SGN2011-00129 n CITY OF TIGARD SIGN PERMIT
Permit #: SGN2011-00129
COMMUNITY DEVELOPMENT Date Issued: 12/21/2011
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S110AA01000
Jurisdiction: Tigard
Name of Business: Boy Scout Troop #423
Business Address: 14170 SW PACIFIC HWY
Applicant/Agent: BSA Troop 423,
Work Description: Placement of (1) 24 s.f. banner. Valid 12/21/11- 1/21/11. Sign #1 Banner must be
placed on private property and not in the public right -of -way or visual clearance areas.
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 4'x6'
Total Sign Area: 24
Wall Area:
Wall Face (Direction): Northwest
Sign Height: 8 ft.
Projection From Wall: in.
Illumination: No Illumination
Materials:
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $52.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. 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 expire 10 days from validity date.
Approved By: / r
,
Permittee Signature: b,.
1ba
10 rr'r ' 0
/
7 City of Tigard DEC 1
Sign Permit Application Orr"' g'" r' (2 =s:;
TIGARD '
GENERA INFORMATION
Name of Development /Project FOR STAFF USE ONLY
Site G ALDFnl c2S C. 1c,1r L � �- ), Q
Cite
Street Address Permit No.: 541 � t (- 0O( Z /
Location 111 1.-; '.' s A (:. 63 4
Suite/Bldg. # City /State Zip Approved By: P
g 7 Z 7c Date: I L i i!I /
0 Q- ��7(C✓J�Lp
Name Receipt #: / ar of 9 6 3
Property ` f t,-t t (/a / e,S Map /TL #: //,�
Owner Mailing Address Suite Zoning: c.4
7 r $ v ` (A/` Allowable Total Area: Z 7 r - •
Cit Zip Phone
5' / tiff
Electrical Permit Required? ❑ Yes [}■No
Tenant or Naili Building Permit Required? Yes o
Business Q5A- I �. F �-f 2 3 ❑ Ci
Name
c \ Rev 7/1(11
c \land use applications \sign permit app.doc
Sign
Contractor Mating Address •
City /State Zip Phone REQUIRED SUBMITTAL ELEMENTS
(Note: applications will not be accepted
Oregon Coast t Board License # gap. Date without the required submittal elements)
❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway ❑ 2 copies of site /plot plan, drawn to scale
Sign Et'Temp°°r ❑ Roof ❑ Electronic (3 copies, if a building permit is required)
that ❑ Q°a° t• Other size requirement: 81/2" x 11", or 11" x 17"
w .,an)t
❑ 2 copies of elevations, drawn to scale
a New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimensions: ( ` Li I size requirement: 81/2" x 11", to 24" x 36"
Total Sign Area (sq. ft.): z �13i' ❑ $165.00 Fee (Permanent sign, any size)
Total Wall Area (sq. ft El $52.00 Fee (Temporary sign, any type)
S' Data _ %
(Complete all Direction Wall Faces (circle one): NOTES.
items in this
section) N S E W NE Ca SE SW
Height to top of sign (feet): 1, ` - V' • Wall signs do not need to be drawn to scale, but
Projection From Wall (inches): must include dimensions of wall face and sign
placement.
Materials:
\NAIL • Wall signs do not require site /plot plans.
Will sign have illumination? ❑ Yes Er No • Freestanding signs over 6 ft. required a building
_ Type: ❑ Internal E" External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space?
❑ Yes No
If "yes ", a list or diagram of all sign dimensions and square (OVER FOR SIGNATURES)
footage must also be submitted.
C
APPLICANTS:
To consider an application complete, you will need to submit ALL of the REQUDIFILMBIAMAILELEMEMES as described on tb
front of this application in the "Required Submittal Elements" box.
NOTE: Person specified as "Applicant" shall be designated "Permittee" and shall provide financial assurance for work
* When the owner and the applicant are different people, the applicant must be the purchaser of record or a lessee in possession wit
written authorization from the owner or an agent of the owner. The owner(s) must sign this application in the space provided on the bac
of this form or submit a written authorization with this application
BY SIGNING BELOW, THE APPLICANT(S) SHALL CERTIFY THAT:
• If the application is granted, the applicant will exercise the rights granted in accordance with the terms and
subject to all the conditions and limitations of the approval.
• All of the above statements and the statements in the plot plan, attachments, and exhibits transmitted
herewith, are true, and the applicants so acknowledge that any permit issued, based on this application, and
may be revoked if it is found that any such statements are false.
• The applicant has read the entire contents of the application, including the policies and criteria, and
understands the requirements for approving and denying the application.
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.
SIGNATURES of each owner of the subject property are required.
/e//7./
Appli . t ignature Date
C. /mot �� /iZ / //
Signatur of Owner /Agent Date
Contact Person Name Phone No.
6 SA Troop Y
C ,4.A,,sI01-0.4 c y (I
City of Tioarrl I 11196 SW Hall Rlvrl Tiaarrl OR Q7771 I 5111-A 1O-4171 I wuw tioarrl -nr any I PIMP 2 of
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. . -.;CITY OF TIGARD ' RECEIPr.
, •'.-.,,13125.SW Hall Blyd., Tigard OR 97223 ' •
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,-,7 • '. r';' '• ''- ; . i..! ' '• • • -1 •.: - 4 , - Receipt Nurnber: 184963 - 1.2/21/2011.
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CASE NO - r - • '.-.. • . FEB.DESCRIPTION REVENUE ACCOUNT NUMBER :''-.,- PAID J' ,,
sdN2011 - .. - • ,, Sign Permit 100=0000.43115 ', , •, • (' -`-.,,', -
' -$45:00 •-•',,."
. SGN2011 ,".: :. Teti SigryPermit - LRP 100-0000-43117
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PAYMENT METHOD '„ . 'CHECK #.,,,, . CC CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
'., •-• 4- . 4 Cre'dit•Card , ' , I• . ' i•i s' - • ..• -' !: • 120039 KPEERMAN
12/21/2611 $5200
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