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SGN2012-00075 Ip CITY OF TIGARD SIGN PERMIT > Permit #: SGN2012 -00075 COMMUNITY DEVELOPMENT Date Issued: 5-10- a TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 1S135BD01200 Jurisdiction: Tigard Name of Business: Vern Fonk Business Address: 9804 SW SHADY LN Applicant/Agent: Berry Neon Signs, Work Description: New wall sign for tenant space. Permanent: Yes Freestanding: No Freeway: No Temporary: Wall: Yes Electronic: Yes Billboard: No Balloon: No Banner: No A- Board: No Sign Dimensions: 30" x 224" Total Sign Area: 46.6 Wall Area: 784 Wall Face (Direction): North Sign Height: ft. Projection From Wall: in. Illumination: Internal Materials: vinyl /lexan Electrical Permit Required: Yes Building Permit Required: No Total Permit Fee: $165.00 Conditions: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. A permanent sign must be placed within 90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon sign shall expire 10 days from validity date. Approved By: NV4 (J� Permittee Signature: �j'� !r✓ta w 1' II NI City of Tigard Sign Permit Application TIGARD GENERAL INFORMATION Nare of Development /Project Site li I n J r' , �/� FOR STAFF USE ONLY tittl 4 !,� -t -' b vast to i — Permit No.: N 5 l� Address/ Street Address a U a 00 d 7.S Location '� tz caL ! f J { t 4 Approved By: Suite /Bldg. # Ci State 4.ip l` Ylad I 71'73 Date: 5 -l0 - 1a Name Receipt #: /4 9 Property ' 011/1 1 1. "L — Map /TL #: 1 5I 35 13 � t 1) - ()I.:2 O p Owner � M u Mailing Address / Suite Zoning: M / C L� `� ��`�,` � " ��iA Allowable Total Area: /5%0 City /State Zip Phone (i lj (d I) Zi ne (7 ` 2 Z 3 Electrical Permit Required? 0 Yes ❑ No Tenant or Name Business 'fig-'1A ti,k, Building Permit Required? ❑ Yes g .No Name Rev. 7/1/11 ` C � is \curpin \ masters \land use applications \ sign permit app.doc Sign VAIN 1 A All - 110,D. -- -- — Contractor Mailing Address' Lai \ S p i_.,-Auc, City /State Zip ' Phone REQUIRED SUBMITTAL ELEMENTS Y a ltP L “1? i f� 1 �b .t) j 3,.. 7 3 (Note: applications will not be accepted egon onst. Cont. Board L # Exp. Date without the required submittal elements) 1 ❑ Completed Application Form ❑ Permanent ❑ Freestanding ❑ Proposed Freeway ❑ 2 copies of site /plot plan, drawn to scale Sign ❑ Temporary ❑ Roof ❑ Electronic (3 copies, if a building permit is required) (Check all that apply) Wall ❑ Other size requirement: 81/2” x 11 ", or 11" x 17" ❑ 2 copies of elevations, drawn to scale `� New sign? ❑ Alter to existing sign? (3 copies, if a building permit is required) Sign Dimensions: . ;7yt, size requirement: 81/2" x 11 ", to 24" x 36" Total Sign Area (sq. ft.): Lito,ta:,�( i ❑ $165.00 Fee (Permanent sign, any size) Total Wa Area (sq. ft.) ❑ $52.00 Fee (Temporary sign, any type) 0. Sign Data 1 l to _ /J (Complete all Direc i n all Fa , . (circle one): items in this NOTES: section) 9 S E NE NW SE SW Height to top of sign (feet): • Wall signs do not need to be drawn to scale, but Projection From Wall (inches): must include dimensions of wall face and sign placement. Materials: +e • Wall signs do not require site /plot plans. Will sign have illumination? .Yes ❑ No ♦ Freestanding signs over 6 ft. required a building Type: ,..1 Internal p External permit. Are there any existing freestan ding or wall signs at this location, including wall signs that oyerlap a tenant space? Yes [ No �� (OVER FOR SIGNATURES) If "yes ", a list or diagram of all sign dimensions and square footage must also be submitted. City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 718 -2421 I www.tigard - or.gov I Page I of 2 APPLICANTS: To consider an application complete, you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as described on the front of this application in the "Required Submittal Elements" box. NOTE: Person specified as "Applicant" shall be designated "Permittee" and shall provide financial assurance for work. * When the owner and the applicant are different people, the applicant must be the purchaser of record or a lessee in possession with written authorization from the owner or an agent of the owner. The owner(s) must sign this application in the space provided on the back of this form or submit a written authorization with this application BY SIGNING BELOW, THE APPLICANT(S) SHALL CERTIFY THAT: ♦ If the application is granted, the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitations of the approval. ♦ All of the above statements and the statements in the plot plan, attachments, and exhibits transmitted herewith, are true, and the applicants so acknowledge that any permit issued, based on this application, and may be revoked if it is found that any such statements are false. ♦ The applicant has read the entire contents of the application, including the policies and criteria, and understands the requirements for approving and denying the application. 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. SIGNATURES of each owner of the subject property are required. plicant Signature Date Signature of Owner /Agent Date . 1'71- k- fzs -77u Contact Person Name Phone No. City of Tigard I 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 639 -4171 I www.tigard - or.gov I Page 2 of 2 rn CITY OF TIGARD RECEIPT it 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 186669 - 05/10/2012 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SGN2012 -00075 Sign Permit 100 - 0000 -43115 $144.00 SGN2012 -00075 Sign Permit - LRP 100-0000-43117 $21.00 Total: $165.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 04534D CCAINES 05/10/2012 $165.00 Payor: Ronald Jacobs Total Payments: $165.00 Balance Due: $0.00 Page 1 of 1 tieograptnc Intormation Systems - Washington County, Oregon http: // washims. co. washington.or.us / GIS /index.cfin ?id= 20 &sid= 3 &IDV... o V .f Y oo Geographic Information Systems ° �. 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Need assistance with this page? email us 1 of 1 5/4/2012 10:30 AN CONSTRUCTION & MOUNTING DETAIL Minimum 2 on 6'on center 3/8 "all thread thru bolted with 2 "x 2"L-Iron back if metal studs or Minimum 2 on 6' on center 3/8" rated expansion bolts onto concrete or Minimum 2 on 6'on center 3/8" lag bolt thru L -Iron to wood structural member or Minimum 2 on 6'on center 3/8 "x 6 "toggle bolts 11VM A 11V/V1 Raceway °I\ Flat Wall Routed Face backed with polycarbonate 7400 Hardeson Rd Everett, WA 98203 (425) 776.8835 BERRY NEON Fax (425) 774.8221 S I G N S Y S T E M S newpermits @benyneonsigns.co , L 224" E (18'- 8 ") 30" INSURANCE ( 6 ") V E R N F 0 N I( 1 4 503-620-0230 "VERN FONIC'= 18 1/2" COPY;"INSURANCE "= 10 1/8" COPY; PHONE NUMBER = 6 1/2" COPY ) (i� ,. .i, Li t _ ... ONE OF 1WO S/F INTERNALLY ILLUMINATED SIGNS (Aj f'(— ci fi i� ALL #230 -33 RED & #230 -12 BLACK VINYL ON WHITE LEXAN FACES AS SHOWN = SIGN FRAME PAINTED SATIN BLACK tl LP Lf , .-•c.f v ...1- --- -_, . 4 ,,,., et/ws--... .. li '''' ,.i, irSi 9,1\ c ol ek,- s RTLA in IN SURANCE . RN FONK INSURANC J F Om:: , CiEL CO. ' VERN FONK <so3-b�o 0 :30 . � a` R � _ r � t : _, 1 l _. _ _ - j ' ';_ _ i II i i FOHIC ■ W ' - _ 3 NORTH PHOTO ELEVATION SCALE: ±1/8"= 1'- 0" WEST PHOTO ELEVATION SCALE: ±1/8"= 1'- 0" ALSO SHOWN: DOOR GLASS VINYL CITY OF TIGARD Approved H C,onditionally Approved For only the wo�karls descr i n k S P ERMIT NO. )) O [ l See Letter to: Follow A wv 4 T" 3 ..5%i4d� "[LI Job Address: By: o c _ l o y . C �, Date: 0 Job Name: VERN FONK INSURANCE Scale: 1 "= 1'- 0" (OR AS NOTED) Designer: MARTY JOHNSON © Berry Neon Sign Systems, Inc. All Rights Reserved ❑ APPROVED AS IS ❑ APPROVED W/ CHANGES AS MARKED Site Address: 9804 SW SHADY LN TIGARD OREGON Date: 4 / 25 1 2012 Rev. Unauthorized use, reproduction, and or display shall render the infringer CLIENT APPROVAL: SIGNATURE BERRY Sates Rep: RON JACOBS Design No. 042512VERNFONK File Name: VERNTIG3.SCV liable for up to $150,000 in Statutory Damages, plus attorneys fees and costs, SIGN SYSTEMS NOTE: If this file has been emailed or faxed it may be out of scale. NOTE: This Color Drawing is a simulation of the proposed colors and should be verified with actual materials. for each infringement, under the U.S. Copyright Act [17 U.S.C. 412 E 504] DATE APPROVED: Office /Deliveries: 7400 Hardeson Road, Everett, WA 98203 5) (425) 776 -8835 m (800) 488 -2430 al Fax: (425) 774-8221 Ea E -Mail: info @Berryneonsigns.com