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Permit No. N 3- C,,�pG
CITY OF TIGARD
SIGN PERMIT APPLICATION
The applicant hereby applies for a permit for the work indicated or as shown in the
aaxxwpanying plans and specifications.
SIGN IOCATION ADDRESS: �,SS� S `J /l��1 n ' ` 1 ZONING: C� Q
NAME OF BUSINESS:
APPLICANT/AGENr:. -D OWANY: `:� �`1 C -'' PHONE: .� - _����`, ■
11he City of Tigard inposes an annual Business 'rax which must be kept current on all
persons doing business in the City. Do you presently have a current business ta%,?
YES,,d` ) NO ( ) U.L. Label _
PROPOSED SIGN: (Cieck as many as apply)
PERMANENT ( ) FREE MMING ( ) FREEWAY ( )
nNMRARY WALL ( ) ELECTRONIC ( )
O'MER ( ) BTIZ130ARD ( ) BATIMN ( )
SIGN D114 NSIONS: EXPIRATION DATE:
i TOTAL, SIGN AREA (Sq. Ft.) :
WALL AREA (Sq. Ft.) : _
WALL FACE:
HEIGHT (Ft) :
PROMMON FIM WALL: _
ILL. IMLNATION: YES ( ) NO ( ) TYPE:
a01JY:
MATERIALS:: tifr� r=te <:� ( $.
EXISTING SIGNS:
ADMINISTRATIVE PD(CEPHON: N/A ( I-) AP-PROVED ( ) HOW ML"i
AREA ( ) HEIGHT ( )
PLANNING DII'AIUMMHNr All sign permits must be accompanied by a scale
Permit Fee: /(.') drawing and plot plan. If work authorized under
Receipt No:q'3 -t4._ a sign permit has not been cxmpleted within ninety
Approved By: Gam, days after the issuance of the permit, the permit
5 - 13- `7-3shall become null and void.
ELDC MICAL PERMIT I CFRTIEV--1hAT I AM THE REMRDED OWNER OF THE
RBQUIRM: YES ( ) NO AN AG Aid MORIUD by IME c7W TER.
BUILDING PER 11r --
RWRRTD: YES ( ) NO (t,fi ' l�pplicant's Signature
c /I3IQKPE tI' Ads I 'relephoTle
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C VfY OP "!'I DARE) OF PAYMF.*Xr' REC'F I E'T NO. a g 8"100 4 A
CNF CK AMOUNT : !0. 00
Nf�hiF. C h! N.'..i:IN CA�:iN (PIC.IIINT i"li, 00
ADDRELSS MAIN rIAYME=N'I' DATEW,5 IS 93
T I GARD, (art SUBD I V I S I ON a
1I410SE OF PAYME:NI A0101AN'r 1:5F11.!% Ptd4POSE: OF F'O YME NT Ah1171_IN'r I ci m f '
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I; ,� I �'E RM i T FF` GGN93—066
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ATNC_ AMOUNT PAID
10. 00
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