HomeMy WebLinkAboutPermit Signage 1998-06-18SPRINGFIELO JOB I BER QsoauuSIGN PERMIT APPLICATION -
225 Fifth Street
Springf ield, OR 97 477 Zfr,
lnspection Line: 726-3769
Oflice:726-3759
ASITE ADDBESS:
ASSESSOBS MAP:
OWNER
ADDRESS;
CITY
BUSINESS NAME, FIRI'I EfC
TAX LOT:
2 PHONE:
STATE:
N(S): (please check and complete all appropriate information)
Freestanding
-
Proiecting _ Roof _ Marq
ZIP:
DESCRIPTION OF PBOPOSED SIG
-
Wall ,./
m
><tamn
-{'
=U'
_ Single Face /oouob race5t
Square Footage:
Vertical Dimension of sign or enclosure:(u
Dimension {rom Grade
to bottom.of Sign Enclosure:
_ Billboard _ Other
Total Height above Grade:
Horizontal Width of sign or enclosure:
Electrical lnstallation:
-
Y VALUE
red) OF SIGN 2 oo
ll U)
(lf yes additional electrical permit
Material Sign is aonstfucted of
List ALL existing signage and attach a photograph of oach 'lont.-[fi]-Q-
(a) Type
(c) Type
Sq. Ftg
Sq. Ftg
(b) Type
(d) Type
Sq. Ftg
Sq. Ftg
CONTRACTOR/IN STALLER:
jA gotr t PHoNE: lte'- ET{6
ood baADDRESSlzr
STAT ZIP:Qz(oz-
CIT'/:b
CONSTRUCTION CONTBACTORS REGISTRATION NUMBER EXPIRES:4qq
RES:
CITY BUSINESS LICENSE NUMBER:
OFF]CE USE
/(l Ouad AreaSign Distri
Zoning: _
Sign Permit Fee:
REOUIRED INSPECTIONS:
S;te
to--be made ptic.
to sign placement
Footing
prior to placement
ol concrete
e Section:
Approved BY:
Attachment
after fasteners are
installed/Prtor to cover
Electrical
pr- t" energizing
electrical installation
/'
l-./ r,n^,
co.np-letion of sign
rnstallatiorl
DATE:
Additional Comments and/or Conditions:
By signature, rstate and agree, that rhave carefully examined the completed application and do hereby certily that all inlormation hereir
is true and correct, and I further certify that any and all work performed shall be done in accordance with the ordinances of the citv o
Springfield, and the Laws of the State o{ oregon pertaining to the work described herein' lJurther certify that onlv contract0rs an
emploYeeswhoareincompliancewithoRsTol.O55willbeusedonthisproiect.
requiredinspectionsarerequestedatthepropertime,thatpro|ectaddressisreadabIefromthestreet,thi
lront of the property, and the approved set of plans will remain on the site at all times during the installatioo ensure that all
Validation
isl ted
Receipt Number:
s tLC .'-
I
Beceived By 'kL)
I lurther agree t
the permit card
ol the sign(s)
Signature Date
Amount Received:Date Paid C- iq -q<
a
Atiu€/