SGN2001-00217 CITY OF TIGARD
Mt DEVELOPMENT SERVICES PERMIT #: SGN2001 -00217
SIGN PERMIT
13125 SW Hall Blvd., Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 11/20/2001
41
EXPIRATION DATE:
BUSINESS NAME: SENIOR BENEFITS GROUP PARCEL: 2S110AC -0110
SIGN LOCATION: 11300 SW BULL MOUNTAIN RD
APPLICANT /AGENT: ZONE: C -G
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: (2) 4' X 6'
TOTAL SIGN AREA: 48 sq. ft.
WALL AREA: sq. ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 6 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Installation of (1) one 6 ft permanent freestanding sign. Total of faces 45 sq ft.
MATERIALS: WOOD
EXISTING SIGNS:
ELECTRICAL PERMIT REQUIRED: N
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 d• - - • - - ccordance with approved plans. A sign permit shall expire 90
days from approval date. A temporary sign s e 30 days from approval date. A balloon sign shall expire 10
Hays from annmval /lath
APPROVED BY:
PERMITTEE SIGNATURE: C■ G
DATE: 11/20/2001 J
wjpt, ^:l.z SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 FAX: (503) 684 -7297
GENERAL INFORMATION
�� of Development/Project
FOR STAFF USE ONLY
Site Ve Address ��� i1 (c i � J
Address/ Street Address -) Permit No.: C N �O — i J� 7
I
Location / / 30d �-�/ / H75-1 Expiration Date:
Suite /Bldg. # City/State Zip
ra� d_ 972.2 9 Receipt #: Z �O� gy!J p/
9
Name Approved By: '
Property On n C /C� ark k r� Date: 4 f `�
Ld a
Owner Mailing Address Suite Map/TL #: S/ I 0 F' Z - 6 /I (3- l06 5 S PO C l �� Zoning: Cc
Cityf to Zip Pho
Y f wdB� oe 97) y 505-745-01P/ .
Electrical Permit Required? ❑ Yes ] No
Tenant or Name
r €n /I` �r L Building Permit Required? ❑ Yes No
Business v 7 ne U 6r O
Name 6;-41844) Rev: 30 -Jul -01 i:lcurpinUnastersUevised\sign permit app.doc
Sign �: i t✓0r &
Contractor Mailing Address • Suite O REQUIRED SUBMITTAL ELEMENTS
(Prior to permit / i 3 60 SN) Su // M.61 (Note: applications will not be accepted
issuance, a without the required submittal elements)
copy of all City/State Zip Phone _
required are T . _ �( p 6 70' �/S
required it g ( ( J�f"`" _ � Sd5-4.3 ❑ Completed Application Form
or
expired in the QA 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 � ermanent Freestanding ❑ Freeway
Sign ❑ 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: 8 x 11 ", to 24" x 36"
gNew sign? ❑ Alter to e isting sign? ❑ $50.00 Fee (Permanent sign, any size)
sieln
Sign Dimensions: ; '' f ❑ $15.00 Fee (Temporary sign, any type)
g t� � l�' � � •::iii %' �,71�/� ( P tY Y tYP
1 �� � _ �, . i ,iii:. :: - - _
Total Sign Area (sq. ft.): . 07 J / �S , / NOTES:
Sign Data Total Wall Area (sq. ft.) �4l 6, 1/ X / (7 / • • Wall signs do not need to be drawn to scale,
0 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) S . E W NE NW SE SW • Freestanding signs over 6 ft. required a
Height to top of sign (feet): 5/ ) 1 y building permit.
Projection From Wall (inches): • If work authorized under a sign permit has not
Copy: Seim sf''e'r"4tG w Pk. been completed within ninety (90) days after
Materials: 1 /Zp 1 yWed p & Ii S its it* IL �S the issuance of the permit, THE PERMIT WILL
U BECOME NULL AND VOID.
Will sign have illumination? ❑ Yes ;No
Type: ❑ Internal ❑ External
Are there any existing freestanding or wall signs at this ( all jurisdictions accept credit cards, please call jurisdiction for more information.
0 Visa ❑ MasterCard
location, including wall signs that overlap a tenant space? 1
Credit card number
❑ Yes NO Expires
if "yes ", a list or diagram of all sign dimensions and Name of cardholder as sho n 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 r() day of �/1/M4// , 20 0
6 atureofO Agent
S � 503 -47& 7 V
Contact Person Name Phone No.
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-...4. 1. t . . ' iu : ir_ - ei.r . ' .. • . - ' - _. Information on this map is for general location only and
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..'' ,i'' ,.,th ' ::■ ' --. should be verified with the Development Services Division.
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' e e - - - ..;,- .0- .."' ---"--- -i . -- - . , _441 13125 SW Hall Blvd
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,,,.._ ,...1 Tigard, OR 97223
(503) 639-4171
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Community Development Plot date: Nov 19, 2001; CAmagic\MAGICO3.APR
Receipt #: 27200100000000004579
Date: 11/20/2001
- TIDEMARK •
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001 -00217 [SIGN] Sign Permit 100- 0000 - 437000 $50.00
SGN2001 -00218 [SIGN] Sign Permit 100 - 0000 - 437000 $50.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check SENIOR BENEWFITS GROUP 0 3041 $100.00
TOTAL AMOUNT PAID: $100.00
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