SGN2001-00043 f
CITY OF TIGARD SIGN PERMIT
f
DEVELOPMENT SERVICES PERMIT#: SGN2001-00043 13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 02/21/2001
EXPIRATION DATE:
BUSINESS NAME: QUACKERS PARCEL: 2S10213D-00601
SIGN LOCATION: 12725 SW PACIFIC HWY
APPLICANT/AGENT: ZONE: C-G
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: Y FREEWAY:
TEMPORARY: WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 30"X 30"
TOTAL SIGN AREA: 6 sq.ft.
WALL AREA: sq.ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 3 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: INT
DESCRIPTION OF SIGN: Installation of(1)permanent"LOTTERY" sign to be attached to existing
free-standing sign.
MATERIALS:
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: Y
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws;pora
l be done in cordance with approved plans. A sign permit shall expire 90
days from approval date. A n shall exp30 days from approval date. A balloon sign shall expire 10
davc from annmvni anti-
APPROVED BY 01,PERMITTEE SIGNATURE
DATE: 02/21/2001
0;1013!2001 12:19 FAX 5096847297 - City of Tigard Z002
i
Y
SIGN PERMIT APPLICATION
CITY OF TIOARD 13135 li'Mull 3b,d. Tigan.). OR 972 3(503) J39-417/ FAX:(503)684-7297
GENERAL INFORMATION
Name of Dav■lopmarlifProle:l
Site Q� �i��—�/ FOR
Address/ Slt¢Cl Addreer ' `
Location ��-� 5 P��i( Permit No.:� N d
suitelsldcj * cityt tote zip Expiration Date:
tC wd- Receipt#:
Name
Property
Approved By:
(1, 01
Owner Malting Addres Ile Date:
- MaprTL#: a-
i ilylSt7le Zi Phone Zoning:
I
Tenant or Name Electrical Permit Required?' Air Yes ❑ No
Business "
�� S ! Suilding.Permlt Required? ❑ `Yss' No
Name
Ib��I`�
1��/ •/ Rev.-12��/24Q0 is Inimasterelrev�sod�4ign pemdt'a :doc
Sign �1 Ci
Contractor Mailing Address Suite
(Prior to permit
issuance,a I Lt(
ropy of al City/sates Zip Phone RF IRED SUBMITTAL ELEMENTS
iicen"s are Vt.� C�
required �s�`l S 'g (Rote applications will net be accepted
expired in ft Oregon ConstCont:9oard ,cp.Date without the required submittal elements)
I City of Tigerd's License# j
4 datatmse [� Completed Application Form
jProposed Parmancnt Freestanding ❑ Freeway ❑ 2 Copies of Site/Plot Plan, Drawn to Scale
Sign Temporary Wal ❑ Electronie (g copies,i1 a building permit is required)
(Check all that Other ❑ Billboard ❑ Balloon size requirement, 91/2'x 11 or 11"x 17"
I a 1
New sign? Alter to existing sign? ❑ 2 copies of elevations,drawn to scale
Sign Dimensions: (�copi s,if a building permit is required)
32// size re 'cement: 81A'x t 1",to 24"x 36"
Total Sign Area(sq.It.): (fi//__ Fee (Permanent sign,any size)
, t +��
t 6� I [3 $15.00 Fee (Temporary sign,any type)
Sign Data Total Wall Area(sq.ft.) IA v
(complete all Direction Wall Faces(circle onef.
Items in this NOTES:
secum) N S E W NE NW SE SW . Wall signs do not need to be drawn to scale,
Height to to of sign(feet): but must Include-dimensions of wall face and
Projection From Wall(inches : sign placement.
Gop : Wall signs do not require site/plot plans.
Materials: • Freestanding signs over 6 ft, required a
tuf building permit.
Will sign have illumination? Yes ❑ No If work authorized under a sign permit has not
Type: ' Internal External been Completed within ninety (90) days after
Are there any existing frees riding or wall signs at this the Issuance of the permit, THE PERMIT WILL
location, including wail signs that overlap a tenant space? BECOME NULL AND VOID.
❑ Y$6 Y No
tf"yes",a list or diagram of altIgn dimensions and !OVER FOR SIGNATURES)
square foots a must also be submitted.
0;10612001 12:14 FAX 5036847297 City of Tigard R003
s �
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.
DATED this day of 20 �
Signature of Owner/Agent
Cav- V- CA
Contact Pe son Name Phone No.
I
4c o v
CA�&Lt t<-) � sir (Pujcli- S ez4ee-4 -re