Loading...
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 2c) - Rrvtk fr^q 1l