HomeMy WebLinkAboutPermit Signage 1999-3-31 (2)
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SIGN PERMIT APPLlCATI.
SPRINGFIELD
J.MBER <1C(,Q 2> 71
Inspection Line: 726.3769
Office: 726.3759
225 Fifth Street
Spnngfield, OR 97477
SITE ADDRESS: 34J,3
ASSESSORS MAP: Ii ()~
OWNER: () U t (311 c k
ADDRESS:1t.S'O I~/<;t Aut'
CITY: f?... / / ~ 11(' ...
BUSINESS NAME, FIRM ETC.: (JI.I f. h n,... J.:
TAX LOT:
~~A-
PHONE:
<,)1.111;. 11 S20
STATE: W A,
r"f. L ) CI~
.\ ../1 t1 1>011<" /~
ZIP: CUOOc..
~u__-' S'f,~~ I f,#21
DESCRIPTION OF PROPOSED SIGN(S): (please check and complete all appropriate information)
Wall
X Single Face
_ Freestanding
_ Projecting
Roof
Marquee
Double Face
Billboard
Other
.Square Footage: ,l)'7. 2
I q' '"
Total Height above Grade:
L/- / Width of sign or enclosure: I /.1/ ~ //
~callnstallation: -L Yes No VALUE..t{2 ~OO 0 <>
( (I~'~~~r~dditional electrical permit is' quiredl OF SIGN: -J .
-
Material Sign is constructed of: AI,,~ /J..u Ch"A/fV~'- Lt!--tl;H, f' Ali!'Oi-/
r77......'TI_";...\~............ I...., .."'....";roe- UI'\II +n _;~':'I~~I
..\-....- .. -J .. l~vl .;c.. WOR~
List ALL existing Sig~~'e>'Ir'rfdl\flM~qpbllQtg~rlfl,'i\ 'ill fe.g@ ~ti~i:tYrth THIS PERMIT SHALL EXPIRE IF THE ,
NotTfication Center:'fhose ru es are seTTO S PERMIT IS NO
la) Type In OAR 952'001~,lF\tr.rough OAR 952-0011i1 Type ~Lf1tljORIZED UNDER THI
0090, You may obtain copies 01 me rUles by S cnMMENCED OR 18 AtjANDONED FOR
Ic) Type ""llinn~eiSQlrFtb!ote: the telephone Idl Type Sq <:(9 Ale9
numbe'r for the Oregon Utility Notification ANY 11lu U/'I" ?C '
CM'er is ';800'33l-~::l44),
CONTRACTOR/lNSTALLER: t!paih \00 LOm tJll,vtt I-/....c: PHONE: .503 '</01;'- f?'5/n
. .
Venical Dimension of sign or enclosure:
I
Dimension from Grade ,
to bottom of Sign Enclosure: / f;"
ADDRESS: /0 L I 2, AI I=' In fl R.JI. <;-f
CITY: PM f 1;4 '" d
STATE: r?12,.
ZIP: Q122'O
EXPIRES: / -1 q - () (J
CONSTRUCTION CONTRACTORS REGISTRATION NUMBER: 1::2 7 J{7 0
CITY BUSINESS LICENSE NUMBER:
EXPIRES:
OFFICE USE
Zoning:
Code Section:
J;; ~ O"'n
~. .l5ln
Quad Area:
If'.WvJ
Sign District: T - 5
~~
Sig~' Permit Fee: $
('~lu.. Land Use:
~c::;_ !.!
Approved By: <:J.<' t
f'J.. )
Lu~
DATE: =3 -~o -C;~
.
REQl;IRED INSPECTIONS:
Site Footing ~ttachment /Electrical ~al
to be made prior prior to placement after fasteners are prior to energizing completion of sign
to sign placement of concrete installedlprior to cover electrical installation installation
Additional Comments a~d/or c~nditions: .fA./. UAi~ f-"~ hl.O'~ d ~1Tl. ~ i..~J., u~."..",..) .
By signature, I state and agree, that I have car~fully examined the completed application and do hereby certify that all information herein
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 of Oregon pertaining to the work described herein. I further certify that only contractors and
employees who are in compliance with ORS 701.055 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time. that project 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 the installation
of the signlsl,
Signature &.,L
/
~I/~,gk
Date
~- -=5 L
99
Validation:
Amount Received:
~5<5, -
3'33 d..~
Date Paid:
.Receipt Number:
Received By:
'3--01- C, D\
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