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SGN2012-00112 CITY OF TIGARD SIGN PERMIT II . „. Permit #: SGN2012 -00112 COMMUNITY DEVELOPMENT Date Issued: 07/11/2012 TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 1S136DCO2504 Jurisdiction: TIGARD Name of Business: Tigard Triangle Smiles Dentistry Business Address: 7275 SW DARTMOUTH ST 180 Applicant/Agent: Ebrahimi, Anita Work Description: Temporary banner for dental office. Total square footage 24 square feet. Permanent: No Freestanding: No Freeway: No Temporary: 1 Wall: No Electronic: No Billboard: No Balloon: No Banner: Yes A- Board: No Sign Dimensions: Total Sign Area: 24 Wall Area: Wall Face (Direction): Sign Height: ft. Projection From Wall: in. Illumination: No Illumination Materials: Vinyl Electrical Permit Required: No Building Permit Required: No Total Permit Fee: $54.00 Conditions: This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will be done in accordance with approved plans. A permanent sign must be placed within 90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon sign shall expire 10 days from validity date. Approved By: OtLLM . a . Caz- • Permittee Signature: GK Q-ACL ' ' JUL /10 /2012 /TUE 12:51 PM P. 002 RECEIVED JUL 10 2012 . City of Tigard CITY OF b8N Sign Peet Application .. .► ;__ ■ - to .t_ _ , J. Name of Dm opmoat PxoJect _ .141(32)1A —crisettACK """' fit FOR STAFF USE ONLY Site ._ Address/ Street Addtoa p rmit No, 5 o I a ' CO I l 10� ocatien c5 1,1) �^M1' Apprgved By C.A�� . aii/smte ' ctl 7- I 0 i s k ~i;ncurAi D a t a; Name Receipt #; 167 4 8 4 – •—�— p n n o T C C r E t, s� S a S / G . M a p / ' I 7 #; 1 S 13(0 PC " c), - Property d Owner 1 6AN (.1d sotto tm (OCp Allowable Total rlraar N/ A ^'IP) • Ct / smug zip Phone • 1 OR 5n31 Electrical, Permit Required? ❑ Yes No Tenant ox { , � 4! � + Busaxtess d ei ` I i't v'" ` e f i e -s,mt 1 ,eS —14 Building Permit Required? ❑ Yes No N Roy, 7/1/11 • iAcuiphAnvot we ApplicationsVign. peanit app.doc Sign Contractor lQc•in St . Catf /Sate ZiP . - Phone BEQUIREI? SUBMITTAL ELEM$N"['S (Note: applications will pot be accepted t Y Conan Cons Bowl ti ease # Exp. Astc without the required submittal elements) • to. Completed Application. Form Proposed n Pe.,„„,nt [] Pracomedwg CI 1 - wa E 2 copies of site /plot plan, drawn to scale 5agn Tcmpa,:ty 0 Bad ❑ Eioctronic (3 copies, if a but7dtng permit is required) (cbt all that Well Other size requirement S%" x 11 ", as 11" x 17" °PI ❑ 2 copies of elevations, drawn to sole R New silo? n ,Alter to existing sign? (3 copies, if a building permit is required) Sign liaestaious: zA ^,�— size tequixeutettt 3 /a" z 11", to 24" x 36" Total Sign Area (sq. , ,.k:k. ❑ $165.00 Fee (Permanent sign, any size) Sign Data Total Wall.d.r (sq. ft) j $52.00 ' ezik oxary ssgu, a1 type) (connptate at Direction Wall Faces (circle one): 1 items ;n this NOTES; static!!) N S E W NE NW SE SW Height to top of sign (feet)! • Wall signs do not need to be drawn to scale, but 1?saject as Prom CGall (inches : . must include dimensions of wall face and sign Mater +411; placement. 1J�e$���t z,.. \ + Wall signs do not require site /plot plans. Will sign have illumination? ❑ Yet: 2 NO ♦ P xeestaading signs over 6 ft. 'requited a building Type: . 0 Internal ® External permit Are there any existing freestnuding or wall signs at this location, including wail signs that overlap a tenant space? 3Yes ❑ No If "yes ", a list or diagram of all sign dimensions and square (OiR FOR SIGNATURES) foots • must also be submitted. City of Tigard j 13I25 SW Hall Blvd., Tigard, OR 97223 ( 503- 718 -2421 1 www.tigard- or.gov J Page I of 2 JiL /10 /2012 /TUE 12:52 PM P. 003 A t PLIES! To consider an applicatioia complete, you will need to submit ALL o f the RE! I . 1 . iD ut V : ! j as described on the frost of this application in the "Required Submittal E ements" box. y NOT Person apecihed as "Applicant" shall be designated "Permhtee" and abaft 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 this application — - -- . -- BY SIGNING BELOW, TXE APPLICANTS) SHALL CERTIFY THAT: •1 If the application is granted, the applicant will exercise the rights granted in accordance with the terms and subject to all the conditions and limitadons of the approval. M All of the above statements and the statements in the plot plan, attachtneiats, and exhibits transmitted herewith, are true, and the applicants so acknowledge that any permit issued, based on this application, and may be revolved if it is found that any such statements are false, ' •1 The applicant has 'read the entire contents of the application, including the policies' and csateria, amid 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, . . _ Applican •ignatuse Date Signature of Owner /Agent • ' J Date Contact Person Name Phone No. City of Tigard f 13125 SW Hall Blvd., Tigard, OR 97223 I 503- 639 -4171 www- tigaxd- or.gov Page 2 of 2 1 CITY OF TIGARD RECEIPT C� . 13125 SW Hall Blvd., Tigard OR 97223 503.639.4171 TIGARD Receipt Number: 187484 - 07/10/2012 CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID SGN2012 -00112 Temporary Sign Permit 100 - 0000 -43115 $47.00 SGN2012 -00112 Temporary Sign Permit - LRP 100-0000-43117 $7.00 Total: $54.00 PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT Credit Card 083529 CCAINES 07/10/2012 $54.00 Payor: Anita Ebrahimi Total Payments: $54.00 Balance Due: $0.00 Page 1 of 1 Cheryl Caines From: Ebrahimi, Anita < ebrahimia @pacificdentalservices.com> Sent: Tuesday, July 10, 2012 2:36 PM To: Cheryl Caines Subject: RE: Tigard Triangle Smiles Dentistry- Temp Banner Permit Application I had asked the sign vendor to reduce it to 24 square feet. It should be no larger than 24 sq ft. He may have used one of his old template formats to make the artwork.... sorry. Anita Ebrahimi I De Novo Department et PACIFIC mr io #44 GESTAL 2860 Michelle Drive, 2nd Floor Irvine, California 92606 St: (714) 508 -3600 EXT: 2079 f L= : (714) 368 -2099 J: ebrahimia0pacden.com 1 P,www.pacificdentaiservices.com From: Cheryl Caines jmailto:chervlc©tigard- or.govl Sent: Tuesday, July 10, 2012 2:28 PM To: Ebrahimi, Anita Subject: RE: Tigard Triangle Smiles Dentistry- Temp Banner Permit Application Are the dimensions 15 x 3 as the rendering states? Cheryl From: Ebrahimi, Anita f mailto: ebrahimia @pacificdentalservices.coml Sent: Tuesday, July 10, 2012 2:23 PM To: Cheryl Caines Subject: RE: Tigard Triangle Smiles Dentistry- Temp Banner Permit Application Please see attached rendering. The banner will go on the storefront facade. Anita Ebrahimi l De Novo Department `'t PACIFIC generation 4,114 OrNiAL VtRVKAV 2860 Michelle Drive, 2nd Floor Irvine, California 92606 Sr: (714) 508 -3600 EXT: 2079 I 4.14: (714) 368 -2099 !EI:ebrahimia0pacden.com 1 : www .pa cificdenta1services.com From: Cheryl Caines f mailto:chervlc@ tigard- or.govj Sent: Tuesday, July 10, 2012 2 :12 PM To: Ebrahimi, Anita Subject: RE: Tigard Triangle Smiles Dentistry- Temp Banner Permit Application Hi Anita, Will you please also supply a sketch of the banner that shows dimensions? Will the banner be placed on the 72" side of the building or another elevation? Thanks, Cheryl From: Ebrahimi, Anita jmailto:ebrahimia@ pacificdentalservices.coml Sent: Tuesday, July 10, 2012 1:16 PM To: Cheryl Caines Subject: Re: Tigard Triangle Smiles Dentistry- Temp Banner Permit Application Importance: High Good Afternoon Cheryl; Attached please find copy of the Sign Permit Application for the temp banner associated with our dental office, Tigard Triangle Smiles Dentistry located at 7275 SW Dartmouth Street, Suite 180, Tigard, OR 97223. Additionally, I faxed the application along w /the Fax Cover Authorization Form to your attention earlier. Kindly please process the attached. Thank you in advance. Anita Ebrahimi De Novo Department e tax PACIFIC t :,o- a= rtor r i r 2860 Michelle Drive, 2nd Floor Irvine, California 92606 s ir: (714) 508 -3600 EXT: 2079 i 4]: (714) 368 -2099 �:ebrahimia0pacden.com I :www.pacificdentalservices.com, DISCLAIMER' E -mails sent or received by City of Tigard employees are subject to public record laws. If requested, e -mail may be disclosed to another party unless exempt from disclosure under Oregon Public Records Law. E -mails are retained by the City of Tigard in compliance with the Oregon Administrative Rules "City General Records Retention Schedule." 2 */� TIGARD TRIANGLE SMILES et r DENTISTRY 4'� Patients �s f �C' ti C1 d € § k <p� t o,. Cleaning, Exam & *� Digital X- Rays' x' 503 620 . 2319 TigardTriangleSmiles.com b 4v∎ v lCr -- n o ✓.^ a "<- - 41/14 .2k4 S c o _ -Pi • JUL /10 /2012 /TUE 12:52 PM P. 004 g ffl p . f . P 1 H illill IlL, • 1 . ail Illllllf111i11 III — :• 1 J1 111 ,11111111111111• 111. . E 1 �/ ill 1111.11 111111 111" I'': HI i { 111111 li II ;i 1 li I II . �_... ....... . I . i,l l 13 : :1 ...111.i. 1.. � L..._. R 1 Ii 1 I I! 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