SGN2002-00049 C ITY OF TIGARD SIGN PERMIT
444 000 e DEVELOPMENT SERVICES PERMIT #: SGN2002 -00049
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 4171 DATE ISSUED: 4/9/02
EXPIRATION DATE:
BUSINESS NAME: KEYSTONE KAFE & SPEAKEASY PARCEL: 2S112DD -0090
SIGN LOCATION: 15700 SW UPPER BOONES FERRYRD
APPLICANT /AGENT: ZONE: C -
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 12' 1" X 52"
TOTAL SIGN AREA: 52 sq. ft.
WALL AREA: 1,242 sq. ft.
WALL FACE (DIRECTION): W
SIGN HEIGHT: 8 ft.
PROJECTION FROM WALL: 10 in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Installation of (1) one 52 sq. ft. permanent wall sign.
MATERIALS: ALUM CABINET
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 50.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All work will-b done in accordance with approved plans. A sign permit shall expire 90
days from approval date. A tempora ign s all expire 30 days from approval date. A balloon sign shall expire 10
days frnm annrnval rlatP
APPROVED BY:
PERMITTEE SIGNATURE: 2 - ' ,
DATE: 4/9/02
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A�'l, SIGN PERMIT APPLICATION
_ tit 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 KCy/sf °NG K�� £ S`oeaKeAsy ++__
Address/ Street Address Permit No.: 1'7io e Zo Z - o e:
Location /5700 5. (J. Uri re0.acl FCr y IM. Expiration Date:
Suite /Bldg. # City /State Zip
Lake QSwc OR 97O3S Receipt #: 62-‘)c �
eh ✓ Approved By: �
Property r h ' I + L°' f /� aS 0 h Date: y 9 2 *
p Y Z c! (ID
Mailing Address Suite Map/TL #: ,2 ,S // 7!� -• 0 0
/5 ft.J ut %4cnns f tr Rd , Zoning: (V 4
City /State Zip Phone
Lcke 05 wc3 0, OR 97o33 3-12-6P-0717) Electrical Permit Required? Yes ❑ No
Tenant or Name /r�
Business kcy ;+ov1e KA— G F SPCA kec fy Building Permit Required? io Yes No
Name Rev. 30 -Jul -01 is \curpin\masters\revised\sign permit app.doc
Sign geal✓e h / A� `{ it0 vi
Contractor Mailing Address • Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit
issuance, a /725-0 f W u14... 1.44, (Note: applications will not be accepted
copy of all City /State -Zip Phone without the required submittal elements)
licenses afe gee-Ave l~r0► 0e/7 5 644
required ❑ Completed Application Form
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # b j-9 , 1 I / - /8 - O 2 ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway size requirement: 81/2" x 11 ", or 11" x 17"
Y
Sign ❑ Temporary rgi Wall ❑ Electronic ❑ 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"
® New sign? l e x i st i ng s
❑ $50.00 Fee (Permanent sign, any size)
Sign Dimensions: /2 r/ "X .6
❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.): 5
NOTES:
Sign Data Total Wall Area (sq. ft.) / z y 2. „F, ♦ Wall signs do not need to be drawn to scale,
't` but must include dimensions of wall face and
(Complete all Direction Wall Faces (circle one): sign placement.
items in this
section) N S E i\W NE NW SE SW • Wall signs do not require site /plot plans.
• Freestanding signs over 6 ft. required a
Height to top of sign (feet): $' building permit.
Projection From Wall (inches): /0" • If work authorized under a sign permit has not
Copy: !keys{ -opt, Ka4e f S e t a Ke u been completed within ninety (90) days after
Materials: /04 gods) X41 /Nw, nu Cab; „Q•t- the issuance of the permit, THE PERMIT WILL
Will sign have illumination? ® Yes ❑ No BECOME NULL AND VOID.
Type: RI 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 ❑
Credit card number / /
® Yes ❑ 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 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 9 �� day of 'GA es da , 20 0 Z
Signa re of Owner /Agent
Greg (A.) (( h' w, S SD 3 - t/ 9 -
Contact Person Name Phone No.
Receipt #: 27200200000000001275
Date: 04/09/2002
T I D E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
ELC2002 -00159 [ELPRMT] ELC Permit 220 - 0000 - 431510 $53.40
ELC2002 -00159 [TAX] 8% State Tax 100 - 0000 - 207020 $4.28
SGN2002 -00049 [SIGN] Sign Permit 100 - 0000 - 437000 $50.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check BEAVERTON NEON & SIGN 0 6610 $107.68
TOTAL AMOUNT PAID: $107.68
BEAVERTON NEON
17250 S.W. AUGUSTA LANE
BEAVERTON, OR 97006
(503) 649 -1544
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52 "x145" s/f internally illuminated advertising
display. color secdule as follows;
• black finish on display cabinet
• pantone 188c burgundy background
• white sho -thru outline letters
keystone kafe
�8 • pantone 224c pink lavender
speakeasy
17250 Sw E u • Lane • black ampersand with white sho -thru outline
Beaverton. OR 97006
(503) 649 -1544
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