SGN2001-00140 CITY OF TIGARD SIGN PERMIT
DEVELOPMENT SERVICES
PERMIT#: SGN2001-00140
DATE ISSUED: 8/8/2001
13125 SW Hall Blvd.,Tigard, OR 97223 (503) 639-4171
EXPIRATION DATE:
BUSINESS NAME: SKIPPERS PARCEL: 1S136CD-0010
SIGN LOCATION: 11685 SW PACIFIC HWY
APPLICANT/AGENT: ZONE: C-G
BUSINESS TAX NO: JURISDICTION: TIG
SIGN
PERMANENT: FREESTANDING: FREEWAY:
TEMPORARY: X WALL: Y ELECTRONIC:
OTHER: BILLBOARD: BALLOON:
SIGN DIMENSIONS: XX 8'
TOTAL SIGN AREA: 24 sq.ft.
WALL AREA: 704 sq.ft.
WALL FACE (DIRECTIONI: SW
SIGN HEIGHT: ft.
PROJECTION FROM WALL: 1 in.
ILLUMINATION: NON
DESCRIPTION OF SIGN: Temporary Placement of(1) banner sign. Not to be placed in visual clearance
area or public right-of-way.
MATERIALS: BANNER
EXISTING SIGNS: 1
ELECTRICAL PERMIT REQUIRED: N
BUILDING PERMIT REQUIRED: N
ADMINISTRATIVE EXCEPTIONS:
TOTAL PERMIT FEES: $ 15.00
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes
and all other applicable laws. rk will be done i ccordance with approved plans. A sign permit shall expire 90
days from approval date. A t po-dry sign shall e i days from approval date. A balloon sign shall expire 10
dnvc from annrnval riata
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APPROVED BY:
PERMITTEE SIGNATUR .
DATE: 8/8/2001
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 S
Site FOR STAFF USE ONLY
Address/ Street Address
Location !!
C- " W Permit No.:1'" N
`` f _ �1
�
Suite/Bldg.# City/State Zip
01 ExpirationAB
— b
Na ee/� nn Receipt#: J?a-
Property
�I`�ee, li�i F161� Approved
Owner Mailing Address Suite U Date:
Q Ad e. Map/TL#: S �� — 00
City/State Zip Phone
(50 3) zoning: G
72 9 2-5�-O 70 D
Tenant or Name
Business Electrical Permit Required? ❑ Yes No
Name Building Permit Required? ❑ Yes o
Sign
L A ( Rev.12/1/2000 i:\curpin\masters\revised\sign e2rmit app.doc
Contractor Mailing Address oda y 17 Suite
(Prior to permit 7(o t` Ave- 5Oµ,}h
issuance,a
copy of all City/State. Zip Phone('x.53)
licenses are 1 REQUIRED SUBMITTAL ELEMENTS
required if )� A- 1903-�- 4`7 a."7 1 7 (Note: applications will not be accepted
expired in the Oregon Const.Cont.Board Exp.Date
City of Tigard's License# without the required submittal elements)
database
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway E] Completed Application Form
Sign Temporary ❑ wall ❑ Electronic ❑ 2 Copies of Site/Plot Plan, Drawn to Scale
(Check all that Other ❑ Billboard ❑ Balloon (3 copies,if a building permit is required)
apply) size requirement: 81h"x 11",or 11"x 17"
IDA New sign? ❑ Alter to existing signs
❑ 2 copies of elevations,drawn to scale
Sign Dimensions: e X (3 copies,if a building permit is required)
size requirement: 81/2"x 11",to 24"x 36"
Total Sign Area(sq. ): 3
❑ $50.00 Fee (Permanent sign, any size)
Sign Data Total Wall Area(sq.ft.) '- X = 70 $15.00 Fee (Temporary sign, any type)
(Complete all Direction Wall Faces (circle one):
items in this
section) N S E W NE NW SE nsyv NOTES:
Height to top of sign (feet): 3 Wall signs do not need to be drawn to scale,
Projection From Wall (inches): but must include dimensions of wall face and
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 External ♦ 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
Yes [:] No BECOME NULL AND VOID.
If"yes",a list or diagram of all sign dimensions and DOVER FOR SIGNATURES)
square footage must also be submitted.
4
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 0
Signature of ner/Agent
Contact Person Name Phone No.
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Receipt #: 27200100000000003266
__,.,.. ++�'�"- Date: 08/08/2001
T I Q E M A R K
COMPUTER SYSTEMS, INC.
Line Items:
Case No Tran Code Description Revenue Account No. Amount Due
SGN2001-00140 ITemp Sign Perm 100-0000-437000 $15.00
Payments:
Method Payer Bank No Acct Check No Confirm No. Amount Paid
Cash SKIPPERS 0 0 0 $20.00
Change SKIPPERS 0 0 0 ($5.00)
TOTAL AMOUNT PAID: $15.00
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