SGN2012-00135 CITY OF TIGARD SIGN PERMIT
■ Permit #: SGN2012 -00135
COMMUNITY DEVELOPMENT Date Issued: 09/04/2012
TIGARD 13125 SW Hall Blvd., Tigard OR 97223 503.718.2421 Parcel: 2S101AB90121
Jurisdiction: Tigard
Name of Business: Great Smiles
Business Address: 12017 SW 70TH AVE
Applicant/Agent: Hayes, Lisa
Work Description: Install one new wall sign for dental office.
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A- Board: No
Sign Dimensions: 41" x 136"
Total Sign Area: 38.72
Wall Area: 4206
Wall Face (Direction): North
Sign Height: ft.
Projection From Wall: in.
Illumination: No Illumination
Materials: acrylic
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $171.00
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: .eq a • CC42,,—
Permittee Signature.
05/31/2012 15:09 F.AX a 0003/ 0006
PROM : PHONE NO. : 503 244 7753 Aug. a 02 01:49PM P2
ECEI
City of 'Tigard SEP 0 4 2012
`-� OF TIGARp
Sign P erm� t Application IiNC IENGINEEFt ING
GPNERAr. IN ORMA '. ON
Naar otDeveJvairnt/Pia)tcr FOR S� STAFF USE (}NI Y
Site N, e. iL - Gre eJZ-
Addsess/ Save Addam pctmit NC.: G N < c)04.)-00 13 5
.... . Location 1 'a C� 1 rl S O ff ` t� ✓e. Approved By; C • CR .e,✓l -h
Saa1811g . cry /were LP
a f LA Cl l 2,1 Date: al — Li —t e.
Nmuc Receipt Ai: 1 B b .
Property 6 (N1 - LL- ; asly ch id
`3` Ow= Ivitirenddress 3#14c Zoii JV1 u E
0-011 S ,a lot,. ltnotaable Total A - I 4 _
Crewe tie,
Teasel or J Electric' Permit Requiced? [] Yes q. No
Business �e Q4 5YY) t \f, I t Building Pesach Required? ❑ Yes No
Co>nuacxor ad&e L 1
iST 4 j(
Ckr /srwe 2p Pe,00e REOLIRED SCiRR1141TTAL Rd,RAi3?NTS
, i /ts p (Note: applications will ass be accepted
• w ithout the requited submittal elexmts
. . ..... Co unt. Coot Bond sae a Pap. t� rt4 )
IS. 77$7_ li 1 /1q 0 Completed Application Form
Proposed ersin .a 0 ParrWwdmi ❑ 9ea•n.ey ❑ 2 copies of site /pbt plan, drawn to scale
Sigh Trevonty ❑ Roof E} Eldon (3 copJes, if a un
Peck at that oa El clip:: acquirement Pe a it is I I " or 11" required) "
WPi:)
❑ 2 copies of r:levarions, drawn to scale
ra New sign? ❑ Alter to eaistirg sign? (3 copies, if a. hating permit is regixixed)
S i g n Dimensions: u) i) h . X I � y 1 0 i t Wki{ size c e q u u t t b t oo t t 13 x 11 ", to 24"x36"
TAI 5i$° Area (sq. ft.): $ 1? ❑ $171.00 Fee (Pe:ioane t sign, any sire) .
Sign Data T Will i t fsc ) :.a, i ❑ $54.00 Fee (Temporary sigo, any type)
(ctortsiete al Direction Wall (circle one):
isztra is+lass .N
seat,) N S E6D NE NW SE SW
Height to top of sign (feet): 34 0, • Walt signs do not need to be drawn to scale, but
Projection Flom Will Cuxhes): amour include di'mtaaio»s of wall face and sign
placement.
• Adaterialx IV-n.0 ■c, • Wan signs do nor require aite/pice pl.
, WM sign have u& [{ Yes No • Freestanding signs over 6 !t_ required a building .
Type: ❑ Iaterna) ❑ External pent.
Are ti ne any existing freestanding or all signs at this Location,
including -wall signs tine • a tenant space?
•
•A Yes ❑ No
' If "yes", a list or diagram of all sign dimensions and square (OVER FOR SIGNATURES)
FS)
. foe mast also be tabrniized. w
City of Tigard I 13125 SW gall Blvd., Tigard, OR 9723 I 303.718 -2421 j www.tigard- ar_gov I Page 1 01.2 '
,
08/31/2012 15:10 FAX Z 0004 /0006
FROM : PHONE NO. : 503 244 7753 Aug. 30 2012 01: 5091 P3
APPLICANTS;
To Confider an application tompkto, yen 't %* naafi t4 enbmit ALL of et• maaltraaD LMatFI A.. EuagE 2 su+ tielitTaled ca the
front of this applicadua in the "Rocwire4 Subauitul Elements" box.
NOTE: Person specified as "Applicant" shag be designated "Permittee" and shall protide fxnaucial mum= fur work
* When the owner and the app6eanr are cliff=ent people, the applicant must he the purchaser of record or a lessee is possession with
of the tenet thin estioa ire the a& of
�oratsea authorization from the (AMU at WI agues owner. The owner(e) scgn spph �'e provided om the h
ens form or submit a writhe authorization with this applkerion
BY SIGNING BELOW, THE APFLICANT(S) SEAALL CERTIFY THAT
• U the application is granted, the applicant will exescise the rights granted in accordance with the terms and
subject to all the condi and limitations of the approval.
• Ali of the above statements and the statements in the plot plan, att 1 enta, and exhibits tmnsmirtxxl
herewith, are true, and the applicants so aclsowlec ;e that any permit issued, based on this application, and
ma.y be revoked if it is far nd that any such statetnerrts are false.
• The applicant has read the entire contents of t :he application, including the policies and criteria, and
understands the requirements for approving and denying the application.
I hereby acialowiedge that I have read this application, that the itrforesataou given is correct, that I am the
owner or authorized agent of the owner, and that plaits *ubmitted are in conapbaace with the City of Tigard..
SIGNATURES of cacti owner of the subject property are required.
deg 1
g,T
:.. atnt,Signatur Date
03111
of Owner/ ' -• Date
ContactPerson Name Phone No.
•
•
City of Tim I 13125 SW Hall Blvd., Tigard, OR 97225 ; SC3 -71$ -2421 www.tigsrd- or.gav { Page 2 of
CITY OF TIGARD RECEIPT
13125 SW Hall Blvd., Tigard OR 97223
503.639.4171
TFGARD
Receipt Number: 188228 - 09/04/2012
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2012 -00135 Sign Permit - LRP 100 - 0000 -43117 $22.00
SGN2012 -00135 Sign Permit 100 - 0000 -43115 $149.00
Total: $171.00
PAYMENT METHOD CHECK # CC AUTH. CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 2279 CCAINES 09/04/2012 $171.00
Payor: Fast Signs Tigard
Total Payments: $171.00
Balance Due: $0.00
Page 1 of 1
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Existing Sign
192 FT. Long
36"x 96"
eti x
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- TM`- g' ' Great cmiCes Tgarcf •
'M rt ,, - itumiekoniftillftifist ry
20 ft. W
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17ft.H 18.41 ft.h 40ft.H 18.41 ft H 1 7 ft. H
Back Side of building has same measurments
BACK SIDE OF BUILDING:
136"
neat Smiles gi ar - 10"
41" Jcn'ni1 Family &
Cosmetic Dentistry —7.5"
.25" thick black acrylic dimensional lettering
flush mounted to wall
Great`.miCes agar
Cosmetic Dentistry
FRONT SIDE OF BUILDING:
120"
j reat Smiles li arc( —8.75"
36.5" Jai'nitij &
Cosmetic Dentistry —6.85"
.25" thick black acrylic dimensional lettering
flush mounted to wall
COLORS SHOWNARE APPROXIMATE THIS DESIGN AND ENGINEERING IS SUBMITTED SOLELY AS PART Of OUR PROPOSAL AND IS TO REMAIN PROPERTY OFFASTSIONS TIGARD AND ANY OTHER USE HEREOF IS PROHIBOED AND SUBJECT TO DESIGN AND USE CHANGES
FASTSIGNS
PHONE 503 244 8813
More than fast. More than signs. FAX 503.244.7753