SGN2013-00071 CITY OF TIGARD SIGN PERMIT
Permit#: SGN2013-00071
COMMUNITY DEVELOPMENT Date Issued: 05/20/2013
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 2S102AB05800
Jurisdiction: TIGARD
Name of Business: SYMPOSIUM COFFEE
Business Address: 12345 SW MAIN ST
Applicant/Agent: BATES, KEVIN
Work Description: NEW PROJECTING SIGN MEASURING 35.5 INCHES WIDE AND 48 INCHES TALL
TO BE LOCATED AT SOUTHEAST CORNER OF THE STRUCTURE.
Permanent: Freestanding: No Freeway: No
Temporary: Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions: 35.5 X 48
Total Sign Area: 24
Wall Area:
Wall Face(Direction): Southeast
Sign Height: ft.
Projection From Wall: 35.5 in.
Illumination: No Illumination
Materials: CEDAR
Electrical Permit Required:
Building Permit Required:
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: �
Permittee Signature:
■ • City of Tigard
Sign Permit Application
TIGARD
y
GENERAL INFORMATION
Name of Development/Project
Site ��f�tFas(,U wt (/�//O-Gt L FORS STAFF USE ONLY
Address/ Street.Address nn Permit No.: ��/�o''�I3-OM 7/
Location 1.23 ci .5 fsJ ,4 l at Sr r
Approved By: J/"
Suite/Bldg.r City/State /,ii
q s-av-/3
'r°�4 y� / 7 Z Z 3 Date:
r
Name l r`1 Receipt#: If fief
Property (LY 4.M4 i (..,0P14}4"}4"*"-- Map/TL#: /�///�
Owner Mailing Address Suite Zoning: AVP-ci N
Jas Y S- M et,i Allowable Total Area:
City/State 7.i1, Phom
7' GO
A) tz 3 5503 ggo
Tenant or
N Electrical Permit Required? 0 Yes No Tenant
Business wev5.Jr4A- e_ c.c_ Building Permit Required? ❑ Yes No lit-
Name A" Rev.7/1/12
c\eur cutpl pin\roasters\land use applint+ons\sign permit app.dcx
Sign
Contractor Mailing M/d ss Suite
Alfa.
City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
(Note: applications will not be accepted
Oregon Const.Cont.Board License# Exp.Date without the required submittal elements)
ig Completed Application Form
Proposed Permanent ❑ freestanding ❑ Freeway
❑ 2 copies of site/plot plan,drawn to scale
Sign ❑ Temporary ❑ Roof ❑ Electronic
(Check all that (3 copies,if a building permit is required)
❑ Wall
apply) ,h r� size requirement: 81/2"x 11",or 11"x 17"
S%
❑ 2 copies of elevations,drawn to scale
®'New sign? Ei Alter to existing sign? (3 copies,if a building permit is required)
Sign Dimensions: 2\ x A size requirement: 8'/2"x 11",to 24"x 36"
Total Sign Area(sq..fft.): },L ' ❑ $171.00 Fee (Permanent sign,any size)
Sign Data Total Wall Area(sq.ft.) I = ' Z Li $54.00 Fee (Temporary sign,any type)
,mplete all Direction Wall Faces(circle one):
ncros in this NOTES:
,,C1on) 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 Wall(inches): SG 4 must include dimensions of wall face and sign
Materials: placement.
• Wall signs do not require site/plot plans.
Will sign have illumination? ❑ Yes jig No • Freestanding signs over 6 ft. required a building
Type: ❑ Internal jij,External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space? .
❑ Yes ❑ No �l/
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 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.
s/az/i
Ap cant ignature Date
/011(.12Z 6/2043
Signature of Owner/Agent Date
je—e—t/ ti, c ,e s 563 /IC o�-6
Contact Person Name Phone No.
City of Tigard I 13125 SW Hall Blvd.,Tigard,OR 97223 I 503-718-2421 I www.tigard-or.gov I Page 2 of 2
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CITY OF 11GARD .c?�i
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wooed, -
ptlnally Approved'..nbed�� .o7r ]
For only the work as /l/ .L ]
PERWAll NO Follow---------- --- - ---1
See Letter to.. Attao -s� 4,n
Job AddCest Date:
' By.
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IIIII CITY OF TIGARD RECEIPT
■ •
. 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 191431 - 05/20/2013
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2013-00071 Sign Permit-LRP 100-0000-43117 $22.00
SGN2013-00071 Sign Permit 100-0000-43115 $149.00
Total: $171.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 410212 JFLOYD 05/20/2013 $171.00
Payor: KEVIN T BATES
Total Payments: $171.00
Balance Due: $0.00
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