HomeMy WebLinkAboutPermit Signage 1998-1-30
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SIGN 'PERMIT APPLICATION.
SPRINGFIELD
JOB N'::ctiO~::\:~
Office: 726-3759
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OWNER: _m, ~~ <i- 0 0Tl1'\.tA.- ff\()",){1 nLD
ADDRESS:iq,;U TfltU'1\O-..{-;IJf\O.J (U(U..A
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CITY: "'l nr; "3{!.; e\ ci STATE: ()l{Z
BUSINESS 'NAME, FIRM EiC.:_ A rtl.ll~ c; I ii fY\ 1)<, A '. .
225 Fifth Street
Springfield, OR 97477
SITE ADDRESS: ~_~ I
ASSESSORS MAP:
TAXLOT:~ rjf)9~i
PHONE: 7L17- X-&(,,()
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ZIP:
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DESCRIPTION OF PROPOSED SIGN(SI: (please check and complete all appropriate information)
~ Wall _ Freestanding _ Projecting Roof
1- Single Face Double Face Billboard Other
Square Footage: .~::l C/J Total Height above Grade: (3~' ~
_ Marquee
Vertical Dimension of sign or enclosure:
Xl
tal Width of sign or enclosure:
L/.
Dimension from Grade ,el
to bottom of Sign Enclosure: ()I.]
Material Sign is constructed of: ()'\(L'tn (
Electrical Installation: Yes No
(If yes additional electn al p rmit is required)
VALUE~C-O^~
OF SIGN: 0 U
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List ALL existing signage and sttach s photograph of aach sign: ((\ 0 rLL '\
(al Type Sq. Ftg. ~.-...J
CONTRACTOR/INSTALLER: ,c:;<;<>J-A 'LI\ e-
ADDRESS: I diD ('nt,j}1J...-t-rh Qd
CITY: r:;.1)().UU-
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CONSTRUCTION CONTRACTORS REGISTRATION NUMBER:
CITY BUSINESS LICENSE NUMBER: q5Q 3'1' 1
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.STATE: r')R.... _c~ ~ ~1~'9 7l/.()-;).
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OFFICE USE '" /::5 ~ .
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DATE: I (;11.~
(d) Type
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Sq. Ftg.
Sign DistrictS()Q.~o.ll\a..~k
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~..J.and Use:
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Zoning: _
Code Section:
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Sign Permit Fee:
Approved By:
Site
to be made prior
to sign placement
Footing
prior to placement
of concrete
~tachment
after fasteners are
installed/prior to cover
v-EI~ctrical
prior to energizing
electrical installation
~I
completion of sign
Installation
REOUIRED INSPECTIONS:
Additional Comments and lor Conditions:
.. By signature, I state and agree, that I have carefully examined the com"leted ap~lication and do hereby certify that all information herei,
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 0
Springfield. and the Laws of the State of Oregon pertaining to the work described herein. I further certify that only contractors an
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, thl
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 installatio '
of the sign{s).
Signature (l J;/l) riP//! / ')()tJ-t{)(;(A" ~
I
,
Date
/ ~d)--9[?
Received By:
\ - 30 - '9 '{
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Receipt Number:
_ri3.JJO
1fts h'1 c(
Date Paid:
Validation:
Amount Received: