SGN2001-00176 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2001 -00176
I- ' 13125 SW Hall Blvd., Tigard, O R 97223 (503) 639 -4171 DATE ISSUED: 9/28/2001
EXPIRATION DATE:
BUSINESS NAME: MOUNTAIN PACIFIC MACHINERY
SIGN LOCATION: 11705 SW 68TH AVE PARCEL: 1 S136DD -0260
APPLICANT /AGENT: ZONE:
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 41" X 28" RECOPY
TOTAL SIGN AREA: 8 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of (1) one temporary A -frame sign. Sign shall not be placed in public
right -of -way or visual clearance area. Sign #2 (Valid 9/29/01 to 10/29/01)
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 , sr will be done in accordance with approved plans. A sign permit shall expire 90
days from approval date. Ate • ora sign shall expire 30 • ays from approval date. A balloon sign shall expire 10
riavc fmm annmval riata
APPROVED BY:
PERMITTEE SIGNATURE: Q,Q'4`3 1 1 1 M
DATE: 9/28/2001 1
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4„1,l� 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/Prot
' FOR STAFF USE ONLY
Site ACUR7A/441 ` �/ 1 ;�
Address/ Street Address C ermit No.:5(- Oad 0. I •
Location //70 6 S 6 10 '/ II • '
Expiration Date: 01 0 a-• ,
Suite /Bldg. # Ci / tate Zip
aQ ei7aa5 Receipt #: pt); /,
Name Approved By:
// --11 Date: ! C3-- b f
Property (� �/YEU.: i�.r�
Owner a iling Address ' Suite Map/TL #: - b D -
/ 2 926 ��c�tia4 �cp,10 g:
Zon in
•
_CO/State fn� � Ziip Phone G
02. ` 2 35 S 6,Z ; 0 7 Electrical Permit Required? ❑ Yes [ o
Tenant or N e
Business , / C� wAL Building Permit Required? ❑ Yes No
Name Rev. 30 -Jul -01 is \curpin\masters\revised\sign permit app.doc
Sign C
Contractor Mailing ddress Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit i 51 (0.7 (Note: applications will not be accepted
issuance, a C� 7�` w th requ su elements)
copy of all City /State Zip Phone
licenses are
required if �
ve iaa 153 ayv7 09 ❑ Completed Application Form
expired in the Or n C onst. Cont. Board Exp. Date
City of Tigard's License # ❑ 2 Copies of Site /Plot Plan, Drawn to Scale
database) (3 copies, if a building permit is required)
Proposed ❑ permanent Freestanding ❑ size requirement: 81/2" x 11 ", or 11" x 17"
Freeway
Sign emporary ❑ Wall ❑ Electronic ❑ 2 copies of elevations, drawn to scale
(Check all that Other ❑ Billboard ❑ Balloon (3 copies, if a building permit is required)
apply) size requirement: 8 x 11', to 24" x 36"
❑ New sign? ❑ Alter to existing sign? ❑ $50.00 Fee (Permanent sign, any size)
Sign Dimensions: /t
!y ! Jr e42s ❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.):
I^ NOTES:
Sign Data Total Wall Area (sq. ft.) • Wall signs do not need to be drawn to scale,
9 but must include dimensions of wall face and
(Complete all Direction Wall Faces (circle one): sign placement.
items in this • Wall signs do not require site /plot plans.
_section)__- _ - _ N---S E W —NE- NW-- SE -_ -. — •_
• Freestanding signs over 6 ft. iequired a —
Height to top of sign (feet): 3 ( building permit.
Projection From Wall (inches): • If work authorized under a sign permit has not
Copy: been completed within ninety (90) days after
Materials: • the issuance of the permit, THE PERMIT WILL
• Will sign have illumination? Yes No -
BECOME NULL AND VOID.
Type: ❑ Internal External /
Are there any existing freestanding or wall signs at this / Not all jurisdictions accept credit cards, please call jurisdiction for more information.
0 location, including wall signs that overlap a tenant space? Visa MasterCard
Credit card number 1 /
❑ Yes ❑ No - Expires
If "yes ", a list or diagram of all sign dimensions and Name of cardholder as shown on credit card
square footage must also be submitted. S
Cardholder signature Amount
(OVER FOR SIGNATURES) . •
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 ; 20
Signature,of.Owner /At, -nt \ .
Contact Person Name �; Phone No
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Receipt #: 27200100000000003934
_...0°,. Receipt
09/28/2001
T I D E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001 -00176 [SIGN] Temp Sign Perm 100- 0000 - 437000 $15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check MOUNTAIN PACIFIC MACHINERY, INC. 0 0 5709 $15.00
TOTAL AMOUNT PAID: $15.00