SGN2014-00013 ry CITY OF TIGARD SIGN PERMIT
1111 x Permit#: SGN2014-00013
COMMUNITY DEVELOPMENT Date Issued: 01/27/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 1S136AD04000
Jurisdiction: Tigard
Name of Business: Mom to Mom LLC
Business Address: 11511 SW PACIFIC HWY
Applicant/Agent: Kristensen, Kelene
Work Description: Temporary sign permit,24 square feet in size, for Mom to Mom, LLC, located at 11505
SW Pacific Terrace
Permanent: No Freestanding: No Freeway: No
Temporary: 1 Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: Yes A-Board: No
Sign Dimensions: 3'x8'
Total Sign Area: 24
Wall Area:
Wall Face(Direction):
Sign Height: ft.
Projection From Wall: in.
Illumination: No Illumination
Materials:
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $56.00
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: A !Ci.(,
Permittee Signature: VIA a//1141V6tP f'
1
RECEIVED
I 111 City of Tigard JAN 2 7 2014
� P�ANNIN DF TIGARD
Sign Permit Application G/ENGINEERING
1 ..r
GENERAL 1NFORMA.TION
Nagy of Developm atJProjece
Mont rn Tn MO NA. ���,�, FOR STAFF USE ONLY
Site , �, , 1_
Address/ Setae Add"" % • . Permit No.: Std ' 7 0 13 ..
Location 1 161 I c1 W Mc) G Yr.i-t.1 Approved By
!:�Si City/State Zip
GP I .`-IqO�� . 0 RI'123 Date: II.1 1 I4
Fee, (Q.l
Property $ l.. e Terse.¢ ' Avil V LL Receipt#:
Owner r V ids Suite Map/TL#: ISl?l.O A DCx}t0
tpILsw mcrn'un PO zoning., C—C.
City/State
Zip Phone Allowable Total Area:
RI*Mitr,d Oa 91VS- 5U3-1.23 .3171
Tenant or blunt
Business MOM I o Mom LI C, Electrical Permit Required? U Yes , rNo
Name Building Permit Required? ❑ Yes ,Ef No
Sign `C L/2ty
vand u..Appliwbaa.\Sip.P.ewitdoc
Contractor M hig Addta. Suite
City/Start Zip Phonc
R$OUIRED SUBMITrALEL
Oregon Coast.Cont.Bo.rd licewe* Esc,Iite
❑ Completed Application Form
proposed ❑ P. El Feanaadrng ❑ Ftecway ❑ 2 copies of elevations on SW'x 11"or 11"x 17"
Sign ® T 0 Roof o Blame pages(must be drawn to scale for freestanding sign)
(Check A') ell d'" ❑ Well ❑ Other
o
❑ 2 copies of site/plot plan,drawn to scale,on
8W x 11"or 11"x 17"pages(required for
lc New sign? ❑ Alter to twisting sign? freestanding sign only)
Sign Dimensions: alt -v 3 .1. ❑ Application Fee
Total Sign Area(sq.f.): �A, 56, 1.4, :
Sign Data
To Wall Area(sq.ft:) _ % • Applications will not be accepted without p requited
submittal elements.
(Complete'' Direction Wall Faces(- ..c): 4 Wall sign elevanona must include dimensions of sign
heroli is this -- and wall face and show the location of sign on the wall.
"`"A°) N S E W NE "" SE SW
Height to top of sign(feet): a Freestanding signs over 6 ft.in height and walls signs
Pm ection From Wall utcitu: of which any element weighs 20 lbs.or more requite a
l ) permit from the Building Division for conatruedon.If
Materials: \4 1►1—{ I any element of a wall sign weighs 70 lbs. or more,
Will sign have illuminations' ❑ Yes E No plans must be prepared by a structural engineer.
Type: ❑ Internal ❑ External • When a Building permit is required, 2 additional
Are there any existing freestanding or wall signs at this location, copies of elevations and, if sign is freestanding,
including wall signs that overlap a tenant space? site/plot plan must be submitted with application.
❑ Yes IS No
If"yes",a list or diagram of all sign dimensions and.squ
footage must also be submitted. 2J 2,le-4 —2/ I t:I I y (OVER FOR SIGNATURES)
.
City of Tigard I 13125 SW Hall Blvd.,Tigard,OR.97223 I S03-718-2421 I www.tigard-or.gov I Page 1 of 2
8/l. L.08-5I.9 COg V{usq(0)1 NV 60.O L.L L 01.0Z/LZ/ue
Jan/27/2014 11.1003 AM keybank 503 615-8511 2/3
JAN. 27. 2014 ' 1 :03A1,1 NoR :S AND SEVENS NO. 7327 P. 3
C'd 1 AorzolatriNitht iZbL'BTin% I MU VO PP'�!s'PAM IITH/tB SZiit '. PnlE,Li4 4PJ
�
3�a1Ai�kI (Tam a •' °": P41;00
rhols pWnabar aae Suadeads qna*qua=LAO OWN oSIi, ' toffs
?amp Alp p' a in pauftwinv gand ptre`saga 2103o Nag 9911401gall m now
Mo aip pin 9a74edde 40,1 nom:O
Pus 49744Fa Flo 37FRod l 2VITPul toPritidai aR4 lo qtrquo2 alma at peas 3C1 ddr s
'as(rj ids wDfl1 xls rime 6tse 3 ptmcg gF 3ssi metal fit(Listti
Fri •o p ncl`p.".T 3rmd Aug rrgi 89PoT tat ssSW*);atg pot 1/4414 azr Valeatq
PRFARPC4 g4FIRM pa: 4214AURZTOI 62151 zojd uT=cams np pas Otwortris 10 RY'
Tim:odds DTI 3o=1a'Inn maw=sip As as=01
pav tT&tsa9uo3al1 ag PAMIR COIF m$fir+i56 adds Value II IM 3I 4
-�
Aalna3 T'!VHS(S)L'ZVO1idd1►'REVAICYlEte ON1M91€A
vin s*oqut ro/Of tardy.qt pF (i)3acao WA"IT O0 u so IX416o p}=4
yc►i uo�rod w issi ,' io� a Imma Turmas ciqt*OKI a I
V01144 aamra#m 7170toli VIV Pus 0114mIscin Plandi f 24 Troll arluwirddito n PPM&°0°'a 4110314
m4•Amumsra t latt 16 tcpiogdd °Mail
eq+oo PQnP r: +RV$7IV%Palm as Puy MA not`age="oP> dt u n ay+
IUNVD'WY
nrA PK v..nin nnn an.nl i ngrnr•��•nI �rntii��nr�n-
111111 q
CITY OF TIGARD RECEIPT
$ . 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 194687 - 01/27/2014
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2014-00013 Temporary Sign Permit-LRP 100-0000-43117 $7.00
SGN2014-00013 Temporary Sign Permit 100-0000-43115 $49.00
Total: $56.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Credit Card 135871 AKOWACZ 01/27/2014 $56.00
Payor: Kelene Kristensen
Total Payments: $56.00
Balance Due: $0.00
Page 1 of 1