SGN2011-00135 CITY OF TIGARD SIGN PERMIT
... Permit #: SGN2011 -00135
COMMUNITY DEVELOPMENT Date Issued: 01/24/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 • Parcel: 1 S136CD00100
Jurisdiction: Tigard . •
Name of Business: Sushi Hana
Business Address: 11705 SW PACIFIC HWY L
Applicant/Agent: Kim, Dae
Work Description: Installation of one (1) permanent wall sign 32" x 240"
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 32" x 240"
Total Sign Area: 56
Wall Area:
Wall Face (Direction): East
Sign Height: ft.
Projection From Wall: 12 in.
Illumination: Internal
Materials:
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: „ Juar
Permittee Signature: —� -
N . City of Tigard
Sign Permit Application �
TIGARD Sign �i
GENERAL INFORMATION
Nance of Development /Project
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Address/ Street Address Permit No.: FOR STAFF U DUI SE ONLY
Site /1 , S( ao tl- 3,
( , � /C � —`
Location // /, or SA) / PQ )/ tlaP E i 4i/ 1(
Suite /Bldg. # City/State Zip Approved By:
*X 7 :-. 44 W f (.)/ Date: /21 I I
Name J Receipt #: I g ce
Property W ; cCO 43;q( EC :rcik Map /TL #: 1 S l 66 4'� (Q'1)
Owner Mailing Address Suite Zoning:
4 ( T 'y S r /0 c) Allowable Total Area: 16 -17D
City /State Zip Phone
, a/Pr4 6W 9pvr5t3 2y5L-oyo)
Tenant or Nance _
Electrical Permit Required? Yes ❑ No
il
u din Permit Required? Business Building q ❑ Yes No
Name Rev. 7/1/11
is \curpin \ masters \land use applications \ sign permit app.doc
Sign * 34 4 16 Contractor Mailing �� / Suite j
40o S u» II
City/ State Zip Phone REQUIRED SUBMITTAL ELEMENTS
(Note: applications will mi be accepted
Oregon Coast Cont_ Board License # Exp. Date without the required submittal elements)
2- (IS 2 1 / ❑ Completed Application Form
Proposed Q petmanent ❑ Freestanding ❑ Freeway ❑ 2 copies of site /plot pl , raven to scale
Sign ❑ Temporary ❑ Roof ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Wall ❑ Other
apply) size requirement: 8 %z » x 11", or 11" x 17"
❑ 2 copies of elevations, raven o scale
[New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimensions: Y r"/ �0 size requirement: 8','2" x 11", to 24" x 36"
Total Sign Area (sggq ft.): s` cp. ‘3 ❑ $165.00 Fee (Permanent sign, any size)
Total Wall
= O,Q S Area (sq. ft) o ❑ $52.00 Fee (Temporary sign, any type)
Sign Data l " 0
(Complete all Direction Wall F ces (circle one):
items in this NOTES:
section) N S 0) W NE NW SE SW
Height to top of sign (feet): /S`, r • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): I Z ; ✓1 Ch . must include dimensions of wall face and sign
Materials: A ‘14. ilk. placement.
• Wall signs do not require site /plot plans.
Will sign have i11u ination? Yes ❑ No • Freestanding signs over 6 ft. 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 SIGNATURES)
footage must also be submitted.
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.
Applicant Signature Date
Ai
�
Signature of Owner /Agent Date
Contact Person Name Phone No.
City nfTioar(' I 1'2115 RW Na11 Rlvrl Ti crawl OR Q77')1 1 5(Yt -62Q_4171 I www tioarr1_nr crav I Anon 7 of
SUSHI HANA
IVI) S I LJ S H _ _ A\ NI
\__\ Graphic presentation only.
P lease see your salesmen for
material sample
Stacked Number:
Date of Design :
SIDE VIEW/ DETAIL. Sales person
( ACK IN RETURNS) General : SUSHI
BLACK IN COLOR Red Acrylic w/ Black trim caps
0.83' min.
Bolt hole wi Silicon water tight sea i Set of Front Pan Individual Channel Letters All Completed Sign, Design, And Graphics Work
HA MA Wh ite Acrylic w/ Black trim Ca s Belong Pop Sign Until Payment Is Made In Full. "_ -c---- • with L.E.D. Illuminated rY P
1 , µx , Wall Disconnect switch will in sign S , e . :SCRE f lr ing lip Black color Painted Aluminum Body u v White Acrylic w/ Black trim caps This Design Belong Pop Sign .
1 fl-- -c. f "FLEX CONDUTAND Thur wall wiring ready '* '' BLACK Vinyl on it All Right To Use Altering Or Reproduction Are
Acrylic Fro. CONNECTORS w /Silicon water Proof All channel built by 0.90 thickness black paint aluminum
sign install Prohibited Without Written Permission.
1 CITY OF TIGARD
II "m'M all letter inspect by UL and and section label Approved -- ...._».. { t/, ClientApproval
LED
Conditionally Approved . ................__._....... --.. f ; includes colors, s elling, graphics. 1 n For only the work as de cribed in•
PERMIT NO.O 3�t�' lS�
----
1 See Letter to: Follow . ...- ......__._._.___.._ -.-1
1 Attach ( ] Date : / /6A j ack Hz
LETTER$ 1 Job Ad ess: it •'1 Q.,c__ � P� ____L-._1..-4- � /// - Landlord Approval :
120 VOLT LED POWER SUPPLY \�/ By: k: fj�/'�_ inclu es colors, spelling, graphics.
t l _ Date. al ,(it = 0,A4 s Co.
NI 16 ' ; nit Pfaffle st.
4 . ; ,� +: ., NO SUBCONTRACT ALLOWED •
_ _ Shop drawings must be fabricated directly by the
. `_ .r ; ., • ••• r „ „ a+ A b company contracted by Tenant per the approved
i x l =. - .. V 41 „ ' >o v. , . s shop drawings and Landlord's sign criteria
' NO EXCEPTIONS.
- -1
'" ', 1 S i n L O C - - t i O n le I .0 . APPROVAL does not constitute the assumption
1 , , 61 p-
.z� ~ � > j p sh p dra for fabrication the compliance
"WIT - ''1 1 l∎-_ 1 _ 1 ■ 7 1 - 1 S u P A ' r y F O � thereof with any governmental of other requirements.
} • -,f• M' _ �fj \ all of which shall be solely your responsibility.
' - • 1' APPROVAL DOES NOT EXCLUDE THE
isollp.... •
v�.� t. VENDOR'S RESPONSIBILITY to review and comply
J ,. ,. . with all Landlord's sign criteria as been provided.
_ Mill t: _ t sle+ y
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' 'd J . .? A
_ . CITY OF TIGARD RECEIPT
11
_' 13125 SW Hall Blvd., Tigard OR 97223
• 503.639.4171
TLGARD
Receipt Number: 185041 - 12/30/2011
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2011 -00135 Sign Permit 100 - 0000 -43115 $144.00
SGN2011 -00135 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 1508 STREAT 12/30/2011 $165.00
Payor: Gregory Y Kim Sole Prop DBA Pop Sign
Total Payments: $165.00
Balance Due: $0.00
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