HomeMy WebLinkAboutPermit Signage 1995-10-4
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PHONE:
JOB NUMBER C\ ::s 1512 V
e,pection Line: 726.3769 .
Office: 726-3759
TAX LOT: ()\oC\c~ j)
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ISIGN .~ER~IT APPLICATION
.
SPRINGFiELD
225 Filth Street
Springfield. OR 97477
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SITE ADDRESS: . q. 6"2- "7 fV\f'-.1 tJ
~SSESSORS MAP: =:::rJ]J~~ \~ \ -
OWNER: "j3{<vc...E. 't>A\.AS
ADDRESS J"!' A\<' \+J~'1 C~
~"T'E
\-\
BUSINESS NAME, FIRM ETC.:
STATE:
~MPtS~
ZIP:
CITY:
DES~ION OF PROPOSE~ SI~N(SI: (please cheo:l: and complete all appropriate information)
Wall _~_ Freestanding _ Projecting Roof
_ Single Face
Double Face
Billboard
...-
Other
Marquee ~
I~~
Square Footage:
b t.
Total Height above Grade:
,
Dimension from Grade
to bottom of Sign Enclosure:
l/Q
~ Horizontal W~'d f sign or enclosure:
Electrical Installation: Ye 0 VALUE
(If yes additional electrical perml .reqUlred) OF SIGN:
~
'\-ill,cD
Vertic.1I Dimension of sign or enclosure:
Mntcriill Sign is constructed of:
List ALL existing signage and attach afCQtOgraph of each Sl~
(aJ Type~ff,~ s\I: F~~~Wi) (bl Type
(cJ Type Sq. Ftg. (dl Typ~
Sq. Ftg.
Sq. Ftg.
. '
CONTRACTOR/lNSTALLER:.rS'\ ~~.. a~ -8-- -r\. ~') PHONE:~-~Q
'3>hb~ U.: \,~
,
CITY: ~ b~E; ~ rt- STATE: ZIP: t::f7 ~d t,Z.-
-t::tl/d IoS EXPIRES: 10. 2 y... If S-
ADDRESS:
CONSTRUCTION CONTRACTORS REGISTRATION NUMBER:
CITY BUSINESS LICENSE NUMBER:
EXPIRES:
OFFICE USE
REOUIRED INSPECTIONS:
Land Use: ~?-l')O Ouad Area: ~c.-S C./
Code Section:. q - f) - -E:. ~~ ') . . '.
'APproved By: \'~f'{\-~Q,"D\.Vj./ DATE: ~~ H13~CE)
. v:::
Attachment
after fasteners are
installed/prior to cover
Electrical
prior to energizing
electrical installation
completion of sign
inslallation
Sign District:\'\fN,JI\\ 1\ \ \ \ Y
Zoning: W il
4j.cV
Sign Permit Fee:
Site
to be made prior
to sign placement
Footing
prior to placement
of concrete
Additional Comments and lor Conditions:
By signature. I state and agree, that I have carefully examined the completed application and do hereby certify that all information herein
is true and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of ,he City of
Springfield. and the Laws of the State of Oregon pertaining to the work described herein. I further certify that only contractors and
employees who are in compliance with ORS 70t .055 will be used on this project. .
Ilurthe ree to ensure that all required inspections are requested at the proper time, that proiect address is readable from the street. that
the p mit card is 10 ed at the front of the propNtV. and the approved set of plans will remain on the site at all times during the installation
of the nisi.
Validation:
Amount Ileceived:
io4- 4. (imlA
I/O, Q)
Receipt Number: / C( F .fY)
Date
/~/~~
"" eo;, _~{ LLS
Received By: I ^~
. '- ~~
~
Signature
SI~N P~RMIT APPLlCA T10~
225 Fillh Street
Springfield. OR 97477
SPRINGFIELD
JOB NUMBER cr ~ I
elnspection Line:
Office: 72 6-3 7
.SITE ADDRESS: 41:>"2. 7 MP.~
ASSESSORS MAP: . \"\ ()~ ~ \
<or-
ADDRESS:
""R e.. \J e.. &:-
OI\~v...J"',(
OAU 1t:J.
C~~
.:;""iE-. fI-
TAX LOT: nlO'iC.(')
PHONE: 4 '" '" - ~':H,.b
SU~E:,(.JE. '11 Qo (
.
OWNER:
CITY: STATE: ZIP:
BUSINESS NAME, FIRM ETC.:~Ii?e..~
DESCRIPTION OF PROPOSED SIGN(SI: (please chcr.l: and complete all appropriate information)
.:6. Wall Freestanding _ Projecting Roof Marquee
_ Single Face
Double Face
Billboard
Other
-
Dimension from Grade
to bottom of Sign Enclosure:
\,0
Total Height above Grade:
;z.- Horizontal Width of sign or enclosure:
Electrical Installation: Ye~'o VALUE
(If yes additional electrical permi~~dl OF SIGN:
\'"02-
~
3:f),CfJ
/,~+
-~
.........--...
Square Footage:
:I c.c. '
Vertical Dimension of sign or enclosure:
Matcri(ll Sign is constructed of:
~ f~,..J.
~ J1..-.lt))'tl
List ~~IL;:;:ti~~~a~;~~;~ig~~o~ ~n:
(c) Type SQ. Ftg.
(bJ Type
SQ. Ftg.
(d) Type
SQ. Ftg.
...
CONTRACTDR/lNSTALLER:
~ J oA.-c..
\.L).. t \~
~~~ ~ STA.TE:
CONSTRUCTION CONTRACTOR~ ~~(7; ~MBER: "" ~l/O.b S EXPIRES:
CITYBUSINESSlICENSENUMBE' r~) -~S ~ U~.)
eJ-f
~ TL~~E: tns: 2f(t;q
ADDRESS: -?:::>f~G:. L
CITY:
ZIP:
qJ 7 ~ OZ;..
I ~. 7... "I,.. 9S
\
OFFICE !,lSE
Sign DistriC(.:.i\l'{\\'{\\I(\\~ k-
Zoning: 0~ ./ \J
~).Q)
Sign Permit Fee:
Land Use: D tJ.:I ) Ouad Area: -3 ~S ~' ../
Code Section,\ . _ C{- ( ) - \:4- (\ J ~
Approved By: ~\.~" ~~DATE: [().(5.GlS
REOUIRED INSPECTIONS:
Site Footing Attachment Electrical
to be made prior prior to placement after fasteners are prior to energizing
to sign placement of concrete - installed/prior to cover electrical installation
^";"'~~;;.~; '\~1fk1~'j':\~~t~p I' ,"
By Signa~re. I state and agree, that I have carefully examined the completed apJ.i\,tion and do hereby certify that all information herein
is true and correct, and I further certify that any and all work performed shall b~ne in accordance with the Ordinances of the City 01
Springfield, and the Laws of the State of Oregon pertaining to the work described herein. I further certify that only contractors and
employees who are in compliance with ORS 701.055 will be used on this project.
~inal
completion of sign
inS!al~a~A
) l' .lU'. t'\
Ilurther agree to ensure that all required inspections are requested at the proper time, that proiect address is readable from the street, thaI
the p~rd is located at the front of the property, and the approved set of plans will remain on the site at all times during the installation
;:.:''"':~'fD41 + ~I ,-- D.. /oI~f.cc-' ~
S~~~~n: _ ~~ Amount l1eceived: .~\ \'()~3-))
.'),~ ~ _-'\0.00 Receipt Number: ~(
LlceMe.. -3D ~
Date Paid: n IV'~
Received B ~ J 1"11""\ )
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