HomeMy WebLinkAboutPermit Signage 1996-04-04:!
I
SPNINGFIELO JOB NUMBEN
' 1 ".q5\149SIGN PERMIT APPLICATION
225 Filrh Street
Springlield. OR 97477 i Qt,
lnspection Line: 726-3769
Ollice: 726-3759
SITE ADDRESS:
ASSESSOBS MAP:
D
OWNER:Ro'1Gp61 PHONE:b6q- ex1{
TAX LOT:
ADDRESS lffiz s-loc** *ca,.o 3t.
CITY:J
BUSINESS NAME. FIBITT ETC.
STATE: (}(?--ZIP:ql Wrf
DESCBIPTION OF.PnOPOSED SlGNlsl: (please check and complete all appropriate informationl
' )F Watt
-
Freestanding
-
Prolecting
-
Roof
_ Single Face Double Face Billboard _ Other
Square Footage:
Vertical Dimension ol sign or enclosure:2
Marquee
Total Height above Grade:tu'
Horizontal Width of sign or enclosure: ?g:
Electrical lnstallation: _ Yes A tto VALUE
(lf yes additional electrical permit is requiredl OF SIGN:Zaoo
}D
Dimension from
to bottom ol Sig
Grade , - t
n Enclosure: Lv
Material Sign is constructed of:Hb TtUooo
List ALL existing signage and attach a photograph of each sign:
(al rvpe
----
Sq. Ftg.
.' lc) Type Sq. Ftg.
(bl rype
ldl Type
Sq. Ftg.
Sq. Ftg.
CONTNACTOR/IN STALLER:laaq&J ka\PHONE:+t1
z.o4 JqHaoAADDRESS:
CITY:&toeua &-4140L
CONSTRUCTION CONTRACTORS REGISTNATION NUMBER:Wrc
cTTvBUSINESSLIcENSFNUyBER:iLA3y'a ExHnEs: ?fi
OFFICE USE
STATE:_ ZIP:
EXPIRES:1
Sign Dis
Zoning:
Sign Permit
REOUIRED INSPECTIONS:
Land Use:
Code
Approved By:
Attachment
after fasteners are
installed/prior to cover
Ouad Area:
Electiical
prior to energizing
electrical installation
DATE:
V rinat
completion ol sign
installation
.......Site'' to be made prior
to.slgn placement
Footing
prior to placement
of concrete
Addltional Comments and/or Conditions:
t
By signature, I state and agree, that I have carelully examined the completed application and do hereby certify that all inlormation herein
is true and correct, and I lurther certily that any and all work perlormed shall be done in accordance with the Ordinances ol the City ol,
Sprin'gfietd, and the Laws of the State ol Oregon pertaining to the work described hereln. I lurther certily.that only contractors and
employecs who are in compliance with OnS 701.055 will be used on this project.
I luflher agree to ensure that 8ll required inspections are requested at the proper time, that proiect address is readable lrom the street. that
the permit card is located at the front ol the property, and the approved set ol plans will remain on the site at all times during the installation
of the si0n(sl
Signeture <{iVa
Validatido:
.l
Amount Received:Date Paid:
Receipt Number:2Dq 5'l Received By
)t
Trotteerl Srr*aa*
I
CITY OF OREGO'V
SPFIINC;FIELc,
225 FIYIE STREET
SPRTNGFTELD, OREGON 97477
INSPECTION REQLIEST. 726-:376$ :'
"'OFFICE: 726-3759
3
1
JOB DESCRIPTION
Permits are non-transferable and expire
if vork is not started vithin 180 days
of issuance or if vork is suspended for
180 days.
2. COMRACTOR INSTALI.ATION ONLY B
EIec t r i ca I Con t rac tor .ftl Ft rt t r Tl' iV*-cK' <
Address Z 33 2? NE P'?ut- n
tna Phone nLO- ae-8497
ee_
o".:-1lw-EI,ECTRICAL PERHIT APPLICATION
ob Number QS ll +K
3. COHPI,ETE FEE SCMDULE BELOV
A. Nev Residential-Single or
Multi-Family per dvelling unit.
Service Included:Items Cost Sum
Ci ty
Supervisor License Number 26s)-s
Expiration Date lO -o ( *?7
Constr Contr. Number 3 c2g?
Expiration Date 2 0
Signat of ing Electrician
Name
Address
s 1s.00
$ 40.00
Services or Feeders
Installation, Alterations
or Refocation:
amps I
amps
000 amps_
Over L000 amps/vo1ts
-
Reconnect 0n1Y
Temporary Services or Feeders
Installation, Alteration or Relocation
1000 sq.ft. or less
Each additional 500
sq. ft or portion
thereof
Each Manuf'd Home, or
Modular Dvelling
Service or Feeder
200 amps or I
201 amps to 4
401 amps to 6
601- amps to 1
200 amps''or less
201 amps to 400 amps
Over 40L to 600 amps
Over 600 amps or L000
s s0.00
s 60.00
sr.00.00
s130.00
s300.00s 40.00
ses
00
00
40
55
BO
:€
s 8s.00
00
00
00
@
E0
C
E.
J-s
$
$,-GfTs se rBr a5ot6-
Ci Ph (tK-Gt'is
OVNER INSTALI.-ATION
The installation is being made on
property I ovn vhich is not intended
for sale, lease or rent.
0vners Signature:
Circuit or vith Servicq; , , t2a)or Feeder Permi t I S 2.oo /b-
Miscellaneous (Service/feeder not included)
Branch Circuits
Nev, Alteration or Extension Per Panel
One Circuit
Each Additional
s 3s.00
-Each instaflation
Pump or irrigation
Sign/Out1ine Lighting-
Limited Energy/Res
SUBTOTAL OF ABOVE
5Z State Surcharge
3Z Administrative Fee
TOTAT
D
$ 40.00
$ 40.00
$ 20.00
s 36.00
DATE:
RECEI
RECEIVED B
.43-
5
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