SGN2014-00130 CITY OF TIGARD SIGN PERMIT
Permit#: SGN2014-00130
COMMUNITY DEVELOPMENT Date Issued: 10/14/2014
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 2S102CC00500
Jurisdiction: Tigard
Name of Business: Ichi Teriyaki
Business Address: 13500 SW PACIFIC HWY 30
Applicant/Agent:
Work Description: New wall sign (west facade).
Dimensions 2'x 12'
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: Yes
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions: 2'X 12'
Total Sign Area: 24
Wall Area: 360
Wall Face(Direction): West
Sign Height: ft.
Projection From Wall: 6 in.
Illumination: Internal
Materials:
Electrical Permit Required: Yes
Building Permit Required: No
Total Permit Fee: $192.00
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.
i
Approved By: Q-
Permittee Signature: '�
ipli
City of Tigard
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Sign Permit Application
GENERAL INFORMATION
Name of Development/Project
Site r Ch( 'Qr(Ya k( FOR STAFF USE ONLY
Address/ Street Address / Permit No.: c-3 Cy N3 Q 0 1‘4 "00 Id 0
Location 135°0 Cs Pa,,f t` I 1 w Y Approved By: CAC---'
Suite/Bldg.# City/State Zip
a r`iArJAle Q n 2-9 Date: O — , —114
Name Fee: I 9.? - Go
Property ''.0b ii l)C <0(� / Receipt#: 19'8000
Owner 1M1ailing Address L! / Suite Map/TI.#: 015 I D��-R CG 005 a 0
1 3506 SW past i e ( 3 v Zoning: C — \7
City/State Zip Phone
! S 0/0
-rpriAc. 972 14 V[g 2-5-5 1 Allowable Total Area:
Tenant or Name
Business 4, -7" ✓2y ct At f Electrical Permit Required? 0 Yes ❑ No
Name Building Permit Required? ❑ Yes 0 No
��G (Men S1 4) Rev.10/21/21)13
Sign I:\CURPLN\Masters\Land Use Applications\Sign Permit.doc
Contractor Mailing Address Suite
11183 sw T✓ Hwy
City/State Zip / Phone
A 1 o h kOQ ! i Pal c,i 3 0(1q
3 REQUIRED SUBMITTAL ELEMENTS
Oregon C�nst.Cont.Board License# Exp.Date
q14-35"4- 1/2.2/j'o r t7 ❑ Completed Application Form
Proposed g Permanent ❑ Freestanding ❑ Freeway ❑ 2 copies of elevations on 81/2"x 11"or 11"x 17"
f
f
a
pges (must be drawn to scale for freestanding Sign ❑ Temporary ❑ Roof ❑ Electronic g si gn)
(Check all that
apply) ® Fall ❑ Other ❑ 2 copies of site/plot plan,drawn to scale,on
81/2"x 11"or 11"x 17"pages (required for
IT New sign? ❑ Alter to existing sign? freestanding signs only)
Sign Dimensions: 2--It X i L TL ❑ Application Fee
Total Sign Area(sq.ft.): 2-r/sJ NOTES:
Total Wall Area(sq.ft.) '' • Applications will not be accepted without all required
Sign Data /O =VII o submittal elements.
(Complete all Direction Wall Faces(circle one): • Wall sign elevations must include dimensions of sign
items in this and wall face and show the location of sign on the wall.
section) N S E W NE NW SE SW
• Freestanding signs over 6 ft. in height and walls signs
Height to top of sign(feet): l of which any element weighs 20 lbs. or more require a
Projection From Wall(inches): 6 permit from the Building Division for construction. If
Materials: any element of a wall sign weighs 70 lbs. or more,
Will sign have illumination? ® Yes ❑ No plans must be prepared by a structural engineer.
Type: El 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 No
If"yes",a list or diagram of all sign dimensions and square
footage must also be submitted. (OVER FOR SIGNATURES)
. 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,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 below 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.
Applica• ' ature Date
Signature of Owner/Agent Date
Owner/Agent's Name (Please Print) Title Phone Number
City of Tigard 13125 SW Hall Blvd.,Tigard,OR 97223 503
ty 'g I 'g I 718-2421 I www.tigard-or.gov I Page 2 of
CITY OF TIG AR_ D
Approved.- __ [X 1
Conditionally Approved_ ... [ I
For only the work as descried in:
PERMI�TNO. �1�5 -2tI.S 0,
Letter to: Follow 135 0 0 S w Pr,C,,,.. 9 ! 3°
TIGARE MARKETPLACE Attach i
SITE PLAN Job Address:
THOME` i 18643 SW Tualatin Valley Hwy
Beaverton.OR 97006
503-442-0193
SELL-111A0 1(11i _ • ,- sPOR 'S B' ,j
.. y . CCB#194354
METRO#10784
Customer:
,, Ichi Teriyaki 25
Address:
", 13500 SW Pacific Hwy#30
I 8, Tigard OR 97223
• ► L
t
.� �. L ..' .4- Phone: 503-442-0193
r'Aclf HIGHWAY-99
Y
.. 3/8"x 3 1/2"Lags
RSCR Tgatd Slarketplace Pr 1 oar"I 1319 3
Aluminum sidewall
-ilt I 2 LED LIGHT Bulbs
1 1
N
* f ggf Plex Face
r Jpr i
vim ....
112"Spacer
2, 1 n
jJ�1�
1
Remote Flex Conduit
I JeweliteTrim
Transformer Box
w/enclosed
Transformer{s) Wall
Total Signage : 24 Sq Ft Red color Plex face INSTALLATION
Scale 1' = 3/4' 5" Dark brown returns Plex face 250ma LED illumination
Individual Channel Letter 1" Dark Brown Jewelite trim on letters Internally Illuminated with LED Light
Sign UL labeled w/visible disconnect
Use 1/2 spacer between sign &wall
Jewelite trim on letters
J
III CITY OF TIGARD RECEIPT
1 • 13125 SW Hall Blvd.,Tigard OR 97223
503.639.4171
TIGARD
Receipt Number: 198000 - 10/14/2014
CASE NO. FEE DESCRIPTION REVENUE ACCOUNT NUMBER PAID
SGN2014-00130 Sign Permit-LRP 100-0000-43117 $25.00
SGN2014-00130 Sign Permit 100-0000-43115 $167.00
Total: $192.00
PAYMENT METHOD CHECK# CC AUTH.CODE ACCT ID CASHIER ID RECEIPT DATE RECEIPT AMT
Check 1323 CCAINES 10/14/2014 $192.00
Payor: The Green Signs
Total Payments: $192.00
Balance Due: $0.00
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