SGN2001-00095 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT#: SGN2001-00095
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 5/22/2001
EXPIRATION DATE:
BUSINESS NAME: MADDY'S DELI PARCEL: 2S102AA-00491
SIGN LOCATION: 12085 SW HALL BLVD 130
APPLICANT/AGENT: MADDY'S DELI ZONE: CBD
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X 4'
TOTAL SIGN AREA: 12 sq.ft.
WALL AREA: sq.ft.
WALL FACE (DIRECTION):
SIGN HEIGHT: 4 ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary placement of(1)A-frame sign. Not to be placed in visual clearance
area orublic right-of-way. Si9n P ermit#1-Valid 6/1/01 to 7/2/01.
P
MATERIALS:
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED.
N
PERMIT
BUILDING PE REQUIRED: N
U
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
This permit is issued subject to the lations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All rk ill be done in acc ance with approved plans. A sign permit shall expire 90
days from approval date. A to r ry ign shall expire 0 ays rom approval date. A balloon sign shall expire 10
rtavc frnm nnnrnval rtata
APPROVED BY:
PERMITTEE SIGNATURE:
DATE: 5/22/2001
7!
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 /2b
Suite/Bldg.# City/State Zip
zo
Name
Property
Owner Mailing Address Suite
Ob
City/State Zip Phone
Tenantor Name
Business
Name
Sign
Contractor Mailing Address it
(Prior to permit
issuance,a
copy of all City/state p Phone REQUIRED SUBMITTAL ELEMENTS
licenses are
required if (Note: applications will »t be accepted
expired in the Oregon st.cont.Board Exp.Date without the required submittal elements)
City of Tigard Is Lice #
database) _ Completed Application Form
Proposed p ❑ P anent Freestanding ❑ Freeway 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 1 ize requirement: 8'h'x 11",or 11"x 1T
a
❑ New sign? ❑ Alter to existing sign? 2 copies of elevations,drawn to scale
Sian Dimensions: r� (3 copies,Ifa building permit is required)
size requirement 61/2"X 1 1",to 24"X 36"
19�
Total Sign Area(sq.ft.): ❑ $50.00 Fee (Permanent sign,any size)
Sign Data
Total Wall Area(sq.ft.) 5.00 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 • Wall signs do not need to be drawn to scale,
Height to top of sign (feet): :g' but must include dimensions of wall face and
Projection From Wall (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 No building permit.
Type: Internal emal • If work authorized under a sign permit has not
Are there any existing freestanding or wall signs at this been completed within ninety (90) days after
location, including wall signs that overlap a tenant space? the issuance of the permit, THE PERMIT WILL
BECOME NULL AND VOID.
❑ Yes ❑ 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 1 have read this application, that the information given is
correct, that 1 am the owner or authorized agent of the owner, and that plans submitted are
in compliance with the City of Tigard.
S
DATED this t day of 20-C f
Sign trelrownerhAyent
Rye!) SAY
Contact Person Name Phone No.
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Receipt #: 27200100000000002121
'Ak_....�, Date: 05/22/2001 '
T 1 0 E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001-00095Temp Sign Perm 100-0000-437000 $15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check CO-ZAK VENTURES,LTD. 0 3198 0 $15.00
TOTAL AMOUNT PAID: $15.00
CO-ZACK VENTURES LTD. 24-03236 319 8
MADDY'S & SPAGHETTI ALREADI 01230 5
PMB 418 503-244-2142
3 MONROE PARKWAY, SUITE P Date S1.2
LAKE OSWEGO, OR 97035
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Orderof ^ $ !o00
Order of ��
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Wells Fargo Bank
E 5615 Southwest Macadam Avenue
Portland,OR 97201
www.wellsfar o.com
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