HomeMy WebLinkAboutPermit Signage 1981-04-02rto+ifiEd b\%
INFOR\IITI0N : 726- 575J
CI:trTT OF SPF,I}TGFIEI-.,]f
SPRINGFIELD. OREGON 97 477
CITY OF SPRI),iCFIELD
SIG:.| CONSTRUCTION A.\D ELECTRI C.lL I}ISTALIITION
CO}IB INATION APPL ICATIO]i/ PE R\IIT
ISSPECTIO)i REQUESTS: 7:6-j:o9
LOCATIoX OF SIGI{(.{o0RESS)
LEGAL DEScRIPTIo:'I / 7 O=2 2G
ot{:iER oF
ADDRESS
PROPER,TY
Olf,iER 0F SI6:r(IF gffiER TH,rr\ PROPERTY
ADORESS
1 rn'c oF BUSINEss, FIf\r, ETC.
TY
&-f
TAX LOT !
PHONE
r/toeNrIrr
-
PROJECTING
INCIDENTAI
DOUBLE FACE
PHONE
EXP. DATE
_ NON-IDE}ITITY
SECONO.\RY
-4rxcre *ce
lruLT I. FACE
PEoFBUSTNEss@
LIC.\BLE I
ERECT
R.ELOCATE
ALTER
OTIIER
htrfifu otl
??wrf Aar ffiffiC;
ro ruat
VE]-OORS. CO)JR \CTCRS
SIGN EREMCR
A.DDP€55
CITY LICSNSE ;\"I.J:.lBER o5
SIGN }LL\UFACTURER (IF OT]IER TIL{\ ERICTOR
ADDRESS LICENSE NINIBER
rZ-a.*^-oC
o PHONE
zlP
\
u/li,a:.;-
:_ RooF
I'IARQUEE
OTHER
FREEST,I\DING
PROJECTI}iG
READER BOARD
BI LLBOARD
TOTAL HEICiIT ABOVE VERTICAL DI}IENSION OF SIGN
DI:rElrsIoN FRou cR.lDr ro Borrou oF sIGN 91 ' , THIcr$iEss oR DEprH oF sIGN 3"
DoEs sl6'l pRo;Ecr BEyoso pRopERry LrNE ,T /io IF YES,DI}IENSION BEYOND PROPERTY LINE
HORIZONTAL ITIDTH OF SI c:t.24'__
IiOTE: IF PROJECTIO.\' IS I.|ORE TII)"\ 12'' OVER PUBLIC PROPERTY l}IE SIGN TRTCTOd I.II.,IST FILE I{ITII THE BUILDI}IG DIVISION COPIES OF
HIS PUELIC LIABILITY ND PROPERTY DA}IAGE INSURfu\CE POLICIES.
lrtLl sIcN HAVE ELEcTRICAL I{TRING? yEs y'tto IF yEs, wHIcH Apply? ELEcTRIcAL SIGN rLLU}IINATED (INDIRECTLy LIGHTEo)
DEsce.rBE fipE oF y-rrE9,r.\Ls sr6]1 Is cousrp.ucrED o.E Exf*taA ?Z/,/DZ .H*r
PROVIDE UL MJ}IBER IF APPLICABLE VALUE OF SIGN
SITE INFOR\L\TION (L'"\D USE).-EXISTING USE OF BUILDING OR LA.\D (OR LAST USE IF
o
PROPOSED USE oF BUILDI.T"G OR LA.l,iD
CHECK ONE IF APPLICABLE:I}iDOOR BUSINESS OTIIDOOR }IERCHfu\DISING
EXISTIT;G SIG,{S (S:GN C00E):
FIRY, ETC.:
ARE THERE EXISTING SIGNS?_YES IF rES, DESCRIBE ALL E-IIST-ING.SIGNS..FoR BUS.INESS,s{o
Ar,L Exrsrruc srcNs oN pRElrrsEs(sAlrE rAx Lor) , ll SCa-43 OZ( (n , -
I HAVE CAREFULLY EX,$|INEO Ehe coruplered application for peroit and do hereby certify that all information hereon. is true and
correct, and I further certify that all work performed shal
Uniform Sign Code as adopced by the City of Springfield and
the State of Oregon pertaining to the work described herein
City of Springfiel.d is in full force and effect as required
all required sign inspections Listed on the approved pernit,
I be done in accordance with the Springfield Sigtl Ordinance, the
all othe! Ordinances of the City of Springfield and the laws of
I further certify that ny Sign Contractors License with the
by Springfield ty Codes 8-2-6(1) and 9-7-20(2). I vill request
NAME(PLEAsE PRrlrr) l/ry?r/cmc4J SIGNATURE
FOR OFFICE E ONLY
SIGN DISTRI ZONE DISTRICT TOTAL fOOTAGE OF SIGN
INSPECTIONS REQUIRED:SITE,/ LOCATION _FooTING 0R I{ETIIOD 0F A1-I.{C}L\IENT ELECTRICAL I-{NAI
FEES
TMAL FEE FOR PERTIIT:
STATE SURCHARGE:
DATE
OTHER
CTI.ARCES:
ELECTRICAL PER-\IIT:
TYPE OF SIGN:
looelss . fffiEBe-%i€ plo*Ejfi.t€%__
ELECTRIC.{L COYTR,\CTOR . PHONE-
SIGN PER}IIT:ou*rrt, #/J-C O
PLEASE i'At)
t) Seoer:te Siqn Aocl icericn: A separate applicetion is required for each
separrre srgn rs derrne<i in the Sign Code.
2) Electrical: Any pernit issued under this application will include wir-
ing rn or on sign structure, the supply wires for connection must be
covered on an electri,cal pernit. Electrical connection must be made
only by 3 State Licenscd Electrical Contractor. Illuminated signs (both
interneily and exrernally) must conform to Seccions 9-7-.1 (4)6(5) and
9-7-tS of rhe Springiield Sign Ordinance.
3) Plens Reouired: This application is to be submitted with two complete
sets of pLans drarn to scale, showing dimensions and height of sign; ad-
vertising nessrge on sign; location of sign on properry with dimensions
to property Iines, structual details of support frarning, bracing and
foocings; nrterials of construction for sign and sign structure; elec-
trical equip:eenc and lighting; size and location of existing signs on
ProPerly for the sane business, all. as required to deternine complianceuith rhe Springficld Sign ordinance (Article 7 of the Springfield City
Code). Also, show the foilouing inforroation on the plot plan (plan
showing property lines and location of signsJ;
a) Show the location of all e-xisting sign(sJ as well as proposed sign(s)
b) Shor.r the length of the streec frontage taken up by the business or
building.
c) Shov the location of entrances open to the public and driveways.
4) l{hen required, because of design, size, etc., engineered drawings and
calculf,tions nust be prepared by a licensed engineer or shall coni-orm
to desian standards on iile at the Building Divisi.on Office.
5) Plans of insufficienr, clari.ty or detail will be returned to the ap-
plicanl virh no perniE being issued.
6) Signs nust meet corner vision clearance requirenents as described in
Fig. 9 of the Springfield Conprehensive Zoni.ng Code.
7) I(OTE: .r-o sign nay be erecred which is less than 12 feet hori:ontallyor vertically from overhead electrical conductors in excess of 750
volts, or less than 5 feet in any direction froo overhead electlical
lines vhich are energi:ed at less than 750 volls. I
B) If :r si;n is not instrlled rtithin 60 days after the date of issue ofthis pernit. the perrit shall be void.
9) Insoect ions
c n ion - to be made before the si gn is placed. Usual1y,
the lioo i r;: q I ;r soec t ion (if applicabJ.e) may be made at the sane
tine as che Sice lnspeccion, The Footing Inspection j.s to be
oade after hole(s) is excavated, but prior to the placernent of
conclet e.
b) finel lr,soection - to be made upon completion of all work
c) Electri.cal - All electrical signs nust be inspected for electri-cal hoox up efter the sign is erected and before the sign is
turned on.
cAtL FOR THE REqUIRED TNSPECTIoNS 0N THE 24 HOUq, INSPECTIoN LINE AT726-3769. t:
SPECIAL CONDITIO.\S TO BE SATISFIED EEFORE ERECTION OF SIGN:
LID.\TIO:J
a)
CLERK
DATE
ADDITIONAL INFO&\I"ATION NEEDED BEFORE PERMIT I'!{Y BE ISSIJED:
PLd''lS REVIEi{ED BY DATE
\
,lcrifrid b\ twstt
CIITTT CF SPF,I}TGFIEIJD
SPRINGFIELD. OREGON 9A 427
INFOR$ATIoN: 726-i7is ISSPECTIo)i REQUESTS: 715-;:o9
CITY OF SPRI}IGFIELD
SICS CO.\STRUCTIO:I d\D ELECTRI CAL I],'STALIJTION
co}lB INAT IOlt AP PL ICATI0)i/ PE &\lIT
LOCATI0x OF SI6l'i(I0ORESS)
LEGAL DESCRIPTIOX / 7
ofir\..ER OF
o > 2_(-TAX LOT 9
PHONE
zlP q
r/toeNrrrr
-
PROJECTING
INCIDENTAL
DOUBLE FACE
NON- IDE.\TITY
SECCNDARY
t/slxctg Frce
}[ULT I. FACE
ADDRESS
ERTCT
RELCCATE
PAt^trtu oN
? Ywnr 4tr frr**€c:
-.-^-l /t3. Sf
oiil;ER 0F SI6li(IF OTHER TILL\ PRoPERTY OIINER)
ADDRESS
1 xxre oF BUsIrEss. FIR\I , ETC EOFBUSI}IESS@
ALTER
crntER
A,!/-,
I{ALL
ROOF
I"ARQUEE
OTHER
FREEST.d\DING
PROJECTLT-G
READER BOARD
BI LLBO.{RD
vEri0cRs CO:,7
SIGN ERECTCR
ADOPISS
CITY LIC=.\-SE :\l.J:l3ER o
slclr I|I\UFACTURER (IF OTITER TtL$r
ADORESS
EIICTRICAL CO}{T&\CMR
PHONE
DATE
ADDRESS LICENSE NI.II'IBER
TOTAL HEIGiIT ABOVE GE,\05 }ERTICAL DI}ENSION OF SIGN :ONTAI hIDTH OF SI d 24',u
DTIIENSION FR,O}I CR,IDT TO EOTTO:.I OF S ICKNESS OR DEPTH OF SI6N 3//
DOES SICN PRO.JECT BEYOSD PROPERTY LI}IE YES NO IF YES, DIIIENSION BEYOND PROPERTY LIT.IE
IiOTE: IF PROJECTION IS:'iOR.E TIII\ I2'' OVER PUBLIC PROPERTY TTIE SICN ERECTOR I.iTJST FILE IYITII TTIE BUILDI)IG OIVISION COPIES OF
HIS PUtsLIC LIAAILIfi tr\O PROPERTY DA}[,\GE I),ISURA"\CE POLICIES.
hrLL SIGiI HAVE ELECTRTCAL rvrRI.YG?
-veS
/UO IF YES, WHICH APPLY? ELECTRIC{L SIGN ILLU}IINATED (INDIRECTLY LICTTED)
DEscg.IBE TYPE oF I,ITE3I.\IJ sI6}I Is Co}ISTP.UCTED oF fu/OR ,Z/o/D?.4rlf
PRC}VIDE UL Id,l}t8ER TF APPLI VALUE OF SI6N
SITE INFO&\L\TION (LNO USE)-.EXISTING T'SE OF BUILDING OR LA.\D (OR I-{ST USE IF
!.
o
PROPOSED USE OF EUItDING OR IJ.IiD
C}IECK ONE IF APPLICABLE If,iDCoR BUSII\ESS
-OIIIDOOR
}IERCHA.\DIS I NG
EXISTING SIG'IS (SIGN CODE): ARE lllERE EXISTING SIGNS? YES IF YES, DESCRTBE ALL EXISTITIG .SI6NS..F0R 9r.iS.{._\ESs,6,
?ALL EXISTIITG SIGNS 0N PREIIISES(SA.uE TAX LoT):
I HAVE CiA,EFULLY EXA\IINED the completed application for pe:mi.t and do hereby certify that all infonaation hereon. is tnre and
be done in accordance with the Springfield Si gn- Ordinance, the
d and the laws ofall other Ordinances of the City of Springfiel
I further certify that Dy Sign Contraclors License rith the
correct, and I further certify that all r.ork perforned shal
Uniforra Sign Code as adopred by the City of Springfield and
the State of Oregon pertaining to the work described herein
City of Springfield is in full force and effect as required
aII required sign inspections listed on the approved pernit.
NA,YE(PLEAsE PRIr1t l-@?@lA^J s
by Spri.ngfield ty Codes 8-2-6(.3) and 9-7-20[2]. I rill request
R OFF E USE ONL'
SIGN DISTRICT ZONE DISTRICT TOTAL fOOTAGE OF SI6N
INSPECTIoNS REQUIRED SITE/ LOCATION _FOOTING OR I'IETIIOD OF ATT.{C}{.\[ENT ELECTRICAL I<FiNAL
IGNATURE
.DATE
FEES
TOTAL FEE FOR PER\IIT:a
STATE SURCHARGE:
OTHER #
SIGN PER}IIT:
CTi,1RGES:flt J- a o C}IARGES
EIJCTRICAL PER.\IIT
TYPE OF SIGN:
\LIDiT
l)Seoer:te Sien lqct icetion: A separate appiication (SePar3te irgn Js.lerrneo in t he Sign Code
2) Electrica : Ary pernit issued under this applicacicng ln or on sign structure, Che supply wires for cc
\Ecovered on an electrical pernit Electricrl connectonlv by e Srace Licenscd Electrical Contractor, Illinternslly cnd excernally) nusc conform to Sections9-7-13 of che Springfield Sign Ordinance. i
3) Plans Reouired: This apptication is to be submitted
\
sets ot plans drarn to scale, showing dimensions andvertising nessrge on sign; location of sign on propeto propercy lines, structual details of support fram i, t
foocin3s; nrrerirls of construction for sign and sig.trical equipnenr antt lighring; size and loiation of,properry for the sr"':re business, all as required to d,nith the Springficld Sign Ordi.nance (Article 7 of thr 6riCode). Also. show the t'oltowing infoniaricn on the Ishowing property lines and location of signs):
a) Shorr the locarion of all existing sign(s) as well ( p
b) Shor the length ot' rhe sr:eet frontage taken up tbuildiag.
c) Shos che locarion of entrances open to che publle (a
4) lt'hen required, bec:use of design, size, etc., engineecalculations nus! be preoared by a licensed engineer
Co desrgn srendards on iile at the Building Division r iic,
5) Plans of insufficienc cl,arity or detail will be returtplicanE vith no perniE being issued
i6,) Signs nust meet corner vision clearance requirenents !Fig. 9 of rhe Springfi.eld Conprehensive Zoning Code. i
7) !iOTE: .r*o sign ncy be erected which is less than t2 fJ lhoor verric:lIy fron overheed electrical conductors in evolts, or less thJn 5 feet in any direction fioo overhtines vhich ere energi:ed at less than 7S0 volts.
8) If a si;n is nor inst:lled r;ithin 60 days afrer the dathi.s perait. thc per.eir shall be void.
9) Inspect ions:
a) Site Insoection - to be made before the s ign is ol
CITY OF SPRINGFIELD
CitY Holl
SPringlield, Orogon
Dcportmenl of Public Workg
OFFICIAT NECEIPT
Jlo. B 56299
Dote
F
(
Received For:
(.
Amount Received
Y, SHELIoi.TURxEULL PllxrERs - EUGEiE. oR 9t'ol 36arr.6
!Y
t:the l:ooi l::i tn!_pectiol (if applicable) may be najetine-iilii3l?i-Tn-lFIccion.' - The Fooiing' Inspecti< (s
uade sfter hole(s) is excayated, but prior to the ; 'concrete. +_.
b)Finrl Insoection - to be made upon completion of all work
c) Electricel - All electrical signs nust be inspected for electri-cal hooi up :fter the sign is erecred and before the sign is
Eurned on.
c,AtL FoR THE REQUIRED INSPECTIONS gN TtE 24 HOU4 INSPECTIOX LINE AT726-376s. i
SPECIAL CONDITIO.\S TO BE SATISFIED BEFORE E.C,ECTION OF SIG$
DATE
ADDITIO}IAL INFOR\ITTION NEEDED BEFORE PER},IIT I.IAY BE ISSUED:
PL{.YS REVIEi{ED BY:DATE
\
(
\
,#210tt t
CITTT OF SPF,I}TGFIEIJ]f
SPRINGFIELD. OREGON 97 477
INFOR.VATI0N: 726-5753 ISSPECTIOI- REQUESTS : 7:6-;;b9
CITY OF SPRIXCFIELD
S I C:{ CONSTRUCTI O}I A,\D E LECTRI CAL INSTALTTTION
COiIB INAT ION APPL ICAT IO)I/ PE R\IIT
LoCATIoN 0F SIGN(ADoRESS)
LEGAL DEscRIPTtos /7 o a
or{riER oF pnopenry&3 CLI/
ADDRESS { -5- 4J
oliliER 0F SICX(IF OTHER TH.ru\ PRoPERTY olrNE
ADDRESS
NA.\E OF BUSISESS, FIL\I, ETC.
TYP E
,u
OF BUSI}IESS
TAX LOT 4
ounrrE
IDENTITY
PROJECTING
INCIDE\TAL
DOUBLE FACE
caa
s
ERECT
RILOCATE
ALTER
gNIER
NON. IDESTIfi
SECO)iDARY
y'st""cl; rrcs
TruLT I. FACE?at/.r'm op
fulwmn A*o
!,E\DORS, COTiL\CTCRS
P
PHONE
siTYPE CHECii APPLI
IVALL
ROOF
I"tARQUEE
OTHER
FREEST,L\T,ING
PRoJECTI.\iG
REAOER BOARD
BILLBOARD
SIGN ERECTOR
ADDRESS
CITY LICE.T.SE }iI.J:.IBER
PHONE
EXP. DATE
SI6N }h\UFACTURER (I F oTrER rrL\\ ERncroRt 54ZE
A.DDRESS
E LECTRIC.\L CO}TTRACTOR
ADDRESS
PHONE
LICENSE NI.'IIIBER
),i ,\'iD I
TorAL HEIGI{T ,lsove cR^oE la /IIIERTICAL DI}GNSION OF SIGN HORi:ONTAL WIDTH OF SIGN
DI}IENSION FRO}I GR,\O[ TO BOTTO}I OF SI6N /O THICKNESS OR DEPTH OF SIGN
DoES SICN PROJECT EEYOSD PROPERTY LINE YES Z*IF YES, DI}'ENSION BEYOND PROPERTY LINE
r\OTE: IF PROJECTIO.T- IS I'iORE TllA.\ 12" OVER PUBLIC PROPERTY TtlE SIGN ERECTOR l.ruST FILE I{ITII THE BUILDI)IG DMSION COPIES OF
HIS PUBLIC LIAEILITY I\O PROPERTY DA}[,\6E INSUR"\CE POLICIES.
rILL sIcN nAvE ELEcTRIcAL r{rRr.yc?
-vw
4!o IF yEs, r{ulcH Apply? ELEcTRICAL sIGN _rILU}TTNATED (INDIRECTLv LIcnED)
DESCPIBE TYPE OF I'.TTERI.\LS S16}! IS CO}ISTP.UCTED OF
PROVIDE UL M,,}IBER IF APPLICABLE VALUE OF S
SITE INFOR\ATION (L'"\D USE)--EXISTING USE OF BUILDING OR LA.\D (OR LAST USE IF
rcxE_fi.Zdo 3.O
vfci.rri, #ffef---flf?* -
PROPOSED USE OF SUILDI;\G OR LI.t'iD
CHECK ONE IF APPLICABLE BUSINESS _OUTDOOR IIERCHA\DISING
EXISTING SI6ls (SiGN CODE): ARE TIIERE EXISTING SIGNS? YES t4NO IF rES, DESCRTBE ALL EXISTTIIG.SIGNS..FoR BUS.INESS,
ALL EXISTING SIGNS 0N PREITTSES(S,$tE TAX LoT)
I HAVE CAREFULLY EX.A.UINEO the completed application for pemit and do hereby certify lhat all inforoation hereon. is t:rre and
correct, and I further certify that all rork performed shall be done in accordance with the Springfield Sign- Ordinance, the
Uniforrn Sign Code as adopred by the City of Springfietd and all other Ordinanees of the City of Springfield and the laws of
the Scate of 0regon pertaining to the work described herein. I further certify that ny Sign Concractors License rith the
City of Springfield is in full, force and effect as required by Springfield ty Codes 8-2-6(.3) and 9-7-20(2). I rill request
alI required sign inspections listed on the approved pernit
NAME(PLEASE PRI}IT)SIGNATURE
.. ''DATE
OFFICE USE ONLY
SICN DISTRI ZONE DISTRICT TOTAL fOOTAGE OF SIGi'I
INSPL:CTIoNS REQUIRED: _ SITE/LoC.\TI0N FOOTING OR I{ETIIOD OF A'ITAC}i.\fENT ELECTRICAL O1}IER
$
FEES:
TOTAL FEE FOR PER\IIT ,7{,0 O
SIGN PER}IIT:
CHARGES:15.0c EI.ECTRICAL PER.\IIT:
C}IARGES:
STATE SURCH.{RGE: ?
PLEASE i'TO
1) Sep:rete Siq n Aocl icetion:A separate appiication is required for each
seParsEe srgn Js dL'rrneo in the Sign Code
2) Elqgl11ga!: Aay pe rni t
ng ln or on sign struct
covered on an electrical permit. Electrical connec!i.on must be nade
onlv by J, Sta[e Liccnsed Etectrical Contractor. Illuminated signs (both
i.nternelly and excern:Ily) must conforn to Sections 9-7-1 (4)6(S) and
9-7-13 oi the Springr'ieJ.d Sign ordinance.
3) Plans Reouired: This application is to be submitted with two complete
secs o! pl.rns dreHn co scale, showing dimensions and height of sign; ad-
vertising nestage on sign; locati.on of sign on propercy with dimensions
to properE/ lines, srructual details of support framing, bracing and
foocings; naterials of constn:ction for sign and sign structurel elec-
trical equipnent rnd lighting; size and l.ocation of existing signs on
Property for the sa.ne business, all as required to determine compliance
riith the Springficld Sign Ordinance (Article 7 of the Springfield Cicy
Code). AIso, show the r-ollowing informati.on on the plot plan (plan
shouing properEy lines and location of signs):
a) Shov the location of al1 existing sign(s) as well as proposed sign(s)
b) Shov the length of the street frontage taken up by the business or
building.
c) Shov the locarion of entrances oPen to the public and driveways.
4) l{hen required, beceuse oi desLgn, size, etc., engineered drawings and
calculerrons nusr be prepared by a licensed engineer or shall cont-orm
to desr;n standards on iile at the Building Division Office.
5) Plans of insufficienc clarity or detail will be returned to the ap-
Plicans viLh no per::l!,r being issued.
6) Signs nrust meet corner vision clearance requiremenEs as described in
Fig. 9 of the Springfield Conprehensive Zoning Code.
7) NOTE: lio sign nay be erected which is less than 12 feet hori:ontally
or vertic3lly fron overhead electrical conductors in excess of 750
volts, or l,ess Ehf,n 5 feet in any directi.on frotr oyerhead electrical
lines vhich are energi:ed at less than 750 volts. I
B) If : si;n is noc insrell.ed rtithin 60 days after the date of issue of
this perlnit, the per.xit shall be void.
e)Insoect on5:
a) Site Inscection - to be made before the sign is placed. Usually,
the i:oci rn Insoeciion (if applicable) nay be nade at the s:une
tine as che ce lnspeccion. The Footing Inspection is to be
oarje after hole(s) is excavated, but prior to the placenent of
concret e.
b) Final L.,soection - to be made upon completion of all work.
c) Electri,cel - All electrical signs nust be inspected for electri-
cal hook up sfrer the sign is erected and before the sign is
lurned on.
CALL FOR IHE REQUTR.EO INSPECTIoNS 0N THE 24 HOUT.INSPECTION LINE AT726-376e. jl
SPECIAL CONDITIO.\S TO BE SATISFIED EEFORE E.qECTION OF SI6N:
issued under this application will include wir-
ure, the supply wires for connection musE be
R,i!IT \,\LID,\
CLERK
DATE
ADDITIONAL INFOR\I.\TION NEEDED BEFORE PERMIT IIAY BE ISSI,JED
PL{YS REVIEiiED BY:DATE
,#a
10tt ,/-
I:,lFOR\ATI0N: 726-5753
CIETT C)F SPF,I}TGFIEIJ]3
CITY OF SPRI:ICFTELD
S IG:{ COXSTRUCTI O:{ A.\D E LECTRI C.{L IYSTALIATIOI.I
COltB INAT I0N APPL ICATI0.T-/ PE R\IIT
IlisPECrIo.\ REQUESTS : 7t6_ j:69
LocATIo.rr 0F sIGs(.{DDRESS
LEGAL DEScRIpTIo:t z7 C
orh-ER oF pnopeRrylz'- Cc-Zl
ADDRESS * 5-<)
OIf,iER OF SIC,\(IF OTHER THIY PROPERTY
ADORESS
IIA.\IE OF BUSISESS, FIR\I, ETC.
t-a
E OF BUSINESS
TAX LOT !
PHONE
P
PHONE
IDE}fTITY
PROJECTING
INCIDE\TAL
DOUBLE FACE
l/
v en:cl
RELOCATE
ALTER
crntER
_ NON-IDESTITY
_ SECONDARY
y'srxcre recs
}IULTI - FACE
qar*tr'rr> o*;
L{ulrron a^tr)
I
I{ALL
ROOF
I,IARQUEE
OTIIER
FREEST,L\DING
PROJECTIIiG
REAOER BOARD
BI LLBOARD
SIGS ERECTOR
ADDRESS
CITY LICE)iSE
sI6N lrA\uFAcruREB (IF orrER TrL.r.\ ER[croR] $hE
AODRESS
EIJCTRIC.{L CO}TTRACTOR PHONE
ADDRESS I ICENSE NI,.IIUBER
TOTAL HEICiiT AEOVE GR,ADE
DIIENSIoN FRou c&ro[ To Borro]r oF sIcN /O
DTITENSIoN oF srGN 3 'HORI]ONTAL TIDTH OF SIGIIIC.{L
THIC$;ESS OR DEPTI{ OF S
DoEs sro. pRo.JEcr BEyo)iD pRopERry LrNE -rii-7xo IF YES, DI}IENSION BEYOND PROPERTY LINE
!{OTE: IF PROJECTIO.I' IS !.iORE TII.I"\ 12" OVER, PUBLIC PROPERTY TTIE SIGN ERECTOR I.iIJST FILE I{ITII THE BUILDI}IG DIVISIO.\ COPIES OFHIS PUBLIC LIAEILIfi A.\O PROPERTY DA.\L,\GE INSURA.\CE POLICIES.
rlLL slcx il,rvE ELECTRICAL ttIRI.\G?
-v* 4!to IF yEs, $lHIcH Apply? ELEcTRIcAL SIGN rLL$TINATED (INDIRESTLy tlcrrEo)
DESCPIBE TYPE OF !,ITER,I.\LS SIIS)I IS CO}ISTP.'JCTED 09
PROVIDE UL NU}I8ER IF APPLICAE
SITE INFO&\IATION (LA,\D IJSE).-EXISTING IJSE OF BUIIDING OR LA.\D (OR IjST USE IF
m-{._$43,o 3D
u'
LE 0Fs
I
l.
PROPOSED USE OF BUILDING OR II.IiD:
C}IECK ONE IF
EIISTING SIG'IS (S:cN C00E) : ARE THERE E.{ISTING SIGNS? YES
DCOR EUSINESS
-OI'TDOOR
IIERCHT\DISINC
IF YES, DESCRTBE ALL EXrSrrNG.srGNS..FoR pljslllEis,
APPLICAB
t4"
tE.
IIRV, ETC.,
AIL EXISTIIIG SIcNs 0N pREltIsES(sA.\rE TAX LOT)
I HAVE CAIEFULLY EX,"\!INED the conpleted application for peruit and do hereby certify that all information hereon. is tnre and
done in accordance with the Springfield Sigrl Ordinance, the
other Ordinances of the City of Springfield and the laws offurther certify that Ef Sign Contractors License rith the
correct, and I further certify thar all work performed shall be
Unifom Sign Code as adopted by rhe City of Springfietd and allthc State of Oregon pertaining to the work descri.bed herein. ICity of Springfield is in full forcc and effect as required byalI required sign inspections lisred on the approved pernit.
Springfield ty Codes 8-2-6(.3) and 9-7-20C2). I vill rcquest
NAr'.rE (PLEASE
INSPECTIONS REQUIRED: SITE/LOCATION
SIGNATURE
TOTAL IOOTAGE OF SIGN
-FOOTING
OR I.IETIIOD OF ATT.qCEIIENT ELECTRICAL
ZONE DISTRI
FEES:
TOTAL FEE FOR PE&IIIT:a{,0 o
STATE SURCHARGE
.DATE
OTHER 4J--t
SI6N PER}IIT:
CTL{RGES:d .0c EIJCTRICAL PER.\tiT:
CMRGES:
s
. DATE
SICN
PLEASE i'AI)
l) Seoeret: Siqn lo:l ir'rticn: A separate applicerion
separ3r,e slgn JS uerrnco in the Sign Code.
2) Electricel: Any pernir issued under this applicatiring rn or on sign structure, the suppty uires for cr
covered on 3n electrrcal per:nit. Electrical connectonly by r Srire Licensed Elecrricil Conrracror. Illinternllly rnd externelly) nust conforn co Seccions9-7-tS of rhe Springfield Sign Ordinance.
4) l{hen required, beceuse of design, size, etc,, enginee
calculrtions nusE be prepared by a licensed engineer
Co design standerds on r'ile 3t the BuiLding Division
5) Plans of insuffici.ent clirity or detail will be retur:pliclnt vith no peraiE bei.ng issued.
6) Signs nust meet corner vision clearance requi,renents iFig. 9 of the Spri.ngfield Conprehensive Zoning Code. I
I7) |SOTE: No sign nay be erecced which is less than 12 fCor verticrlly fron overhead electrical conductors in evolts, or l,ess thrn 5 feet in any direction froo overh
lines vhich ere energi:ed at Less than 750 volts.
8) If :r si;n is noc insr:lled rithin 60 days after the dathi,s pcr.:ric. the penrir shall be void.
s)In so ections:
a) Site Inscection - ro be made before the si gn is ol,;the l:ooi r;i I:r:oection (if applicable) nay be rcade
tine rs tne Srce lnspeccion. The Foocing Inspectic
uade gfter hole(s) is excavated, but prior to the Iconcrere. +-
CITY OF SPRINGFIELD
Ci?y Holl
Springfield, Oregon
Deportment of Public Works
OFFICIAL RECEIPT
No. B 56299
PEIt.\!IT '.'1L
(
3) Plens Reouired: This epplication is to be submitted DOtesecs ot plans dr:rn ro scale, showing dimensions andvertising nessrte on sign; location of sign on propeto property Iines, structual derails of support fran
foocings; nrtcrials of construction for sign and sig.trical equipeent and lighcing; size and l,ocation ofproper!), for the sa,::re business, all as required to dtrith thc Springfield Sign Ordi.nance (Article 7 of th,Code). Also. shon the iollowing infor:iaricn on the Ishouing properry lines end location of signs):
a) Shov 3hs locarion of all existing sign(s) as well
b) Shov the length of the streeE frontage taken up tbuilding. i
c) Shov che locerion of entr3nces open to the publii
i
\r
6ir
t-
(a
i.ho
From
('
,{'llCl
(
(
(
BY(.
(s
Amount Received
SIGN
Y, aHaLrox_ruixaull ttltYEra ' EuGExE' o' l"or !tll!''
-..ql
b) Finel lr,soection - to be made upon completion of all work.
c) Electricsl - All electrical signs nust be inspected for electri-cal hooi up after the sign is erected and before the sign is
turned on.
CALL FOR I}rE REQUTRED IUSPECTIONS ON THE 24 HOU4 INSPECTION LINE AT726-376e. jl
SPECIAL CONDITIO.\S TO 8E SATISFIED EEFORE E.C,ECTION OF SIGN
DATE
ADDITIO.\AL INFOR\T{TION NEEDED EEFORE PE&VIT I,IAY BE ISSIjED:
PLTYS REVIEi{ED BY DATE
(
Received For:
(
\,
. .'t i
\
INSPECIOil lrNE
726-3769
NA.f,{E (pleose
I HAVE CAREFUI.I.Y EXAMINED thc completed oppli coiion for permii, ond do he reby certify rhot oll informolion hereon is lruecertify thot ony ond oll work performed sholl be done in ociordqnce with the Ordinonces of the City ofpertoining lo ihc work dc :oibed herin, ond thot N O OCCUPANCY witl be of ony slruclure wiihout tsion of@ttl{y thot my regi:totion with the Euilder,r Boord is in full force ond effect o red by ORS 701 .055,heron,ond thot only rubcontrociors ond who ore complione with .055 will beEosir for Builder,r
CIIY OT sPRINGTIETD
COMBINAIION APPIICAIION/PERMIT
INTORMAIION TINE
7?5^3753
ond correcl, ond I furtherond the of tha Stote of Oregon
Divirion. I furrher
the lor exemplion ir
DATE
)
lue of Work:
Sooo
lOa,
3
ntegol
R.
Addrer;d
5q. frg. OtherWoler Heoler
Heol
d ttoched
Sq. Ftg. Access.
Sq. Flg. Moin
--Other
New-Add/Alr".-Rep.
--Fence-Demo-Chonge/
Use
Building Permit lnfo: Deccribe Work (i.e., Build Single
e.r
-v,
0r
0
0\
.0
/454 4e,PhoneAddre r r )
(nome)(oddress)no.)(expires)DESIGN TEAA
Slruclurol
r/-
PIUMBING
A,lECHANICAL
fEE
Reridence of furnoce/burner lo
RS ddre
,('
ETECTRICAT
NO.CHARGE NO.CHARGE ARGE
Eoch fix turc ft
Electricol
A{echonicol
Relocoted building
fir. oddirionol)New circuiis, olterorionr
or extensions 2 arOfile,/f,*Applionce vent
SERVICES Slolionory evop,
coo le r
cs <h T Cons lruclion Vent fon with
duct
Addirionol borh
Wqter rcrvice
Sewcr
ler
Slorm Sewcr FEEDERS
ISSUANCE OF PERAAIT
cAITOT.CHARGES 6ATIOT,CHARGES
TIO'AL CHARGEs
5TWHERE LAAIE w REQUIRES ,hot ,hc workElectricol be done th€by Electricol Conlrabello theclot,bcrnhos elsctricoldon thisofrigncbyEla ctri <q I portionControclor :hollpcrmit nolond br vclidtoitochsd untiltheelectricolnsl.Po
SIGNATU
2{. oo /s.60 /U,4 .Plqn Ck. Res
foR
Per
?e
Per
-Sa Ftg- Accelr
Plon Ck. Com mli"d
Conrlrvp.l
Sy:lems Development
IoodFlood Ploin
Zone
x
-Volue
IOTAT VATUATIONBUITDING PERMII
Chorger ond
Surchorges
Sq. Frg. Other--Grovp i?' 2 -
Fire Zone Bedroomr
MBPI.U ING PERMIT
ondChorges
Surchorges
Demo Torol Comb. Permit S6PERA{IT
ondChorges
Surchorges
c
Sidewolk
-6o
I. PERAAIT,!IECHANlCA
Chorge: ond
Surchorge:Curb Cut
TOIAI.s6. /6
I
'ey )<-/
seporoleS.F. Rcridencr
(l borh)
Ampr.Vent lfslem oport from
heoting or A.C.
Mechonicol exhou:l
irood ond duct
Heot Pump
Ampr.Air hondler b
10,000 cFM
Air hondler ovar
10,000 cFA^
o
(I.59^l
Fence
^ aa
COMBINATION APPLICATION/PERMIT (CAP)
l. Applicorrt t6 furnish
A. Job Address
B. Legol Description
l. exomple-lox lot 100, Lone County Mop Referer
2. ex#FE-Lot l. Block 3,Znd Addition to Springfi
C. Nome, etc. of owner ond construction lender
D. EnergY Sources
I . exo mpl e'heo t /ell5ili cg I cei I i n-9 / o, {:::"d:"-9.
2 e-7o1fr6]E'wo te' trEEfe'-/6lEi?i?o I ro i solE r
E. Squore footoge or voluotion, etc.
l. exomple-l 250 sq. foot house, 500 sq' foot gorot
2. to#E-iTi-e, ' proiect, check nEi-if oddition' <
odd, etc.
t. Building permit informotion:
i. "r"iif"-construct single fomily house wilh on c
goroge
Z. J*o.rrilu-remociel existing goroge into for-nily rc
a. t"*PC-convert single fomily residence into
i6lGiEnt (chonge of use)
G. Volue of work os defined in Section 303 (o) of the
Structurol SPecioltY Code
H. DESIGN TEAM AND CONTRACTORS
To ovoid design or construction deloys' Building Di
Sloff must betbte lo contoct oppropriote Persons I
design informotion or iob site correclions' etc'
ll. Abbrevioted Plumbing' Mechonicol & Electricol Schedt"
A. Except where blonk spoces occu.r-in the description
of the Mechot;;i ;"i Electricol Schedules' the opr
need fill-in ..iylftt No' Bo"es odiocent to the oppr
item(s) to be instolled
B. Full Plumbing, Mechonicol' o1d. ElectricoI Schedule-'
";; ovoiloble ot the Buitding Division
l. To conser""-t;;;t ;;ihu"p"t-it form the sched
hove been obbrevioted
2. lf the itt-fJl-tl'[u instolled ore not covered on
. ot"a ttn"iii"'-yt' ti"'ra consult the full sched
C. BUITDING OTVISIO,N STAFF WILT FILL OUT 'ALT FEES-' iilnors oN THE ScHEDULES
lll. APPlicont to sign ond doie
Whenever pot'ible' the iniriol ooplicotion will be used
worksheet ""lv' ilh;;; f"ttlUf""Buildino Division Stot
prepore " ,rr"*''i'l;'1;ii'J l:t:i: ';t" the oppiic'
the time the octuol permi'tis issued for his signoture'
i1i
PERMIT VALIDATION
CITY oF SPRINGFIELD ( |
Ci?y Holl
Springfield, Oregon
Deportment of Public Works
OFFIC!AL RECEIPT
No. B
r9
d ,l
5602C
Do
Add
I (
(
(
(
6,,
Qi
(
(
Rece ived For:
2
\l nt ReceivedDAmou
SHELION'TUiXEULL
Permit Clerk
EY
HORIZEO SIGNATURE
(
PirrlEi3 EUGEiE. oi 97'Ot lasrr'a
tV. Fees ond Chorget L
Plon check fees ore due ond poyoble ot the time of the opplicolion'
ond no plons will il;;;;JJ"itit tt'"'" fees ore poid' All
other fees "na tr"'o"'!Jt;t';;; onJ poy"blu when the permit
is issued.
V. FOR OFFICE USE ONLY
PROJECT CONDIIIONS TO BE SAIISFIED BEFORE OCCUPANCY:
(z-t
Addirional Proiect lnformotion:
/
PLANS REVIEWEU BY'
dote
signoture
+
nome
?'- /l At-z>1
J*
(
(
nctiFt<.cl a'ttVfufr
CIItrTf OF SFF,II$GFIEIJIS
SPRINGFIELD. OREGON,97 477
INFORIL\TI0I: 726- 3753 IISPECTIO.\- REQUESTS: 7t6- j:o9
CITY OF SPRI}IGFIELD
SIC:i CONSTRUCTIO}I {\D ELECTRI CAt TNSTALIJTION
CO}IB INATION APPL ICATION/ PE R\tIT
LoCATI0.Y oF SI6)J(.{DDRESS)
LEGAL DESCRIPTIo:'I I 7
OIT}.ER OF PROPERTY
AODRESS
EREfi
RELCCATE
() b 2_Q
sf
TAX LOT T
PROJECTING
INCIDENTAT
DOUBLE FACE
NON- IDE)ITITY
SECCIiD.\RY-rdr*.., ,^.s
IruLT I - FACE
OliliER 0F SI6r"(IF OTHER TIL\\ PROPIRTY OlrNE R)
ADORESS
l( *** oF BusrsEss , FIf\I, ETC.
TYPE
or ausr.tEs s fr d p@Ag</4)€
y'roexlrryALTER
crntER
PAran€tl ON
?W,.*? 4^lf W6:.P-ufrll
D
ztP q
oF ifoRii PE OF SIGN:EC;:L
FREEST.d\DINc
PROJECTI!i6
READER BOARD
BILLBOARD
,r/wett
ROOF
I"TARQUEE
OTTIER
VE\OCRS CO:;TL.RS
SIGN ERECTCR
ADDPJSS
CITY LICE);SE }iU.IgER o5
PHONE
EXP. DATE
sIGN IIA\UFALrU-RER (IF oTI|ER TrL\.{ ERICToR'
ADOR,ESS
ELECTRI C.{L CO}IT&\CTOR
ADDRESS
PHONE
PHONE
LICENSE NIJIIBER
TOTAL HEICiIT AEOVE GRrDS DII{ENSION OF SIGN AL wrDrH op stc:t.Z4t
DI:rElrsIoN FRou c&ro[ To Borro]r oF sIGN 91 ' THIcKNEss oR DEprH oF sIGN 3"Z NO IF YES, DI}fENSION BEYOND PROPERTY LINE
I{OTE: IF PROJECTIO:I IS:.IOR-E TIIA.\ I2.'OVEN, PUBLIC PROPERTY TTIE SIGN TeecToi }ilJST FILE I{ITII THE BUILDI}IG DiVIsIoN coPiEs oFHIS PU3LIC LIAAILITY A.\O PROPERTY
HILL SIGX HAVE ELECTRICAL IVIRI]{G? YES
INSURA.\CE POLiCIES.
IF YES, MIICH APPLY? ELECTRICAL SIGN
-ILLU}IINATED
(INDIREfiLY LI6}ITED)
DA.i'[.\GE
fio
DESCPIBE ?TPE OF }l1TER,I.\IJ 516}I IS CO}IST9.'JCTED OS
PROVTDE UL MJ.UBER IF APPLICAE
SITE INFOR\L\TION (LI\D USE)..
VALUE OF SI6N
EXISTING USE OF SUITDING OR LN"\D (OR LAST USE IF
,.
I
o
PROPOSED USE OF BUILDING OR L{IiD
ITiDCOR BUSINESS
-OLTTDOOR
}IERCHA,\DIS ING
IF rES, DESCRIBE ALL EIISTIIiG SI6NS..F0R pqS.{,_\ESS,
FIRV, ETC.:
IIii '-';JI AII..ABLE
Af,L ExrSTrlrG Sr6Ns oN pREltrsEs(sA.\rE rAx Lor) . ,l- 9/l:'::*/J,2 rn/', (1o ,'-
I HAVE CAREFULLY EXi\IINED the completed application for pernit and do hereby certify that all info:mation hereon. is tnre and
correct, and I further certify that all r"ork perforned sha]1 be done in accordance with the Springfield Sign- Ordinance, the
Uaiform Sign Code as adopted by the City of Springfield and all other Ordinances of the City of Springfield and the laws of
the State of oregon pertaining to the work described herein. I further certify that oy Sign Concractors License sith theCity of Springfield is in full force and effect as required by Springfield ty Codes 8-2-6(.3) and 9-7-20C2I. I vill requestaIl required sign inspections listed on the approved pernit.
NAHE(PLEASE PRI}IT) L@/(ME4,) SIGNATURE
.. ..DATE
F E E ONLY
SICN DISTRI
INSPECTIoNS REQUIRED:
ZONE DISTRICT TOTAL
_FooTING 0R FrETiloD 0F ATr.{C}r\tENT ELECTRICAL lrflsru
fOOTAGE OF SIGN
-SITE/LOCATION
FEES:
T0TAI FEE FOR PER\IIT:
STATE SURCHARCE
OTHER p
SIGN PER,IIIT
CI{ARCES:
EECTRICAL PER.TIIT:fit J- c o CIIARCES:
DOES SIGN PROJECT BEYor"D PRoPERTY LINE YES
8t.c o a
l) Seoer:te Siqn Aocl icrticn: A separate application
separl,ce srgn Js uerrneo rn the sign code.
2) Electrical: Any pernit issued under this applicati<
ing rn or on sign itructure, che supply sires for cc
covered on an electrical pernit. Eleccricel connect
only by I Srire Licenscd Electricel Contractor. III
internslly and externelly) nust conforn to Sections
9-7- lS of che Springfi,eld Sign Ordinance.
3) Pl:ns Reouired:This application is to be submitted
5e!s or pians drrrn Eo scale, showing dinensions and
vcrtising nessege on sign; location of sign on prope
to property lines, structual details of support fran
footings; nsteritls of constnrcrion for sign and sig:
trical equip:rent and lighring; si:e and loiarion of ,
Properi), foE the sa.ne business, all as required to d,r.ith che Springficld Sign 0rdinance (Article 7 of thr
Code), Also, show rhe r'ollowing i.nfor:iation on the 1shouing properry lines and location of signs):
a) Shou the locac|on of ell existing sign(s) as well
b) Shov the length of the stree! frontage raken up t
bu i lding.
c) Shos the locccion of entrances open to the public
4) l{hen required, becsuse of design, size, etc., enginee
calculat:,ons nust be prepared by a licensed engineer
to desr;n standards on r'ile at the Building Division t
5) Plans of insufficienr clarity or detail wil,l be rerurr
plicent vith no pernrE being issued.
6) Signs nust meet corner vision clearance requiremenEs !
Fig. 9 of the Springfield Conprehensive Zoning Code. ;
7) !(OTE: tr'o sign nry be erecled which is tess than 12 fJor veriic:lly fron overhead electrical conductors in e
volts, or less rhrn 5 feet in any direction froo overh
lines vhich ere energi:ed ac less than 750 volls.
8) If:r si;n is nor. inststleC within 60 days after the dathis pcr.iiE. rhe per.iir shai.1 be void.
9) Insoect ions:
a) Site Inspection - to be made before the sign is ol:
e) nay be nadethe I:ooil;:i [:l5oection (if applicabl
tine as rn.: Srte Inspeccion, The Footing Inspecti<
oade efter hole(s) is excavated, but prior to rhe Iconcrece. l-
CITY OF SPRINGFIELD
CitY Holl
Springfield, Oregon
Deportment of Public Works
OFFICIAT RECEIPT
No. B 50299
l9
Rece ived For
t,
Amounl Received
'r'.\LtD.\il0:l
r
\II
iho
te
i!
pr:r
tp
(a
licr
(
(
(
(
(
(
("
_3r-
(:IH
Y, sHELtoR_YuRilu!! ?RlNfEEs - EUGENE oi 97'ol 345!l''
b)Fin:l Ir.,soect ion - to be made upon completion of all uork.
c) Electricel - All electrical si.gns nust be inspected for eleccri-
cal hoox up efrer the sign is erecled and before rhe si.gn is
turned on.
c{LL FOR lHE REqUIRID INSPECTIoNS 0N THE 24
726-3769.
SPECIAL COXDITIO.\S TO BE SATISFIED EEFORE ERECTION OF SIGN:
DATE
HOUR INSPECTION LINE AT
;.
ADDITIO.\AL INFO&\IATION NEEDED BEFORE PER}'IT }IAY BE ISSIJED:
PL4.!S REVIEi(ED BY DATE
I
(
(
\
5to^)2
CITTT OF SPH,I}TGFIEI-D
SPRINGFIELD. OREGON 97 477
I:{FORYATI0I: 726-3753 I.\-SPEC[I0:{ REQUESTS: 716- j:o9
CITY OF SPRI}ICFIELD
SI6]i CONSTRUCTIOI f\D ELECTRI C.lL IYSTALIATION
COTIB INATIOT AP PL ICATION/ PE R\ItT
LocATrox oF sIG:{(.{o0RESS)
LECAL DESCRIPTIO:I /-G
ou:{ER oF pnopgnrrAz'-
ADDRESS * 5-<J
oriliER oF slct'i(IF gorER TH.:r\ PROPERTY ot{!\iE
AOORESS
NA\IE OF BUSIT-ESS, FIf,\I, ETC
iioR K
O/<
OF BUSI}IESS
TAX LOT {
PHONE
ZIP
PHONE
IDENTITY
PROJECTING
INCIDE\TAL
DOUBLE FACE
a
s
ERECT
RELOCATE
ALTER
crnlER
_ NON-IDESTITY
SECOI{DARY
y'srxcu: rrc=
-
IruLTI.FACETantrer> o*,hlwmo A^o
IYALL
ROOF
r'TARQUEE
OlHER
FREEST,L\DING
PROJECTLT-G
READER EOARD
BILLBOARD
VE\DORS CO}iiL\CTCRS:
SIGN ERECTOR Ft,/lFtrtF </Zi/4
ADDR.ESS
CITY LICS.\SE !\LN,I3ER,EXP. DATE
sIGN In\UFACTURER (IF OTIER TrL\\ eer.Crpn fuF
A'DRESS -54/28 1$ 4P;, -
E LECTR I C.\L CO$TR^CTO R
ADDRESS ICENSE NI.I}IBER-
TOTAL HEICIIT AEOVE CE,1D5 VERTICAL DI}IENSION OF SIGN HORI:ONTAL WIDTH OF SIGII
DIIIENSIOX FRO}I GR,\D[ TO BOTTO}I OF SIGN 'THICI(.I.ESS OR DEPTH OF SIGN
ooEs srclr pRGJEcr BEyorio pRopERfi LINE trt {C IF YES, DI}IENSION BEYOND PROPERTY IINE
lioTE: IF PRoJECTIO.\- IS :.ioRE TtlA.\ 12" OVER. PUBLIC PROPERTY THE SIGN ERECToR !.iUST FILE ltlTtl THE BUIIDIIIG DIVISION COPIES OF
HIS PUSLIC LIABILITY A.ID PROPERTY DA.\L,I.GE INSURI"\CE POLICIES.
frLL SIG.Y tlAvE ELECTRICAL IvIRIIJG?
-UtS
,/NO
DESC.D.IEE TYPE OF }'.1TERI.T6 516.\I IS CO}ISTP]JCTED 09
IF YES, WHICH APPLY? ELECTRIC\L SI6N ILLUITINATED (INDIRECTLY LI6HTED)
PROYIDE UL I|I,,}IBER IF APPLICAELE VALUE OF S
SITE INFOR\IATION (LT.\D IJSE).-EXISTING USE OF BUILDING OR Lq.\D (OR IAST USE IF
o
PROPOSED USE OF BUILOING OR L\}iD:
C}IECK ONE IF APPLICAELE BUSINESS _oUrDOoR :IIERCHI\DISING
EXISTING SIGIS (S:GN CODE) : ARE 'IHERE EXISTING SIGNS? _YES 6, rF Es, DEscRTBE ALL ExrsrrNc.srGNs..FoR prfs.{}lEis,
ALL EXISTIilC SIGNS 0N PREUTSES(S.$rE TAX LoT):
I HAVE CAIEFULIY EXA.UINED rhc coEplered appl ication for pe:mit and do hereby certify that all inforruation hereon. is tnrc and
correct, and I further certify that all r.ork perfor:l ed shall be done in accordance with the Springfield S ign- Ordinance, the
ld and the laws ofUnifom Sign Code as adopted by the City of Springfie ld and all other Ordinances of the City of Springfie
the State of Oregon ining to the work described herein.I further certify that ruy Sign Concractors License rith thePertais inCity of Springfield full force and effect as required by Springfield ty Codes 8-2-6(.3) and 9-7-2OC2\. I vill request
all required sign inspections listed on the approved pernit.
NAI.{E(PLEASE PRI}rT)SICNATURE
.DATE
SIGN DISTRI ZONE DISTRICT TOTAL fOOT,\GE OF SIGN
I
INSPECTIoNS REQUIRED: SITE,/LoCATIoN FOOTING 0R IlETlloD 0F ATTACIL\IENT ELECTRICAL L
FEES:
TOTAL FEE FOR PERIIIT:,7{,0 O
STATE SURCHARGE:
I--FINA OTHER
SICN PER}IIT
CHARGES:d {,oc ELECTRICAL peR.rrir
CIIARGES:
\LtD.\iI0:t
l) Seotrrte Siqn Aocl ic:ricn: A separare applicetion ,.separrre ilgn rs ,riiliti-r.n the Sign Code. (CITY OF SPRINGFIELD
Ci?y Holl
Springfield, Oregon
Deportment of Public Works
OFFICIAL RECEIPT\P
2) Electricrl: Any perni.r issued under this applicatiting rn or on sign structure, che supply wires for cr
covered on Jn electrrcal pernit. Eleccrical connectonly by r Stare Liccnscd Electrical Contraccor. Illintern:rlly and externtlly) nust conform to Seccions9-7-tS of che Springfield Sign Ordinance,
3) Plens,Qeouired: This
No. B 56299
sets or plens dr:rn to
epplicacion is to be submittedscale, showing dimensions and
t9
vertising nessJge on sign; Iocarion of sign on propeto propeny lines. structual details of support franfoorin3s; nrtcrials of constnrction for siln and sigtrical equiprenr snd lighting; si:e and loiation of-properiy for the sa"re business, all as required to dvith rhe Springfi.cld Sign Ordinance (Article 7 of thrCode). Also. show rhe r'ollowing infor:iation.on the Ishoring properry lines and location of signs)':
a) Shon the locacion of all existing sign(s) as well
b) Shov the length of rhe sr:eet fronrage taken up t
bui ld ing. ,
c) Shov the location of entrances open to the public
4) l{hen required. becruse of design, size, etc., engineecalcul:tions nust be preoared by a licensed engineer
Co desrgn srendards on r'ile at the Building Division
5) Plans of insufficienc clarily or detail will be rerur:plicent rirh no pernrE being issued.
6) Signs nust mee! corner vision clearance reo.uirenenrs ;Fig. 9 of rhe Springfield Conprehensive Zoning Code. ;
7) IiOTE: lio sign nay be erected which is less than f2 fJor vertic:lIy fron overhead eleccrical conductors in .volEs, or less then 5 feet in any direction froo overhlines vhich are energi:ed at less than 750 vol,ts.
8) If r si;n is no! insr:Iled liithin 60 days after the dathis per:.rir. rhc penrir shall be void.
9) Insoect ions:
a) Sire InsDection - to be made before the sign is ol;
@ (if applicable) nay-be ruaiet1:re as cne Srae lnspeccion. The Footing Inspectiraade .rfter hole(s) is excayated, but pri.or to the I
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b) Finel lr.soection - to be made upon conplelion of all work.
c) Elgc.tric:l - All elecrricar signs nusr be inspected for electri-cal hook up :fter rhe sign is erected and before the sign isturned on.
CILL FOR THE REQUIRED INSPECTIONS ON THE 24 HOU4,INSPECTION LINE AT726-3769. ,i
SPECIAL CONDITIO.\S TO BE SATISFIED BEFORE E.R,ECTIC,Y OF SIGN:
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ADDITIOIAL INFOR\ATIO.\ NEEDEO BEFORE pER.\rIT l,ti{y BE ISSTED:
PI..A,YS REVIEi{ED 8Y:
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