SGN2012-00019 IN w.,
CITY OF TIGARD SIGN PERMIT
Permit #: SGN2012 -00019
COMMUNITY DEVELOPMENT Date Issued: 02/14/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S102AC00700
Jurisdiction: Tigard
Name of Business: Benjamin Moore
Business Address: 12540 SW MAIN ST 120
Applicant/Agent: Taylor, Joe
Work Description: Installation of one (1) permanent wall sign 3' 4" x 18'
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 3' 4" x 18'
Total Sign Area: 60
Wall Area: 1872
Wall Face (Direction): North
Sign Height: 20 ft.
Projection From Wall: 8 in.
Illumination:
Materials: Metal /Plastic
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: ))/AVLity .i£1
Permittee Signature: rht.9 a
RECEIVED
111 ,q City atrigard FEB 09 2012
c1
_,,
' Sign Permit Application
CITY OF TIGARD
‘,,,, 'AUVRIANNING/ENGINEERING,,IAJW., ,' ,bb
GENERAL INFORMATION
Name of DvrelopmenriPtoject.
FOR STAFF USE ONLY
Site
Address/ Street Address Permit No.: %0 9
Location 17..sot ,I. "AA1P li .
Approved
Suite/Bldg. # City/State Zip
"i 1 * A *Net. , 0 dt- ,/ 7 2- 3 Date: aleth 2--
Name Receipt #: t 65g I t f
l> o 1... n ,-4 (s'. , L. L C.. . Map/11.#: ,,2-5 WA MO? 01)
Property
Owner Mailing Address Suite Zoning: M („/ 6..L
Allowable Total Area: i5?P
City/StAte Zip Phone
r)2 r 1 o3
Toiii Ao% 0 ,oil. ' - 1 2 -2. 3
Electrical Permit Required? 1:2 0 No
Tenant or Name
Business ?;:a v....i4 5 A ,....4 1+ .0 to o it. e Building Permit Required? D Yes 6/ 21 V No
Name Rev. 7/1/11
iiictirpltAiriastc.rOdand star applicauiinsAsign permit app.doc
CA A Mit C. rT Sittv, Coe t 1• •
Sign
Contractor Mailing Address Suite
ql I M-at' ST.
City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
, ,, 3,
V A ti4 0 tA t.,0 . (oci& .404 3 (Note: applications will not he accepted
(,.. u t iki , (14 1 4 '
without the required submittal elements)
Oregon Const Conc. Board license # Exp. Date
0 Completed Application Form
Proposed Er Permanent El Freestanding Ell Freeway 0 2 copies of site/plot plan, drawn to scale
Sign D Temporary 0 Ruth' 0 Electronic (3 copies, if a building permit is required)
(Check all that
[3 Wall 0 Other
apply) size requirement: 81/2" a 11", or 11" a 17"
0 2 copies of elevations, drawn to scale
a New sign? 0 Alter to existing sign? (3 copies, if a building permit is required)
Sign Dimensions: , ... .... .. size requirement: 81/4" x 11", to 24" a 36"
Total Sign Area (sq. ft.): ( 0 rt , El $165.00 Fee (Permanent sign, any size)
Total Wall Area (sq. ft) 0 $52.00 Fee (Temporary sign, any type)
Sign Data i g 12..
(Cotnpkte all Direction Wall Faces (circle one):
Items in this NOTES:
section) (;) S E W NE NW SE SW
Height to top of sign (feet): 2 3, '..- b " )t • Wall signs do not need to be drawn to scale, but
Proection From Wall (inches): roust include dimensions of wall face and sign
j it "
placement.
Materials: 1 ...4 nei A k, ( Pt. 4,s. 1 I t....
• Wall signs do not require site/plot plans.
Will sign have illumination? 2--Yes 0 No • Freestanding signs over 6 ft. required a building
Type: a Internal 0 External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space?
0 Yes 13 No
(OVER FOR SIGNATURES)
If "yes", a list or diagram of all sign dimensions and square
footage must also be submitted.
City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503-718-2421 1 www.tigard-or.gov I Page 1 t[2
to— ..
APPLI
To consider ap application complete, you will need to submit ALL of the REOUIRED .__SUBMILLAi.,_..E.,LEMETS. as described the
front of this application in the "Required Submittal Elements" box.
NOTE: Person specified as "Applicant" shall he designated 'Permittee" and slialiproiride firiariciaiassurance for work.
t When the owner and the applicant are different people, the applicant Must We thePiirelia,ser, of reccir&or a lessee in possession with
written authori from the owner of:anagent of:the" owner. Th0.:pWiidt(s) sign thiSapplication in the space provided on the back
of ot submit 'a • authori2ationWith'thie'apPlitation
BY SIGNiNG BELOW, THE APPLICANT(S) SHALL CERTIFY TI-Lit:
• If the application is g,Irantecl, the applicant will exercise • the rights grantecl:Waccordatice,with the terms and
subject.to all the conditionISYandjimitations'of ,the.appttaVal.
• All of the above statements and the staternentS.I.4 the plot plan ittachinents'. and exhibit s- transmitted
herewith, are true, and the applicants so•.'aCkiloWle4e that any permit isstied,Ibasea on this application, and
may be revoked. if it. is found thdt any such stateMents, are fahc.
• The applicant has read the entire cpptents applicatibu, including the polidcs and criteria, and
understands the requirements for appedVing and denVing the application.
I hereby acknowledge that hate read this appiicatiit.;,-,that.the giNieri:isqorrt,i, that itun the
owner or authorized agent of the. owner,, and rlikir;OaOS': irroinpIiance with the City of Tigard:
SIGNATURES of eaen'Ownernfi,die§rifijOrAirutierry required.
v".'
Applicant Signature Date
I
Signature ofOwner/Agent S • , Date
• •
• '
Contact Person Name Phone No.
City of Tigard I 13125 SW Hall Blvd., Tigard;.,OR,97223 I 5O3-63 I, www.tigard-or.gov I Page 2 of 2
7 Y OF TIGARD
- Approved
the work as described in:
Rf.k,liT NO. WV •
Letter to: Follow I 1
Attach
e: 0 it [ aita)
CITY OF TIGARD RECEIPT
7,f--*4,,SZ4..:, 13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TiGA*
Receipt Number: 185494 - 02/09/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2012 -00019 Sign Permit 100-0000-43115 $144.00
SGN2012 -00019 Sign Permit - LRP 100 - 0000 -43117 S21 00
Total: $165.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 888386 STREAT 02/09/2012 $165.00
Payor: Dana M Taylor /Garrett Sign Co., Inc
Total Payments: S165.00
Balance Due: $0.00
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