SGN2002-00254 J
CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2002 -00254
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/22/2002
EXPIRATION DATE:
BUSINESS NAME: SOUTHWEST FAMILY PHYSICIANS PARCEL: 1S135DD 04400
SIGN LOCATION: 08847 SW CENTER ST
APPLICANT /AGENT: SOUTHWEST FAMILY PHYSICIANS ZONE:
BUSINESS TAX NO: JURISDICTION:
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4X8'
TOTAL SIGN AREA: 64 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 13 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Freestanding sign
MATERIALS: METAL /ACRYLI
EXISTING SIGNS: 2
ELECTRICAL PERMIT REQUIRED:
BUILDING PERMIT REQUIRED:
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 e ire 10 days from validity date.
APPROVED BY:
PERMITTEE SIGNATURE: -71X )LU
DATE: 11/22/2002
13125 SW Hall Blvd. 9:13:42AM
"� iiii Tigard, Oregon 9 72 23
�-,,
IL. (503) 63 9-4 17 1
Receipt #: 27200200000000004447
Date: 11/22/2002
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2002 -00254 [SIGN] Sign Permit 100- 0000 - 437000 30.00
SGN2002 -00255 [SIGN] Sign Permit 100 - 0000 - 437000 30.00
Line Item Total: $60.00
Payments:
Method Payer User ID Acct. /Check Approval No. How Received Amount Paid
Check CLASSIC DIMENSIONAL MET 10414 In Person 60.00
GRAPHICS
Payment Total: $60.00
u..„:,lra SIGN PERMIT APPLICATION
: .41 , X
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -41171 FAX: (503) 684 -7297
GENERAL INFORMATION U
Name of Development/Project
FOR STAFF USE ONLY
Site SOLL1 1- twe r �y 13 r4Ys►u S,
Address/ Street Address Permit No.: c6/.../2- - 0 025/
Location it ?OU 4,4,L1 & E) 7v 8u/26r Rt Expiration Date: JJ /f+'
Suite /Bldg. # City /State Zip
7`'/ cDR c,7Z2-3 Receipt #: ZODZ - KHy'�
Name Approved By: 11/14.7
$FIV•u--ii t.I ./ all.-& Z.
Property C - r-t /A G-U Li CJC- C/O Date: Ii /22/02-
Owner Mailing Address Suite Map/TL #: 14/15 IV - 1 /(too
11900
:-..,-)ee -eN e Uf2 G-42.0 Zoning: /-?
City/State Zip Phone 563
7 - 1 b'20 T � 0 ' 55540 Electrical Permit Required? Ees 111 No
Tenant or Name .
Business fllD Li} -c._, CLi /�1 / C., Building Permit Required? Yes ❑ No
Name Rev. 30- Jul-01 is \curpin \masters\revised \sign permit app.doc
Sign
C..4.41-Si CL, E i er-.'J 4S yS7 wt
M ailing Address • Suite
Contractor 2_0 0 REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a 7c.9O0 tS W LA fe f t ii - Va• - ` 0—E>
copy of all City/State Zip Phone 5 03 without the required submittal elements)
licenses are -/-
/
required if I crpeWQ0 87223 t 3 q , Ste 5 0 VI, Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # 778633 Y o 4 2 Copies of Site /Plot Plan, Drawn to Scale
database)
(3 copies, if a building permit is required)
Proposed Permanent Freestanding ❑ Freewa size requirement: 81/2" x 11 ", or 11" x 17"
y
Sign
❑ T emporary ❑ Wall ❑ Electronic (z. 2 copies of elevations, drawn to scale
(Check all that ❑ Other ❑ Billboard ❑ Balloon (3 copies, if a building permit is required)
apply) size requirement: 81/2" x 11 ", to 24" x 36"
ig New sign? ❑ Alter to existing sign? 21, •• :1.00 Fee (Permanent sign, any size)
Sign Dimensions: , i
4 ic 8 ❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.):
32 .1ZS NOTES:
Sign Data Total Wall Area (sq. ft NlA • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
(Complete all Direction Wall Faces (circle one): sign placement.
items in this q site/plot p
section) N S 6)0 NE NW SE SW • Wall signs do not require site/ lot lans.
• Freestanding signs over 6 ft. required a
Height to top of sign (feet): 10. S building permit.
Projection From Wall (inches): NS • If work authorized under a sign permit has not
Copy: SEE 147r ei-HE0 been completed within ninety (90) days after
Materials: twlE —c. Et /lC42yLt Cr the issuance of the permit, THE PERMIT WILL
Will sign have illumination? 6. Yes ❑ No BECOME NULL AND VOID.
_ 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.
location, including wall signs that overlap a tenant space? visa ❑ Mastercard
f2 E /lair Credit card number 1 /
❑ Yes 21 No
Expires
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. g
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 / 8 1-H day of AlcD , 20 0 --
Signature of Owne gent
•
wvu�� 603- 6,3
Contact Person Name Phone No.
11 Sou es
1 c1
m I lyi ,..,
Physicians
Creating Maximum Impact
••.... For Business Identities
Date:
11/18/02
Client:
CABINET: Southwest
4' x 8' sign cabinet Family
2" retainers Physicians
Acrylic Lense
Florescent internal lighting Contact:
UL approved Dr. Cynthia Gulick
Weight: 150 lbs. Benjamin R. Stutz
SUPPORT: Grade
8.5' above grade
schedule 40 pipe ~< FOOTING: CLIENT
4" diameter, or as required .ed . 3' X 3'x 3' deep, APPROVAL
4' through sign " ' or as required Please initial & date
4' below grade 4 Colors:
Spelling:
r Graphics:
' Dated:
CLASSIC SIGN
Grade S •Y•S •I •F •M •S
I 7800 SW Durham Rd.. Ste. 200
Portland, OR 97224 -7577
Phone: 503 -639 -5656
These plans are the exclusive property of Classic Sign Systems and the result of the original work of Its employees, They are submitted to your company for the sole purpose of your consideration of whether to purchase Fax 503 -624 -8706
these plans or to purchase from Classic Sign Systems a sign manufactured according to these plans. Distribution or exhibition of these plans to anyone other than employees of your company, or use of these plans to email: classigns.com
construct a similar sign Is expressly forbidden. In the event exhibitor occurs, Classic Sign Systems will be reimbursed $500 for time and effort, Scale: /z = 1'0"
o U r - I1-(J� ! v . I s
, X .r 1 w
Q IN I0 .
`, I / (7) .:):: e I 4 • , _
• I� al
�. I t. I N
\ 1_ i
�\ I dPti I
•
` 1 \ .1 , . . :
\ ! 1 l'
[ I ® I AO
I • I
BELOW: drawn at 1" = 20' \� i 11N `
Enlargement at 3/8" =1' - \ �� r !� • \ \
.\, • 1 1 \
. <. O I a s \
r a t, .- C a ns — , fir . / I
4 : - ,..%.i.••1444:4.3 , *.f.e.i \40 a a=te aa� g
•� W , . \ •9 i • Ib ap \ \ - r
\ /9 I
4 I
\ o \ _
-, 4 /1/4&
g