SGN2019-00137 CITY OF TIGARD SIGN PERMIT
Permit#: SGN2019-00137
COMMUNITY DEVELOPMENT Date Issued: 12/09/2019
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 1S134AA01900
Jurisdiction: Tigard
Name of Business: Burger King
Business Address: 10105 SW NIMBUS AVE
Applicant/Agent: Boyington,
Work Description: New Wall Sign
Permanent: Yes Freestanding: No Freeway: No
Temporary: Wall: Yes Electronic: No
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions: 6x6
Total Sign Area: 28.27
Wall Area: 1953
Wall Face(Direction): North
Sign Height: 20 ft.
Projection From Wall: 5 in.
Illumination: Internal
Materials:
Electrical Permit Required: Yes
Building Permit Required: No
Total Permit Fee: $228.00
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: 00° a_
pp
Permittee Signature:
RECEIVED
City of Tigard
.1 DEC 0 9 2019
COMMUNITY DEVELOPMENT DEPARTMENT
1CITY OF TIGARD
TIGARD Sign Permit Application PLANNING/ENGINEERING
o
SIGN LOCATION
REQUIRED SUBMITTAL
Address: (010U6 5114 i\1vAbvS Ate Rd Suite#: ELEMENTS
City/state: Tloh d., Q� Zip: ?223 El 2 copies of elevations on 81/2"x 11"
Tenant or business: 130C .A.-- � ` 92157.-
inlj or 11"x 17"pages(Wall sign
.1 elevations must include dimensions
6 ML CPA-tr. of sign and wall face and show the
1�
Property owner name: 1\1 IUy S ,,, AsScu;4, $ L. location of sign on the wall.
Address: 101 W& 6( ccit+1V l. Freestanding sign elevations must
City/state: -4:36Y'-0Grjt , O Zip: 911.3 be drawn to scale.)
-� _
Phone: ' •
--' '?6 Email: AffitAti nalf ll 1 U 'e(� ❑ 2 copies of site/plot plan,drawnto scale,on 81/2"x 11"or 11"x 17"
pages(not required for wall signs)
Sign contractor: Sal 4i\Mi Si(7w' Cd=,,ThL. ❑ List or diagram of all existing sign
Address: al. FC NE . dimensions and square footage
City/state: SA1JA`A"a /Zip: qi O( ❑ Application Fee
Phone:56j 111-(03(o2' Email: Md 1j' e SGt(f1 l h,.GOVT
NOTES:
CCB License#: (g52.617 Expiration date: 301o/2.o
• Freestanding signs over 6 ft.in height
Contact person: bit' 133/1'1* and walls signs of which any element
weighs 20 lbs.or more require a
building permit for construction.
SIGN DATA(Complete all items in this section) If any element of a wall sign weighs
TYPE (Check all that a 1 70 lbs.or more,plans must be prepared
pP y)
I, New sign by a structural engineer.
❑ Freestanding Cgi Electrical • Building permits require 2 sets of
❑ Alteration to x Wall construction drawings and,if sign is
❑ Freeway
existing sign freestanding,2 copies of site/plot plan
❑ Roof El Other and 2 sets of engineering must be
Sign#: submitted with building permit
application.
f c' 4(ireti itf
Sign dimensions:�� (0 (h) x4(w) = Zb•1'7 sq.ft. sign area
New sign:—v.27sq.ft.+ Existing sign area 30 sq.ft.=_Total FOR STAFF USE ONLY
Total sign area:,'. • 7sq.ft./ I9�uilding face sq.ft. =.03 %of bldg face Case No.: S'iv o;D/Q 00/37
Height to top of sign: 10 ft.Projection from wall: 5 in. Related Case No.(s):
Materials: JVt/1iMA l 14a 1)'v Fee: a eiF
Application accepted:
Is the sign under 20 lbs.? pl, Yes ❑ No By: 5 CO Date: (,://1
(Building Permit required if over 20 lbs.)
Application determined complete:
Direction wall faces (circle one):®S E W NE NW SE SW /�
By: 7 L w Date: 0/9/1
�1
Will the sign have illumination? f2r Yes ❑ No
If yes,what type: N Internal ❑ External l:\Community Development\Land Use Applications\02 Forms and
Templates\Land Use Applications Rev 12/14/2017
MN II.
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 1 of 2
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 he 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
recjuirements for approving or denying the application.
I hereby acknowledge that 1 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 required.
%
' a# &/14l -' 4/7
Applicant's signature Print name Date
J,nibic
s gslnature Cr c 450C)— name /VCtc-Ctv-1-6/1Kr1..14, �z, i /a 5
OwnerPr.
t +,c�it�g ' Date
�
.! f /
Owner's signature 'int name Date
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MGN PERMIT APPLICATION
City of Tigard • 13125 SW Hall Blvd, • Tigard,Oregon 97223 • www.tigard-or.gov • 503-718-2421 • Page 2 of 2
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Burger King - 10105 SW Nimbus Ave Rd - Tigard, OR 97223