HomeMy WebLinkAboutPermit Building 1981-04-08CIItrTT
CITY OF SPRINCFIELD
SIGN CONSTRUCTION AND ELECTRICAL INSTATLATION
cot tB INAT I ON tpp L I CATIOT-,/ pE RIIIT
C)F SPF,II$G3-IEIJD
sPRINGFIELO. OREGON 97 477
INFORI{ATION: 726-375s Irr-SPECTIOIi REQUESTS : 726-3:69
LOCATION OF SIGN(ADDRESS)
LEGAL DESCRIPTION 7'O
OI{NER OF PROPERfi
ADDRESS
Oh')'iER OF SIGN(IF OTHER TtLd\l PRoPERTY OlrllER)
ADORESS
NA}IE OF EUSINESS, FIR\I,
n
PHONE
E OF BUSINESS
ERECT
RELOCATE
2../o,//
ALTER
OTHER
zIDENTITy
PROJECTING
INCIDENTAL
DOUBLE FACE
_ NON-IDENTITY
SECONDARY
j.-SINGIE FACE
_ I.IULTI.FACE
VENDORS CoI\TR \CTORS
TAX LOT f
PHONE
zlP
t
L, OF IVORK TYPE OF SIGN:SIGN I
FREESTANDING
PROJECTING
READER BOARD
BILLBOARD
SIG}I ERECTOR
A.DDRESS
CITY LICENSE NtJ}IBER
PHONE
DATE 3-a-fa-"
SIGN }IIu\UFACTURER (IF OTIIER TlLtr\
ADDRESS
ADDRESS LICENSE NIJ}IBER
DII.IENSION FROII GRADI TO BOT'TOII OF S CKNESS OR DEPTH OF SIGN
DOES SIGN PROJECT BEYOND PROPERfi LINE YES T' NO IF YES,DI}IENSION BEYOND PROPERTY LINE
!iOTE: IF PROJECTION IS i.lORI Tlltu\ 12" OVER PUBLIC PROPERTY THE SIGN ERECTOR itlUST FILE hIITH THE BUITDING DMSI0N C0PIES 0F
HIS PUBLIC LIABILITY A,\D PROPERTY DAI,IAGE INSURANCE POLICIES.
rILL SIGN HAVE ELECTRTCAL I{IRTNG? _YES c=NO IF YES, WHIC}I APPTY?ELECTR]CAL SIGN ILLUI.'INATED ( INDIRECTLY LIGTTTED)
OF SIG}'I HORIZONTAL WIDTH OF SI6N
DESCP.IBE fiPE OF YNTERI.\IS SIG}.I IS COIISTP]JCTED 09
PROVIDE UL NUMBER IF APPLICAB VALUE OF SIGN
SITE INFOR}IATION (lfu\D IJSE)--EXISTING I.6E OF BUILDING OR LAND (OR LAST USE IF VACANT)
rE
Fll >","-3 -C/u./,'nJ
PROPOSED USE OF BUILDING OR LAND:
C}IECK ONE IF APPLICABLE INMOR BUSINESS OUTDOOR}TERCHfu\DISING
EXISTING SIGIS (siGN CODE) : ARE 'IllERE EXISTING SIGNS?
-YES
4!O Ir YES, DEscRIBE ltl rxGrlrc.SIGNS..FoR lqs-lllEss,
FIRM, ETC.:
AIL EXISTING SIGNS ON PRETIISES(SA]'IE TAX LOT):
I HAVE CAREFULLY EXAI'IINED the conPleted application for pernit
correct, and I further certify that all work perfonned shall be
Unifom Sign Code as adopted by the City of Springfield and al1
the State of Oregon pertaining to the work described herein. I
City of Springfield is in ful.l force and effect as required by
and do hereby certify that all inforroation hereon is true and
done in accordance with the Springfield Sign Ordinance, the
other Ordinances of the City of Springfield and the laws of
further certify that rDy Sign Contractors License with the
City Codes 8-2-6 and 9-7-20[2]. I rill request
all required sign listed on
NAME(PLEASE PRINT)
SIGN DISTRICT ZONE DISTRICT C-L TOTAL SQUARE }OOTAGE OF SIGN
pernit.
IE IGNATURE DATE
F"OTHER
E ONLY
tl
SIGN PERMIT
CTIAR6ES:'6609 ELECTRICAL PERI*IIT:
CTIARGES:
STATE SURCIIARGE:
FEES:
TOTAL FEE FOR PERI.IIT:$s.o)L
>TNALL
-.t_ ROoF
_ MARQUEE
_ OTHER
TOTAL HEIGHT ABOVE GRADE
INSPECIIONS REQUIRED: _SITE/LOCATION FooTING oR METHOD 0F ATIACHI.IE}{r ELECTRICAL
(j
INFORII{TIOI: 7 26- 3753
CIltrY OF SPF'IITGI-IEIJD
sPRINGFTELD. OREGON 97 477
CITY OF SPRINCFIELD
SIGN CONSTRUCTION AI.ID ETECTRICAL INSTALIJTION
COI\IB INAT I ON APPL ICATION,/ PE R.\IIT
INSPECTIOS REQUESTS: 736-J;69
LOCATION OF SIGI|(ADDRESS
LEGAL DESCRIPTIO:{7'6 3
OI{NER OF PROPERTY
ADDRESS
Oh'liER OF SIGN(IF OTHER TH.[{ pRopERTY oI{NER)
ADDRESS
NAME 0F BUSI):ESS, FIR\t,
TAX LOT T
OF BUSINESS
/ twcr
R.ELOCATE
-2,/o//
ALTER
OTHER
.T IDENTIfi
PROJECTING
INCIDENTAL
DOUBLE FACE
LEI
-
NON-IDENTITY
-
SECONDTRY
i<-SINGLE FACE
-_ }'IULTI.FACE
PHONE
ZIP
t
TYPE OF SIGN:SIGN CII ECK
p-NALL
j_ RooF
_ MARQUEE
OTHER
FREESTANDING
PROJECTINC
READER BOARD
BILLBOARD
VENDORS
SIGN
A.DDRESS
crrY LIcENsE Nr.ruBER Pao S? S EXP. DATE 3- A -&au'
slclr l'rtu\UFAcTURER (IF oTltER T't[\
ADDRESS
ToTAL HEIGHT ABovE GRADE /3,6
DIT.IENSION FRO.\I GRADE TO BOTIOiII OF SIGN
DOES SIGN PRO.'ECT BEYOND PROPERfi LINE YES Tl NO
CIC\ESS OR DEPTH OF S
IF YES,DI}IENSION BEYOND PROPERTY LINE
DITIENSION OF SIGN ZONTAL I{IDTH OF SI
N:OTE: IF PROJECTION IS l.lORE Tllts\ 12" 0VER PUBLIC PROPERTY THE SIGN ERECIOR I.IUST FILE I{ITH THE BUILDING DMSION COPIES OF
HIS PUBLIC LIAEILITY A,\D PROPERTY DA}IAGE INSURANCE POLICIES.
wtLL SIGN !|AVE ELECTRICAL I{IRING? _yES eiNO IF yES, WHIC{ APPLY? ELECTRICAL SIGN ILLITUINATED (INDIRECTLY LIGHTED)
DEscp.IBE TypE oF *{TERr.\Ls sl6l.r IS co}:srp.ucrED oF -S/uro^f,oa zar
PRovIDE UL NUMBER IF APPLIcABLE _- VALUE OF SIGN
SITE INF0RIIATION (Ln"\D I'SE)--EXISTING IJSE oF BUILDING oR I''Ar\D (0R L{ST USE IF VACANT}
F;l >, p ss -C/u./,
PROPOSED USE OF BUILDING OR l"A,ND:
CHECK O}.IE IF APPLICABLE: / INOOOR BUSINESS OI'TDOOR IIERCHIT\DISING
ExrsrrNc srcNs (sicu C0DE) : ARE rHERE EXISTING sIGNs? _YEs 4!o IF YEs, DESCRTBE ALL ExIsrING.sIGNs..FoR !!ls.li!Es!,
EIDM rf .
ALL EXISTING SIGNS ON PREI.TISES(SAI'IE TAX Lo|r)
I HAVE CAREFULLY EXAI'IINED the co,lpleted application for peroit
correct, and I further certify that all rork perfonoed shall be
Llnifo:m Sign Code as adopted by the City of Springfield and aIl
the State of Oregon pertaining to the work described herein. I
City of Springfield is in ful.l force and effect as required by I
and do hereby certify that all infornation hereon is true and
done in accordance uith the Springfield Sign Ordinance, tbe
other Ordinances of the City of Springfield and the laws of
further certify that Ey Si.gn Contractors License with the
City Codes 8-2-6 and 9-7-20C2I. I rill request
all required sign ions listed on
NAI'{E (PLEASE
SIGN DISTRICT ZONE DISTRICT TOT.A.L SQUARE IOOTAGE OF SIGN
INSPECTTONS REQUIRED:SITE/ISCATION
-FOOTING
OR METHOD OF A'I-TACH}'IEM ELECTRICAL
perruit.
.DATE
-OTHER
ELECTRICAL PERI-IIT:
CIIARGES: ------HI.II"1 6{, a9FEES:
TOTAL FEE FOR PERTIIT $ s. o-e-
STATE SURCTIARGE:
ELECTRICAL CoNTRASTOR --- PHoNE_
LICENSE NTJLBER_
,
CITY OF SPRING_FIELD
City Holl
Springfield, Oregon
Deportment of Public Works
OFF!CIAI RECEIPT
I{0. B 5628:
Received
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Received