HomeMy WebLinkAboutPermit Signage 2020-02-21OREGON
Web Address: www.springfi eld-or.gov
Building Permit
Commercial Sign
Permit Number: 81 1-2O-OOO2O6-SIGN
IVR Number: 811064399583
City of Springfield
Development and Public works
225 Fifth Street
Springfield, OR 97477
54r-726-3753
Email Add ress: permitcenter@springfield-or.9ov
SPRINGF!ELD
tb
Permit Issued: February 2L,2O2O
TYPE OF WORK
Category of Construction: Sign
Submitted Job Value: $0.00
Description of Work: Signs (5) for Dutch Bros kiosk
Type of Work: None Specified
,OB SITE INFORTTIATION
Worksite Address
1503 MOHAWK BLVD
Springfield, OR 97477
Parcel
170325340440r
Owner:
Address:
MOHAWK PARTNERS LLC
PO BOX 7283
SPRINGFIELD , OR 97475
LICENSED PROFESSIONAL INFORMATION
Business Name
ES&ASIGNCORP-Primary
License
ccB
License Number
163470
Phone
54 1-485-5546
PENDING INSPECTIONS
Inspection
6999 Final Sign
6910 Sign Footing
6940 Sign Attachment
6950 Electrical Service - Sign
Inspection Group
Signs
Signs
Signs
Signs
Inspectaon Status
Pending
Pending
' Pending
Pending
SCHEDULING INSPECTIONS
Various inspections are minimally required on each project and often dependent on the scope of work' Contact
the issuing jurisdiction indicated on the permit to determine required inspections for this project'
Scheduleortrackinspectionsatwww'buildingpermits.oregon.gov
Call or text the word "schedule" to 1-888-299-2821 use IVR number: 811064399583
Schedule using the Oregon ePermitting Inspection App, search "epermitting" in the app store
Permitsexpireifworkisnotstartedwithinl8oDaysofissuanceorifworkissuspendedforlsoDaysorlongerdependingon
the issuing agencY's Policy.
All provisions of laws and ordinances governing this type of work will be complied with whether sPecified herein or not'
Granting of a permit does not presume to give authority to viotate or cancel the provisions of any other state or local law
regulating construction or the performance of construction'
ATTENTIoN:oregonlawrequiresyoutofollowrulesadoptedbytheoregonUtilityNotificationcenter.Thoserulesareset
forth in oAR 952-OO1-OO1O through oAR 952-OO1-OO9O. You miy obtain coPies of the rules by catling the center at (503)
232-L947,
Allpersonsorentitiesperformingworkunderthispermitarerequiredtobelicensedunless
(structural/ltechanical), ons czi.sto (Electrical), and oRs 693.O1O-O2O (Plumbing).
Ptinted oni 2l2U2O Page 1 of 2
exempted bY ORS 7O1.O1O
l
C:\myReports/reports//production/0 1 STANDARD
"-l
Permit Number: 81 1-20-OOO2O6-SIGN Page 2 of 2
Fee Description
Sign or outline lighting
Technology Fee
Copies - > 5, up to 11x17, per each
State of Oregon Surcharge - Elec (L2o/o of applicable fees)
Permanent sign - 0 to 35 square feet, per sign
Sign plan review, per sign
Prinled oil 2/2Ll2O
Quantity
5
5
Total Fees:
Fee Amount
$44s.00
$56.6s
$18.00
$s3.40
$440.00
$230.00
$1,243.05
5
36
Page 2 of 2 C: \myReports/reports/ / prcduction/ O I STAN DARD
PERMIT FEES
SPTINGTIELD
OREGO'i
www.springfield-or. gov
Record Fees
B 1 1-20-000206-SrGN
1503 MOHAWK BLVD, Springfield, OR97477
City of Springfield
Development and Public Works
225 Fifth Street
Springfield,OR 97477
Phone: 541-726-3753
permitcenter@sprin gfield-or. gov
Sign plan review, per sign
Sign plan review, per sign
Sign plan review, per sign
Permanent sign - 0 to 35 square feet,
per sign
Copies - > 5, up to 11x17, per each
Sign or outline lighting
Sign or outline lighting
Sign or outline lighting
State of Oregon Surcharge - Elec (12olo
of applicable fees)
State of Oregon Surcharge - Elec (12%
of applicable fees)
Technology Fee
Technology Fee
State of Oregon Surcharge - Elec (12olo
of applicable fees)
Technology Fee
$0.00
$0.00
$0.00
$2s6.00
$0.00
$0.00
$0.00
$0.00
$0.00
$18.00
$0.00
$0.00
$44s.00
$0.00
9
9
5
5
36
9
9
5
1
1
$4L4
$414
$230
$440
Qtv
Qtv
Qty
EA
Qtv
Ea
Ea
Ea
Ea
Ea
EA
Ea
Ea
EA
$18.00
$801.00
$801.00
$445.00
$96.1 2
$74.45
$74.45
$53.40
CREDTTED
CREDiTED
INVOICED
INVOICED
INVOICED
CREDITED
CREDITED
INVOICED
CREDITED
CREDITED
CREDITED
INVOICED
00
00
00
00
$0.00
$0.00
$230.00
$ 184.00
$0.00
$0.00
$96.12 CREDITED $0.00
$56.65
1
1
1
$0.00
$0.00
$o.oo
$0.00
$0.00
$s3.40
1 $56.65 INVOICED
Total Fees:
Total Invoiced Fees
Total Fees Paid:
Total Balance Due:
$1,243.05
$ 1,243.05
$414.00
$829.05
C : \myReports/reports//prod uction/0 1 STANDARD
REPORTS/std_Fee_Payment_By-Record-pr. rpt
2/20/20 10:30 am Page 1 of 1
Work Description: Signs (5) for Dutch Bros kiosk
Fee Fee Amt Fee Status
#
Qry Amt Paid Balance Due
Fee List
Record lD: 81 1 -20-000206-SIGN
Menu Add Delete Void lnvoice ReCalc
Page I of 1
Fee Total
Help
$453.60Fee Galc. Factor:
Showing 1-3 of 3
[] Fee ltem
Page of1
Job Value(Contractor)$0.00 v
aq Unit
f Sion olan review. per sign
f Cooies - > 5. up to 11x17. per each
I Technoloov Fee
I
36
432
Qtv
Qtv
Automatic
:.1
https://av-oregon.accela.com/portlets/fee/feeList.do?mode:list&module:Building 211912020
5t,fllh{GffEL0
Transaction Receipt
811-20-000206-5IGN
IVR Number: 81 1064399583
Receipt Number: 473700
Receipt Dale:1131120
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
54L-726-3753
permitcenter@spri ngfield-or. govRE6ON
www. springfield-or. gov
Worksite address: 1503 MOHAWK BLVD, Springfield, OR97477
Parcrel: 17Q3253404401
Transaction
date
1t31t20
2120t20
9.00 Qty
9.00 Qty
2t20t20 5.00 Ea
2120t20 5.00 Oty
Description
Sign plan review, per sign
Sign plan review, per sign
Permanent sign - 0 to 35 square feet,
per sign
Sign plan review, per sign
Fees Paid
Account code
224-00000 -425602- 1 030
224-00000 -425602- 1 030
224-00000-425602- 1 030
224-00000-425602- 1 030
Fee amount
$414.00
$414.00 Voided
$440.00
$230.00
Units Paid amount
$414.00
$(414.00)
$184.00
Payment Method: Credit card Payer: kim bennion
authorization: 03187j
Transaction Comment: via phone
Payment Amount:$414.00
Cashier: Katrina Anderson Receipt Total $414.00
Prinled. 2120120 1 0:1 3 am Page 1 of '1 FIN TransactionReceipt_pr
,{&
$230.00
SPRINGfIELD
w
Transaction Receipt
811-20400206-StGN
IVR Number: 811064399583
Receipt Number: 473700
Receipt Date:1131120
City of Springfield
Development and Public Works
225 Fifth Street
Springfield, OR 97477
547-726-3753
perm itcenter@spri n gfield-or. govOREGON
www.springf ield-or. gov
Worksite address: 1503 MOHAWK BLVD, Springfield, OR97477
Parcel: 1 703253404401
Fees Paid
Account codeTransaction Units
date
1t31120 9.00 Qty
Description
Sign plan review, per sign 224-00000 -425602- 1 030
Fee amount
$414.00
Paid amount
$414.00
Payment Method: Credit card Payer: kim bennion
authorization: 031 87j
Transaction Comment: via phone
Payment Amount:$414.00
Cashier: Katrina Anderson Receipt Total:$414.00
Ptinled: 1 131 120 2:47 pm Page 1 of 1 F I N_Tra nsaction Receipt-pr
U,- rd
CITY OF SPRIN(iFIELD. OREGON SPNINGFIELO
City Job Numbe r,illZ\-Mxyc SraN pdestrirn-orlentcd signs that rafsfy Municlpal Code 8.250(3) (J0)"-?.,J***.k,,"
225 FIFTH STREET i' SPRINGFIELD, oR 9747'l * PH: (541)726-3759 * FAx(541)726-3089
Slte Address:
Assessors Map(s):Tax
Owner:Phone
OREGON
ls due wlth eppllcation, EXCEPT for
#
nvqT\H-Address:
Buslness Namg Firm, etc:i),--\.\ Ro ,S
DESCRIPTION OF PROPOSED SIGN(S)
TYPE OF WORK: Please mark atl thet tpply: New: :l= Replacement: Alteration/Relocation:
-QUANTITY OF SIGN TYPE(S): Pleese indicrte how many of each sign you propose to instell:
Wall: X Freestanding:
-Projecting:
Roof:- Marquee:
-Billboard:
Other: _
-Pedestrian-Onented
Sign (Downtown Sign District ONLY, See Municipal Code 8.250): WindowAfu'all: or Blade:_
DESIGN & PLACEMENT: Please attach edditionel information if more than one sign is proposed:
Single-Sided, X- Double-Sided:
-
Non-Itluminated:
-
Illuminated: Internal * or Exrernal
-Square roouge:fl0 [ [z Vertical Dimension: frffii{orizontal Dimension: e
Distance from adjacent grade to bottom of sign t L' j[-o. Total heieh;;graa",lfll/n)
f.ORWALL SIGNS: length of uall on which the sigrr is located: l-e-n.
FOR WINIIOW SIGNS: Gross glass area of all windows on the side that the sign is located:
--sq.
ft.
Electrical installation: Yes:V No:+-(lf "yes," additional electrical permit required.)
Materials:t$,?,)QS
n
\
I
List!L!
(a) Type:
(c) Type:
existing signage and attach a photogreph ofeech
l/ / /Y' Sq. Ft.:
sign:
(b) Type: Sq. Ft.:
Sq. Ft.: _ (d) Type: Sq. Fr.:
Con tractor/lnstaller :
Address:State:av (J?\oZ
Construction Contractors Number:lb 9rt?o Expires:o
Print Name:Slgneture:
OFFICE USE: Sign Dish'lct:Zoning:
By signature, I strte rnd rgree, that as owner or ownero agent, that I have csrefully examined the completed appftcation
and do hereby certify that all lnformation herein ls true rnd correct and I further certtfy thet eny rnd rll work performed
shall be done in sccordence wlth the Ordinances of the City of Springfield, end the Laws of the State of Oregon perteining
to the work described herein. I further certify that only contrrctors and employees who are ln compliance with ORS
701.055 will be used on this project. I further agree to en$ure that all required inspections are requested et the proper
time, thet project eddress is rerdeble from the strcct, thrt the permit card ls located at the front of ttre property, and the
approved set of on the site et all tlmes during the installation of the
Signature:
Edired 0?/17/2019 BJones
Date:Tozb
\-1 0 V>534
SPR.INGFIELO
225 FIFTH STREET * SPRINGFIELD, OR 97477 i PH: (541)726
City Job Number:
Site Address;
Assessors Mao(s): Tax
is due withapplicetion, EXCEPT for
pedertrien-orlented dgnr thet mtlsfy Munldpd Code 8.250(3) ($0)
-37 59 * FAX(54 I )726-3689jiqft]&.z
Pth-Rr&rlw rcc otClo pcr rtgn
OREG()N
Ovner:Phone
Addrers:z,p q?\Tf
Bucineso Neme, Flrm,ut, ?.A& &t;
DESCRTPTTON OF PROPOSED SrGN(S)
TYPE OF WORK: Please mark ell thet apply: New: * Replacement: . Alteration/Relocation:
-QUANTITY OF SIGN TYPE(S): Please indlcate bow meny of cach sign you propose to instell:
iWall:{Freestanding:Projecting:Roof:-Marquee:Billboard:othcr:-
_Pcdcsbian-Oriented Sign (Downtown Sign District ONLY. See Municipal Code 8.250): WindowA}'rll: or Bladc:
-DESIGN & PLACEMENT: Please attech edditionel informetion lf more then one sign ls proposed:
Single-Sided, X- Double-Sidcd:
-
. Non-llluminated:
-
Illuminated: lnternal I orExtemal
-t*"..."""r18-vrrtir"r o,."r,r.*alLiorizontal oilIlon, 4' .
Distance from adjacent grade to bottom ors,gn rl-e, [io Total height above g."a.,lltn.
FOR WALL SIGNS: I-ength of wall on which ttre sign is located: la t.
FOR WINDOW SIGNS: Gross glass area of all windows on the side that the sign is located:
--sq.
ff.
Elecnicatinstallation:Yes: V No:(lf "yes," additional electrical permit re4uired.)
Materials:Value ($):2,ll+
List4l;.
(a) Typc:
erlsdng signage and attach a photogreph ofeech
l/ ik sq. Ft.:
rlgn:
(b)T1Ae: q.Ft.:-
Zip:
Erplres:
(c) Tlpe: Sq. FL:
-
(d) TtPe: Sq. ft.:
-
Con tractor/Installer :
Y State:o
ature:
OFFICE USE: Sign Dlstrlctr Zoning:
By signature, I strte rnd agree, that as olyner or owoers 8gent, thet I have carefully exrmined the completed applicadon
end do hereby certtfy that all informafion herein is true rnd corec! and I further certiS that sny rnd all work performed
shall be done in eccordance with the Ordinances of the City of Springfield, rnd the Laws of the Stete of Oregon perteining
to the work descrlbed herein. I further certify that onty contractors and employees who are in compliance with ORS
701.055 wlll be used on this project. I further agree to etrsure that ell required irspectlono are requested at the proper
time, tbat project address ls reedable from dre street, thst the permit cerd ls locrted at the front of the property, rnd the
approved set of on the site at dl times durlng the installation of the
Signature:
Editcd 07ll 7/2019 BJones
Date:Zozd
C'lTY OF SPRINCFIEI-D. ORfr(,(X{
^A,ddress:
Construction Number:
Print Ngme:
SPRINGFIELD
225 FtrTH STREET * SPRINGFIELD, OR 97477 4 PH: (541)726
City Job Number:
Site Address:
Assessors Map(s): Tax
is duc rlth rppllcrtion, EXCEPT for
pcdcrtrien-orlented signs thrt srtls$ Munfiipd Code 8.250(3)($0)
-37s9 * FAX(54l)726-3689
Siq/t+3
Pla-i Rqi/w Fct ol$46 per rlgn
OREGON
Owner:Phone
Address:uet 4?\7A"-
Buslness Nemg Flrm' etc:
DESCRTPTION OF PROFOSED SIGI{(S)
TYPE OF WORK: Please mrrk ell thrt rppty: New: >anephcement: Alteration/Retocation:
-eUANTITY OF SIGN TYPE(S): Pterse indicete bow meny of eech sign you proPose to lnstall:
wall:*nreestanding:Projecting:Roof:-Marquee:BilIboard:othcr:-
_Pedcstian-Oriented Sign (Downtown Sign District ONLY. See Municipal Code 8.250): WindowAl/all:-or Blade:
-DESIGN & PLACEMENT: Pleese attrch additionel informetlon lf rnore then one sig;n is proposed:
Single-Sided' X- Double-Sided:
-
Non-{lluminated:
-
ffltlminatea:.Ft.rn.f X orExternat
-Square Footage: (i.'NV"ni"ut oimension:|')(&Horizontal Dimension: ?'-tOtlt|" ., -r, N
Distance tom adjacent grade to bottom of sign hce: -L I Total height
"Uor.
gpa.6 -Ylf;.
FOR WALL SIGNS: kngth of wall on which thc sigr is located: -k-n'
FORWINDOW SIGNS: Gross glass area of all windows on the side that the sign is locatcd:
-.sq.
ft.
installation:Yes: X No (If "yes." additional electrical permit required.)
n Value 1q: '1,31\
sign:
O)Type: Sq. Ft.:-
(c) Type: q. Ft.:
-
(d)Tyle:Ft.:
Contrac{orllnstaller :
Address:E"aenL- stete:nv q7\o?*
Construction Contrsctors Number:Expira:
Print Name:Signature:
OFFICE USE: Sign Distrlct:Zoning:
Electrical
Matcrials:
List l\ll
(s) Type:
erlsttng slgnage and attacb a photograph oferch
/l /k sq.Ft.:
-
By signahre, I stete and agree,that as owner or owners agent, tlat I have careful$ examlued the completed epplicadou
end do hereby ccfriry thet all lnformatiou herein is tme and correc! end I further certlfy that eny rnd all work performed
shall be done in accordance wlth the Ordinarcet of the City of Springfield, and the Lews of the State of Oregon pertaining
to the work descrlbed herein. I further certlfy thet only contractors and employees who are in compliance with ORS
701.055 wtll be used on this project. I further agree to ensure &at etl reguired lnspections ore requcstd at the proper
tlme, ttet project eddreis ls reedable from the ttreet,thct the permit card ls located 8t the front of &e property' and the
on the site at all times during the installation of theapprovedset of
Signature:
srgnG).
I lEo lzrro
Editcd 07/l 7/201 9 BJoncs
Date:
CIT\' OF SPRIN(iFIIjLT]" OREGO\;
C ITY OF SPR I}{GFIELD. 0RT.,GON SPRINGFIELD
22588-fH STREET * SPRINGFIELD, OR 97471 i PH: (541)726-3759 + FAX54l)726-3689
"*d}..kt.,gnisduc
ONEGO
City Job Number:
Site Address:
Assessorc Map(s): Tar
with rppllcedon5 EXCEPT for
pedestrirn-orlcnted signs thet rrtlsS Munldpd Codc 8.250(3) (t0)
Orvner:Phone
Address:z.p q?17+-
Buslness Name, Firm, etc:D,A"\ Au,S
DESCRTPTION OF PROFOSED SIGN(S)
TYPE OF WORK: Please mrrk atl thet eppty: New: *Replacement:
-Alteration/Relocation: -QUANTITY OF SIGN TYPE(S): Plerse indlcste how meny of cach sigp you proPose to lnstrll:
Wall: F Freestanding: Projcctrng: Roof:
-
Marquce: Billboard: Other:-
_Pedesbian-Oriented Sign (Downtown Sign District ONLY. See Municipal Code 8.250): WindowAffall: or Blade:
-DESIGN & PLACEMENT: Plesse eftech edditlonrl informetion if rnore then one oign is propo*d:
Single-Sidcd, Y Double-Sidcd:
-
NonJlluminatcd:
-
Illumingted: Intemal X o, Extcrnal
-SquarcFoouge:rb]?v,a""tol.ension,3,]6f[Ho.i-nt,tDirrrension:,?,-to,ft,,,
Disrance from adjacent grade to bottom of sign t *, 3O, Toal height above grd"r[) ' Stlttt"
FOR WALL SIGI{S: t ength of wall on which the sigr is located: 9L*.
FORWINDOW SIGNS: Gross glass area of all windows on the side that the sign is located:
-_sq.
ft.
Elcctrical installation: Yes: X No:(lf "yes," additional electrical permit required.)
Materials:Value ($): l, 3l{
Listlll
(e) Type:
(c) Tlpe:
Construcdon
Prlnt Neme: _
--sq. Ft:
slgn:
(b)Type:
(d)Tpc:
Contractorflnstgller:
Address:F4,€N-=-st^t,7lp:\o
Number:J Expira:
Slgneture:
By slgneture, I state end egree, that as owner or oryners sgenq thtt I heve carefully exrmined the completed applicetion
ana Ao hereby certiS thet ell lnformation herein is true and correcg and I further certlfy thrt any rnd ell work performed
shgll be done in accordgnce with the Ordinances of the City of Springfleld, rnd the Laws of the Sttte of Oregon pertalnlng
to the work descrlbed herein. I further certify thet onty contractors and employees who are in c:omplience wlth ORS
70f .055 wlll be used on thls project.I furtber egree to ensure that all required lnspections are requested et the Proper
time, tbat project address is recdeble from the street, tbrt the permit crrd lc loceted rt the front of fre property, snd the
approved set of site at all times during the instellation of the
Signature:
exisdng slgnrge end rttach e photograph of each
Ft.:
Ft.:
Editcd 07r172019 BJoncs
on the
Date:Tozb
L.-
OFFICE USE: Stgn Dlrtrtct: Zonlry:
( I'TY OF SPRINGFIELD. 0REGON SPRINGFIELD
225 FIFTH
City Job
Site Address:
TarAssessors Mep(s):
Owner:Phone
Address:zlp q7\7+-
'A"h -,SBuslness Neme, Firm' etc:p
DESCRTPTION Or PROPOSED SIGN(S)
Tl/pE OF WORK: Pleaee msrk all that apply: New: )4 Replacement: Alteration/Relocation:
-QUANTITY OF SIGN TYPE(S): Plerse indicate bow many of each elgn you propose to install:
Wall:-Frcestanding: Projecting: Roof:
-Marquse:
Billboard: Otlrer;
_pedcs6ian-oricnted Sign (Downtown Sign District ONLY. See Municipal Code 8.250): windowruall: or Blade:
-DESIGN & PLACEMENT: please atrch edditionel lnformetion lf more than one rign is proposed:
Single-sidedr X- Double-Sided:
-
Non-Illuminated:
-
Illuminated: Intemal
-
or Extemal
-il";;;;UL;;";;,'* ifi*;;*Htatoilnsion'Q"@Qk6",.
Distance &om adjacent gnde to botlom of sigr ,I"-r 30. Total u.,gni"-* o^", ffil'|"
FORWALL SIGI\S: I*ngth of wall on which the sign is located: -!tzt.
FOR WINDO'til sIGNS: Gross glass arca of all windows on the side that the sign is located:
-sq'
ft'
Electrical instaltation: Ycs: Y= No:(lf "yes." additional electrical permit required')
Malerials:Value ($):t.3 rq
Listtll
(a) TWe:
(c) Tlpe:Ft.:
slgn:
(b)Type Sq. Ft.:
(d)T1pe: Sq. FL:
Con tractor/Instsller :
Address:
Construcdon Contractors Number:
Print Nrme:Slgnature:
OFFICE USE: Sign Dtstrlct:Zonlng:
State:apt,4?\oZ-
Explres:o
Editcd 07r I ?/2019 BJone-s
signage and rttach r PhotograPh
('lT\' OF SPRING['I[LI). ORI(jON SPRIXGf IEI.O
725 FlIrfH STREET r SPRINGFIELD, OR 97477 * PH: (541)726-3759 * FAX(541)726-3689
#J#1"*,k.*
-"on.r()RE6ON
is due wtth rppllcrtioq EXCEPT for
City Job Number:pede$:irn-orleuted slgns that srtls$ Muntcipal Codc E.250(3) ($0)
Site Address:
Assessors Map(s): Tex
Owner:Phone
Address:z,p,q?1?+-
Buslnesc Neme, Firm, etc:O,A"\
DESCRTPTION OF PROFOSED SICN(S)
TYPE OF WORK: Pleeee mark atl thet apply: Wew: ->lRcplaccment: Altcration/Relocation:
-QUAI{TITY OF SIGN TYPE(S): Pleace indicete how meny of each sign you propo3e to install:
Wdl: -{Freestanding: Projccting: Roof:
-Marquce:
Billboard: Other:
_Pedcstrian-Oricnted Sign (Downtown Sign District ONLY. See Municipal Code 8.250): WindowAilall: or Blade:
-DESIGN & PLACEMENT: Please attech rdditionel informrtion lf more than one sign ls proposed:
Single-Sidcd, X- Double-Sided:
-
No^n{flq$nated:
-
Illuminated; Internal X- * Extemal
-square root"g"' 9, I vertical Dimentior' ,'- ? l/#;ntal Dimmsion' l'- (( '/6tt
,_, 13/6\.
Distance from adjacent grade to bottom of sign face: l\-t. Total height above grade: ltlhl
FOR WALL SIGNS: Length of wall on which ttre sign is located: )aO
FOR WINDOW SIGNS: Gross glass area of all windoun on the side that the sign is located:
-sq.
ft.
installation: Yes:-[ No'(If "yes," additional electrical permit required.)
Value ($):4q
Electrical
Materials:
ListALL
(e) Tlae:
existing signage and attach a photograph ofcach
/l lk sq.Ft.:
-
sign:
(b) Type:
(d) Type:
Ft.:
Ft.:(c) Tlae: Sq. FL:
-
Contractor/Insteller :
Address:Endn,(- state:zzrp,4?\o7-
Conetruction Contractore Number:J Expirc:
Print Neme:Signeture:
OFFTCE USE: Slgn lXstrict:Zonlng:
By slgnature, I state and agree, thet as owner or owners agent, thrt I heve cerefully examined tbe completed applicetion
,na a, hereby certlff that all lnformation herein is true and correc! end I further cerdS that any and all work performed
shall be done in accordance wtth the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining
to the work descr.lbed herein. I further certify that onty contrrctors and employees who are in eompliance with ORS
70f.055 will be used on thls project. I further agree to ensure thet eII requlred inspections are rquested at the proper
tlne, thet proJect address is reedeble from tte street,thet the permit cerd is located rt the front of the property, end tbe
approved set of on the site rt all times during the installatlon of tbe
Slgnature:
Edilcd 07/l 7/2019 BJonas
Dete:ToZb
C'IT\' OF SPRINCiFIELD. OREGON SPRINGFIELO
225 FIFTH STREET . SPRINGFIELD, OR 97477 * PH: (541)726-3759 + FAX(541)726-36893iar-+7m/nuJ' rc.Jfuplrrlgn
'bon€GON
ls duc wlth rpdlcetion, EXCEPT for
pedertrirn-orletrted sigD3 thrt rsdsfy Mutdctpd Code 8.250(3) (S0)Ctty Job Number:
Site Address:
Arsecsors Mep(s): Ter
Owner:Phone
Address:z.p,4?\?A-
Buslness Name, Firm, etc:Cr\"\ g
DESCRTPTION OF PROPOSED SIGN(S)
TYPE OF WORK: Please mrrk all thrt rpply: Ncw: * neplaccment: Alteration/Retocation:
-QUANTITY OF SIGN TYPE(S): Plersc indicete how meny of each dgn you proPosc to lnstrll:
Wall: _Freestanding: _Projccting: Roof:
-
Marqucc: Billboard: Other:-
_Podcsbian-Oricnted Sign (Downtown Sign District ONLY. See Municipal Code 8.250): WindowAilrll:
-or
Bladc:
-DESIGN & PLACEMENT: Please attsch eddttional lnformgtlon lf more than one sign ls proposcd:
Single-Sided, X_ Doublc-Sided:
-
Non-Illumiuated:
-
Illuminated: lntemal
-
or External
-squarc r-tue;fLv"a""r oir,'*io*&!dt)),t; ;,r*" r, y121 f - -
Distance from adjacent grade to bottom of sigrr face: LL * Total height above grade: f',ln. '
FORWALL SIG?{S: t*ngth of wall onwtrich the sigp is located:312-n.
FOR WINDOW SIGNS: Gross glass arca of alt windows on the sidc that the sign is located:
-sq.
ft.
Electrical installation: Ves: X No:(lf "yes," additional electricsl permit required. )
Materials:Value (s)UqS
Llct lLl
(g) TWe:
eristing slgnage and ettach a photogreph of erch sign:
(b)Type:
(d)Type:
Ft.:
FT:(c) Tlpe: Sq. Ft.:
-
Contrector/Instdler:
Address:
Constructlon Contractors Number:
Print Nrme:Signature:
OFFICE USE: Slgn lXsfict:Zoning:
Stete:zrp,9HZ
o
LJta l&ozr-
Expirc:
By signaturg I sttte and agree, thst as owner or ownerc egent'thet I have cerefully exemlued the completed epplicetion
and do hereby certlfy thrt ell lnformetlon hereln i3 hrre rnd correct'end I further cerds thrt rny and allworkperformed
shsll b€ done ln eccordrnce wlth the Ordinances of the City of Sprtngfield, end the Laws of the Strte of Oregon perteiahg
to theworkdescrlbed hereln. I furtherceffi thrt only contrectors and employees who are in ctmplience wlth ORS
701.055 wllt be used on thls project' I further egree to cnsure thet all required inspections rre rtquested rt tbe proper
time, thrt proJect eddrets is rerdeble from 6e stre€t'thrt the permlt card ir loccted et the frontofthe propcrty' end the
the installation of theapprovedset of
Signature:
sign(s).
laE lzoro
Editcd 07i I ?O0l 9 Blancs
on the slte rt all tlmes during
Dste:
CITY OF SI'}tlING['ItrLD^ OttE(jON SPRINGFIELD
225 FIFTH STREET r SPRINGFIELD, OR 97477 t PH (541\726'3759 * FAX(S4I)726-3689
,-.,#l**#,,."
-r':
OREGOil
ir due wit[ rpplicrtion, EXCEPT for
pedestriu-orlcuted rlgns thrt ndrfy Munidpd Code t.250(3) ($0)City Job Number:
Site Address:
Assecsors Il!ap(s): Tu
Ovvner:Phone
Address:np 4Wf
Business Neme, Firm, etc:D,A,\S
DESCRTPTION OF PROBOSED SIGN(S)
TYPE OF WORK: Plcese mark dl thet apply: New: * neplacement: Alteration/Relocation:
-QUANTITY OF SIGN fiPE(S): Pleese indicete bow meny of eacb siEr you propose to lnstrll:
Wall:
-
Freestanding: Projccting:
-Roof: -
Marquce: . Billboard: Other:-
_Pcdcstrian-Orientcd Sign (Downtown Sign District ONLY. Sec Municipal Code 8.250): WindowAilall: or Blade:
-DESIGN & PLACEMENT: Please attr$ edditionel informrtlon lf rmre then one rlgn ls proporod:
Single-Sided, Y Double-Sidcd:
-
Non-lllpminated:
-
Illuminated: lnternal
-
0r External
-
7-n
Squarc Footagc: h. fi/erticat oimension :Q3[(fl1)i^nt"t Dimension: ?'' Z'k t\
Distance fiom adjacenr gnde to botom of sign face: Edi. Total height aUore gr"dc:I5 - ) n.
FOR WALL SIGNS: I*ngtb of wall on which the sign is located: JJ-n.
FOR WINDOIY SIGNS: Gross glass area of all windows on the si& thet 0re sign is located:
-sq.
R.
Electrical installati on: Yes:V No:(lf "yes," additional electrical permit requircd.)
Materials:Value (s):5rb
LtstAll
(e) T}?e:
eristing signage end tttach a photograph of eech
/l /k sq.Ft.:-
sign:
(b) Tlpe: Sq.Ft.:-
(d)T1Ae: Sq.Ft.:-(c) Tlpe: Sq. trt.:
-
Contractor/Insteller :
Address:En(n(- stere:uzrpt q+\o?-
Number:J Expircs:oConsfuctton Contractors
Print Name:Signature:
OFFICE USE: Sign Dlstttct:Ttningz
By stgne$re, I strte rnd agree, thst as orvner or ownert egenq thet I have crrefully eramlned &e completed eppllcatton
""a do hereby certlfy thrt eU informetion herein is true and correc! end I further cerd$ that ily and dl work performed
shalt be donein accordance wtth the Ordlnances of the City of Springfield, end tbe Lews of the State of Oregon pertrining
to the work descr-lbed herein. I further certify thet only contrrctont and employees wbo rre in compErnce with ORS
701.055 wlll be uced on thls project. I further agree to ensure thet all required Inspectlone me rqueeted et tte proper
time, thrt project address is resdeble from tte street'thet the permit card ls loceted rt the frontof the property, rnd the
on the site et all times during the installation of the
I ltz kozr-
approved set of
Signature:
:slgn(r).
I lqq lzoro
Edited 07/l 72019 BJones
Date:
t-r -i
CIT\' 0F SPRINGFIELD, 0REGON SPRINGFIELD
225EtF-tH STREET I SPRINGFIELD, OR 97477 + PH: (541)726-3759 * FAX(541)726-3689
,,;.1#I**1,,,"
ontGON
lc duc wftlrpfllcetion, EXCEPT for
pedestrian-orlctrted sigtrr thrt srtlsfy Munldpal Codc t.250(3) ($0)City Job Number:
Slte Address:
Assesson Msp(s): Ter
Orvner:
Address:
Business Neme, Firm, etc:
Phone
zle:4?174-
c
DESCRTPTION OF PROPOSED SIGN(S)
TYPE OF WORK: Please mrrk ell thet epply: Ncw: *neplacernent:
-Alteration/Relocation: -eUAI{TITY OF SIGN TYPE(S): Plerse indicete how mrny of eech clgr you proPosc to lnstell:
Wall:
-
Freestanding: F p-.i...ing:
-Roof: -
Marquce: Billboard: Ot[er:
-
_Pcdcstrian-Oricntcd Sign (Downtown Sign District ONLY. See Municipal Code 8.250): WindowA{all: or Blade:
-DESIGN & PLACEMENT: Please attech edditionel lnformrdon lf more then one sign ls propostd:
Single-Sided, X- Doublc-Sidcd:
-
Non-Illupninated:
-
Illuminated: Internal X a External
-squ-"." ,*o*E@uenical Dimen
"ion
7'-2(&8i-r,"r Dimension: ?'- Io4/4"|
Disrance from adjacent grade to bottom of sigrr face: )-lLn. Total height aUove greae:5r1f n.
FORWALL SIGIr{S: frngth of wall on which the sigr is located:
-ft.FOR WINDOW SIGNS: Gross glass area of all windows on the side that the sign is located:
-sq.
ft.
Elecuical
Materials:
installation: Yes:-[ No (lf "yes." additional electrical permit rcquired.)
($), l/ ? Nq
eristing slgnege end ettach a photogreph oferchListl\ll
(a) Type:
(c) Type: Sq. Ft.:
-
Contrector/Installer :
Address:Eq^€a( ststet Zlp:o
Consructlon Contractors Number:l(, jq --fr:J
Erpirc:
Prlnt Neme:Signature:
OFFICE USE: Sign Dletrict:Zoning:
By signenrre, I state rnd agree, thet as owner or owners rgent, thrt I hrve carefully exrmlned thc completed epplication
"nO
d'o hereby certifi ttrrt a1 lnformetion herein ls true and correct, and I further certify that any and all work performed
shall be done ln accordrnce wtth the Ordinences of the City of Springfield, and the Laws of the State of Oregon perteining
to the uork descrlbed hereln. I further certify thrt on$ contractors end employees who are in compllance with ORS
701.055 wlll be used on this project. I further agree to ensure thet eU required inspec{iono are rquested at the proper
tlme, that proj ect eddress ls reedeble from the street thrt the permit card le loceted at tte front of the property' and the
on the site at all times during the instaUation of the
sign:
ft)Tvoe: Sq. Ft.:
(d) Type: Sq. Ft.:
approved set of
Signature:
dgnG).
t ko lzoro
Edircd 07/l ?/201 9 BJones
Date:
tr
Electrical Permit tion DEPARTTTIENT USE ONLY
permit no.: 20 - 00D2de
Date: t lgo(srea
This permit is issued under OAR 9t&309-0000. Permits ere nontransfereble. Permits expire if work is not sterled within 180
days ofissuence or ifwork is suspended for lEO days.
FEE SCHEDULE
Numbcr of lnspecdons per ltem ( )Qty.Cost
ee.
Totd
cost
Residenthl, pcr unlt, ccrvlce lncluded:
1,000 sq. ft. or less (4)$17't.00 $
Each additional 500 sq. fl. or porrion
thereof $ 33.00 s
Limited energy (2)$ ,ft.00 $
Each manufactured home or modular
dwelling service or feeder (2)$ 8r.00 $
Services or feeders: installation, alteralion, relocation
200 amps or less (2)$ t03.00 s
201 to 400 amps (2)$120.00 s
401 to 600 amps (2)$203.00 $
601 to 1,000 amps (2)s26t.00 s
Over 1,000 amps or volts (2)$599.00 $
Reconnect only (2)$ 81.00 (
Temporary serryices or feeders: instollation, aleration, relocation
200 amps or less (2)s 81.00 (
201 to 400 amps (2)s l{1.00 s
401 to 600 amps (2)s{62.00 s
Over 600 amps or 1,000 volts, see services or fecders section above
Bronch circuits: nev,, aheration, e\lension pa-panel
a. Fce for branch circuits with purchase of a scrvicc or fccder fce:
Each braneh circuit s 7.00 $
b. Fce for branch circuits without purchase ofa service or feedcr fee:
First branch circuit (2)$ 81.00 $
Each additional branch circuit s 7.00 $
Mlscellaneous fees: sen,ice orfeeder not included
Each pump or irrigation circle (2)s 8t.00 $
Each sign or oulline lighting (2)q $ 93.00 $93+
Signal circuit or a limited-energy panel,
alteration, or exlcnsion (2)$ 93.00 s
Eech eddltlonel lnspectlon: (l)$93.00 s
DEPARTMENT USE
(A) Enter subtotal of above fecs
(Mlnlmum Permlt Fee $93.00)'89 ?
(B) Enter 12% surcharge (.12 x [A])qoo,tl.l
(C) Technolog Fee (5% of[A])s ',l1.3>
(D) Continuing Education Fee $2.50 s2.50
TOTAL feee rnd surcharges (A through D):$v
Kil225 flfti Sre.loSprlqfield, OR 97a77oPH(5r41f26,,,3?53oFAX(s{l)72G36t!t
LOCAL GOVERNMENT APPROVAL
Zoning approval verified? n Yes n No
CATEGORY OF GONSTRUCTION
E Residential E Government plCommercial
JOB SITE
/tJob site address: \SOT /a
State: OR ZIP 97477
Taxlot.:
OESCRIPTION OF WORK
t
PROPER'
Name: \
Address:
State ZIP:
Phone
or farm property
family, This
onmadeinstallationThis
immediateownedmeby
intended or rent.OARexchange,lease,
and 479.
Property is
479.s40(r)s60(r ).
E-mail
GONTRACTOR INSTALLATION
Business name: ES&A Sign and Awning
Address: 89975 Prairie Rd
City: Eugene State: OR Zl?: 97402
Phone: 54 Itl85s546 Fax.54148s581s
E-mail : csoodmanfriresasisns. com
CCB license no.r 163470 BCD licsnse no., (L9ZOS\,
Signing supervisor's license no.: SI4SIG
Print name of signing supervisor: Gordy Roseboro
Signature ofsigning supervisor: I
Last edited i,5-$2017 BJoncs
CITY OF SPRINCFIELD, OREGOI(
AN rl
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ZONE OCCUPANCY GROUP
UNIT OCCUPANCY LOAD
THE CONTENTS HERE ON HAVE BEEN REVIEWED, WITH
ATTERATIONS NOTED ONTHE PI.IINS OR BYATTACHMENT
CHANGES ORALTERATIONS MADE TO THE APPROVED
DRAWINGS OR PROIECTAFTER THE DATE BELOW SHALL
BE APPROYED BY THE BUILDING OFFICIAL.
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