 20, 2003 1115 ANI Roar Fax 0: Page 2 of 2
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COUNSELING SERVICES, P.C. ). 1
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6in.xn.x6ft. Pressure boated s 1
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/ ! , I i , sign attached to posts wf 1/2 in x 4 in 1 j ., ..1 ..,
‘. l ag balls eil wasli .... f. 1
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21N.X3FT.X6FL Redwood sandblasted sign titi/S .,
total $1190.00 IlikA41144--65r1.--
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4inx• 4in.x7tt.pressure treated pasts I agin,
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total $1276,00
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1335 E. Main St.Hilsboro. OR 97123.
(503) 648-6783
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I SITE DATA:
ADORE= 7455 SW BEVELAND ROAD
TIGARD OR 97213
TAX MAP: 25/WOMB 11160B 0
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CI Project No. Drowing No.
EX 3.0
ECMIIIT 3 eh'. Sheet No.
Copyright 2002 0