SGN2012-00008 III ,, CITY OF TIGARD SIGN PERMIT
Permit #: SGN2012 -00008
COMMUNITY DEVELOPMENT Date Issued: 02/21/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 1S136AD06000
Jurisdiction: Tigard
Name of Business: Carl's Jr.
Business Address: 11437 SW PACIFIC HWY
Applicant/Agent: Carl's Jr.,
Work Description: Installation of (1) one 35 s.f. permanent wall sign.
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 3' -6" x 10'
Total Sign Area: 35
Wall Area: 1500
Wall Face (Direction): East
Sign Height: 24 ft.
Projection From Wall: 5 in.
Illumination: Internal
Materials: AlumNinyl
Electrical Permit Required: Yes
Building Permit Required: No
Total Permit Fee: $165.00
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:
, / #1(
Permittee Signature: y /
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A CEIVED
SIGN PERMI T APPLICATI
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297 JAN 2 7 2012
CITY OF TIGARD
GENERAL INFORMATION PLANNING /ENGINEERING
Name of Development/Project
/
Site i : , FOR =STAFF USE "
Address/ Street Address r : , �# ,jam s ti
y 7
Location i SW aQCI-F1C HWY Permit g No
Suite /Bldg. # City /State Zip _._''-'' rt u \ ( `: " a 're', r x ° '' ,ar r
xpiration Date " fi " 1 ;
Receive # ". .0 r , . 3v,.w5 , -�
Name ..
`' Approve By Y24 "! d `
Property Kw V FaoDS : - N . 0, ,._ 0 ? 4 r L r ..
Owner Mailing Address Suite Date A:44-40+" 4 ^ � . ` a` fi
e a r x 2sx y r t a <<
M # - 8 � �t .' ! -
City/State Zip Phone L{� L ' , ,,41;.? 3 ?,�,`� {.> ` t2,,:.'„17,s-- :
Zoning
L Nei l'' ? �N 5` 10'ki rfi� * y
Tenant or Name n "��
Electr I Pe R ?. a� �;. s ' � ®. No .
Business C�� � S � ` ' ' ', ,4, r , '" , , ,
Bulld ng l P,O iit Requi eq, ? ; t � ,. , .� Y es .N o
Name •.a': " - v : " wf �4 ; ; w r. M x< , w ..
. . Rev. , 12/1/2000 i:\curpinlmsterslrev�sed\sign permit app:doc ' t", `
Sign Al>vANCf) &1RTriIC SIGNS
Contractor Mailing Address Suite
(Prior to permit
issuance, a 1550 (Y},.1NRiVis/l• I(
copy of all City /State Zip Phone 3C REQUIRED SUBMITTAL ELEMENTS
licenses are
required if WOODLAND WA 910Y / D;),5'6,8 (Note: applications will n .t be accepted
expired in the Oregon Const. Cont. Board Exp. Date without the required submittal elements)
City of Tigard's License # y
1
database) 7- /9 -
I ❑ Completed Application Form
Proposed 21 Permanent A Freestanding ❑ Freeway
Sign ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
Si
9 ❑ Temporary d ❑ Electronic (3 copies, if a building permit is required)
(Check all that ❑ Other • Billboard ❑ Balloon size requirement: 8 x 11 ", or 11" x 17"
apply)
bt New sign? El Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
5 �� (3 copies, if a building permit is required)
Sign Dimensions: 3 / `N ) 1 1 l size requirement: 81/2" x 11 ", to 24" x 36"
A
`t-ra pIA) Total Sign Area (sq. ft.): <' l i /f 1:1 / �`rot)7ert Fee (Permanent sign, any size)
AND D 1 Total Wall Area (sq ft I '''. P /p 111 $15.00 "Fee (Temporary sign, any type)
I 9 J
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N 0 W NE NW SE SW • Wall signs do not need to be drawn to scale,
Height to top of sign (feet): )` —I l but must include dimensions of wall face and
Projection From Wall (inches): sr; sign placement.
Copy: C AIt.SL (kw Qntn1 . Wall signs do not require site /plot plans.
Materials: Al,„,. p . Freestanding signs over 6 ft. required a
Will sign have illumination? -it Yes ❑ No building permit.
Type: .,[/] Internal ❑ External • If work authorized under a sign permit has not
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 (OVER FOR SIGNATURES)
I square footage must also be submitted.
t
APPLICANTS:
To consider an application complete, you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as described on the
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 with
written authorization from the owner or an agent of the owner. The owner(s) must sign this application in the space provided on the back
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.
S GNATURES of each owner of the subject property are required.
ham -Ia
Applic. t ignature Date
Signature of Owner /Agent Date
�c. 4 34PILS ‘P)r v- 215 -6G.G
Contact Person Name Phone No.
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 639 -4171 I www.tigard - or.gov I Page 2 of 2
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CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TIQAR.D
Receipt Number: 185582 - 02/21/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2012 -00008 Sign Permit 100 - 0000 -43115 $144.00
SGN2012 -00008 Sign Permit - LRP 100 - 0000 -43117 $21.00
Total: $165.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 1074 KPEERMAN 02/21/2012 $165.00
Payor: ADVANCED ELECTRIC SIGNS, INC.
Total Payments: $165.00
Balance Due: $0.00
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