SGN2002-00198 CITY OF TIGARD SIGN PERMIT
i DEVELOPMENT SERVICES PERMIT #: SGN2002 -00198
°' 6.4 DATE ISSUED: 10/21/02
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
EXPIRATION DATE:
BUSINESS NAME: SOURCE ONE NETWORK INC
SIGN LOCATION: 11650 SW 67TH AVE PARCEL: 1 S136DD 03900
APPLICANT /AGENT: ZONE:
BUSINESS TAX NO: JURISDICTION:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 8'
TOTAL SIGN AREA: 24 sq. ft.
WALL AREA: 700 sq. ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT: 15 ft.
PROJECTION FROM WALL: 1 in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of (1) one 24 sq ft wall sign.
Banner must be framed
MATERIALS: VINYL &FRAME
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 dat •r sign permit shall expire. A temporary sign shall expire 30 days from
validity date. A balloon sign shall exp e 1 • .. ys from validity date.
1
APPROVED BY:
PERMITTEE SIGNATURE: '!' A H7ijL
DATE: 10/21/02
.
�, <; -ti,ll' SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
Name of Develop nt/Projec
Site
Y'U L Vll2_ V FOR STAFF USE ONLY
Address/ Street Address Permit No.: c5-4N 2 -` 3O Z-- — 00 L a
Location I I r ii0 S� tv1• -PC11
--� Expiration Date:
Suite /Bldg. # City/State Zip
'11 tl7. `G_ a'1n% Receipt #:
Name Approved By: (If
Property � Vll 1l�' N . C�1cD Date: l a�l�/
Owner Mailing Address Suite Map/TL #: [C06 6 P D- 0 3 1 0 0
I I1 be SW o11t.Mt Zoning: M tk t-
City/State Zip Phone
- ritioLat ci °l'l2V3 6 1014kDQaC Electrical Permit Required? ❑ Yes E- No
Busi nt s j m I� Qi� a _ _ 1, T _
Business "u f(�/� / ( , (/1 Building Permit Required? ❑Yes p No
Name Rev. 30 -Jul -01 is \curpin \masters\revised\sign permit app.doc
Sign
Contractor Mailing Address • Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuaoc a w ithout the required submittal elements
copy of all City/State Zip Phone q elements)
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)
Pro Proposed size requirement: 8 x 11 ", or 11" x 17"
p Per manent ❑ Freestanding ❑ Freeway
Sign ❑ Temporary H Wall ❑ Electronic El 2 copies of elevations, drawn to scale
(Check all that ❑ Other Billboard ❑ Balloon (3 copies, if a building permit is required)
apply) size retirement: 8 x 11 ", to 24" x 36"
it New sign? ❑ Alter to existing sign? 4{ j Fee (Permanent sign, any size)
Sign Dimensions: `f''`
:..),),I X V ❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.): AV
� NOTES:
Sign Data Total Wall Area (sq. ft (oD / • 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
section) 0 S E 0 NE NW SE SW • Wall signs do not require site /plot plans.
l • Freestanding signs over 6 ft. required a
Height to top of sign (feet): t 5 III building permit.
Projection From Wall (inches): I • 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
Will sign have illumination? ❑ Yes No BECOME NULL AND VOID.
Type: ❑ Internal External \
Are there any existing freestanding or wall sins at this Not all jurisdictions accept credit cards, please call jurisdiction for more information.
CI
location, including wall signs that overlap a tenant space? visa ❑MasterCard
Credit card number / /
❑ Yes . 3a 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. $
\ Cardholder signature Amount
(OVER FOR SIGNATURES) \
i
i
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 iS day of CSC 2ere_ , 20 C 'L--
4._ 4 „,41 : -. 7ry p
Signature of Owner /Agent
p p 60 c 3 - C .
Contact Person Name Phone No.
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0,ITY OF .
AK, loyal — [X I
iy Approved
Fo. 6-nly the woq:, as ttescrikeil 1■11:
F hc4MIT
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CITY OF TIGARD 10/21/2002
13125 SW Hall Blvd. 8:48:57AM
� , � i Tigard, Oregon 97223
(503) 63 9-4 17 1
Receipt #: 27200200000000004002
Date: 4.0/21/2002
Line Items: •
Case No Trail Code Description Revenue Account No Amount Paid
SGN2002 -00198 [SIGN] Sign Permit 100 -0000- 437000 30.00
SGN2002 -00199 [SIGN] Sign Permit 100- 0000 - 437000 30.00
SGN2002 -00200 [SIGN] Sign Permit 100- 0000 - 437000 30.00
Line Item Total: $90.00
Payments:
Method Payer User ID Check No. Approval No. 1 Received Amount Paid
Check SOURCE ONE NETWORK INC kjp 400 In Person 90.00
Payment Total: $90.00