SGN2002-00055 CITY OF TIGARD SIGN PERMIT
�4 DEVELOPMENT SERVICES PERMIT #: SGN2002 -00055
6• I' DATE ISSUED: 4/22/2002
`--' " 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171
EXPIRATION DATE:
BUSINESS NAME: MADDY'S PARCEL: 2S102AA - 00491
SIGN LOCATION: 12085 SW HALL BLVD 130
APPLICANT /AGENT: MADDY'S ZONE: CBD
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 4' X 3'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: 0 in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary placement of (1) A -board sign. Not to be placed in visual clearance
area or public right -of -way. Valid 5/1/02 - 6/1/02 Sign #1
MATERIALS: WOOD
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 OR. Specialty Codes
and all other applicable laws. All . II be done in accordag- �,e with approved plans. A sign permit shall expire 90
days from approval date. A tem • •raDt sign shall expire 30 days,lfrom _ pproval date. A balloon sign shall expire 10
(lays from annmval riatP
APPROVED BY: l / 61,/
PERMITTEE SIGNATURE: "
DATE: 4/22/2002
r ,
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
Site FOR STAFF USE ONLY
Address/ Street 20 W Address QW�
Location , 5 Permit No. (k/ r 02- 4 0 ( o2 9 Z — 000 Suite /Bldg. # City/State Zip
3 ° Tl S r ( o q 772_3 Expiration Date: ` C.�
Name Receipt #: .� M ^ I 4 (-R,i7
Property
I.,. i/Sc in iK.
ue vT Approved By: U S
Owner Mailing Address Suite Date: NI 6 /II a
2.7, Si- el Alk q 3 tic Map/TL #: 4,11 I — - Ie
City/State Zip Phone Zoning: C---BD
1po el q /2.a/ 03 29Y Co/-
Tenant or Name
Business Electrical Permit Required? ❑ Yes ErNq
Name Building Permit Required? ❑ Yes o
Rev. 12/1/2000 is \curpin\masters \revised \sign permit app.doc
Sign
Contractor Mailing Address Suite
(Prior to permit
issuance, a
copy of all City/State Zip Phone
licenses are REQUIRED SUBMITTAL ELEMENTS
required if (Note: applications will not be accepted
expired in the Oregon Const. Cont. Board Exp. Date
City of Tigard's License # without the required submittal elements)
database)
Proposed Completed Application Form
Pro
p ❑ Permanent ❑ Freestanding ❑ Freeway
Sign ❑ Temporary ❑ Wall ❑ Electronic ,L.I~d,r 2 Copies of Site /Plot Plan, Drawn to Scale
(Check all that ❑ Other ❑ Billboard ❑ Balloon (3 copies, if a building permit is required)
apply) size requirement: 8'/2" x 11 ", or 11" x 17"
❑ New sign? [�Alte to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: / y (3 copies, if a building permit is required)
tea' 'AV ,?C size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
❑ $50.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) ❑$15.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this
section) N S E W NE NW SE SW NOTES:
Height to top of sign (feet): ! 1/ • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
Projection From Wall (inches): sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: (,., • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes [r No building permit.
Type: ❑ Internal Dtxternal • If work authorized under a sign permit has not
Are there any existing freestanding or wall signs at this been completed within ninety (90) days after
location, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
BECOME NULL AND VOID.
❑ Yes ❑ No
If "yes ", a list or diagram of all sign dimensions and LOVER FOR SIGNATURES)
square footage must also be submitted.
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 day of 7 4e" ( , 20 OZ
t
ignature of Owner /Agent
2 /t
Contact Person Name Phone No.
Receipt #: 27200200000000001446
Date: 04/22/2002
T I D E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2002 -00055 [SIGN] Temp Sign Perm 100 -0000- 437000 ,$15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check CO -ZAK VENTURES, LTD. DCP 4667 0 $15.00
TOTAL AMOUNT PAID: $15.00
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