HomeMy WebLinkAboutPermit Miscellaneous 1990-12-15
city of springfield
225 n. 5th street
SPRINGFIELD
.
I N FORMATION: 726-3753
.
INSPEC'T10NS: 726-3769
SIGN PERMIT APPLICATION
J\. LOCATION OF SIGN (ADDRESS)
LECAL DESCRIPTION
/C;]I.{
Yha..-r. fJ III
r?d.
ADDRESS
PHONE
;O~tA~d
LMM /'-'Uflt,!P .
LttLi - 1ft I, z.. .
TYPE OF BUSIllESS tei.Ju, i 1
TAX LOT-f!
2&-]-1.{1I/
f17'l/7
ZIP
mINER OR PROPERTY 1M) N,..... #t1f"rl1~f A/- /,v-
ADDREss311J AlG;cI.. i-n~h/r(l.:VV t (/uJJ tJrlvf
OUNER OF SIGN (IF OTHER THAN PROPERTY OWNER}_~. rydtr
i 17 1-0 G,.e,pJr. fdrtS j(tA.. . bf.1t;ot'^l
NAME OF BUSINESS, FIRM, ETC. TJ." rJ,d{ /;vt.Wphofft,le
PHONE
B. TYPyg.F WORK:
JL..ERECT _ALTER
_RELOCATE
_OTHER
C. STRUCTURAL TYPE OF SIGN:.
~ALL _FREESTANDING
____ROOF ____PROJECTING
____MARqUEE
____UNDER liARqUEE
____OTHER
[). USE AND CPJlRACTER OF SIGN:
VIDENTITY .
INCIDENTAL *
_DOUBLE FACE "
~LE FACE ' .
____MULTI-FACE
____PJEADER BOARD
____BILLBOARD
E. VENDORS, CONTRACTORS, . .
SIGN ERECTOR J't)htl Stir... 5ylV;,..,/
'I.DD~-ESS /67(( LvPJT jf:! ~.
CITY LICENSE NU!1BER C(tf-# &Zk)7
SIGN liANUFACTURER (IF OTHER THAN ERECTOR)
ADDRESS
PilON!:
Lj~I.j-l..{n'lz.
ZIP otl't/2
1/4?
~/j,JJ
EXP.
DATE
PHONE
F,
DIMENSIONS, IIlSTALLATION & CONSTRUCTION
TOTAL HEIGHT ABOVE GRADE f.{" 1- () {(
VERTICAL DIMENSION OF SIGN :;2 '-01/
HORIZONTAL WIDnl OF 5 IGN 2 r i. z l{
DIMENSION FROM GRADE TO /'1, '~fJ If
BOTTOM OF SIGN ~
1"2. II
~NO
G. EXISTING SIGNS , /
ARE THERE ANY EXISTI!lG ~IGNS? _YES ~NO
ITIn1BER SIZE IN SO,FTG.
ALL EXISTING SIGNS
FOR EUSINESS, ETC.
-~
-
THICKNESS OR DEPTH
DOES SIGN PROJECT BEYOND
PROPERTY LINE? _YES
IF YES, DIMENSION BEYOND
PROPERTY LINE ' .'<,--
NOTE: IF PROJECTIOn IS !-lORE THAN 12"
OVER PUBLIC PROPERTY TEE .SIGN ERECTOR
IruST FILE WITH THE BUILDiNG DIVISION
COPIES OF HIS/HRR LIABILITY AND PROP-
ERTY DAMAGE INSURANCE POLICIES.
H. UI~L SIGN HAVE ELECTRICAL..)fiRIIlG? Y {l J
IF YES, WHICP. APPLY? VELECTRlCAL SIGN
ILLUMINATED (INDIp~CTr? LIGHTED) .
ELECTRICAL CONTRACTOr.. -IA YIlt hlJlNv..
ADDRESS
LISC. NUMBER
0i~1
n~-
PIlONE
I. DESCRIBE TYPE OR I'ATERIALS SIGN IS
CONSTRUCTED OF, II /1- .
fiVJJ.vJ.~ mt1J!J.ll!1!f!:! wl'lt..
ptal'ht /itI-,( f- hlb l/tf4"'"
J. SITE INFOPllATIOII (LAND USR) -- EXISTING USE
OF BUILDING OR LAND (OR LAST USE IF VACANT)
~ VaLftlr:!- red-q;iI ~/q~-
K. VALUE OF SIGN:
J. ~ f}() !:L
/
l/INDOOR BUSINESS OUTDOO~ ~ERCHANDISING
PROPOSED USE OF BUILDING OR LAND:
~rHtL;/ f)ViJr (iA~
.
L'I HAVE CAREFULLY E~IINED the completed application for permit and do hereby certify that all
information is true and correct, and I further certify that all work performed shall be done in
accordance with the Springfield Sign Ordinance. the Uniform Sign ,Code as adopted by the City of
Soringfield and all other Ordinances of the City of SprinRfield and the laws of the State of
Ore~on pertaining to t~e work described n~L~Ln. I further certify that my ~~3n Co~tractor Li-
cense with the City of Springfield is in full force and effect as required by Springfield Codes
8-2-6(3) and 9-7-20(2). I will request all required sign insoections listed on the approved
permit.
NAME (PLEASE PRINT)
SIGNATURE
}:;.1I...... Jr9h1j
/2/J'~ Q,w~
c/
DATE
11- j{,-QD
.~
PLEAS E
REAt
... -- .
..
1)
A separate application is required for each separate sign as defined
2)
Seoarate Siqn Aoolication:
in the Sign Code.
Electrical: Any permit issued under this application will includ~ wiring in or on sign structure,
the supply wires for connection must be covered on an electrical permit. Electrical connection
must be made only by a State Licensed Electrical Contractor. Illuminated signs (both internally
and externally).must conform to Sections 9-7-4 (4) & (5) and 9-7-18 of the Springfield Sign Or-
dinance.
3)
Plans ReQuired: This application is to be submitted with two complete sets of plans showing di-
mensions and height of sign: advertising message on sign: location of sign on property with di-
mensions to property lines, structural details of supoort framing, bracing and footin8s; materials
of construction for sign and sign structure; electrical equipment and lighting; size and location
of existing signs on property for the same busienss, all as required to determin~ com~liance with
the Springfield Sign Ordinance (Article 7 of the Springfield City Code). Also,. show the follow-
ing information on the plot plan (plan showing property lines and location of signs):
a) Show the location of all existing sign(s) as well as proposed sign(s).
b) Show the length of the street frontage taken up by the business or building. For wall
signs, show the length of the building frontage.
c) Show the location of entrances open to the public and driveways.
When required, because of design, size, etc., engineered drawings and calculations must be pre-
pared by a licensed engineer or shall conform to design standards on file at the Building Divi-
sion Office.
Plans of insufficient clarity or detail will be returned to the applicant with no permit being
issued.
Signs must meet corner vision clearance requirements as described in Figure 9 of the Springfield
Comprehensive Zoning Code.
NOTE: No sign may be erected which is less than 12 feet horizontally or vertically from overhead
electrical conductors in excess of 750 volts, or less than 5 feet in any direction froD overhead
electrical lines which are energized at less than 750 volts.
If a sign is not installed within 60 days after the date of issue of this permit, the permit shall
be void. '
Inspections:
4)
5)
6)
7)
8)
9)
a) Site Inspection - to be made before the sign is placed. Usually, the Footing Insoection
(it applicab.Le) may be made at the same time as the Site Inspection. The !'oot1ng Inspec-
tion is to be made after hole(s) is excavateci, out prior to the placement of concrete.
b) Final Insoection,- to be made upon completion of all work.
c) ~lectrical _ all electrical signs must be inspected for electrical hook up after the sign
is erectea and before the sign 1s turned on. ..
CALL FOR THE REQUIRED INSPECTIONS ON THE 24 HOUR INSPECTION LINE AT 726-3769
,;, \ FOR o,r:Jf1cfr USJ:; ONLY
SIGN DISTR~CT\l1Yr1[1\J ZONE D~ICT '\.' 1 \ .J . ,JOBfi~
TOTAL SQUARE FOOTAGE OF SIGN \ \ '2'\0' . SIGN PERMIT F~O .,...... /' '\
REOUlRED INSPECTIONS: ~C'\ ~
t;yOOTING OR METHOD OF ATTACHMENT
AlNAL
_ S}TE{LOCATlON
..0LECTRICAL
.t......t.......A.A~~i..;...::..:
FIi::::
. ; -5'- :~.n. S1:.~:
OTHER
,~~ \l f't(> \C\()D_, ~\ t- ,-f<.)
~ r-c::A '\l '4 '" 11'\'\0 0) "j\ \)!
~-, Q. \l~~ [' ion N - (j
TOTAL:
'-~~ .SO
DATE --;-717 ft/ RECEIPT 2D<grJ&
CLERK. (1 /f/t;1.;---..Q.
t
SPECIAL CONDITiONS TO BE SATISFIED BEFORE ERECTION OF. SIGN:
ADDITIONAL INFORMATION NEEDED BEFORE PERMIT MAY BE ISSUED:
~,
DATE
\\.2D.Qc)
of-/
APPROVED 8Y: W~
SECTlON,J<6 TRO
SPRINGFIELD SIGN ORDINANCE
lor
I INSPECTION LIIIE
726-3769
.
CITY U~ SPRINGFIELD
COMBIIIATlON APPLICATION/PERMIT
EIIERGY SOURCES:
Heat
Hater Heater
Range
ValuE of Hark:
.
INFORlIATION UNt
726-37S3
Sq. Ftq. 1,Iain
~q. Ftg. Access.
Sq. Ftg. Other
lIew Add Alter Rep.
-Fence Demo Change/Use
Other- -
~
........
.~
o
Job Address /q':3~
Legal Description /7~:Z-25"-':;;r~
- ,
MA"'~C6'4- ~
~ /e:::rt?J
owner,~L/..AY~p :~;P..DiP
Addres<~;:;-.- ..v. , h? '" "fH4~"';
,??,~r/~--:V..D,. ~.
Construction Lender
Phone
BuilriinQ Permit Info: Describe Work(;~e.. Build Single
Family nes;dence With Attached Garaoe)
Address
UtSHjN TEAI1
(name)
Phone
(address)
~~~~ ,~?r
dJ-.:P',df" ~~~~&r5'~
~ .$~~~.
flies. no. J (exoires) (ohane
,
no. )
Primary
-~~~
~
Structural
Electrical
Mechanical
CONTRACTORS
(namel
(iHfrlrpc;s)
flie". no,)
(j:lXO;I"PC:'
(OhOflP no..)
Genera 1
Plumbina
Electrical
~'echan;cal
- J""") . L_ _ __
1.J~~ER5-S;o/ A'""'~
PLUI1B I NG
ELECTRICAL
MECHANICAL
NO.
FEE r.HARGF NO
EEL..l:lfAlli NO
SQ. FT.
furnace/burner to
I BTU's
Floor furnace
and vent
I t:t"c i IJiAR.G..E.
Each single fixture
Residence of
6.--
Relocated building
(new fix. additional)
New circuits alts.
or "extensions
S.F. Residence
(] bath)
Ouplex (1 bath) each
Additional bath
SERVICES
Recessed wall
~n~rp hp~tpr ~nrl vpnt
~later servi ce
Temporary Construction
Change in existing
rP'l i dflnr:p
l'multifamilY, comm. or
Industrittl
IOf amps.1
ICOMI'I./IND. FEEOERS I
Ilnstall/alter/relocate I
dic:trih. fppdprc;
10f amp~1
I
I
I
Appliance vent
seoarat.p
Stationary evap.
cooler
I I. Vent fan with
sinole duct
I' Vent system apart
,heating or A.C.
I Mechanical exhaust
hood and dur.t
I ~'lood stove/heater
I
I
I
J.--
Sewer
Storm Sewer
from
/?7..w .
./5:- .
/e::r.- '
~
ISSUANCE OF PFR'IIT
TOTAL CHARGES TOTAL CHARGES
WHERE STATE L\H REQUIRES that the Electrical work be done by an
shall not be valid until the label has been signed by an Electrical
TOTAL CHARGES
"2--5':
"Electrical Contractor, the electrical portion of this perQit
Supervisor and returned to the Building Division
I HAVE CAREFULLY EXAMINED the completed application for permit, and do hereby certify that all information hereon is true
and correct, and I further certify that any and all work Derformed shall be done in accordance with the Ordinances of the City
of Springfield and the laws of the State of Oregon pertaining to the work described herein, and that" rw OCCUPAIKY will be made
of any structure without the permission of the Building Division. I further certify that my registration with the Builder's
Board is in full force and effect as required by O~S 701.055, that if exempt the basis for exemption is noted hereon. and that
only subco~tractors and employees who are in compliance with OP.S 7~1.055 will be used on this project.
IlAI-lE(please print) I ). ,(j/i~ f' ,dtc...1.-Ie.. SI(:IIATURE ~t".7~ OATE /Z/rA;;.,)
FO~ OFFICE USE Dlll.Y' -.,
Zone Tvpe/Const. Units Sq. Ftg. riain x Value
Fire Zone Bedrooms Occy load Sq. Ft!J. Access x Value
Flood Plain Stories Occy Group Sq. Ftg. Other x Value
TOTAL VALUATION
BUILDING PWIlT
Charges and
Surcharges
Plan Ck. Comm/Ind
65%/Bldo Pj'r Fee
Plan Ck. Res
30%/Bl do Per Fee
Fence
Systems Development
Charqe (1.5%) .
PLU'1BING PERMIT
Charges and
Surcharges
O~mo
. ISidew, 1 k
----------~-I A/C.Paving,
... ..~ .-
"25:"~ I Curb Cut
-----/:~?I
'- Tqt3~1. Comb. Permi ~
ELECTRICAL PERI~IT
Cha rges and
Surcharges ..'
MECHANICAL PERMIT
Charges and
Surcharges
,
,
iOTAL
::;.>tG.2S-
,
.
,
~ . . l~
"'. .
COMBINATION APPLICATION/PERMIT (CAP)
.... .'
I. Applicant to furnish
A. Job Address
B. Legal Description
1, examele- Tax Lot 100, Lane County Map Reference
11 OJ qj
2. examp1e- Lot 1. Block 3, 2nd Addition to
springtield Estates. ,'" ..
C. Name. etc. of ownerand'construction'lender
D. Energy. ?ource~ ..~" _ ,.' ,..... .... . \
1.... example: h'eat/el'ectrfcal'ceilin...Q/or' forced air Q3S
2. examyle- ~a~~rhe~ter/electr;call.~r~~
E. Square "footage or valuation, etc:
1. example- 1250 sq. foot house, 500 sq. foot garage
2. example- if new project, check new - if addition,
check add, etc.
F. Building permit information:
1. example - construct single family house with an
attached garoge
2. example - remodel existing garage into family room
3. exam~le - convert single family residence into
restaurant (Change of use)
G. Value of work as defined in Section 303 (a) of the
Structural Specialty Code
H. OESIGN TEM1 AND CONTRACTORS
To avoid design or construction delays. Building
Division Staff must be able to contact appropriate
persons regarding design information or jOb site
corrections. etc.
II. Abbreviated Plumbing, Mechanical, & Electrical Schedules
A. Except where blank spaces occur in the description
portion of the Mechanical and Electrical Schedules.
the applicant need fill-in only the No. Boxes adjacent
to the appropriate item(s) to be installed
B. Full Plumbing, Mechanical, and Electrical Schedules
are available at the Building Division
1. To conserve space on the permit form the schedules
have been abbreviated
2. If the item(s) to be installed are not covered on
the abbreviated schedules you should consult the
full schedules
C. BUILDING DIVISION STAFF WILL FILL OUT ALL FEES AND
CHARGES ON THE SCHEDULES
D. As noted on the CAP, the label must be delivered to the
electrical contractor for signature by his electrical
supervisor. The general contractor is .not authorized
to sign the electrical label. ---
111. Applicant to sign and date
Whenever possible, the initial application will be used as
a worksheet only. Where possible, Building Division Staff
will prepare a type written copy and return it to the
applicant at the time the actual permit is issued for his
signature.
IV. Fees and Charges
Plan check fees are due and payable at the time of the
application, and no plans will be processed until these
fees are paid. All other fees and charges are due and
payable when the permit is issued.
V. FOR OFFICE USE ONLY
........;
.....,.,..
P~OJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
.
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Permi t C1 erk (j J1AM.t.....
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Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
PLANS REVIEWED BY:
~R~ ;i2s:7~Signature~"':.Y
. "
name
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C-,'
.l ~.--?late
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