SGN2001-00077 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT#: SGN2001-00077
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 04/25/2001
EXPIRATION DATE:
BUSINESS NAME: PRINT SOURCE INC.
PARCEL: 2S102AC-0010
SIGN LOCATION: 09040 SW BURNHAM ST
APPLICANT/AGENT: PRINT SOURCE INC. ZONE: CBD
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: X FREESTANDING: FREEWAY:
TEMPORARY: WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 66"X 36"
TOTAL SIGN AREA: 17 sq.ft.
WALL AREA: 3,600 sq. ft.
WALL FACE (DIRECTION): N
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Installation of wall sign.
MATERIALS: ALUM
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 50.00
This permit is issued subject to the regulations contained in a Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. A k will be done in ac nce with approved plans. A sign permit shall expire 90
days from approval date. A t pora sign shall expir 30 ay from approval date. A balloon sign shall expire 10
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APPROVED BPERMITTEE SIGNATURDATE: 04/25/
SIGN PERMIT APPLICATION
CITY OF TIGARD 13125 SW Hall Blvd., Tigard, OR 97223(503)639-4171 FAX.- (503) 684-7297
GENERAL INFORMATION
Name of Development/Project
Site
Address/ Street Address .
Location CI n�p S,t'�i . (�v 2N k -eA
Suite/Bldg.# city/ tate Zip
Name
Property
Owner Mailing Address Suite
9 a qo
City/State Zip Phone
Tenant or Name
Business A6o-ve7
NameY
Sign
Contractor Mailing Address Suite
(Prior to permit
issuance,a
copy of all City/State zip Phone REQUIRED SUBMITTAL ELEMENTS
licenses are
required N (Note: applications will M be accepted
expired in the Oregon Const.Cont.Board Exp.Date without the required submittal elements)
City of Tiigard's License#
database) Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway 2/2 Copies of Site/Plot Plan, Drawn to Scale
Sign ❑ Temporary Wall ❑ Electronic (3 copies,if a building permit is required)
(Check all that ❑ Other ❑ Billboard ❑ Balloon Tuirernt'
e reqen8'h"x11",or 11"x 1T
aNew sign? ElAlter to existing sign? copies ofelevations,drawn to scale
copies,if a building permit is required)
Sign Dimensions: �u X 36 tl size requirement 81h"x 11",to 24"x 36"
Total Sign Area(sq.ft.): I-1 [� $50.00 Fee (Permanent sign,any size)
Sign Data
Total Wali Area (sq.ft.) E] $15.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces(circle one):
Items in this NOTES:
section) N S E W NE NW SE SW • Wali signs do not need to be drawn to scale,
Relght to top of sign(feet): but must include dimensions of wall face and
Projection From Wali (inches): sign placement.
Copy: • Wall signs do not require site/plot plans.
Materials: • Freestanding signs over 6 ft. required a
Will sign have illumination? ❑ Yes C� No building permit.
• If work authorized under a sign permit has not
Te: Internal 0 External
been completed within ninety (90) days after
Are there any existing freestanding or wall signs at this
the issuance of the permit, THE PERMIT WILL
location,including wall signs that overlap a tenant space?
BECOME NULL AND VOID.
❑ Yes O(No
If"yes",a list or diagram of all sign dimensions and (OVER FOR SIGNATURES)
square footage must also be submitted.
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.
DATED this �'� day of PN4f l L. 20<5 _
Signature of O ner/Age
Contact Person Name Phone No.
Receipt #: 27200100000000001746
_.. Date: 04/25/2001
T I D E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001-00077Sign Permit 100-0000-437000 $50.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check B&B PRINT SOURCE 0 21595 0 $50.00
TOTAL AMOUNT PAID: $50.00
REMITTAN E ADVICE 96-8/1232
B & B PRINT SOURCE
9040 S.W.BURNHAM
TIGARD,OR 97223 21595
503-639-9835
PAY DOLLARS
p T TO THEORDER OF I GROSSDESCRIPTION I
s Z`j0 L J 0
PRINT SOURCE,INC.
WEST COAST BANK
11675 SW PACIFIC HWY.,TIGARD,OR 97223 -
II'0 2 S 9 SII' 1: 1, 2320001384 2 5000 L 4 911'
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