SGN2020-00023 CITY OF TIGARD SIGN PERMIT
I • Permit#: SGN2020-00023
COMMUNITY DEVELOPMENT Date Issued: 03/11/2020
T I(—; R p 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2421 Parcel: 2S110AA01200
Jurisdiction: Tigard
Name of Business: Performance Dental Coaching
Business Address: 14300 SW PACIFIC HWY
Applicant/Agent: Lanphere, Dave
Work Description: Electronic Sign Permit
Permanent: Yes Freestanding: Yes Freeway: No
Temporary: Wall: No Electronic: Yes
Billboard: No Balloon: No
Banner: No A-Board: No
Sign Dimensions: 48)(96
Total Sign Area: 32
Wall Area: 0
Wall Face(Direction): Northeast
Sign Height: 6 ft.
Projection From Wall: 0 in.
Illumination: Internal
Materials: Electronic
Electrical Permit Required: Yes
Building Permit Required: Yes
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: ` ' • 6 4 Q
Permittee Signature. ,.- 2 �—""-" -•-~---{
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City of Tigard RECEIVED
■ COMMUNITY DEVELOPMENT DEPARTMENT MAR i i 2020
Sign Permit Application
CITY OF TIGARD
TIGARD PLANNING/ENGINEERING
o
SIGN LOCATION
REQUIRED SUBMITTAL
Address: 140 S Suite#: ELEMENTS
City/state: 1 t^A.N -, tel. Zip:41 - t 2 copies of elevations on 8'/z"x 11"
Tenant or busines3 9#` +r tkaAlt 1�J / or 11"x 17"pages(Wall sign
yt elevations must include dimensions
oProperty owner name: ,'r A4 S 4 t/P%SDn location sign ando walln on tfacehe
and show the
P �' of sign on the wall.
Address: / /3O ' St„) 96'4t ./i"� I9—o ' Freestanding sign elevations must
I'
" d Q /
City/state: Zip: 9 .2.Y be drawn to scale.)
r
' 2 copies of site/plot plan,drawn
Phone: Email: ;Prtjt i.Ri !�yi174' .001/ to scale,on8'/2"x11"or11"x17"
, ,
pages(not required for wall signs)
Sign contractor: 0 CA-11 Sy` .s4Ak -
Aiii List or diagram of all existing sign
Address: I.Lola-0 y).., -V,V4.1. dimensions and square footage
City/stateCtivd-t Zip: ell aVi JA Application Fee
Phone:5L)39 40 dtlEmail:r-30,i✓ c.hcowInAlkh&outus NOTES:
CCB License #:•••10SioiSg Expiration date: 135:4 a.C7
met,r_ l �r_L._. • and andsig signs Over
ic 6 ft.in het
Contact person: � 6`• � 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
70 lbs.or more,plans must be prepared
TYPE (Check all that apply)
0 New sign by a structural engineer.
Freestanding jzi_Electrical • Building permits require 2 sets of
Alteration to 0 Freeway ❑ Wall construction drawings and,if sign is
existing sign freestanding,2 copies of site/plot plan
❑ Roof 0 Other and 2 sets of engineering must be
Sign#: submitted with building permit
application.
Sign dimensions: 7 (h) w) = B 32' sq.ft. sign area
7z- FOR STAFF USE ONLY
New sign: 3 Z sq.ft.+ Existing sign area-9- sq.ft.=_Total Total sign area:1 Z sq.ft./ building face sq.ft.= %u of bldg face Case No.: S6 N 2020—0 0 0 2'3
Height to top of sign: (0 ft.Projection from wall: in. Related Case No.(s):
Materials: Fee: / ZZia
Application accepted:
Is the sign under 20 lbs.? 0 Yes R/No By: v.v.) 6 Date: 3 /I I /20
(Building Permit required if over 20 lbs) ��
Direction wall faces (circle one): N S E W l/ NW SE Application determinedat com lete:
l/ 3 lJ i I 2-G
_/ By: �� Date:
Will the sign have illumination? EVYes 0 No
If yes,what type: Ca Internal ❑ External 1:\ranmunity Develo ei ent�land Use APPlicationr Forms and
`)p Templates\taM Use Applications Rw 1If14(201�
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 1 of 2
APPLICANTS
NOTE: Person specified as`Applicant"shall be designated"perrnittee"and shall provide financial assurance for work
When the owner and the applicant arc different people,the applicant must be the purchaser of record or a lessee in possession with written
authori'ration from the owner Gran 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,arc 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.
SIGNA S of each owner of the subject property required. .-
II /#4/11R11
Ap canes signature Print name Date
U 514 so n �/9/c?•0
Owner's signa e Print name Date
Owner's signature Print name Date
SIGN PERMIT APPLICATION
City of Tigard • 13125 SW Hall Blvd. • Tigard,Oregon 97223 • wwwtigard-or.gov • 503-718-2421 • Page 2 of 2
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