SGN2002-00013 CITY OF TIGARD
I DEVELOPMENT SERVICES PERMIT #: PERMIT
2 -00013
A c� ERMIT
SIGN P 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 1/22/2002
EXPIRATION DATE:
BUSINESS NAME: TIGARD PLAYSCHOOL PARCEL: 2S102BD -0170
SIGN LOCATION: 12860 SW PACIFIC HWY
APPLICANT /AGENT: TIGARD PLAYSCHOOL ZONE: C -
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2.5 X 2
TOTAL SIGN AREA: 45 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 2 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary placement of (1) A -Board sign. Not to be placed in public right of way.
Valid 1/23/02 - 2/23/02 (Sign #1)
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. Iwo ,k will be done in ccordance with approved plans. A sign permit shall expire 90
days from approval date. A mporaSY sign shall expir 30 •.ys from approval date. A balloon sign shall expire 10
riavc from annrnval riatP /
APPROVED B :
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PERMITTEE SIGNATURE:
DATE: 1/22/2002
'1 %& zo - o-c c3 ,, ,, A � -�
C ITY OFTIGP,.RD ` Sign Permit Application R e cd B y - . �, /
Date Recd
13115 SW HALL BLVD. Permanent or Temporary Permit No.
TIGARD, OR 97223 Commercial or Residen Permit Fee l Q7
(503) 639 -4171 • Receipt No. aMar
Please Print or Type. Called
Incomplete or illegible applications will not be accepted.
Name of Development/Project Are there any existing freestanding or wall signs at this
Site LU . .- location, including wall signs that ov Flap a tenant space?
g S treet Ad ss “yes,, ❑ Yes TiNo
Addres / If `yes , a list or diagram of all sign dimensions and
Location a� W
�� - square footage must also be submitted.
Suite/Bldg. # City /State Zip
Name NOTE: If work authorized under a sign permit has not
Property �r,..A.ct, C s t C 111;_L� be completed within ninety days after the
Owner Mailing Address Suite issuance of the permit, THE PERMIT WILL
� BECOME NULL AND VOID.
�'N/45 ,Sv\l Anu Oia
City /State Zip Phone I hereby acknowledge that I have read this application, that the
1 CiC. 51 Z.23 031 - (i 6 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.
Tenant or Name (Si l0° 1 , I
(
Business i C ) cw(,t - p IevySC i cC I S ignature of Owner /Agent Date
Name l `J .� 2
A
Sign Contact Perso ame Phone
Contractor Mailing Address Suite Arny Sara -i 24.L1 5.2_ -31
Prior to permit
issuance, a
copy City /State Zip Phone
of all licenses
are required if Required Submittal Elements
expired in Oregon Const. Cont. Board Exp. Date
C.O.T. license # Q Completed application form
database ❑ 2 copies of site /plot plan, drawn to scale
Proposed ( copies i f a building permit is required)
-Sign ❑ Permanent , El Freeway � - m. T Freestanding ❑ Electronic size requirement: 8-1/2" x 11 ", or 11" x 17 "
Check all that
apply Other ❑ ❑ B alloon signs q
Wall N o t e: W ns do not require site/plot P -
lot' Tans.
-_ ❑ Billboard ❑ 2 copies of elevations, drawn to scale
(3 copies, if a building permit is required)
g New sign? size requirement: 8 -1/2" x 11 ", to 24" x 36"
❑ Alteration to existing sign? Note: Wall signs do not need to be drawn to
Sign Dimensions: scale, but must include dimensions.
Y X °2 . ❑ $50.00 Fee (Permanent sign, any size
Total Sign Area (sq. ft.): ❑ $15.00 Fee, (Temporary sign, any type)
Sign 1-1' 2 S --
Data Total Wall Area (sq. ft.)
-
Please
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complete Direction Wall Faces (circle one):
each item FOR OFFICE USE ONLY:
in this N S E W NE NW SE SW Map/TL# /� Zonin
section 0-SIb t —O ( �
Notes
Height to top of sign (feet): a, y
Projection From Wall (inches) Electrical Permit Required? ❑ Yes IiN
Copy: .S lie- plan :—
Materials: ,,l\Snnr1 Building Permit Required? ❑ Yes No
Will sign have illumination? No Yes ❑ . ��
• . :.`► / - Date of Approval:
Type: ❑ Internal ❑ External
Expiration ! a ` 0 — — 3 51f2n___,L,
. . , , _ _ 1 1 11 ----,
. SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Development/Project FOR STAFF USE ONLY
Site
Address/ Street Address Permit No.:
Location Expiration Date:
Suite /Bldg. # City /State Zip
Receipt #:
Name Approved By:
Date:
Property
Owner Mailing Address Suite Map/TL #:
Zoning:
City /State Zip Phone
Electrical Permit Required? ❑ Yes ❑ No
Tenant or Name
Building Permit Required? ❑ Yes ❑ No
Business
Name Rev. 30 -Jul -01 i:\curpin\masters\revised\sign permit app.doc
Sign
Contractor Mailing Address • Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City/State Zip Phone
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
size requirement: 8 x 11 ", or 11" x 17"
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway
Sign ❑ Temporary ❑ Wall ❑ Electronic ❑ 2 copies of elevations, drawn to scale
(Check all that ❑ Other ❑ Billboard 0 Balloon (3 copies, if a building permit is required)
app size requirement 8 x 11", to 24" x 36"
❑ New sign? ❑ Alter to existing sign? El $50.00 Fee (Permanent sign, any size)
Sign Dimensions:
❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.):
NOTES:
Total Wall Area (sq. ft.) ♦ Wall signs do not need to be drawn to scale,
Sign Data but must include dimensions of wall face and
(Complete all Direction Wall Faces (circle one): sign placement.
items in this ♦ Wall signs do not require site/plot plans.
section) N S E W NE NW SE SW • Freestanding signs over 6 ft. required a
Height to top of sign (feet): building permit.
Projection From Wall (inches): ♦ If work authorized under a sign permit has not
Copy: been completed within ninety (90) days after
Materials: the issuance of the permit, THE PERMIT WILL
BECOME NULL AND VOID.
Will sign have illumination? ❑ Yes ❑ No
Type: ❑ Internal ❑ External
Are there any existing freestanding or wall signs at this /Not all jurisdictions accept credit cards, please call jurisdiction for more information.
❑ Visa ❑ MasterCard
location, including wall signs that overlap a tenant space? / /
Credit card number Expires
❑ Yes ❑ No
If "yes ", a list or diagram of all sign dimensions and Name of cardholder as shown on credit card
square footage must also be submitted.
Cardholder signature Amount
(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 ja_tr\ -00._r , 20 0 2
tea&
Signature of O T / gen
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Contact Person Name Phone No.
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cond, ;y Approved I
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Let:— to Follow__ ...................
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Receipt #: 27200200000000000255
....0s,_.......01 Date: 0112212002
T H Y E M A R K
COMPUTER SYSTEMS, NC,
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2002 -00013 [SIGN] Temp Sign Perm 100 - 0000 - 437000 $15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check TIGARD PLAYSCHOOL, INC. 0 2690 0 $15.00
TOTAL AMOUNT PAID: $15.00
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