HomeMy WebLinkAboutPermit Signage 1998-07-15SPl. dFIELO
D EV E LO P M ENT S ERVI C ES D E PARTM E NT
225 Fifth Street
Springfield, Oregon 97 47 7
BANNER PER]VIIT
COMMUNITY SERVICES DIVISION
225 FIFTH STBEET
SPBINGFIELD, OR 97477
(s41) 726-3753
FAX (s41) 726-368e
Zfr,
Office: 726-3753
INSPECTION LINE: 726-37 69
CITY OF OREGON
Banner Location
Assessors Map
Owner of Property:
Address:
City:
Tax Lot
Phone
zip
Contractor/InstaIler:
Phone #:
City:State:zip:
a
Construction Number:
Description:S n
Date of Installation:1-Date of
Banner Permit Fee $40.00 Deposit Required $f00.00
By signature, I state and agree that I have carefully completed this application and hereby certiff that all
information herein is true and correct. I further agree and understand that the above described banner (s) is not
larger than 60 square feet, and will be removed within ten (14) days from the date listed above. If the banner(s)
is not removed within the timeline specified, I will forfeit the $100.00 deposit. I also understand that this special
permit can be issued only twice per calendar year per development area. I also agree to call the inspection line at
726-3769 by the end of the l4th day to request an inspection to veriff the removal of the banner(s). This inspection
will begin the process to return the $100.00 deposit if the banner(s) has been removed.
5
Date of
OFFICE USE
Job #Receipt- 3008>
State:
Issued By:
,l,l
Amount Collected:4D e)Qttzrltq
CITY OF SPR'A'GFIELD, OREGO'V
SP,\ .FIELO
D EVELOPM ENT S ERVIC ES DE PARTMENT
225 Fifth Street
Springfield, Oregon 97 477
BANNERPERMIT
COMMUNITY SERVICES DIVISION
225 FIFTH STREET
SPRINGFIELD, OR 97477
(541) 726-3753
FAX (541) 726-368s
Office: 726-3753
INSPECTION LINE: 7 26-37 69
PtZ >C sn SP*UAcrd e DYA:
(=
Banner Location
Assessors Map \l
Owner of Property:
Address: b't,t sur ftoc
Tax Lot
$/LAv*'T G'
rrfurn- *lra Phone *: -k? Z{L*wtt
State: D{zip ?'lz.t^
Phone ,f(r fPE of ?)^
City:
Contractor/Installer:
Address:
Date of
-?lM
AL(
City:State: (2'zip , 7? F7)
Construction Contractors Registration Number:Expires
Description:-N o'-'.l
Date of Installation:
By signature, I state and agree that I have carefully completed this application and hereby certi! that all
information herein is true and correct. I further agree and understand that the above described banner (s) is not
larger than 60 square feet, and will be removed within ten (14) days from the date listed above. If the banner(s)
is not removed within the timeline specified, I will forfeit the $100.00 deposit. I also understand that this special
permit can be issued only twice per calendar year per development area. I also agree to call the inspection line at
726-3759 by the end of the l4th day to request an inspection to verifu the removal of the banner(s). This inspection
will begin the to return the $100.00 deposit if the banner(s) has been removed.
Date
i
of
Fee
OFFICE USE
Job #:
Date
Receipt #:
Issued By:Amount Collected:
cDn;- P,ZLI
988-
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05./12./98 18:29 1B50l 728 3889v,vrr f Ertv||, ArPLlcATfoN DEV. SER
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ASSESSORS I
OWNER:
ADOBESS:51 3
CITY;
EUSINESS NAME. FIBM
DESCRIPTION OF PHOPOSED StGN(Sl: lptcasc check and complele
venical Dimension of sign or enclosura: 25,,
225 Filrh Straet
Springtield, OA g7417
LOCAT'ON OF Pf,OPOSED WORK:
Dimension ,rom Grade /t Fito botrom ol Signi L tf.
lcl Type
-
CONTRACTOR/INSTALLER:
5A
PHONE:
appropriate informationl
-_ Eoo{
Heighl 3!qys Qr?6s; t4
_ - Sq. Frg,
_ Sq.Ftg.
o
DATE:
EXPTRE IFTHi ' ''(
THIS PERMN
COMiilEN6ED OR IS ABANDONED FOi.
-
M.rquee $\/ 1gfl Dr'/ P€FIOD.
ra.
0
00
c
_ Wa[-X Freesranaing
K singre race ' Double Face _ Billboard . Other
square Footage:g ,f,
Electrical lnstal,adon:Yesllf yes additional requiredl
Material Sign is construded of:
List ALL existing signags and anach a photograph of each sisn: {\t ne-.(al Type Sq. Frg.
Sq. Ftg.
(bt
re I dood
(dl
_ Attachment
after lasteners are
5)-al toAODRESS:UI
CITY:a
CONSTRUCTION CONTRACTONS FEG ISTBATION o0 86L
C]TYEUSINESS LICENSE NUMBER:
OFFICE
tand Use:
Zoning:Code
Sign Permh Fee:Approved By:
ZIP:
sisn
nEoUrREo TNSPECIONS:
V si.
lo be ,niide prior
to sign placsment
{ roons { rinar
compledon ol
installation
_ Electrical
ptior to enefg;zing
prior to placement
of concrete installed/prior to sign
Addhional Comments and/or Conditions:
By signature, I srate and agreo, that I have caretully exarninsd thc application and do hereby certify that all inforniation hereinis trug and correct, and I funher certify that .ny and all work pertormed be done in accordance with the Ordinances of rlre Ciry olSpringrield, .nd rhc Laws of the slale of Oregon porrrining ro the described hersin. I {unher lertifyproject.rhat only contractors andemployees who are in oomplirnce with oBS 701 .055 will be used on
I tunhcr agree lo ensure that all rcquired inspections are rrquestBd et tht time, that project address is readabls lrom the streel, tharlhe pe.m[ card is located ar the front o, lhe propsny.and the apgroved of plans will remain on thr site at all times during the installationof rhe sign(sl.
Signature
Date
Arnount Rcceived:Dae Paid:
Receigt Number:Receivod By:(/O
P. A5
Validarion:
MAY-1e-199€r t6"49 543 726 3649 ?62
VALUE:
6 1'