SGN2014-00117 CITY OF TIGARD SIGN PERMIT 11111 ■ Permit#: SGN2014-00117
COMMUNITY DEVELOPMENT Date Issued: 09/24/2014
TIGARD 13125 SW Hall Blvd..Tigard OR 97223 503.718.2421 Parcel: 1S134BC00200
Jurisdiction: Tigard
Name of Business: Pharmaca
Business Address: 12180 SW SCHOLLS FERRY RD
Applicant/Agent: Kosmas, Jessica
Work Description: New wall sign approximately 82 square feet located at 12180 SW Scholls Ferry Road on
the north face.The sign will be lit internally.
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions: 3.3'x 24.5'
Total Sign Area: 81.65
Wall Area: 1054
Wall Face(Direction): North
Sign Height: 17 ft.
Projection From Wall: 5 in.
Illumination:
Materials: Aluminum
Electrical Permit Required: Yes
Building Permit Required: No
Total Permit Fee: $192.00
Conditions:
This pen-nit 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: Az%r,,,,(� c-Qpf/�
Permittee Signature: 7,efAiM/r/C■-) \6i 10____------
Nor+h clegarcon Slap 1
REC VED
• City of Tigard SEp 24 2014
Sign Permit Application CITY OF TIGARD
TIGARD pLANNINGIFNGINEERING
GENERAL INFORMATION
Name of Development/Project
��n,^,�,t��� FOR STAFF USE ONLY
Site Ulr r Y\ SC
,N2.-011-1 Street Address Permit No.: ,C,N 2011-1 OOl l
Location \2 \ 0 SW S_1(1 0115 Rr rd
Approved By:
Suite/Bldg.# City/Stateer/� Zip ��
T1qu 4_ "(�I^�223 1 Date:
Name Receipt#: oi-i�2-
Property 1 Vt�bew /� y zi n lC/F
Map/TL#: 1st 34 M.coi 0
Owner Mailing Address Suite Zoning: C -G
3 �t i��]]"1' r' k C 1 0 Allowable Total Area: I J ]O
City/State( Zip Phone
PoYIlUV1( �� �� �U V LO Electrical Permit Required? 0 Yes ❑ No
Tenant or Na e
Business Vharmaea Building Permit Required? ❑ Yes 'No
Name Rev.7/1/12
n,, /t L. c\curpin\masters\land use applications\sign permit app.doc
Sign POMS CRA S tq� 'I
Contractor Mailing Address Suite
G (po SEWy,-1 aye
City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
QoYi IUnd 612-Cri O p 5031 TJ 4 555 (Note: applications will not be accepted
Oregon Cons.Cont.Board License# Esp.Dace without the required submittal elements)
(07,47-2- ❑ Completed Application Form
❑ Permanent ❑ Freestanding ❑ Freeway
Proposed ❑ 2 copies of site/plot plan,drawn to scale
Sign ❑ Temporary ❑ Roof ❑ Electronic (3 copies,if a building permit is required)
(Check all that rs Wall ❑ Other t
apply) size requirement: 81/2"'x 11",or 11"x 17"
❑ 2 copies of elevations,drawn to scale
ffg New sign? ❑ Alter to existing sign? (3 copies,if a building permit is required)
Sign Dimensions: l y i1 % .24 1 U,q size requirement: 81/2"x 11",to 24"x 36"
Total Sign Area(sq. ft.): 81 . LD6 tta ❑ $171.00 Fee (Permanent sign,any size)
Si Data Total Wall Area(sq. ft.) =7•ly o ❑ $54.00 Fee (Temporary sign,any type)
‘1OSu.So
(Complete all Direction Wall Faces (circle one):
items in this NOTES:
section) N S E W NE NW SE SW
Height to top of sign(feet): I'7 I • Wall signs do not need to be drawn to scale, but
Projection From Wall(inches): 5" must include dimensions of wall face and sign
Materials:a»,rn\rV m placement.
• Wall signs do not require site/plot plans.
Will sign have illumination? Yes ❑ No • Freestanding signs over 6 ft. required a building
Type: a Internal ❑ External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space?
❑ Yes ❑ No
(OVER FOR SIGNATURES)
If"yes",a list or diagram of all sign dimensions and square
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 I 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.
A4/7116 L-I I(4
Ap.1R,nt Signature Date
Wokka g -(4
Signature of Owner/Agent Date
t S U _U Yc3S maS S o 3 1 -t s
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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