SGN2013-00072 CITY OF TIGARD SIGN PERMIT
`_- Permit#: SGN2013-00072
COMMUNITY DEVELOPMENT Date Issued: 05/29/2013
TI Or) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 2S103DD00600
Jurisdiction: Tigard
Name of Business: Handsberry Stand
Business Address: 13770 SW PACIFIC HWY
Applicant/Agent: Rickard, Jim
Work Description: Proposal for a temporary use permit to sell berries at the Tigard Grange.
Permanent: Freestanding: No Freeway: No
Temporary: Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: Yes
Sign Dimensions: 3'x 4'
Total Sign Area: 12
Wall Area:
Wall Face(Direction):
Sign Height: 4 ft.
Projection From Wall: in.
Illumination: No Illumination
'Materials: wood
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: CA,,Ly a_ uc�.
Permittee Signature: ,444
III
City of Tigard
Sign Permit Application
TIGARD Application
t t
GENERAL INFORMATION
Name of Development/Project
�, � ��� ��� J� FOR STAFF USE ONLY
Site �!
Address/ JS rereet Address Permit No.: 5 CAN 0 i 3 -00 J 7a
Location tY `))U/ S e ML7 7 fi�7 ,C, • Ctw.v✓
Approved By:
Suite/Bldg.# City/State Zip
p� /�
-Le i Ag f -/ 7JL Date: 5 - ,Gl- 1.3
Name ^�� �( Receipt#: i 1 155 S 1
Property G//iW C 11//i 'i 4g Map/TL#: A s)(..) 3 D D - d O b O
Owner Nlailing Address l Suite Zoning: C - v
/3)•205a/Me 11`7Gi��iy Allowable Total Area: J/ A
City/State Zip Phone
rib At D,aR 9V(l Electrical Permit Required? ❑ Yes 0 No
Tenant or Name
Business Building Permit Required? ❑ Yes F No
Name Rev.7/1/12
is\eutpin\masters\land use applications\sign permit app.doc
Sign Al//"nn
Contractor Mailing Address Suite
City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
(Note: applications will not be accepted
Oregon coast.Cont.Board License# I?sp.Date without the required submittal elements)
XI Completed Application Form
Proposed 0 2 copies of site/plot plan,drawn to scale •
P D. Permanent ❑ Freestanding ❑ Freeway
Sign ®- 'Temporary ❑ Roof ❑ Electronic
(Check all that (3 copies,if a building permit is required)
❑ Wall ❑ Other
apply) 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: op i y size requirement: 81/2"x 11", to 24"x 36"
u
Total Sign Area (sq. ft.):/,n / ❑ $171.00 Fee (Permanent sign,any size)
Total Wall Area(sq. ft.) ❑ $54.00 Fee (Temporary sign,any type)
Sign Data - ,,
(complete all Direction Wall Faces(circle one):
items in this NOTES:
1eCtiOn) 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
Projection From W all (inches): must include dimensions of wall face and sign
placement.
Materials: • Wall signs do not require site/plot plans.
Will sign have illumination? ❑ Yes No • Freestanding signs over 6 ft. required a building
Type: ❑ Internal ❑ External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space?
E:1 Yes t(] No
If"yes",a list or diagram of all sign,dimensions and square
(OVER FOR SIGNATURES)
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 1 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 s and
subject to all the conditions and limitations of the approval.--- \ \
•, All of the above statements and the statements in the plot,plari;,attachments, and exhibits transmitted
herewith, are true, and the applicants so acknowledge that ariysperriiit.issu 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 amihe
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.
•
Applicant Signature Date •
Signature of Owner/Agent Date
Contact Person Name Phone No. k r —
•
• Y+,
•
•
•
•
City of Tigard I 13125 SW Hall Blvd.,Tigard,OR 97223 I ,503-718-2421 ,1 www.tigard-or.gov .1 Page 2 of 2
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This agreement is entered into for each of the respective parties between:
Jessica L Cousineau,for the Tigard Grange No. 148, and
Cindy Hand, for the renter.
Rental Manager
Si a ature Dat - - — - -- Position - — -
Signature Date Position
Renter's Mailing Address:139 S. 11`h Ave., Cornelius, OR 97113
Renter's Phone Number: (503) 367-4689
Phone Number Alternate Fax
Renter's Email Address: plank dog1( vahoo.com
Grange Rental Manager:Jessica Cousineau Phone: (503) 317-6694
Email: rentals(a,tigardgrange.com
Alternate Contact-for-Gr -ge:-MarkSchnetzkv _ Phone: (5_03) 807-7619 ___
Tigard Grange Hall Rental Agreement-Page 6 of 6
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71 CITY OF TIGARD RECEIPT
■ i 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 191551 - 05/29/2013
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2013-00072 Temporary Sign Permit-LRP 100-0000-43117 $7.00
SGN2013-00072 Temporary Sign Permit 100-0000-43115 $47.00
Total: $54.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 1822 CCAINES 05/29/2013 $54.00
Payor: Cynthia Denee Hand
Total Payments: $54.00
Balance Due: $0.00
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