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HomeMy WebLinkAboutPermit Signage 2000-1-27 Jan-1B-OO 03:27P ESA SIGN PERMIT APPLlCATIO. &P~'NO"'''LD 225 Fifth Street ~ Springfield," OR 97477 ~ ~ SITE ADDRESS:/oofbHAiX"WW JeoAb -- - . ASSESSORS MAP: I -, D~ 7 7 IC-<) Li~I'-k{~;u, l ~ .. ~.". ADDRESS: :'>~.J':'.J Ghd '?PS-i-ui~; j.'5\Q-VV~ \'<.c.l CITY: t-:.V(:C8}.jC- P.03 JOS.BER ft1l - C1rD gel - 0 I TAX LOT: n^.~<.. i/31- L.j <;;3'if Inspection Line: 726-3769 Office: 7.Mi'oP~'192000/2:46 PM/$ 1.20 ACCT#:100-00000-426605 1<1:1-" n ~ I!} :r1.!:l!1n.'IJ~A (5'-/ ~8#:00-00084-0i BUSINESS NAME. FIRM ETC,: L\ \;':> Ci? + L-J STATE: 13/\.1'-1 ;,::- PHONE: ~. 20(5 c."Y.P ;'::'0.0/"': ZIP: ~ILj'10 OWNER: DESCRIPTION OF PROPOSED SIGNCS.: (please check and complete all appropriate Information) LWaU Fr!"Bstanding Projecting Roof Marquee Single Face Double Face Billboard Other Vertical DimensIon of sign or enclosure: ':')' :Total Height above Grade: . I I ~;> - 10 " .:;J.. L( I -.,., l 7) C.o''-- Square Footage: CI 2..17.> Horizontal Width of sign or enclosure: Dimension from Grade to bottom of Sign Enclosure: , .' \ '1, Iu 'Electrical Installation: )I.', Yes No (If yes additional electrical permit 1$'iiCiUlred) VALUE OF StGN: Material Sign Is constructed of: List ALL existing slgnage and attach.. photograph of each .Ign: . \ ( ..1\-,('\ ""', rf.. 101 Typ. I.vAU , t;;... ) Sq. Ftg: I ..~., Ibl Type l~kU. CSO) Sq. Ftg. Sq, Ftg, '-l-Z. c;i " (c) Type Sq. Ftg. (d) Type CONTRACTOR/INSTALLER: t:::;...~3-r'_.\ -:1" ~c.. ADDRESS: r~lo (:lt~F'..\'''IL..i''\ i2D, CITY: 8Ul..-1::.:l-.j 8 PHONE: A'2:: E? t.E,4. L CONSTRUCTION CONTRACTORS REGISTRATION NUMBER:' CITV8USINESS LICENSE NUMBER: (..1 we' " (j'2.-' STATE: III 't. '(',... ne+:r~ ZIP: C11 '-j(:;'2:- EXPIRES: . t- -2..' C ( EXPIRES: t..,- '36 .- c>L.' OFFICE USE Code Section: <5 ?, 017 (t."~l? II) <KL<j- LUu..". Quad Area: 2.. e 10/AJ S. D' . Ii '... Il~ . IQn Istrlct:! nw...M1LO..! UA ('.I'IVR...vV\. Zoning:. e......o....- (j Lend Use: Sign Permit Fee: .ItJG, ~ Ap'proved By: DATE: I - ZI-/Y1) REQUIRED INSPECTIONS: Site' to be made prior to' sign placement Footing prior ,to placement of concrete / Attachment after fasteners are Installed/prior to clJver ~ h. l>l-vi c..ll...-l . / Ele~trlc~1 prior to energizing electrical Installation Additional Comments an~/or Conditions: ~ . ht.u'Jt.LGt ~~ 6 /' Flnai completion of sign installation ~ -; k..t..La.....(,'n\. BV signature, I state and agree. that I have car~ful,ly eXBmined the completed application ,and do hereby certify that all information herein is true and correct. a0d I further certIfy that any and all work performed shall be done in accordance 'W"lth the Ordinances of the City of Sprln..Q:fleld, and the '~aw8 of the State of Oregon pertaining to the work described herein. I further certify that only contractors and em'pl?yeeS 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 stroet, that the permit card is located at the?Jz;t of the property, and the approved set of plans will remaIn on the site at all times during the installation of the slgnlsl. ( 7 I . . Signatu,e ~- C--::-~7d _--' Dot. { - I e, - CO l '\ r" '~ Validation: Amount Raaalnd: Oata Paldi Receipt Number: Received By: