HomeMy WebLinkAboutPermit Signage 2013-7-1 SPRINGFIELD — 225 Fifth St
i. ._ CITY OF SPRINGFIELD Springfeld,OR97477
Phone: 541-726-3753
OREGON Building / Sign Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
• PERMIT NO: 811-SPR2013-01496
www.springfieldor.gov permitcenter @springfieldor.gov
PROJECT STATUS: Issued ISSUED: 07/01/2013 EXPIRES: 12/27/2013
STATUS DATE: 07/01/2013 APPLIED: 07/01/2013
SITE ADDRESS: 445 HARLOW RD,Springfield,OR 97477 SCOPE: Sign
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ASSESOR'S PARCEL NO: 1703224407200 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Sign-wall sign Radiology Associates Tenant Sign
OWNER: RLS HOLDINGS LLC Phone Number:
•ADDRESS: 445 HARLOW RD STE 200
• SPRINGFIELD OR 97477
L CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
Sign Contractor IMAGE KING INC CC8 161313 09/01/2014 541-484-1482
INSPECTIONS REQUIRED
Inspections
6940 Sign Attachment
6999 Final Sign Sign Final: After all required inspections are conducted and approved and the sign
• installation is completed.
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By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all •
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with the
Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO
OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further
certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree
to ensure that all required inspections are requested at the proper time,that each address is readable from the street, that the
permit card is located at the front of the property, and the approved set of plans will remain on the site at all times during •
construction.
Owner or Contractor Signature - Date
ATTENTION: Oregon law requires you to N�TiCE:
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follow rules adopted by the Oregon Utility THIS PERMIT SHALL EXPIRE IF THE WORK
Notification Center. Those rules are set forth AUTHORIZED
in OAR 952-001-0010 through OAR 952-001- UNDER THIS PERMIT IS NOT
0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR
. calling the center. (Note: the teleph:.,o ANY 180 DAY PERIOD.
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 7/1/2013 1:39:44PM - Page 1 of 1
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SPRINGFIELD CITY OF SPRINGFIELD
225 Fifth St
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TRANSACTION RECEIPT Sphngfield,OR 97477
�i@+@+yamy�,00.EGON 541-726-3753
811-SPR2013-01496
www.springfield-or.gov 445 HARLOW RD permitcenter @springfeld-or.gov
RECEIPT NO: 2013001404 RECORD NO:811SPR2013-01496 DATE:07/01/2013
fol�.'i�1 ouiu]'1-2 e` r. s=;LS..'a.!a`-!:��w'ACCOUNT,CODE/TRANS ODEE" ,eleS AMOUNTha1114-;...
Admin fee(10%of applicable fees) 224-00000-426605 1098 8.00
Sign Plan Review 224-00000-425602 1018 42.00
Signs: 0-35 Square Feet 224-00000-425602 1007 80.00 • .
Technology fee(5%of permit total) 100-00000-425605 2099 4.00
TOTAL DUE: 134.00
PAYMETt1TYPE yRAYOR cASRIER: sDN MilMN''. ME-N.M;MMI3MantrAMOUNTiEYSIDniagnigri
Check IMAGE KING INC 134.00
20010
TOTAL PAID: 134.00
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(T(Ti CITY OF SPRINGFIELD, OREGON
225 FIFTH STREET • SPRINGFIELD,OR 97477 • PH:(541)726-3753 •FAX: (541)726-3689
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City Job Number '5/7—O l q "
'I�1 LiC/51 r JJ
r site Address: [J(�OGtJ�l'.
Assessors Map J 7 D 3 ZZ-r ( Tax Lot: 0 7 70 0
ti i Owner: (ZLS riJLAIi✓GS Phone:
II _ ' ' qn ' ,�
U� Address: L 4 C / i ato0 IZb
City SP�""f _/� State Q e_ Zip 9 747 7
Ip
r� Business Name,Firm,etc '�1�� Ass o C-(
c!1---1(- /
P1 1 Desc' rition of Proposed Sign(s): (Please check and complete all appropriate information)
oi c41 V Wall Freestanding Projecting Roof Marquee
Single Face Double Face Billboard Other
�j
Square Footage: Total Height above Grade: O
I _i 5/
r I Vertical Dimension of Sign or Enclosure: Horizontal Width of Sign or Enclosure:
I
Dimension from Grade to Bottom of Sign Enclosure Electrical Installation: Yes �No 4
(If yes additional electrical permit r quired) U
v; ( . Q /umiAvm /7o00
Material Sign is Constructed of: i tf Value of Sign:
r
Pi1 List ALL existing signage and attach a photograph of each sign:
o I\v/x,u- -1
(a) Type A Sq. Ftg. (b) Type Sq.Ftg
rO1 (c) Type t-1N\ Sq. Ftg. (d) Type Sq. Ftg. /
1 Contractor/Installer. `1 t \Qq e. I y\.1 t i i'1 Phone:54 I -4v`I-I Lf Fa
I .5-4— 0/�
�� Address: OS■ I� ( � �-
City: Ev 9 State:V re Zip: 7 U i
I1 Construction Contractors Registration Number: /6/ / Expires: ` 1 /-
OFFICE USE
11 Sign District:
/��
�`' Zoning: z•
r1
•: 1Byf signature, I state and agree,that I have carefully examined the completed application and do hereby cert ify that all
information herein is true and correct,and 1 further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield,and the Laws of the State of Oregon pertaining to the work described herein. I
iIrnl1 further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project.
r
I further agree to ensure that all required inspections are requested at the proper time,that project address is readable from the
Z street,that the permit card is located at the front of the property,and the approved set of plans will remain on the site at all
times during d--11)0 ns allattionn of_t_h'e sign ).
Signature am'°`— Date 6 b 9/3
Shared DriveM)/Building Forms/Sign Penult Applicalion1-02.doc