SGN2002-00204 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2002 00204
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 10/18/02
EXPIRATION DATE:
BUSINESS NAME: VERIZON WIRELESS
SIGN LOCATION: 15495 SW SEQUOIA PKWY 150 PARCEL: 2S112DD 01600
APPLICANT /AGENT: ZONE:
BUSINESS TAX NO: JURISDICTION:
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3' X 10'
TOTAL SIGN AREA: 30 sq. ft.
WALL AREA: 200 sq. ft.
WALL FACE (DIRECTION): SE
SIGN HEIGHT: 10 ft.
PROJECTION FROM WALL: 1 in.
ILLUMINATION:
DESCRIPTION OF SIGN: Installation of (1) one 30 sq ft wall sign.
MATERIALS: VINYL &FRAME
EXISTING SIGNS:
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 wor . II be done in accordance with approved plans. A permanent sign must
be placed within 90 days from approval da •• or ign permit shall expire. A temporary sign shall expire 30 days from
validity date. A balloon sign shall expir- I • =ys from validity sate.
APPROVED BY: A v dAlso
tom —
PERMITTEE SIGNATURE: ZONE' V
DATE: 1 • 8/02
f . , .
A
�a, ;t If � 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 (Jeff( it c,1 �t'veLeCI'
Address/ Street Address n Permit No.: 4 (.114 ?.o,� U n )-
Location (.r" 91 Del 1� vO rq ?ku4/1
Expiration Date:
- Suite /Bldg. # jtC y/Statd Zip
—- fro 1 is .,0" / ce. 9? 2 2 Qf Receipt #: (-op L - 3 "i 4
Name Approved By'
/J
; e c � p e k e . / r ( 7 ��. Date:
16 10
Property � /
Owner Mailing Address S e p 1-
Map /TL #: A 55 / 2 D 1J -o/ 606
kf310 SU'' . oi^/11eK > 0t2 Zoning: ( j
/S e / Zip Phone s0,3 —
'
0"1-A ce � I( C 2 y ---741?--- Electrical Permit Required? ❑ Yes No
Tenant or Na /
Business V ` vr ' 4 Fe1 2' r4 ( 1144-C Building Permit Required? ❑ Yes No
Name Rev. 01 -Jul -02 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
issuance, a
copy of all City /State Zip Phone without the required submittal elements)
licenses are
required if al/ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # Ft(2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
Proposed Permanent ❑ Freestanding ❑ Freeway ize requirement: 8 x 11 ", or 11" x 17"
Sign Temporary 44-wall ❑ Electronic
(Check all that ❑ Oth ❑ Billboard ❑ Balloon 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 ›c__ ( Q ❑ $30.00 Fee (Permanent sign, any size)
Total Sign Area (sq. ft.): (-2(0 0$15.00 Fee (Temporary sign, any type)
Sign Data Total Wall Area (sq. ft.) 2010
(Complete all Direction Wall Faces (circle one): NOTES:
items in this
section) N S E W NE NWED SW
• Wall signs do not need to be drawn to scale,
Height to top of sign (feet): / 0
■ but must include dimensions of wall face and
Projection From Wall (inches): sign placement.
Copy: ,S, 4-1 -tom 11-g-c.Q • Wall signs do not require site /plot plans.
Materials: • Freestanding signs over 6 ft. required a
building permit.
Will sign have illumination? ❑Yes — • 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.
❑ Yes ❑ No
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
(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 I day of `r C,1 . , 20 0
Signatu f • /Agent
Ceo0ee 10 3- 2/ti
Contad Person Name Phone No.
1,11 Y vt 11tjAtuW
13125 SW Hall Blvd. 4:04:41PM
rli Tigard, Oregon 97223
a IL (503) 63 9-4 17 1
Receipt #: 27200200000000003999
Date: 10/18/2002
Line Items:
Case No Tran Code Description Revenue Account No Amount Paid
SGN2002 -00201 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
SGN2002 -00202 [SIGN] Temp Sign Perm 100 -0000- 437000 15.00
SGN2002 -00203 [SIGN] Temp Sign Perm 100 - 0000 - 437000 15.00
SGN2002 -00204 [SIGN] Sign Permit 100- 0000 - 437000 30.00
Line Item Total: $75.00
Payments:
Method Payer User ID Check No. Approval No. How Received Amount Paid
CreditCard JIRI KUBIS VERIZON WIRELESS KJP 098637 In Person 75.00
Payment Total: $75.00
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Condizionly Approved
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