HomeMy WebLinkAboutPermit Signage 1981-11-17$ssn
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CIEfT OF SPH,I}SGFIEI-D
INFoR.!,1{TI0N : 726-3753
SPRINGFIELD. OREGON 97 447
CITY OF SPRI}{GFIELD
SIGN CONSTRUCTIOS AND ELECTRICAL I}ISTALI.{TION
COIIIB INATION APPL ICATION/ PE R\IIT
INSPECTI0:." REQUESTS : 7?6-51o9
LOCATIOX OF SI6N
LEGAL DESCRIPTIOII o
OiI\LR OF PROPER T
ADDRESS
olfl,iER 0F sI6N(IF Tltlu\ PROPERTY
ADDRESS C 't\
PHONE
ztP
B
S<)
S
qt--\_)
NA.\IE OF EUSINESS, FIR\I, ETC
IiORK
E OF BUSINESS
ERECT
RELOCATE
ALTER
OTHER
IDENTITY
PROJECIING
INCIDENTAL
DOUBLE FACE
NON- IDENTITY
SECONDARY
SI}iGLE FACE
}ruLTI- FACE
VEr*DORS COSTP-lCTORS:
TAX LOT !
t PHONE
N L
FREESTAT\DING
PROJECTING
READER BOARD
BILLBOARD
Xx,
I,JALL
R,OOF
MARQUEE
OTHER
P PHoNE 1 a -Yp6SIGN ERECTOR
ADDRESS
CITY LICE);SE NU'IBER
SIGN I'.IA,\UFACTURER (IF OTIIER TIITL\
. EXP
PHONE
PHONE
ADDRESS
ELECTRIC.{L
ADDRESS NIJ}IBER
l-t-.t+*
TOTAL HEIGHT ABOVE GRAD:DIIIENSION OF SIGN HORIZONTAL WIDTH OF SIGN .-,
DIIIENSION FRO}I GRiDI TO BOTTO}I OF SIGN THICKNESS OR DEPTH OF SIGN
.)ll(>.'
DOES SIGN PRGTEfi BEYOND PROPERTY LINE
-
YES -:Y.nO IF YES, DIIiIENSIoN BEYoND PRoPERfi LINE-
---!{OTE: IF PROJECTION IS i.iORE TIIPq\ 12" OVER PUBLIC PROPERTY TTIE SIGN ERECTOR I'IUST FILE I{ITII TIiE BUITDI}IG DIVISION COPIES OF
HISPUBLICLIABILIfiA.\DPRoPERTYDAI.!\GEINSURA.I{CEPoLICIES.
rrLL SIGN lrAvE ELECTRICAL I{IRING?
-YES
{lrO
DESCPIBE TYPE OF Y.\TER,I.\LS SII:}I IS CO}ISTP.UCTED
IF YES, WHICH APPLY?SIGN ILLU}IINATED (INDIRECTLY LI6HTED)
0.E
PROVIDE UL NUI'IBER IF APPLICAB LE VALUE OF SIGN
SITE INFOR.\I,\TION (LA,\D IJSI)..EXISTING USE OF BUILDING OR LAND LAST USE IF YACPU\T)
I
PROPOSED USE OF BUILDING OR LAND
OIECK ONE IF APPLICABLE:
EXISTING SIGIS (SiGN CODE)ARE TTIERE EXISTING SIGNS?YES
FIR.U, ETC.
X;Gunoon BUSINESS
-ourDooR
IIERcHA'\DISING
yES, DESCRIBE ALt E-xrsTING.SIGNS. FoR 9LlslilEss,yNo IF
ALL EXISTING SIGNS ON PREIIIISES(SA'UE TAX Lor)
I HAVE CAREFULL'Y EXAIIINED the comPleted aPPl ication for Permi t and do herebY certifY that all infornation hereon is true and
nsfield Sign Ordinance, the
Siringfield and the laws of
t;actors License with thecorrect, and I further certifY that all qork perform ed shall be done in accordance wi th the SPri
Uniforrn Sign Code as adoPted bY the City of Springfie Id and all other Ordinances of the City of
the Hork described herein. I further certify that mY Sign Con
e and effect as required by Springfield CitY Codes 8-2-6(i)and g-7-zOLZl. I ri1l requestthe State of Oregon
City of SPri ngfi el d
perta in ing
is in full
to
forc
all, requi red sign insPections I ist ed on the aPProved Perroit
NAME(PLEASE PRII{T)
SIGN
INSPECTIONS REQUIRED:
ONL
ZONE DI
SITE/LOCATION
TOTAL SQUARE ,FOOTA6E OF SI6N
ELECTRICAL
ELECTRICAL PER.IIIT
CII,ARGES
SIGN PERMIT j[5.o o
CHARGES:
FEES
T0TAL FEE FOR PER.IIIT:
d6i, o o
STATE SURCH.qRGE:
VrrNrl orHER
I
(-
FOOTING OR METHOD OF ATTACH}IENT
"'\LtDtTI0.\i
1l SeDsrste Sien Aoplicecion: A separate appiicati.on is required for each
sep"race 5rgn rs oeir-neo in the Sign Code'
2) Flectrical: Any permir issued under this application wi.Ll include wir-
lng rn or on srgn structure, the supply wires for connection must be
covered on an electrical permit. Electrical connection must be made
onlv by a State Licensed Electrical Contractor. Illuninated signs (bothinternrlly and extern:lIy) must conform to SecCions 9-7-.1 (4)6(5) and9-7-lS ot- che Springr'ield Sign Ordinance.
3) llSns-Reoyi.red: This application is to be submitred with rwo conpletesets or prans draun ro-sccre, showing dimensions and height of sign; ad-vertising nessage on sign; location of sign on properry iith dimensionst-o property lines, structual details of support framing, bracing andfootings; naterials of construction for sign ana sign Iiructure; erec-trical equiomenr and lighting; sizd and loiation of""*isii.ig signs on
P!'aperf:y for the sane business, arl as required to determine complianceBirh rhe springr.'ierd sign ordinance (Arriile 7 of the springfieri cityCode). AIso, show the foil.owing infornoation on the pfoi liin qpfanshowing properry lines and location of signs):
a) show the location of all existing sign(s) as werl as p'oposed sign(s)
b) Shov che rength of the street frontage taken up by the businer.s orbui,lding.
c) shon the location of enrrances open to the public and dri.veways.
4) l{hen required, because of design, size, etc., engineered drawings andcalculccions rnust be prepared by a li.censed engineer or shalr conformto design standards on !-ile at the Buitding Di.vision Offi.ce.
S) Plans of insufficienr clarity or detail will be returned to the ap-plicanr wirir rro pernir being i.ssued.
6) signs must meer corner vision clearance reeuirenents as described inFi.g. 9 of the Springfield Comprehensive Zoning Code.
7) NorE: ir"o sign-nay be erected which is less than 12 feet hori:ontallyor verticelly fronr overhead electrical conductors in excess of 7s0volts, or less than s feet in any direction froa overhead erectricarlines yhich are energized at less than 750 volts. .
tc -,. - --. . _^- :f _1 rl !a.- ..:-\:1r ra .l_." u! : ji.: :j: .- :h; j;;_ -.f ..,:..;- ;.ithis peri:rit. lire yer:nit shall be void.
9) Insoect ions:
i
iiA0
a) Sice Insoect ion - to be made before the s 1gnthe is placed
rnade at
Usual 1y,the samet i.n
Foorrnr: Insoection (if
e as the SrEe lnspection
applicable) Eay be
The Footi.ng Inspection is to bemade efrer hole(s) ii excavat ed, but pri.or to the placement ofconclet e.CLERK
b)Finc I Inspect to be made upon completion of a1l work
c)
CALL FOR THE REQUTRED INSPECTIONS ON THE 24
726-3769.
HOUq INSPECTION LINE AT
SPECIAL CONDITIO.\S TO BE SATISFIED BEFORE ERECTION OF SIGN:
ion -DATE
Elgclrisal - All electrical signs nust be inspected for electri_cal hooK up after the sign is erected and before tte sign-is---turned on.
ADDITIONAL INFOR\I,{TION NEEDED BEFORE PERMIT I,IAY BE ISSIJED:
PI.A.IIS REVIEI{ED BY:
DATE ,--g
\
It":
5/gu
&*3't
o'ffiS,d)
rer-t I wro u nt Se d
tr i {h bo l,ts .
3U
'aPPRgy@
5',l9
Po.r i nrg i nr ReaF
aln
o+i7oe-
(
C-oxl6TR v cT t o d rn meuro
(
/
e-l
I
7';,,t'ffiS,*)
wo-\ \ rvro u rrt Te- d
tst*h boI'tS' (
eU
ffireaovsr(- /( t
.ItltrX
, EJ,5'
Siqned
Aln
i NIPErK
Iuttq0e
/
i nr ReaF
OD f,ls
INFOR!.!\TI0N: 726- 37Ss
CI:TTT OF SPF,IA\TGFIEIJ]D
SPRINGFIELD. OREGON 97 477
CITY OF SPRINCFTELD
SIG:'I CONSTRUCTIOS AND ELECTRI CAL I}ISTALI.ATION
COI{8 TNATION APPL ICATION/ PE R\IIT
I);SPECTIoT- REQUESTS: 7:6- j:b9
LocATto.Y oF SIGX(ADDRESS)
LEGAL DESCRIPTIOX
OI{I.iER OF PROPERTY
ADDRESS
oli)iER 0F SI6X(IF OTHER THA\ PRoPERTY ot$\iER)
BUS I NESS
PHONE
zlP
PROJECTIN6
INCIDENTAL
DOUBLE FACE
o()5\x)
U\k
ADORESS
NA.\IE OF BUSIXESS, FIf\I, ETC.
ERECT
RELOCATE
ALTER
OTTIER
_( torNrtrr NON- IDENTITY
SECONDARY
SINGLE FACE
[ruLTI. FACE
TA)( LOT 4 o'DGI
e I
SIGN APPLICH
FREEST.L\DING
PROJECTING
READER BOARD
BILLBOARD
I'IARQUEE
OTHER
VET"DORS CO\Tfu\CTO
SICN ERECTOR
ADDRESS
CITY LICENSE :(LN,IBER
SIGN TIA.\UFACTURER (IF OTIIER TII.{\ E
ADORESS
E IICTR I C.{L CO}iT RACT0R
ADDRESS
Or-r-).r-o1-
PHONE
EXP. DATE
r((-
LICENSE NLFIBER
'ALL\0fi 0
TOTAL HEIGHT ABOVE GR,\DE o DII{ENSION OF SIGN ZONTAL WIDTH OF SIGN
DITIENSION FROiiI GRADI TO BOTTO}I OF SIGN CK}{ESS OR DEPTH OF SIGN ?2v
DOES SIGN PROJECT BEYONO PROPERTI LINE, YES ,ry NO IF YES, DI}IENSION BEYOND PROPERfi LINE
I{OTE: IF PROJECTION TS I.|ORE TII,Iq\ 12'. OVER PUBLIC PROPERTY TTIE SIGN ERECTOR I'ruST FILE I{ITII TI1E BUILDI}IG DIVISION COPIES OF
HIS PUELIC LIAEILITY .d\D PROPERTY DAIU\GE INSURANCE POLICIES.
rILL SICN HAVE ELECTRICAL I{IRING? YES IF YES, WTIICH APPLY? ELECTRICAL 5t,ICN ILLU}IINATED (INDIRECTLY LIGTTTED)$"
DESC.D.IEE TYPE OF YNTER,I..\Ls SIG}I IS CO}ISTP.UCTED OF
PROVIDE UL NUI'IBER IF APPLICABLE OF SIGN
SITE INFOR.\IATION (LA.\D t6E)..EXISTING USE.OF oR LA.\D .(0R LAST USE IF yACA.\T)
PROPOSED USE OF BUILDING OR I.AND
ONE IF APPLICABLE:BUSINESS OUTDOOR }IERCHfu\DISING
EXISTING SIGIS (S;GN CODE): ARE THERE EXISTING SIGNS?_YES {No IF yEs, DEscRIBE ALL EIIsTING sIGNs FoR BUsINEss,f
FIR.Y, ETC.:-
or
AI,L EXISTING SIGNS ON PRE}IISES(SA,\IE TAX LOT):
I HAVE CAREFULLY EXAI'IINED the conpleted application for perait and do hereby celtify that all infornation hereon is true and
correct, and I further certify thit all work performed shail be done in accordance with the Springfield Sign Ordinance, the
Uniforrn 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 pertiining ro the work described herein. I further certify that D)' Sign Contractors License uith the
City of Springfield is in fuli force and effect as required by Springfield City Codes 8-2-6(!) and 9-?-2oL2\. I nill request
all required sign inspections listed on the approved perroit.
NAI,{E(PLEASE PRIm)(Al\RI A \+ E,AIA,, GP,2'JI
stcN DrsrRrcrJbywJ4l
.DATE i/;
INSPECTIoNS REQUIRED: SITE,/LoCATIoN
GNATURE
TOTAL SQUARE .FOOTAGE OF SIGN
FOOTING OR I'{ETHOD OF ATTACFI.\IENT ELECTRICAL
ZONE DISTRICT
ONLY
FEES
TOTAL FEE FOR PER.\IIT 6-<.cc
a
STATE SURCH.{RGE:
$t*^t OTl{ER
SIGN PERMIT:
CHARCES:6 S. a o ELECTRICAL
CTIARGES:
PERIIIT:-o
PLEASE Si.{O
l) Seperete Siqn .{oplic:rion: A separare application is required for each
separare rrgn:rs.:efineci in the Sign Code.
2) Electrical: Any pernit issued under this applicacion will, include wir-ing rn or on si.gn structure, the supply wires for connection must be
covered on an electrical permit. Electricrl connection must be madeonty by a state Licensed Electricel contractor. Illurninated signs (bothinternelly and externelly) must conforn to Seclions 9-7-4 (4)€,(a) and
9-7-1.3 of rhe Springfield Sign Ordinance.
3) Plans leouired: This application is to be submitted with two completesels or plans drarn to scale, shorving dimensions and height of sign; ad-vercising nessrge on sign; locati.on of sign on properr)' with dimensionsto properry lines, structu3l details of support franing, bracing andfoocings; natcriels of construction for sign and sign irructureJ elec-tricel equipnent antl lighcing; size and loiation of existing signs onproperly for the sa-ne business, al1 as required to deternine compli.ancerith che Springfield Sign Ordinance (Articie 7 of the Spri.ngfield CityCode). Also, show the following information on the plot plan (plan
showing properry lines and location of signs):
a) Shov the locacion of all existing sign(s) as well as proposec'. sign(s)
b) Shora the length of the stree! frontage taken up by the business or
building.
c) Shov the locagion of entrances open to the publ.ic and driveways.
4) l{hen required, because of design, size, etc., engineered drawings andcalculsrions nust be prepared by a li,censed engineer or shall conformto design standards on file ar the Building Division Office.
5) Plans of insufficient clarity or detail will be returned to the ap-p!.icant xi,th no pernir being issued.
6) signs must meet corner vision clearance requirenents as described inFig. 9 of the Springfi.eld Comprehensive Zoning Code.
7) NOTE: lio sign raay be erected which is less than 12 feet horizontallyor vertically from overhead electrical conductors in excess of 750volts, or less th3n 5 feet in any direction froo overhead electricallines vhich are energized at less than 7S0 volts. t
B) If r si;n is no! insralled r{ithin 60 days after the date of issue ofthis permic. the pernir shall be void.
s)In tons:
a) Site Inloection - to be
T ','.11 I DA'
the Foott;rr: lnsoection (
tine as rhe Site Inspect
made before the si.gn is piaced. Usual.J.y,
if appl.i.cable) nay be made at the sane
ion. The Footing Inspection is to be
nade after hole(s) is excavated, but prior to the placenent of
concret e.
b) Finel Inspection - to be nade upon completion of all work
c) Electrical - All electlical signs nust be inspected for electri-cal hook up efrer the sign is erected and before the sign is
turned on.
CALL FOR THE REQUTRED TNSPECTToNS 0N THE 24 HOU4, INSPECTION LrNE AT726-s76s.
;r
SPECIAL CONDITIO.\S TO BE SATISFIED BEFORE ERECTION OF SIGN:
CLERK
DATE
ADDITIONAL INFOR\IATION NEEDED BEFORE PE&VIT I'IAY BE ISSUED:
PI.,.fu\S REVIEI(ED BY:
\
E le.totiost 3/rCoNsfPuctr o^/a. Sheels7 a_N l,tsd b{co'tsU s teel aNqle i ror,l' SuPfo"*S
Sv.orn
to
Ono
s+
.rnd P
/
Ste,-[
An Ste. Ifno hl I
lApP
&:-_-
I
Rrn
BRr,c6,(f
ut
00
s
x
€
e
<E
r0o
o
,1,s
Rfn 6
4
9
el-
H \r utr r)o oF Si
Signed
)
Gs"a Sccle: 4" p.rE
\
1tso+h 6rde5 r-tlr.,for.eJ I' . tP i +h s*eel g, deurircf\i
/
/
/
ttll2ldlfl
\rl
xl\l
ool+
)))
Fro* t of S N ,(
I
I)
)
Signed
(
@l
d1 nni I
O-r r Bo"t i U S
B+l
)))a8+h Street
DRtyct tftl
A
1fi
I -rtv1
Street Fnorytafa ApPno{. 5O{+'
g u ide.^ri re-s
Po op
Wltt
sto tl
9AC/rpooe-
Jj
fla
I
Signed
t \
t,i'
li,
oxsrcirorr\-F+.
Ot)o t I N oNd
R€"3
E:'#b w
,/
)
Fro nt t fSio N l+: $"per fJ
, AfiPROVtE \
/(-
"ry
l9 gL
lt.
)
)
\{
I
O-r r Bo"t i U S
liigned
B+I
@l
nni
11 ocK o$ Signr Scq.le:4"prrl]
E levotiosl
Snorn Qno ulio s+.
nlJ 5 c s
a-Y ,/ ,t s
mJqTEe /A/-(
3/4,,p/1w*J&.
7J
Ll
Jtl6lutlll
\
b(.co't s
S tee I aruq Ie t ror'J
SrPflon*-s
\ tso+h 3rdes u"eirvforceJ
tr: i+l Steel g'deu"'ire
$x
uO
Ste.*
Augt".
\>
Itnor.,J I
Signed
\i
F RRrN T
4(k
e*{ BRxcgLC(f,
uta
s
x
€
e4.
TTo
s*3
4
ax
a
#:-::,
oo
/
l{Y.otr U o Si N
Ca"e_
/
/
4 FRRrn E
a8+h S*reet
ft,€"3
tr
I -'J.f1
DRtyc utAJ
streel f661{afa AlProY.. so{*
g u ide.ri re-s
Po oP
Wltt
sto tl
9Acx
pooQ_
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)
fl0
I
.19
rloN3leirorul-
\O\)Q_-o t,'N c^d tJt
Irl
CI:TY OF SPH,I\TGFIEIJ]D
INFO&{\TIOX: 726-3735
SPRTNGFI ELO. OREGON 97 477
CITY OF SPRT!(CFIELD
SIC:{ CONSTRUCTIO}I AND ELECTRICAL TNSTALL1TION
CO}IB TNAT IO}I APPL ICATIO.\/ PE R\!TT
I\SPECTIOIi REQUESTS : 7:6_ j:o9
LOCATIo.Y OF SIGY(AooRESS)
LEGAL DESCRIPTIO:
?1
O[Y}-ER OF PROPERTY
ADDRESS
OlrlER oF SI6.\(IF OTHER TltL\ pROpERTy
ADORESS t
:{A.\IE OF BUSISESS, FIR\I, ETC
IiORK
G rtl TAX LoT t .1 o
PHONE
zlP
D(}
a\
u3f:-qBUSINESS
J ERECT
RELOCATE
ALTER
CNIER
_( rorNrrrr NON- IDENTITY
SECONDARY
SINGLE FACE
}ruLTI. FACE
PROJECTI$G
INCIDENTAL
DOUBLE FACE
PHONE
PE OF SIG:'I:SIGN Cili\Rr C.\ts LE*ffru>FREEST.\\DING
PROJECTING
READER BOARD
BILLBOARD
ITARQUEE
OTTIER
YENDO
SIGN
ADDRESS
CITY LICENSE }iI,J:.IBER 1?r,
SIGN }IA.\UFACTURER (IF OTIIER TII{\ ERE
A.00REsS
E LECTRI C.{L CO}TR,TCTOR I
ADDRESS
--J o1-
PHO}iE
EXP. DATE
it
(F PHONE
PHONE
ZL:
LICENSE NI.'}IBER
TOTAL HEIGHT ABOVE
DI.IIE}ISION FRO}I GR,rOI TO EOITO}I OF SIGN
DOES SICN PRO.'ECT
I;OTE: IF PROJECT
HIS PUELIC
ICAL DITTENsIoN oF sIGN e
ICKNESS OR DEPTH OF SIGN
HORI :ONTALu I{IDTTI OF SIGN
' BEyoND pRopERT.r LrNE, _ yEs -{ *o IF yES
IO:{ tS i.iORT TIIAI\ 12'' OVER PUBLIC PROPERTY T1IE SIGN E,LIABILITY A\D PROPERTY DA}L{6E INSURANCE POLICIES.
, DIIITENSION BEYOND PROPERfi LINE
RECToR l.lUST FILE I{ITII Tt{E BUILDL\IG DIVISION COPIES OF
IF YES, tfiIcH APPLY? ELECTRIC\L ILLUUI NATED (INDIRECTLY LI GtrrEo)
rlLL srGN uAvE ELEcTRTcAL lrrRrNG? yEs [toDEscg.rBE TypE oF y-rr'Rr.{Ls sr6}r rs ilnrrr.,io, o.*
PROVIDE UL NUTIBER IF APPLICABLE
SITE INFO&inTION ( LA.\D rJsE ) -_EXISTING USE . OF NG OR
OF SI6N OO.
IF VACTT\T):t/o 1kf
or
O .r-t l.^ x ,,q xQ r./- I ,x-!
PROPOSED USE OF BUILDING OR LAIJD:S
EXISTMG SI6IS (S;G\ C00E):
FIR.Y, ETC.:.
ARE fiERE EXISTII{G SIGNS? YES
BUSINESS
-OTITDOOR
IIERCHfu\DISING
1$o rF )Es, DEscRTBE ALL Etrsr.rNc.sIGNs..FoR BusrNEss,(
ALL EXISTING SIGNS ON PREIIISES(SA.\IE TAX LOT):
I HAVE CAREFULLY EXAIIINED the corpleted application for peroit and do hereby certify that all infornation hereon is true andcorrect, and I further certi fy that al.l trcrk perfo:med shall be done 1n acc ordance with the Springfi eld Sign Ordinance thefield and the I aws ofUniform Sign Code as ado pted by the City of Springfield and all other Ordinances of the City of Springthe State of OregonCity of Springfietd Pi s in full force and effect as required by Spri.ngfield City Codes 8-2-6(J) and 9-7-2OL2\. I nill request
ertaining to the work described herein. I further certi fy that lay Sign Contractors License rith the
inspections listed on the approved pernit.all required sign
l{AI.lE (PIEASE pR lirr)IGNATURE DATE it
OFF
SICN ZONE DISTRICT TOTAL SQUARE.FooTACE 0F SIGN
INSPECTIONS REQUIRED: _SITE/LOCATION FS9TING OR t{ETHoD OF ATrAcrd\rENr ELECTRICAL
E
Vn NAL OTHER
FEES:
TOTAT FEE FoR PERTT'IT: g d.
-u&+'51T; tt,} tl
SIGN PERUIT:
CHARCES:65, a o ELECTRICAL PERI.TIT:
CHARCES -bi--
STATE SURCH.{RGE: --i:-'
-N
o
LA\D
sYr-'
\
CIE:T OF SPF,I}TGFIEIJ]f
INFOR\I\TION: 726' 3753
SPRINGFIELD. OREGON 97 477
CITY OF SPRI!(CFTELD
SI G:{ CONSTRUCTI OT AND ELECTR I CAL TYSTALL\TION
COTTB INATION APPL ICATION/ PE R\IIT
ISSPECTIO){ REQUESTS: 7:6-j:o9
LOCATIoX OF SIGN(AoD
LECAL DESCRIPTIO:I o
OITIbR OF PROPERTY
ADDRESS
OF BUSINESS
TAX LOT T
PHONE
ZIP
l=
IDENTITY
PROJECTING
INCIDEI{TAL
DOUBLE FACE
oril{ER 0F
ADDRESS
SIGX(IF OTHER T}I.f\ PROPERTY 0rfNER)
l-)l\,(<\->
SA.\IE OF BUSISESS, FIfuU, ETC.
X. ERECT ALTER
gNIERRELOCATE
\S
:p.Nv'1
F
NON- IDENTITY
SECONDARY
SI,'r"GLE FACE
IIULTI. FACE
L
5 IGNxE
:
FREESTAT\DING
PROJECTING
READER BOARD
BILLBOARD
T"tARQUEE
OI1IER
it00F
I{ALL
9n-I 6PT
CO\TP-\CTORS:
SI6N ERECTOR
ADDRESS
CITY LICE)iSE }iIX.I8ER
SIGN I|,I.\UFACTURER (IF oTltER TILL\ E
PHO}iE
L'L-4,-EXP. DATE-
'_Z-A_E:J.YP 6_
PHONE ? U h-J>
(.
A.DDRESS
ELECTRIC.{L CO}ITR \CmR
ADDRESS
PHONE
IICENSE NIi}IBER
TOTAL HEIGHT ABOVE GR,TD:CAL DI}IENSION OF SIGN HORIUONTAL ITIDTH OF SIGN .,
DIIIENSION FRO}I GR.\D[ TO BOTTO}I OF THICKNESS OR DEP'I]"I OF SI tl
rILL SIGN }I^VE ELECTRICAL IVIRING? YES {No rF YEs, wurcr APPLY?
E TYPE OF I1\TER,I.'\IJ 516]\1 IS CO}IST9.LICTED OF
PROVIDE UL NUTIEER IF APPLICABLE
SIGN ILLU}IINATED(INDIRECTLYLICI TEO)
VALUE OF SIGN
SITE INFO&\I,ITIO|{ (LA,\D I6E)..EXISTING TJSE OF BUILDING OR LA.\D I,AST USE IF YACA.\T]
PROPOSED USE OF BUILDIN6 OR LAIID:
CIIECK ONE IF APPLICABLE: EITIOOON BUSINESS OI'TDOOR }IERCHfu\DISING
-EXISTING SI6IS (siGN CoDE): ARE TI{ERE EXISTING SIGNS?_YE5 )dNo IF yES, DESCRIBE ALL EXTSTING.STGNS FOR BUSINESS,
FInY,ETC.:,
Ar.L EXISTTNG SIGNS ON PREIIISES(SA.\IE TAX LoT)
I HAVE CAREFULLY EXAIIINED the completed application for pe:mit and do hereby certify that all infomation hereon is true andcorrect, and I further certify that all rork performed shall be done in accordance with the Springfield Sign Ordinance, the
Uniforrn Sign Code as adopted by the City of Springfield and all other Ordinances of lhe City of Springfield and the laws ofthe State of Oregon pertaining to the work described herein. I further certify that ny Sign Contractors License yith theCity of Springfi.eld is in full force and effect as required by Springfield City Codes 8-2-6(.3) and 9-?-2OC2\. I yill requestall required sign inspections listed on the approved perruit.
NA.r'rE (PIEASE PR IN-r)SIGNATURE
SIGN ZONE DISTR TOTAL SQUARE fOOTAGE OF SIGN
ELESIRICAL VhrNu ol:tlER7INSPECTToNS REQUIRED:SITE,/LOCATION OR }IETHOD OF ATTACI{,\TENT
FEES:
TOTAL FEE FOR PER,\!IT '8,{" I o
SIGN PERMIT
GIARGES:{6.a o ELECTRICAL PER}IIT
CI{ARGES
STATE SURCHARGE:
AL 2
u
t
DoEs sIcN PRorEcr 8EYoND PRoPERTY IINE _ YEs _Yllo IF yES, DIt'tENsIoN BEyoND pRopERfi LINE_
'-'.-liOTE: IF PRoJECTIoN IS i.iORE TllA.\ 12" oVER PUBLIC PROPERTY TIIE SIGN ERECTOR l.lusT FILE lr,ITIl Tl{E BUILDI}IG DMSION COPIES OFHIS PUBLIC LIABILITY ND PROPERfi DAIIAGE INSURI,},ICE POLICIES.
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