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SGN2002-00237 r ,. CITY OF TIGARD SIGN PERMIT I DEVELOPMENT SERVICES PERMIT #: S 1/5/02 -00237 JAI - I ' l l 1 3125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/5/02 EXPIRATION DATE: BUSINESS NAME: TRI SQUARES DANCE CLUB PARCEL: 2S103DD 00600 SIGN LOCATION: 13770 SW PACIFIC HWY APPLICANT /AGENT: ZONE: BUSINESS TAX NO: JURISDICTION: SIGN PERMANENT: FREESTANDING: FREEWAY: TEMPORARY: X WALL: Y ELECTRONIC: OTHER: BILLBOARD: BALLOON: SIGN DIMENSIONS: 3' X 6' TOTAL SIGN AREA: 18 sq. ft. WALL AREA: 2,714 sq. ft. WALL FACE (DIRECTION): S SIGN HEIGHT: 18 ft. PROJECTION FROM WALL: 0 in. ILLUMINATION: NON DESCRIPTION OF SIGN: Placement of (1) one temporary 18 sq ft banner. Valid 12/1/02 thru 12/31/02. Sign #3 MATERIALS: NYLON 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 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 ays from validity date. APPROVED BY: / / --Q-4- /1 iR�J PERMITTEE SIGNATURE: - 4-1-7 ��`" DATE: 11/5/02 I P ,,,.,,,, SIGN PERMIT APPLICATION CITY OF I 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 `T t okra) G 2A+va C S'�/tJ -2-( Z 0 2-- 3 7 Address/ Street Address Permit No.: Location 13 ? 7 O S.W. Pi .i F I C 14 wy Expiration Date: /z / b ? - 1213 r It) - Suite /Bldg. # City /State Zip Tip A RD, ©� C 2- .3 Receipt #: ),.u0 - yZ Z3 Name Approved By: Property TI GA•2O G /2.A /VC3 Date: / /s f Owner Mailing Address Suite Map /TL #: a 5 (03) 1 -00 (o o- Cc, 216 NE ,qlwstivo r>u Zoning: ( (7 City/State Zip Phone ?WO - LAW OR Ti 2) 8 NONE Electrical Permit Required? ❑ Yes jg No Tenant or Name Business T R t SQuAtZES DANCE CLu13 Building Permit Required? ❑ Yes p No Rev. 01 -Jul -02 is \curpin \masters \revised \sign permit app.doc Name Sign C REQUIRED SUBMITTAL ELEMENTS Contractor Mailing Address Suite (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) Proposed ❑ Permanent ❑ Freestanding El Freeway size requirement: 8 x 11 ", or 11" x 17" Sign ❑ Temporary E Wall ❑ Electronic (Check all that ❑ Other B ❑ B alloon ❑ 2 copies of elevations, drawn to scale apply) (3 copies, if a building permit is required) ❑ New sign? ❑ Alter to existing sign? size requirement: 8 x 11 ", to 24" x 36" Sign Dimensions: / 3 x 6 / ❑ $30.00 Fee (Permanent sign, any size) Total Sign Area (sq. ft.): j 8 ❑ $15.00 Fee (Temporary sign, any type) Total Wall Area (sq. ft.) Sign Data 2 1 I ¢ (Complete all Direction Wall Faces (circle one): NOTES: items in this section) N CD E W NE NW SE SW • Wall signs do not need to be drawn to scale, Height to top of sign (feet): 18 but must include dimensions of wall face and Projection From Wall (inches): 0 sign placement. Copy: • Wall signs do not require site /plot plans. Materials: NYLON • Freestanding signs over 6 ft. required a building permit. Will sign have illumination? ❑ Yes ® No • If work authorized under a sign permit has not Type: ❑ Internal ❑ External 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. CI Yes g( No If "yes ", a list or diagram of all sign dimensions and square footage must also be submitted. (OVER FOR SIGNATURES) 1 . 1 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 pl� day of /Cc zieryee-/' , 20 OZ Si gnat e of Ow r/A ent 9 9 YO &AJT .-03 - SAO Contact Person Name Phone No. 2'Z.2 S W, C©Tro &w000 LANG Tf 4A2.0 l-11 Y it i i tii u -- " 13125 SW Ha11 Blvd. 3:11:39PM Tigard, Oregon 97223 _ ° (503) 63 9-4 17 1 Receipt #: 27200200000000004223 Date: 11/05/2002 • Line Items: Case No Tran Code Description Revenue Account No Amount Paid SGN2002 -00237 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00 Line Item Total: $15.00 Payments: Method Payer User ID Check No. Approval No. How Received Amount Paid Cash TRI SQUARES DANCE CLUB KJP In Person 20.00 Change CITY OF TIGARD KJP In Person (5.00) Payment Total: $15.00 Page 1 of 1 cReceipt.rpt ) D , ) Sign Elevation Tigard Grange North Side op. . 100. • 1 \ — — — — — . • 11 23 - - - - 15' I / 1 . , SQUARE DANCE LESSONS 4 —c-9.--) TY OF rd1. CALL: 503-639-7191 Apr rovati. r.X i Coridt t.■ft.A.ly Approved.. Fo. - ;.1Iy the wokfts i:iescria.e ■41: F..r.i..; Letl tc• Follow. 1 I • i ,-, • Aid D Site Plan N Driveway Gravel and Grass Parking .,..am Tigard Grange 13770 SW Pacific Highway . ____ L I 3x6 Banner Driveway Gravel and Grass Parking