SGN2018-00036 CITY OF TIGARD SIGN PERMIT
. Permit Permit#: SGN2018-00036
COMMUNITY DEVELOPMENT Date Issued: 06/19/2018
T I '\ 7 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 1S135BD01300
Jurisdiction: Tigard
Name of Business: Washington Square Inn
Business Address: 10830 SW GREENBURG RD
Applicant/Agent: Clark, Dale
Work Description: Temporary banner, 24 square feet, located at 10830 SW Greenburg Road. Valid from
6/22/2018 through 9/20/2018. This permit includes all three temporary signs allowed for
the year.
Permanent: No Freestanding: No Freeway: No
Temporary: 3 Wall: No Electronic: No
Billboard: No Balloon: No
Banner: Yes A-Board: No
Sign Dimensions: 5'x 4.75'
Total Sign Area: 24
Wall Area: 1344
Wall Face(Direction): North
Sign Height: 48 ft.
Projection From Wall: 0 in.
Illumination: No Illumination
Materials: Vinyl
Electrical Permit Required: No
Building Permit Required: No
Total Permit Fee: $192.00
Conditions:
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and
all other applicable law. All work will be done in accordance with approved plans. A permanent sign must be placed within
90 days from approval date or sign permit shall expire. A temporary sign shall expire 30 days from validity date. A balloon
sign shall expire 10 days from validity date.
Approved By: A61"..,_,/44/,)
Permittee Signature: /f er...14. -1--4._
City of Tigardill RECEIVED
�� JUN 1 9 2018
COMMUNITY DEVELOPMENT DEPARTMENT
TIGARD
Temporary Sign Permit CITYOFLANNING/ENGINFFRING
a
SIGN LOCATION REQUIRED SUBMITTAL
Address: A980- '� ELEMENTS
City/state:T( 7IC Zip:9 7223 Size information type and size
Tenant or business:W4 + A4-7-0/) 0 6 .E AI IQ
dimensions
Application Fee
Property owner: N.,Property owner signature/
lj pA*Sib+1 C�Z) J QJ
Nwritten authorization
(y�f�lf1v �G`N� � ��nn Address:
`a '3 0 ct) 6te60kil City/state?¢/O NOTES:
0 eo1) Zip: '7722.3 Phone: • Applications will not be accepted
Sla—`573.—9_5.0 mail: i
without all required submittal elements.
Contact name: • Temporary Signs 18.435.100
APPLICANT FOR STAFF USE ONLY
Name: alLgK,S.L6ALS
Case No.:901\12.01.15- 3
Address: PO 4 0)G f113
City/state: (. I#.7.04 Si- C `'7D Y w: Approved and issued:
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Phon 8-72/-AWE/ Email: 41CIGr' iv ice' ,Cali By: AL- Date: @I(91 we
Contact name: 4b4L Permit fee: 4461 Z(, "i0
Base Zone: In WI
SIGN INFORMATION(Check one) g
Total sign area: �4
LIBalloon I:\Community Development\Land Use Applications\02_Forms and
Templates\Land Use Applications Rev 12/14/2017
Install date: (Valid for 10 days)
❑ Lawn Sign
Install date: (Valid for 30 days)
% Banner (flOcS)
Install date: Le/22 118,9 12-0 1g (Valid for 30 days)
Sign dimensions: Sign area: (sq.ft.)
Materials:
Direction wall faces (circle one): N S E W NE NW SE SW
Applicant's signature Print name Date
Owner's signature Print name Date
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of 1
APPLICANTS
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.
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,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 or 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.
0
SIG • TURES of each owner of the subject property required.
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;.nsignature �_ Print name Da
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•wne signature Print name Date
Owner's signature Print name Date
SIGN PERMIT APPLICATION
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 2 of 2
RECEIVED
JUN 192018
CITY OF TIGARD
PLANNING/ENGINEERING
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