SGN2014-00129 PPI
II
TIGARD
City of Tigard
December 4, 2014
Ramsay Signs
Attn: Darcy or Nancy
9160 SE 74th Ave.
Portland, OR 97206
Re: Permit No. SGN2014-00127 SGN2014-00128, GN2014-00129
Dear Applicant:
The City of Tigard has canceled the above referenced permit(s) and encloses a refund for the
following:
Site Address: 10100 SW Washington Square Rd
Project Name: Red Robin
Job No.: N/A
Refund Method: ® Check#215787 in the amount of$460.80.
❑ Credit card"return" receipt in the amount of$ .
Note: Please allow 2-5 days for this refund transaction to be
credited to your account by the company that issued your card.
❑ Trust account"deposit" receipt in the amount of$ .
Comment(s): Per applicant's request to withdraw application. Refund 80% of sign
permit application fees: (3) permits @ 153.60 = $460.80 total refund.
If you have any questions please contact me at 503.718.2430.
Sincerely,
;Koh i
Dianna Howse
Building Division Services Supervisor
Enc.
13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.639.4171
TTY Relay: 503.684.2772 • www.tigard-or.gov
111 City of T i and •• COMMUNITY DEVELOPMENT DEPARTMENT I
=
Request Permit Action 4.2 Any )06e TIGARD 13125 SW Hall Blvd. • Tigard, Oregon 97223 • 503.718.2439 • www.tigard-or.gov
TO: CITY OF TIGARD
Building Division Services Supervisor
13125 SW Hall Blvd.,Tigard,OR 97223
Phone: 503.718.2430 Fax: 503.598.1960 www.tigard-or.gov
FROM: ❑ Owner °Applicant ❑ Contractor ❑ City Staff
c] ck
REFUND OR Name:
INVOICE TO: (Business or Individual) TAI/l y3&1 S S (Mlii1ira'J 0Q Aim mej
Mailing Address: Cl I(110 q--ryi AW-/
City/State/Zip: Pbptifiir) O- Otl�p
Phone No.: So ,' M l , 455
PLEASE TAKE ACTION FOR THE ITEM(S) CHECKED (1):
CANCEL/VOID PERMIT APPLICATION.
REFUND PERMIT FEES (attach copy of original receipt and provide explanation below).
INVOICE FOR FEES DUE (attach case fee schedule and provide explanation below).
REMOVE/REPLACE CONTRACTOR ON PERMIT (do not cancel permit
Permit #: _ 4 - _ 2' 5614 • —cx (2f3 S6N2014— • 2`
Site Address or Parcel #: LC D \iv othInofbel (SQ. r2-01
Project Name: ZfGl (2l n
Subdivision Name: Lot#:
EXPLANATION: "The, S (1S exceed The- <lll/Wee4 1.$IL) O _ GLI levied.
tcpp i VY I:WI/ v v any l ,v\4MA v SI S ran
fi'A cktoi,L . (se. £/1-I *h€4
Signature: '/ 44. Date: l
,¢f-77114
Print Name: `I f V-OWCtC-& /6 7.o — /3'3.6 0 = 33. ya
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Refund Policy I. The Director or Building Official may authorize the refund of: /S3, 4 e 3p vo
a) any fee which was erroneously paid or collected.
/vim not more than 80°.of the land use application fee when an application is withdrawn or canceled before any review effort has been expended.
c) not more than 80°o of the land use application fee for issued permits.
d) not more than 811°o of the building plan review fee when an application is canceled before any plan review effort has been expended.
e) not more than 81>°o of the building permit fee for issued permits prior to any inspection requests.
2. Refunds will be returned to the original Payer in the same method in which payment was received. Please allow 2-4 weeks for processing refunds.
FOR OFFICE USE ONLY
Rte to Sys Admin: Date By Rte to Admin: Date /...z1/2" /9' By 42
Refund Processed: Date%Lf By ize Invoice Processed: Date By
Permit Canceled: Date /.2 y/7/y By -♦ Parcel Tag Added: Date By
Receipt# Date Method Amount S
1:\Building\Forms\RegPermitAction.doc Rev 115/25/2012
City of Tigard
TIGARD
Accela Refund Request
This form is used for refund requests of land use, development engineering and building permit
application fees. Receipts, documentation and the Requestor Permit Action form (if applicable) must
be attached to this request form. Refund requests are due to Accela System Administrator by
each Wednesday at 5:00 PM. Please allow up to 3 weeks for processing of refunds. Accounts
Payable will route refund checks to Accela System Administrator for distribution to applicant.
PAYABLE TO: Ramsay Signs DATE: 11/20/2014
Atm: Darcy or Nancy
9160 SE 74th Ave. REQUESTED BY: Dianna Howse
Portland,OR 97206 AK
TRANSACTION INFORMATION:
Receipt#: 198271 Case#: SGN2014-00129
Date: 11/4/2014 Address/Parcel: 10100 SW Washington Sq Rd
Pay Method: Check Project Name: Red Robin
EXPLANATION: Sign exceeds the allowed 15%of area on front facade. Applicant withdrawing sign
permit application. Refund 80%of application fees.
REFUND INFORMATION:
Fee Description From Receipt Revenue Account No. Refund
Example: Building Permit Fee Example: 2300000-43104 $Amount
Sign permit 100-0000-43115 $133.60
Sign permit-LRP 100-0000-43117
TOTAL REFUND: $153.60 C' -
APPROVALS: SIGNATURES/DATE:
If under$5,000 Professional Staff-' � —�,'—�� _ i/7.7t//y
If under$12,500 Division Manager
If under$25,500 Department Manager
If under$50,000 City Manager
If over$50,000 Local Contract Review Board
FOR TIDEMARK SYSTEM ADMINISTRATION USE ONLY
Case Refund Processed: I Date: I /.L/`///V/ I By: I
I:\Building\Refunds\RefundRequest.doc x 09/01/2010
Agnes Kowacz
From: Darcy Newton <darcy @ramsaysigns.com>
Sent: Thursday, November 13, 2014 8:43 AM
To: Agnes Kowacz
Cc: Roxie Schwochert
Subject: FW: Red Robin Permits_77 Washington Sq
Ames -
Per your discussion with Roxie from Priority Signs, please remove E06, Qty 3 Window Vinyls from the scope
of work for the Red Robin location at 10100 SQ Washington Sq Rd. Based on that information, please advise
what is needed to complete the permit process and when they will be available to pick up.
Thank you for your assistance!
Darcy Newton
Ramsay Signs & Heath Northwest
9160 SE 74th Avenue Portland, Oregon 97206
503 777 4555 Fax 503 777 0220
800 613 4555
darcy(cDramsaysigns.com
www.ramsaysigns.com
et` 7111.31a
'MY
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Please consider the environment before printing this e-mail.
1
•
.L �0,..$) G RECEIVED
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OCTY32014
• • City of Tigard /oz/f/iif � C
PLANNING ENGINEE
Sign Permit Application RING
TIGARD
vimmono .,
GENERAL INFORMATION
Name of/Development/Project FOR STAFF USE ONLY
Site re C i �/ OW I
Address/ Street Address Permit No.: SG1J 01 tk W 0
I Z
Location 1 b100 SW washingthYI Sq Co( Approved By:
Suite/Bldg.# City/State ip
Date: in
Name Receipt#: i-t$2:1
Property Map/TL#:
Owner Mailing Address Suite Zoning:
Allowable Total Area:
City/State Zip Phone
Tenant or Name Electrical Permit Required? ❑ Yes El No
Business fed robin Building Permit Required? ❑ Yes ❑ No
Name Rev.7/1/12
i\cuspin\masters\land use applications\sign permit app.doc
Sign CamSCI9 5 V4 I y�j
Contractor Mailing Address Suite
qtkj:10 SE 14"1
City/State Zip Phone REQUIRED SUBMITTAL ELEMENTS
(Note: applications will not be accepted
Oregon Const Cont.Board License# Exp.Date without the required submittal elements)
L 7)4 ZZ - ❑ Completed Application Form
Proposed ❑ Permanent ❑ Freestanding ❑ Freeway ❑ 2 copies of site/plot plan,drawn to scale
Sign ❑ Temporary ❑ Roof ❑ Electronic
(Check all that (3 copies,if a building permit is required)
apply) Wau i�I size requirement: 81/2"x 11",or 11"x 17"
µ,W V ` ❑ 2 copies of elevations,drawn to scale
7(New sign? ❑ Alter to existing sign? (3 copies,if a building permit is required)
Sign Dimensions: 9.0673 x 1 .�aL 1 Q U\ k , • size requirement: 81/2"x 11",to 24"x 36"
Total Sign Area(sq.ft.): `C _ 't • //t ❑ $171.00 Fee (Permanent sign,any size)
S' Data totalW ll Area(sq.ft.) J �V l ❑ $54.00 Fee (Temporary sign,any type)
Sign of ..0S3 0.
(Complete all Direction Wall Faces(circle one):
items in this NOTES:
section) N 0 E W NE NW SE SW
Height to top of sign(feet): 9 • Wall signs do not need to be drawn to scale, but
Projection From Wall(inches): must include dimensions of wall face and sign
placement.
liaterials:,V unk4 1 • Wall signs do not require site/plot plans.
Will sign have illumination? ❑ Yes ,No • Freestanding signs over 6 ft. required a building
Type: ❑ Internal ❑ External permit.
Are there any existing freestanding or wall signs at this location,
including wall signs that overlap a tenant space?
❑ Yes ❑ No
If"yes",a list or diagram of all sign dimensions and square (OVER FOR SIGNATURES)
footage must also be submitted.
City of Tigard I 13125 SW Hall Blvd.,Tigard,OR 97223 I 503-718-2421 I www.tigard-or.gov I Page 1 of 2
4'
APPLICANTS:
To consider an application complete,you will need to submit ALL of the REQUIRED SUBMITTAL ELEMENTS as described on the
front of this application in the"Required Submittal Elements"box.
NOTE: Person specified as"Applicant"shall be designated"Permittee"and shall provide financial assurance for work.
* When the owner and the applicant are different people, the applicant must be the purchaser of record or a lessee in possession with
written authorization from the owner or an agent of the owner. The owner(s)must sign this application in the space provided on the back of;
this form or submit a written authorization with this application
BY SIGNING BELOW,THE APPLICANT(S) SHALL CERTIFY THAT:
• If the application is granted, the applicant will exercise the rights granted in accordance with the terms and
subject to all the conditions and limitations of the approval.
• All of the above statements and the statements in the plot plan, attachments, and exhibits transmitted
herewith, are true, and the applicants so acknowledge that any permit issued, based on this application, and
may be revoked if it is found that any such statements are false.
• The applicant has read the entire contents of the application, including the policies and criteria, and
understands the requirements for approving and denying the application.
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.
SIGNATURES of each owner of the subject property are required.
.
#pplicant Signature Date
Signature of Owner/Agent Date
3-e c t COk K_CJSmas sod -1-)1 u5SS
Contact Person Name Phone No.
City of Tigard I 13125 SW Hall Blvd., Tigard,OR 97223 I 503-718-2421 I www.tigard-or.gov I Page 2 of 2
E06 Window Vinyl - RR-WV - (Qty 3)
after
Remove any existing vinyl,clean residue from glass,apply new vinyl as shown.
Note:Window mullions and V.0. of windows to be verified.
Application 3M Vinyl Color i *yr - • __ __ _____ __
MEW #77255E-314 Dusted Crystal `�II A ! /; -
lir N.
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48.00" , I 39.38"
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VERIFY Graphic „ ,
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RECEIVED
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1 OCT 13 2014
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Actual surveyed i i i 1
window V.O s J
Approximate logo placement guide
PLANNING/ENGINEERING
CITY OF
with spacing
Scale 1:24
r-D Revisions: Revisions: File Location: Date: 05.13.14 Location:10100 SW Washington Square Rd Site ID: 77 C40492
x x ArtDept\Core)Colors
Red^Oib�/t x x \Red Robin Designer: TMC City: Portland,OR Name: - EOC prlOrltySlCJn
x x V