SGN2001-00171 C ITY OF TIGARD SIGN PERMIT
4,k DEVELOPMENT SERVICES PERMIT #: SGN2001 -00171
- -' 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 9/17/01
EXPIRATION DATE:
BUSINESS NAME: H & R BLOCK PARCEL: 1S126C0 -0010(
SIGN LOCATION: 09225 SW HALL BLVD D
APPLICANT /AGENT: ZONE:
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 2' X 11.16'
TOTAL SIGN AREA: 22 sq. ft.
WALL AREA: 793 sq. ft.
WALL FACE (DIRECTION): E
SIGN HEIGHT: 15 ft.
PROJECTION FROM WALL: 13 in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Installation of (1) one 22.32 sq ft permanent wall sign.
MATERIALS: ACRYLIC /ALUM
EXISTING SIGNS:
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 be done in accordance with approved plans. A sign permit shall expire 90
days from approval date. A temporary sign s -xpire 30 days from approval date. A balloon sign shall expire 10
days from annmval data Sir
APPROVED BY:
PERMITTEE SIGNATURE: \ wa
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DATE: 9/17/01
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- l'i 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 /t"47 /4L FOR STAFF USE ONLY
Address! Street Address
Location £ eg. Permit No.: L 5 C5 /1/ 2 c)`) I - 0 0 ) -- 1 # City/SS tate Zip
D 7i6-472-6 , 97 z 2_3 Expiration Date: 1 •
Name Receipt #: �' J -�•
Property • Approved By:
/
Owner Mailing Address Suite Date: 17 6 o
Map/TL #: I S i t- �i c) - 00 i t ) J
City/State Zip Phone • - -- Zoning: -- ...- -._ ./� ` 3
Tenant or Name
Business f ;� u Electrical Permit Required? [$. Yes ❑ No
�'
Name Building Permit Required? ❑ Yes ❑ No
Sign / 'G� � �
Rev. 12/1/2000 i:�curpin\masters\revised\sign permit app.doc
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Contractor Mailing Address Suite -
(Prior to permit / =
issuance, a 730 6W �sv N
7 .! a :4i -.. - . ���.._e
copy of all City State . Zip Phone T REQUIRED SUBMITTAL ELEMENTS
required if 1 C l�
licenses are . 9722-3 6zo g2� - (Note: applications will not be accepted
expired in the Oregon Cons 6 Cont. Board Exp. Date without the required submittal elements)
City of Tigard's License # / r fO (, / - / _ 3 � Z) 3
database) [o 'C �(
❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway
Sign ❑ Temporary ail EhEiectronic ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
(Check all that ' 1-1 El Billbo (3 copies, if a building permit is required)
Other
apply) size requirement: 8' /2" x 11". or 11" x 17
New sign? ❑ Alter to existing sign? ❑ 2 copies of elevations, drawn to scale
Sign Dimensions: (3 copies, if a building permit is required)
Z i h k ii, i( w size requirement: 81/2" x 11 ", to 24" x 36"
Total Sign Area (sq. ft.):
2:2-. 2:2-. 3 2 .F -r ❑ $50.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area (sq. ft.) ( le 5" sq � ❑ $15.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one): 1
items in this ���
section) N S LO Y" NE NW SE SW NOTES:
• Wall signs do not need to be drawn to scale,
Height to top of sign (feet):. I z— but must include dimensions of wall face and
Projection From Wall (inches): 13 14 sign placement.
Copy: • Wall signs do not require site /plot plans.
Materials: 4-6)1, 041: ? Aim • • Freestanding signs over 6 ft. required a
.
Will sign have illumination? a�es 1=1 No building permit.
• If work authorized under a sign permit has not
Type: gTernal ID External 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 4
LOVER FOR SIGNATURES)
If "yes ", a list or diagram of all sign dimensions and
square footage must also be submitted.
J
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 / 1 day of 20 •
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Appftwerl [)‹.
Condao(fT4ly Approved •
F c.mly the wog: as descri*sel•
PERMIT NO. C7.4 2,-% / 0 / 7/
Lega;r to Follow
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Receipt #: 27200100000000003765
c �. Date: 09/17/2001
TO SYSTEMS, �/
CMPUUTE TEMMS. NC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
ELC2001 -00459 [TAX] 8% State Tax 100 - 0000 - 207020 $12.82
ELC2001 -00459 [ELPRMT] ELC Permit 220 - 0000 - 431510 $160.20
SGN2001 -00170 [SIGN] Sign Permit 100- 0000 - 437000 $50.00
SGN2001 -00171 [SIGN] Sign Permit 100- 0000 - 437000 $50.00
SGN2001 -00172 [SIGN] Sign Permit 100- 0000 - 437000 $50.00
Payments:
Method. Payer Bank No Acct Check No Confirm No Amount Paid
Check MEYER SIGN SO OF OREGON INC 0 4022 $323.02
TOTAL AMOUNT PAID: $323.02
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