SGN2017-00004 CITY OF TIGARD SIGN PERMIT
i ■ Permit#: SGN2017-00004
COMMUNITY DEVELOPMENT Date Issued: 01/03/2017
T
f(;A Ir.f) 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 2S101 BB00301
Jurisdiction: Tigard
Name of Business: Jacksons Shell
Business Address: 11834 SW PACIFIC HWY
Applicant/Agent: Kimmel, Dave
Work Description: New 30-square-foot wall sign on north-facing wall. Single-element less than 20 pounds.
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions:
Total Sign Area: 30
Wall Area: 858
Wall Face(Direction): North
Sign Height: ft.
Projection From Wall: in.
Illumination: Internal
Materials: Plastic
Electrical Permit Required: Yes
Building Permit Required: No
Total Permit Fee: $201.00
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: 4,c/ Litt
RECEIVED
City of Tigard JAN 0 3 2017
.11114 a
COMMUNITY DEVELOPMENT DEPARTMENT
II ' CITY OF TIGARD
T1GARD
Sign Permit Application PLANNING/ENGINEERING
SIGN LOCATION
SUBMITTAL
Address://i334,4 SIC. / 1�w Suite RE� ELEMENTS
CrC'r rte, UIRED
4 #:
City/state:-e litc{ , O� / Zip: ti2 copies of elevations on 81/2"x 11"
Tenant or businessk,T.Cie-Son S 5/? or 11"x 17"pages(Wall sign
elevations must include dimensions
Property owner name':-Pa ea_re 5 T Ener _
y ( L, of sign and wall face and show the
e-.001/Ver-C;
� / location of sign on the wall.
Address: 2/51) /6_ e-.001/9'ZI rt I C Freestanding sign elevations must
City/state: I'�gin is i Q r1 / .-4-7) Zip: j 3(a4� drawn to scale.)
Phone:Png . o-7asgE mail: copies of site/plot plan,drawn
to scale,on 81/2"xl1"or 11"x17"
es(not required for wall signs)
Sign contractor: (iP 5 e o
/� € 4/5-3-57- Inst or diagram of all existing sign
Address:
erasions and square footage
City/state: /5•e_.� U Zip: €) >?/4 Application Fee
Phone:9f8-34c- 2 P z. Email: Eta t//4in sevd5Gr)-CO Pc
CCB License #: /2'O I S Expiration date: NOTES:
• Freestanding signs over 6 ft.in height
Contact person: cric- (.tJr l lr a on 5 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.
124 New sign
0 Freestanding 0 Electrical • Building permits require 2 sets of
0 Alteration to 0 Freeway )4 Wall construction drawings and,if sign is
freestanding,2 copies of site/plot plan
existing sign 0 Roof 0 Other and 2 sets of engineering must be
Sign #: submitted with building permit
application.
Sign dimensions: .3 (h) x /0 (w) = ( ) sq.ft. sign area
New sign: 2 L sq.ft. + Existin sign area r� .ft. = V Total - I ( H y t.A-i F: t N J.'
Total sign area: Osq.ft. / building face sq.ft. = _7 / %of bldg face SgA)Q0 7* -Of .) /
Case No.: �/1
Height to top of sign: ft. Projection from wall: in. Related Cas No(s):
Materials: IQ 6
Fee:
Application accepted: )
Is the sign under 20 lbs.? ,'jBy:Yes 0 No �� Date: �/3 II
(Building Permit required if over 20 lb
Application determined complet :
Direction wall faces (circle one• I* S E W NE NW SE SW
By: L- S Date:
Will the sign have illumination? Igt Yes 0 No
If yes,what type: A Internal 0 External eAeunnrnMasters u"e Use Agi6cat,ons Rev.03/03/2015
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 oft
APPLICANTS
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 tecord 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.
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.
SIGNA URES of each owner of the subject property required.
Cum / iLie_ �iri.eie / l2 -zE -/G
Applicant's signs re Print name Date
�.- SAC.K 'DA v r,s 62.27- is
Ownfgnature Print name Date
Owner's signature Print name Date
SIGN PERMIT APPLICATION
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www tigard-otgov • 503-718-2421 • Page 2 of 2
1
SCOPEsOF WORR.
i REMOVE EXISTING V!NYI LOGO. MR NEW RED VINY!
�
`, $HOWM.
4
Jcicksons
A
IIIIIII NEW LOGO FOR AWNING SCALE:31" - 1'•0"
QUANTITY:1 MANUFACTURE&INSTALL SURVEY RECIBIR
PRIOR TO MFG.
EXISIRJG1BISPLAY
• f V - w - '�,:�.e•' +• i iii
� .r4 '
1 .'fir
CITY OF TIGARD
., Jacivont
APProvec by Flanning
.,,, Date: 1,',3/)
dry' ii t:" c,t1
Initials 2
- yy
4,1,1, �t.
,;,
}Riiti,} sem.',
CITY OF TIGARD
Approved by PI nning
Date: 3
226 Initials: L2 '
- f
SW. PACiFIC r:WY •
A
®E
.e51-C1 (ef,--1)
r- 41 ‘,.
i L
. .
-,-;,
z f P
. n •
9 -
C.f Ce r
< I
to . .... __.__ ______________
I 4 rezzimrwriKewz . ,
61-- WALL ) .,
SIGN ---'
...--
1 11
0 'D
of ri•Thi.1
_.. ._.,,_
\/ !
661.0 1
---ifii-M-----
SCALE: 143T- '...0"
r"\A PRIMARY ID SIGN
`...__I
0.A. 3. 1. - SHE-1.1 1..Efilt-R SF-,S
•....1
iTh
..f:,....) 13X13 t 11G1i Ft SE
Th
1/4.r
. 1 SF WALL SIGN
:...1