SGN2016-00116 CITY OF TIGARD SIGN PERMIT
i ■ Permit#: SGN2016-00116
COMMUNITY DEVELOPMENT Date Issued: 11/28/2016
T f i;Ali 1) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 2S1 10AA01000
Jurisdiction: Tigard
Name of Business:
Business Address: 14170 SW PACIFIC HWY
Applicant/Agent: Bates, Stephan
Work Description: Temporary banner located at 14170 SW Pacific Highway for a Christmas tree lot.
Banner is 24 square feet. 11/28/16-12/25/16
Permanent: Freestanding: No Freeway: No
Temporary: Wall: No Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions:
Total Sign Area:
Wall Area:
Wall Face(Direction):
Sign Height: ft.
Projection From Wall: in.
Illumination:
Materials:
Electrical Permit Required:
Building Permit Required:
Total Permit Fee: $63.00
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: iik7 l.t!) -iiiiti
Permittee Signature: e
RECEVED
City of Tigard
.11 . COMMUNITY DEVELOPMENT DEPARTMENT
. NOV 28 2016
ARo Sign. Permit Application CITY°F T •'ID
pp PLANNING/E9 ERING
SIGN LOCATION I y-("](
5& Fie' ? lbwREQUIRED SUBMITTAL
Address: *44014)
�� y Suite# : ELEMENTS
City/state: ?-I9 Rr6f t OR, Zip: 7722 0 2 copies of elevations on 8'4"x 11"
Tenant or business: 7e .49 nhme rs a 0 kt a it C or 11"x 17"pages(Wall sign
I�S�' Ql�O ) elevations must include dimensions
roperty owner name: 5.4- 4e.� (: Rapes CCI m r'1te5 ge of sign and wall face and show the
r location of sip on the wall.
Address: /4 '- 500 le ie 7?ir c—t— Freestanding sign elevations must
City/state: Tt, 6'rr?l, O R Zip: 9'r &q be drawn to scale.)
Phone: 5b3 3t..2 Email: 5c b o3 r. ®P he 141 Nen eoM 0 22 copies of site/plot plan,drawn
3 to to scale,on 8'i:"x 11"or 11"x 17"
pages(not required for wall signs)
Sign contractor:
Address: 1-1 List or diagram of all existing sign
dimensions and square footage
City/state: Zip:
Application Fee
Phone: Email:
CCB License#: Expiration date: NOTES:
Contact person: • Freestanding signs over 6 ft.in height
and walls signs of which any element
weighs 20 lbs.or more require a
building permit for construction.
• SIGN DATA(Complete all items in this section) If any element of a wall sign weighs
70 lbs.or more,plans must be prepared
TYPE (Check all that apply) by a structural engineer.
El New sign
® Freestanding ( 1 Electrical • Building permits require 2 sets of
Alteration to U Freeway
I 1 Wall construction drawings and,if sign is
freestanding.2 copies of site/plot plan
existing sign El Roof ir Other te- and 2 sets of engineering must be
Sign # : enc r submitted with building permit
application.
Sign dimensions: 3 (h)x q (w)= Z U sq.ft. sign area
New sign: sq.ft.+ Existing sign area sq.ft.= Total i O iz SI,
U Sr' ON I.V
%,
Total sign area:_....._.. sq.ft./ building face sq.ft. of bldg face Case No.: S/V N2olto"COI l V
Height to top of sign: 5 ft. Projection from wall: O in.
Related Case No.(s):
Materials: .1 i n I I —_—.-.-__-.-- Fee: (.123,cO
/ Application accepted:
Is the sign under 20 lbs.'? 1,f Yes 0 No
By: At a1�►e, Date: I I (2M I IIP
(Building Permit required if over 20 lbs.)
Application determined complete:
Direction wall faces(circle one): N S E W N ..� SE SW 'I
Will the sign have illumination? I ' I Yes No By: Alt- Date: tk`2S
te
If yes, what type: n Internal 0 External is it aMiiliKirLlat W:mixt au r i
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of 2
APPLICANTS
NOTE: Person speciAed as"Applicant"shall be designated"Permittee"and shall provide Anancial assurance for work.
*When the owner and the applicant are different people,the applicant must he 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
torn or submit a written authorization with this application.
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,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 or 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 required.
App497(gnature Print name Date
t ,6. X19 to C ii/& //6
Owner', signature Print name Date
Owner's signature Print name Date
SiGN PERMIT APPLICATION
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 2 of 2
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GN CITY CF TIGAR:7.1,',
Approvec! hy Planning
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Initials: C.,