SGN2001-00118 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES PERMIT#: SGN2001-00118
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171 DATE ISSUED: 07/11/2001
EXPIRATION DATE:
BUSINESS NAME: NELSEN'S TIRE &AUTO PARCEL: 2S103DD-0120
SIGN LOCATION: 13880 SW PACIFIC HWY
APPLICANT/AGENT: NELSEN'S TIRE&AUTO ZONE: C-G
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: Y FREEWAY:
TEMPORARY: X WALL: ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: 3'X4'
TOTAL SIGN AREA: 12 sq. ft.
WALL AREA: sq. ft.
WALL FACE(DIRECTION):
SIGN HEIGHT: ft.
PROJECTION FROM WALL: in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Placement of Temporary 3'x4'A-frame sign. Not to be placed in visual clearance
area or public right-of-way. Valid 7/13/01-8/13/01. Sign permit#2
MATERIALS:
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
rM
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. All I be done in ace ance with approved plans. A sign permit shall expire 90
days from approval date. A temp rary gn shall expire 0 ays from approval date. A balloon sign shall expire 10
clave form nnnmval data
APPROVED BY: `
PERMITTEE SIGNATURE:
DATE: 07/11/2001
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
Suite/Bldg.# City/State Zip Y;
6,2 4�aa
Y�
Name
Property ple lD�i>!e E'
Owner Mailing Address Suite
City/State Zip Phone
c9�4 9 �a -
70 7
o2i �
Tenant or Name
BusinessJ I 'JIM ii 11 Ing
e.
Name
Sign
Contractor Mailing Address Suite
(Prior to permit
issuance,a
copy of all City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
licenses are
required if (Note: applications will not be accepted
expired in the Oregon const.cont.Board Exp.Date without the required submittal elements)
City of Tigard's License#
database) Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway 2 Copies of Site/Plot Plan, Drawn to Scale
Sign Temporary ❑ wall ❑ Electronic (3 copies,if a building permit is required)
(Check all that
apply) Other ❑ Billboard E] Balloon size requirement: 8'/2"x 11",or 11"x 17"
❑ New sign? ❑ Alter to existing sign? 2 copies of elevations, drawn to scale
(3 copies,if a building permit is required)
Sign Dimensions: size requirement: 81/2"x 11",to 24"x 36"
Total Sign Area (sq.ft.): l a S Q ❑ $50.00 Fee (Permanent sign, any size)
Sign Data
Total Wall Area (sq. ft.) 21/ $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 ♦ Wall signs do not need to be drawn to scale,
Height to top of sign (feet): 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.
♦ If work authorized under a sign permit has not
Type: C-] internal F] 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 "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 20 Q
f,
Signature of Owner/Agent
Contact Person Name Phone No.
Receipt #: 27200100000000002858
_., Date: 07/11/2001
T I D E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001-00118 [SIGN]Temp Sign Perm 100-0000-437000 $15.00
Payments: '
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Check NELSEN TIRE AND AUTOMOTIVE 0 9103 0 $15.00
TOTAL AMOUNT PAID: $15.00
--
9103
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