SGN2001-00231 •
CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT #: SGN2001 -00231
- • - 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 DATE ISSUED: 11/30/01
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
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 11/30/01 thru 12/30/01.
(Sign #3)
MATERIALS: WOOD
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: '
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 work will be done in accordance with approved plans. A sign permit shall expire 90
days from approval date. A temporary sign pire 30 days from approval date. A balloon sign shall expire 10
rlavc fmm annrnval rlatP
APPROVED BY:
PERMITTEE SIGNATURE:
DATE: 11/30/01
e
<r, /v . 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 c t/M1Y�t. S C7 J Z� 2..3 tl (J cm � f
Address/ Street Address Permit No.:
Location ) ` 015 51,0 ri ) ) L A Expiration Date:
Suite /Bldg. # City /State Zip `
# : f� �
Name �+a���) De 474.2i/ Receipt Approved By: l
y �fL
Property � 4 • p Cy / C1 _ _ Date: By; /
Owner Mailing Address Suite I Map/TL #: 17- 5110 DC-6 i (kr?
/
`^^T'' �� OSwi rd - / /020 Zoning:
t- City/Stat Zip Phone /�/
J 4 ' T 720) 03 "I - 4_ Electrical Permit Required? 0 Yes El—Mr
,
Tenant or Name
Business Building Permit Required? ❑ Yes No
Name Rev. 30 -Jul -01 i:\curpin \masters \revised\sign 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)
Proposed ❑ ermanen ❑ g ❑ size requirement: 8 x 11 ", or 11" x 17"
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: 81h" x 11 ", to 24" x 36"
❑ New sign? ❑ Alter to existing sign? ❑ $50.00 Fee (Permanent sign, any size)
Sign Dimensions:
❑ $15.00 Fee (Temporary sign, any type)
Total Sign Area (sq. ft.):
NOTES:
Sign Data Total Wall Area (sq. ft.) • Wall signs do not need to be drawn to scale,
but must include dimensions of wall face and
. (Complete all Direction Wall Faces (circle one): sign placement.
items in this
section) N S E W NE NW SE SW • Wall signs do not require site /plot plans.
• Freestanding signs over 6 ft. required a
Height to top of sign (feet): _ 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.
location, including wall signs that overlap a tenant space? visa ❑ 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 , 20
7 0{-eti 12 --- 1
Sign'a ure of y ft i ner /Agent
3 6sr-/--,/ • 2/
Contact P Name Phone No.
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Portland, Oregon 97214 a "
(503) 231 -3839 FAX (503) 231 -9511 FROM,
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Call 654- 1891111
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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. Pleas. 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 Is strictly prohibited. -,
O APPROVED AS IS OR AS NOTED. Signature
Q NO1' APPROVED. MAKE CHANGES AS NOTED AND RESUBMIT.
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r Recei p t #.- 27200100000000004694 '
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_,...�' Date: 11/30/2001 .
T= I.DE MA,;R K
CO SYST INC.
Line Items :'
Case No Tran Code Description Revenue Account. No - Amount Due
SGN2001 -00231 [SIGNS Temp Sign Perm 100-0000-437000 $15.00 •
P -
Method Payer - Bank No Acct Check. No Confirm No. _ Amount Paid
Cash - •' SUMMERFIELD APARTMENTS J $15.00
TOTAL AMOUNT PAID: $15:00
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