SGN2001-00197 CITY OF TIGARD SIGN PERMIT
4i1A DEVELOPMENT SERVICES
PERMIT #: SGN2001 -00197
� 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED:' 10/23/2001
EXPIRATION DATE:
BUSINESS NAME: "SUMMERFIELD ASSOCIATES. LLC PARCEL: 2S110DC -0100
SIGN LOCATION: 11175 SW MEADOW BROOK DR OFFIC
APPLICANT /AGENT: ZONE: R -25
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
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PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 30" X 48"
TOTAL SIGN AREA: 10 sq. ft. •
. WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION:
DESCRIPTION OF SIGN: Placement of (1) one temporary A -frame sign. Sign must be placed on private
property and not in the public right -of -way. Date for sign 10/23/01 thru 11/23/01.
(Sign #2)
- MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
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This permit is issued subject to the regulations in the Tigard Municipal Code, State of OR. Specialty Codes
. and all other applicable laws. • • rk will be done in accordance with approved plans. A sign permit shall expire 90
days from approval date. A t= po .. Ty sign shall expire • days rom approval date. A balloon sign shall expire 10
nays from annroval daft?
APPROVED B _ � =` / -
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PERMITTEE SIGNATURE: , = —
DATE: 10/23/2001
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x �:r�, t , .;.,fa 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
FOR STAFF USE ONLY
Site (,//rn
Address/ Street Address I Permit No.: S ., fli I - CM Ct
Location 1 1 I ' Or(j
►-� Expiration Date:
Suite /Bldg. # City /State Zip
T; Dg-q ?2Z11 Receipt #: a� L d
Name � i Approved By: (
Property e. pp ��C4G I � D e. I 0 �O
Owner Mailing Address Suite Map/TL #: D...S 1110 D[ - O l en°
1.500 5 t) F∎ r5+ )&O Zoning: IC. ^ a5
City /State Zip Phone
"C?o■il _ SU3 (SYl .
/ Electrical Permit Required? , El Ills
Yes" ' o
Tenant or Name
F.,,,,4 10 � �ps
Business Building Permit Required? ❑ Yes to No
Name Rev. 30 -Jul -01 is \curpin \masters\revised\sipn permit app.doc
Sign
Contractor Mailing Address • Suite REQUIRED SUBMITTAL ELEMENTS
(Prior to permit (Note: applications will not be accepted
issuance, a • copy of all City/State Zip Phone without the required submittal elements)
licenses are
required if ❑ Completed Application Form
expired in the Oregon Const. 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)
size requirement: 81/2" x 11 ", or 11" x 17"
Proposed ❑ yermanent 'reestanding ❑ Freeway
Sign a Temporary ❑ 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: 81/2" x 11 °, to 24" x 36"
❑ New sign? ❑ Alter to existing sign? ❑ $50.00 Fee (Permanent sign, any size)
Sign Dimegs,�ori�:� �� (1
oo��UU $15.00 Fee (Temporary sign, any type)
Total Sign Ar,e�(sq. ft.):
((�) NOTES:
Sign Data Total Wall Area (sq. ft.) • Wall signs do not need to be drawn to scale,
g but must include dimensions of wall face and
. (Complete all Direction Wall Faces (circle one): sign placement.
items N S E W NE NW SE SW
emi this • Wall signs do not require site /plot plans.
section)
• Freestanding signs over 6 ft. required a
Height to top of sign (feet): 9 building permit.
Projection From Wall (inches): • If work authorized under a sign permit has not
Copy: been completed within ninety (90) days after
Materials: 1JJ0a the issuance of the permit, THE PERMIT WILL
BECOME NULL AND VOID.
Will sign have illumination? ❑ Yes No
Type: ❑ Internal ❑ External
Are there any existing freestanding or wall signs at this 1 Not all jurisdictions accept credit cards, please call jurisdiction for more information .
location, including wall signs that over p a tenant space? D Visa D MasterCard
Credit card number / /
❑ 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. $
Cardholder signature Amount
(OVER FOR SIGNATURES) \
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 day of (9(2■ 6A> , 2 0 0 I
Signature of Ow e r /Agent
jektobsi,ti- eZ - 5) 3 6,3y /891
Contact PersorPName Phone No.
° id W AULLJ Awirdae9.P L I 1 /4I /UU Y:<Y:Dq AAA •a...... ..V.•• I. - U.... w..w . A
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City Sign Company, Inc. ` kv--
E 'l i,i T > j { I Servtrtg the Portland Are 6 �) S(tce 1911
.;41.aI ,,* 304 S.E. Second Avenue 'el & _ ,
Portland, Oregon 97214 °A' '
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(503) 231 -3839 FAX (503) 231 -9511 rRQM; � �
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Thank you for your order. To serve you better, we are providing a sketch of the sign
work you want us to produce for you. Please check the specifications, layouts and
spellings to be sure they are the way you want them. Please Indicate your approval
below and return to us, The information contained herein is the exclusive property
of City Sign Company, Inc. and any disclosure, copying, distribution or the taking of
any action in reliance on the contents of this information I. strictly prohibited.
❑ APPROVED AS IS OR AS NOTED. Signature
In NO? APPROVED. MAKE CHANGES AS NOTED AND RESUEMIT.
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Receipt #: 27200100000000004217
�_.,. Date: 10/23/2001
TIDEMA -RK
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001 -00197 [SIGN] Temp Sign Perm 100 - 0000 - 437000 _ . $15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. - Amount Paid
Cash HSC 0 0 0 $15.00
TOTAL AMOUNT PAID: $15.00
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