HomeMy WebLinkAboutPermit Plumbing 1985-6-27
ItlSPECTION LINE
726,3769
.
CITY UF SPRINGFIELD
COMBINATION APPLICATION/PERMIT
---~
E!IERGY SOURCES: .
Meat ;;:, /P-r ~r, G
!~ater Heater
Ranqe
e..seQ6Q . ~ .~~
. INFDRlIATION U,1l
726-3753
Sq, Ftg. 1,Iain
~q. Ftg. Access.
Sq, Ftg, Other
Ilew Add Alter ~ep,
-Fence Demo Change/Use
Other - -
(),)
~
~
'\I
'I
Job Address 4z.oz- M,<J/A../ S-rJeGG-i
Legal Description S&-r<r /LAlVS:
1?-<:><"'3'<-"3'2. rc.. (P/7O/
,
Owner 77i6-4P2.r9,UT/c.. (.?/"N~/<"ZD
Address fat:.?5 SO, 190 -t~ sf. "107,
ValUE of flork:
(l/)_ 2~., dat:>. -=-
Ph (-za:::,- Builc;;nQ Pennit Info: Describe l~ork(Le.. Build Single
oneB7Z_S'S'Z ~ Familv nesidence Hith .A.ttached Garaoe)
Address
Ut~ lliN r l:.Ar~
.u.0
(name I
Phone ~ ~ ~_A,)
(address.) flies. no.)
CP&lg- ~vrh I'if?,....-~ .>-1'. ...,Ot.. .<6..ur, ~ Sir' "1VtE'l..",
C""USdc..7)~ >,uc:;,.u66~s:', /.(..IC, IzeV/
~-Irwf ~1J1.fJ?7 1'7,":-:/J?<Uh-f ""/ I"v~
/54v,l C."., t:>P.,. UAJW<:rTJ'W,! tfaA:lt1.J(./d". h
./ '
J::::&AJT.
tU/JS' N ,
'18037-
Construction lender 19~
(exoires)
(ohone no.)
Primary
.!5l>,e,;;/Y'lf'dS'67V
1- ?t'X~-!37?--'<;!;Z7,
Structural
Sr<>/Y7C
I -rl/
...,c;.,,,,~~.i< d'h/') . '-L./~-1j'/9
KCLr/,v I &J1err c, =,.<) 1/~4t.>U!;4 h. /5.Jr kl.,!(.. (I",ht. 9/Tio S- 6,q",
(See..lleOZ/GJ I
Electrical e..v~U~ .:r:
Mechanical ~11j,-!5.6J
tONTRACTORS '{ name I
General l,;u/GAJot.</Y
(addre~c;,)
(lies. no.)
(exoirp,,)
(ohnnp nn \
Plumbina
J'
~
dl\..-.
~
IY~
E1 ectrica 1
I,
~'echan;cal
JJ
PLU1IBI NG ELECTRICAL
NO. FFf I rHARr.E NO
Each single fixture j Residence of
1'2, :;- ~~.. SQ, FT,
Relocated building New circuits a1t5.
(new fix, additional) .. or extensions
S.F. Residence SERVICES
(1 bathl
Duplex (1 bath) each
Additional bath ( Temporary Construction
$S ~Iater service 124.... . Change in existing
res. j qp'.nrp
'ad Sewer IS;- multifamily. comm. or
Induc:.triill
J ~ I Of C.::o amps.1
~ Storm Sewer
COMI.1. lIND, FEEDERS
MECHANICAL
~~r: fl-lARG.E.--.tlO.........
furnace/burner to
BTU's
<EL J:JJl\Rlil
Floor furnace
and vent
Recessed wall
~o~rp hp~tpr ~nrl ~pnt
z.
.t-.~. ?V~;&>
Appliance vent
t;eoari'l.tp
Stationary evao.
cooler W .
Vent fan with
sinole duct
Vent system apart from
heat;na or A.C.
Mechanical exhaust
hond and durt
11ft -
I
I
I
TOTAL CMARGES 1'/11. - TOTAL CHARGES /!2::l "1 TOTAL CHARGES /'5'. s;::>
WHERE STATE L'\H REQUIRES that the Electrical work be done by an. Electrical Contractor. the electrical portion of this pemit
shall not be valiJ until the label has been signed by an Electrical Supervisor and returned to the Building Division
l'Install/alter/relocate
,di~trih_ fppdfr~
"3' IOf 7";2.5" amp~:ZS-
I
I
I
I
~/
I
Hood stove/heater
/ tA.- ~
lSSUANCF OF PFR111T
I HAVE CAREFUtLY EXN1INED the completed aprlication for permit, and do hereby certify that all information hereon is true
and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City
of Springfield and the Laws of the State of Oregon p'ertaining to the work described herein. and that rw OCCUPAr~CY 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 DRS 701.055. that if exempt the basis for exemption is noted hereon. and that
only sUbcontractors~d employees who are in comoliance with O~S 701,055 Wil:~ ~roject~
1lAJ.1E(please print) /,ijomh'~ ~ &W&;,A'/h'IYS,47.,! SIGUATURVb ~ ~.//~(: DATE t,!z7IBS-
FO~'OrFICE USE~ r
5'-# Units Sq. Ftg, 11ain x Value"'--' ~J
Occy Load Sq. Ft~. Access x Value
I Occy Group ?~"':2... Sq. Ftg, Other~ld~ Value ~~
, TOTAL VALUATlON7~-"- <
.
Zone
Fire Zone
cc
Tvpe/Const.
Bedrooms
Stories
Flood Plain
BUILDING PERNIT
Charges and
Surcharges
I'P ~ y. :o-S"
JJI: ((46;)
~~2?d.;i?
I
I
___/ff~~__1 Sidewalk I
6.'-' I A/C Paving~.....1
__nL7.:~J Curb Cut I
.78 I I
/~-, ~ 'Plan Ck, Conm/lnd
~~_". 65%/Sldn P~r Fee
-- . ---;j:;;- Plan Ck, R'es
. 17. 7 c:> 30%lBldo Per Fee
,. Vo ot=> I Fence
--- J~~_I D~.o
Systems Development
Charqe (1.5~)
"?3/'S.
0....
PLU'iB ING PERMIT
Charges and
Surcha rges
I
I
I
ELECTRICAL PERlHT
Charges and
Surcharges
11ECHANICAL PERMIT,
Charges and
Surcharges
~6. 6\:)
Total Comb. rermit
B1Z.~t;
i(/n~'!ftG
I TOTAL
I'
"
.
.
COMBINATION APPLICATION/PERMIT (CAP)
PERMIT VALIDATION
1. Applicant to furnish
A, Job Address
B. Legal Oescription
1. example- Tax lot 100, lane County Map Reference
II U3 43
2, example- Lot I, Block 3, 2nd Addition to
Springfield Estates
C. Name. etc. of owner and construction lender
O. Energy Sources
1. examole- heat/electrical ceilinq/or forced air qas
2. examole- waterheater/electrlcal/or solar
E. Square footage or valuation, etc. ------
I, 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 garage .
2. examele - remodel existing garage into family room
3. example - 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, DESIGN 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 OIVISION STAFF WILL FILL DUT ALL FEES AND
CHARGES DN THE SCHEDULES
'0, '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. ---
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.
"
.., -
,
"
III.
V, FOR OFFICE USE DNLY
Permit Clerk
PROJECT CONDITIONS TO BE SATISFIED BEFORE OCCUPANCY:
-;:)/,.::~
~/~ 70
~.a"""'h~ '~~e:r;:-
r-s;hc;..> e:J~ f/U'H(/C ~'/7Y
"7") _ ./.
/ d:r-/A?/'r :"'S$"'~- --J::" ~
Permit applicant exempt from registration with the Builder's Board because:
'Additional Project Information:
':;;~e- .~__o,/ =.;." .~",C. 1?.tS V~>>~~~_Y";.Q.--h?P;:>:'?~"'"
~Y7~ ~~/ __~'.'Z>~/ e=-'--' .:.-?... <~-e~.
,
PLANS REVIEWEO BY:
:,.:.>./ ,/:::l .
name 1...Pi7~ rC.~-~
si~~ature~~
~/ '
date
7-/o-.li?,)~
..'
-~ ~ \
WSPECT ION LIIIE
726-3769
.
eu~v ~
CITY OF SPRINGFIELD
CDHBIIIATIDN APPLICATION/PERMIT
EIIERr,y SOURCES: ,
Heat ;:, If'. /' -rr, C;
Hater Heater
Ranqe
NfORJIATION Ll,
726-3753
Sq. ftg. 1,Iain
~q. !='tg. Access.
Sq, FIg, Other
Ilew Add Alter ~ep,
Fence_Demo _Change/Use
_Other
Legal Oe5cription S&r-r r'"...AVS:
/~~'3<-"32, rc.. tP/70/
Owner 7/i.6 ~_6'.vT;c. f<d' /,1 Fla,~
Address I,,<<,?S 50, 110-/' sf. HID?
I
Job Address
4'1.oz....
~
~
,~
"
M,<;J/A..-J'S-ne..6(77'
Valu€ of Iiork:
(If), Z~ t:'~. ClIO
Phonea;S~;z ~ ~~~~1~n~e~I~~~e Inf~~ Ji.~i:~~~~e(1~~~~e~-.e..
Build Single
J::.I':NT,
Construction
{l.h9!: N, <t!30s z..
Lender 19.<:co
Address
Ul:.~ H.iU T EAr~
..u ..0
(name)
Primary
;6v,e,;"f-'-f'vS'C"'W
Sr9/>'?C
[leelrieal C4~.e(..G.! .:r.
11eehanieal ~14(!SGJ
CONTRACTORS " name 1
General I.>UK,IJO"'-".</
Structural
Plumbina
Electrical
Hechan;ca 1
-1!Q."
/2.
Each single fixture
I'
/,
"
PLUIIBING
Relocated building
(new fix. additional)
S.F. Residence
11 bath)
Duplex (1 bath) each
IAdditional bath
gSf~'ater service
~/I Sewer
~Storm Sewer
I
I
I
I
I
I
TOTAL CHARGES
WHERE STATE L~H REQUIRES
shall nOt be valiJ until the
I HAVE CAREFULLY EXMllNED 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 oerformed shall be done in accordance with the Ordinances of the City
of Springfield and the Laws of the State of Oref)on pertaining to the work described herein, and that UQ OCCUPArKY 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 ons 701.055. that if exempt the basis for exemption is noted hereon. and that
only sUbeontraetors~d employees who are in eomolianee wilh OP.S 7n],055 Wil~ ~~rojeet,~
!lAIIE(please pri"t) //TO.m.-9~ .4. C;W?./;hA7tC/,U?7.j SIr.rI^TUR~ ~./~('. - om ~;t7IBS-
FO~ ij'f'F I CE USE GIlLY .' " - I
Sq. Ftg. Haio x Value .,.~ ~d:
Sq. Ftg. Access x Value
':VA .-
Sq, FIg, Other r<r14~ Value :z/-.~
. TDT^L VALUATIOIl72/..-"_ -
cc
Zone
Fire Zone
flood Plain
BUILDING PERfIIT
Charges anc
Surcharges
PLur~BING PERMIT
Charges and
Surcharges
ELECTRICP.L PERr:1T
Cha rges and
Surcharges
I1ECHAN I CAL PERMIT
Charges and
Surcharges
/ /-:;>-, e>.> Plan Ck, Conm/lnd
--=t.~_~.____'_ 65%/BldC1 p.pr I=""p
~/<:) Plan Ck, Res
1"/. 7 C> 30UBldo Per Fee
,. Vo Dt!> I fence
_n ...I~~-I 06RlO
___LQ~~nl Sidewalk I
6...... I A/e Paving~.-I
____L-Z-=~J Curb Cut I
.78 I I
Type/Canst.
Bedrooms
Stories
&'=-!r-<.e--I /PfJ?- r:m 1'7/,v: /Jttu ,e.J I~/ P'v-,?,>,-,
I /:5/n.v,J O""c-P.. I.JL-'Wcn'W J ~iX 4.1>
Phone I c,.v....cI So ..ell.} ~/ :.
(addres~) (lies. no.) lexnires}
~Z~' Sol/rl-r IW?.-1-'>-f.~/ot.. /C.6.AJ":"J~S~' '1VQ.I'V
CdVS,v~7/<:k >"",r:;d../66.r..~. /OC, /2(3'1/
(ohOnf~ no.)
1'-';:0(,-87?--'<;[;27,
I ,..."rt/.
vt,-"I"->-fi d''''I,") . /-~':>_ij'lq
K..C6/,u (~rr c. nc ,,u 1(~t<:I''{(~i4 PiC. /5.;rkl:. (I"ht. 911!;oS' 6/'1",
(j;etLrfieOZ/G) I
f address)
(11C5. no.)
(p)fl}irpc:)
(ohnnp nn. \
ELECTRICAL
MECHANICAL
FFE CHARGE NO
~~~ r~ NO.
, "LIJJiAB.li.E..
5'
Residence of
furnace/burner to
BTU's
~~.
SQ, fT,
New circuits alts.
or extensions
Floor furnace
and vent
SERVICES
Recessed wall
~~~~,~r ~nrl vpnt
I
6-V-<,.,
. I
I
I~-
I/I~',
I
I
I
I
I
I Z.
1/t9. -I
I I
I II
~I
I I-
IInstall/alter/relocate I I I
dic;,trih. fppdprc;,
amp~I~I7S1'
I I I
I I I
I I I
.;'~ ~ TOTAL CHARGES
Electrical Contractor, the electrical portion of this permit
Supervisor and returned to the Building Division
( lTemporary Construction
IChange in existing
res5 rt.encp'
Imultifamily, COIl1ll. or
Tnrl1Jc;,trial
U ~J ,.......
"'I j~, / -:!~;.-
Appliance vent
c;,~oa ra tp
Stationarv evao.
cooler ~ .
Vent fan wi th
c;,inole duct
Vent system apart from I
heatino or A.C.
I Mechanical exhaust
hood and dUr".t
I Wood stove/heater
I
I
I
2(1. .. '
I /,S7-
I ~s:- I
I
I
I
I
I
I
I'SI". ~ TOTAL CHARGES
that the Electrical work be done by an
label has been signed by an Electrical
10f 6.::0
I COMI.\. /I NO, fEEDERS
amps.1
'3' 10f
I
I
I
-;;z ?5"
I SSUANCf OF PFRIII T
/~ St:>
5'-N
Units
Occy Load
Oee"y Group 7!'~'" '2...
/
~~7:;';-
tr46~
~..;~?d?-
Systems Development I =;~. .,...,.
CharQe (1.5~) /~{~.
'76.~
ITotal Comb. rermit
I TOTAL
81 Z .~~
i(1S'7 '-Y61
.
COMBINATION APPLICATION/PERMIT (CAP)
I. Appl icant to furnish
A, Job Address
B. Legal Description
1. examjPle- Tax lot 100. lane County Map Reference
II UJ 4J
2, example- Lot 1, Block 3, 2nd Addition 10
Springfield Estates
C. Name. etc. of owner and construction lender
O. Energy Sources
1. example- heat/electrical ceilin~/or forced air Qas
Z. examole- waterheater/electrical/or solar
E. Square footage or valuation, etc. -
I, examole, 1250 sq, foot house, 500 sq, foot garage
2. example- if new project. check-new - if addition,
chee k. add. etc.
F. Building permit information:
1. example - construct single family house with an
attached garage
2. example - remodel existing garage into family room
3. example - 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 TEM4 ANO 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, BUILOING OIVISION STAFF WILL FILL OUT ALL FEES ANO
CHARGES ON THE SCHEOULES
O. 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. -
III, 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
,/
/' .
~~ C.s;by ~~ .iPU']lfU.:;'
~/~ 70
"/)
/ 6-T~/r /~~,:"':;; -.-..F ,
u
.v OF SPRINGFIELD
Clly Hell
Sprlngfteld, Oregon
Department of Public Work.
OFFICIAL RECEIPT
No. B 65237 I
Oete ~~~9~;~/~
Rec'd From ~ ! _ /~,,'" ~", --I"~ I
Address 11~1f/:. 1#"4. C)~ 3'2 I
/
=ived For: CJ~#=SS6~.)
'-I3? -.
r:J.? I 7. .,8 t, '.
~ ',./..... "0- '\1\
. .~~ I S.~O l\t
t.~ /~<=...- l1fr
'- f:tf.~ """t;:.' . 0,0 IJ
. /'tI.r~. 1-'1:~ ~
~t;~ ~::: ~
. ~p<. ~ :3!..5 g._eo
~.~~;J::;, "z ~_.
~er,. '7 . '7 JII ~
. ~&..I\L..~""" 10' uo
",,1/":d>. · 7
. 107I'Il.. _~7,. 76
,",-
Amount Received .(I '2S? ?~
I~ d- ~
ID:- /' ~H~~~
I
IIUS1NES$FOFlMS.1NC.
1~]l]n'l"
Permit Clerk
Permit applicant exempt from registration with the Builder's Board because:
Additional Project Information:
S &::-e:- ~A70" C=--=J c:s..c
-i???w~ ~___/ J. ,-_~ '
P &V~~~,./ /
p~ e='~ -' ~'?... <~-8~.
PLANS REVIEWED BY:
y.~~ ,~"yl;'~~A<"
J
riarrie~j~-~~___~
Signature~~
''/ ~,.
date
7-/t:;:)-li?d--
,.
:~-(~'" ~
"
, ,
.
"
.
,INFORMATION: 72603753
city of springfield
225 n, 5th street
SPRINGFIELD
. /(;;~~"m
-
r,
SIGN PERMIT APPLICATION
A. LOCA~ION OF SIGN (ADDRESS) 4202.. M/9/..0 Sr'.e66";
LECAL DESCRIPTIO~ Bee /iI #,ett'A1..LcY .o/~) 17a? ~ 2.3 LTAX LOT '1'
I
OIJNER OR PROPERTY The. .4;/l_a.u./>c ~d~k fh j,J Ce>,
ADDRESS tdG26 f>o. 190 -1-'1; ~/oZ k:.6A.JT, !u195)h
<2/70 /
PHONE I-Zot;-!)7Z--5<;z'Z..
.ZIP PBW'Z.-
o,mER OF SIGN (IF OTHER THAN PROPERTY OWNER)
ADDRESS
NAME OF BUSINESS, FIRM,
PHONE
ETC .,4/!!.L:e) / A+c / PM NIAll NkriR~ OF BUSWESS
/ /
C. STRUCTU~L TYPE 'OF SIGN:.
_HALL LFREESTANDIllG
.8. TYPE OF WORK.:
...K..ERF.CT _ALTER
_RELOCATE
_OTHER
_ROOF
_PROJECTING
D. USE AND CI'.ARACTER OF
lIDEtlTITY
_INCIDENTAL
..K..DOUBLE FACE
SIGN:
_MARqUEE
_UNDER ltARqUEE
_OTIlER
_SINGLE FACE
__'illLTI-FACE
--.:..READER BOARD
_BILLBOARD
E. VENDORS, CONTRACTORS: , / '
SIGN ERECTOR 1\./0 T VGr /GvOu..>V
rIlONI:
!
i
,
,/.DD~.ESS
CITY LICENSE llU!1BER
SIGN I1ANUFACTURER (IF OTHER TFJ<N ERECTOR)
ADDRESS
,ZIP
,EXP, DATE
,
/
f.. / ok.
DUlENSIONS, WSTALLATION & CoNSTRUC'I:-lOl
TOT~ HEIGHT ABOVE GRA~?-I' 7"
VERTICAL DUlENSION OF SIGN """'T;"'t..
HORIZONTAL wronl OF SIGN 10' ro If
DINEtlSION FROM GRADE TO
BOTIO!! OF SIGN
,PHONE
~
I
if!?- G. EXISTING SIGNS
~ ARE TIlERE ANY EXIST!!lG. ~IGNS? ~YES 'y lIO
~. .".... .. 'l~IBE~, SIZE IN SOhG,.
~ ALL ~XISTING SIGNS
FOR EUSINESS, ETC,
15/
;
TlUCKllESS OR DEPTH
DOES SIGN PROJECT BEYOND \.
PROPERTY LINE? ___YES -A-NO
IF YES. DIMENSION BEYOND
PROPERTY LINE
NO':'E: IF PROJECTIOn IS !lORE THAN 12"
OVER PUBLIC PROPERTY THE SIGN ERECTOR
l'lUST FILE WITIl TilE BUILDING DIVISION
COPIES OF IlISIIlF.R LIABILITY AND PROP-
ERTY DA}1AGE INSUP~NCE POLICIES.
H. HI~L SIGN HAVE ELECTRICAL InRIllG? y~
It.. YES. IIIlICH APPLY? X ELECTRICAL SIGN
~LLUMINATED (INDIP~C~ LIGHTED) ,
ELECTRICAL COtlTRACTOlt
ADDRESS
LISC. NUMBER PI:CNr
,
I. DESCRIBE TYPE OR t'ATERIALS SIGN IS
'CONSTRUCTED OF. , /;:>~
~....A'/Y"ac.~r I~
J. SITE INFOF11ATIOll (LAND \J~F.) n EXISTING USE,
. OF BUILDING OR LAND (()R LAST USE IF VACANT) "
(/A(2.4V/ (6)?Vte ~ ) ,
/J..r,',U H ~a,~
.s~VICe-~7l'fTuAl /~ i
~INDOOR BUSINESS __OUTD09R'MERCHANDISING i
PROPOSED USE OF BUILDING OR LAND:
,4IU,O /9 ,A?-.-P/?? ;??,;V) -;?JaA )://1' A/aI) ,
Ci4-1--f ?:
K'VALUE OF SIGN, 5ooo,QVi.
r
L. I HAVE CAREFULLY EXAHINED the completed application for permit and do hereby certify that all
informacion is true and correct, and I further certify that all work performed shall be done in
accordance with the Springfield Sign Ordinance. the Unifo~ Sign Code as adopted by the City of
Soringfield and all other Ordinances of the City of Sprin~field and the laws of the State of
Oregon ger.cainin~ to t:le worl.. uescribeu i1t:&.~.l.n. I further certify thar; my !;~r,!1 CO'1Craccor Li-
cense with the City of Sprin~field is in full force and effect as re~uired by Sprinr.field Codes
8-2-6(3) and 9-7-20(2). I will request all required sign inspections listed on the approved '
permit.
NAME (PLEA~PRI) N0'>1415 -:.-l.' ,8,1.,t::GN""VS&V
SIGNATURE . . ~ . .,J/ G...-. ,J(, _ ._,
- G, /,
"
.z
,
.
;
,
.DATE t;./Z7/8s.-
....-,,-.
..
.
.
PLEASE READ
"
1)
2)
Seoarate Sip.n Aoolication:
1n the ~ign ~ode. .
Electrical: Any permit issued under this application will include wiring in or on sign structure,
the supply wires for connection must be covered on an electrical permit. Electrical connection
muse-be made only by a State Licensed Electrical Contractor. Illumfnated signs (both internally
and externally) must conform to Sections 9-7-4 (4) & (5) and 9-7-18 of the Springfield Sign Or-
dinance.
A separate application is required for each separate sign as defined
3)
Plans Recuired: This application is to be submitted ~ith two complete sets of plans showing di-
mensions and h'eight of sign; advertising message on sign;. location of sign on property with di-
mensions-co property lines. structural details of support framing, bracing and footines: ~aterlals
of construction for sign and sign structure; electrical ~quipment 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-
eion Office.
Plans of insufficient clarity or detail wil~ 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 froe 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..
Insnections:
4)
5)
6)
7)
8)
9)
a) Site Insnection - to be made before the sign Is placed. Usually, the Footin~ Insoection
(1.t appl1.cable) may be made at the same time as the Site Inspection. 'rne .foot1.ng Inspec-
tion is to be made after hole(s) 1s eACavat~ci, Due prior to the placement of concrete.
b) Final Insoection:- to b~ mad~ upon completion of all work.
c) ~lectrical - all electrical signs must be inspected for electrical hook up after the sign
1s erected and before the sign is turned on.
CALL FOR THE REQUIRED INSPECTIONS ON THE 24 HOUR INSPECTION LINE AT 726-3769
FOR OFFlCi::: U::ir: U~~LY
SICN DISTRICT ( fl)..{ Y
JOB IF
xsoSL)(0
de
ZONE
DISTRICT
(" 'Y
TOTAL SQUARE FOOTAGE OF SIGN
REOUIRED INSPECTIONS:~ . .
SITEILOCATION FOOTING OR METHOD OF ATTACHMENT
~ECTRICAL 0UlAL
SICN PERMIT
F~'
'1' '-< :2 I aZ)
ELECTRICAL PERMIT FEE:
If), 0 ()
OTHER
4~ STATE SURCHARGE:
TOTAL:
"Vr'J
Y Y;2. -y ()
J
I,
DATE
RECEIPT
CLERK
SPECIAL CONDITIONS TO BE SATISFIED BEFORE ERECTION OF SICN:
ADDITIONAL INFORMATION NEEDED BEFORE PERMIT MAY BE ISSUED:
APPROVED BY:
J2/-5-
1'-7- 7
7-/t"-J'~
SECTION:
SPRINGFIELD SIGN ORDINANCE
....-- -
" .
city of springfield
225 n. 5th street
SPRINGFlELD
~~
. .INFORMATlON:
726-3753
INSPEC'T10NS:
726.3769
SIGN PERMIT APPLICATION
A. LOCA~ION OF SIGN '(ADDRESS) 420 -z.. M...., >-.l
LECAL DESCRIPTION "'5><.'<l-'<' ,\.." -'-'~--. ~, "
'OWNER OR PROPERTY 1k"T'L^,"";'" 'k>. "'... r.:.. .~ r> (' _
. ADDRESS /6(;,.<.<' ~ 1Clon-r.~'\l'-\OL... 1<..<a..Yr
~ofi"
\107,'l, V,"Z.
lu<l.
TAY. LOT -f 0 "0 1
,PHONE 1- 'l<ll..- 9..1't.- ~~"l......_
ZIP <:1'00'2,"1.....
OlffiER OF SIGN (IF OTHER THAN PROPERTY OWNER)
ADDRESS
NAME OF BUSINESS. FIRM.
ETC. J1~J?A-~ - PH.. !VA)
C'STP.U L TYPE OF SIGN:
L-l ALL _FREE~TANDUIG
_ROOF _PROJECTING
_MARqUEE
_UNDER HARqUEE
_OTHER
,PHONE
TYPE OF .BUSU:E~S
~. TYPE OF WORK:
LERF.CT _ALTER
_RELOCATE
_OTHER
[). USE AllD CPJlRACTER OF SIGN:
A- IDENTITY
.A...INCIDENTAL
_DOUBLE FACE
_SINGLE FACE
_MULTI-FACE
_P~ER BOARD
_BILLBOARD
"
,
E. VENDORS. CONTRACTORS: .. I. , (
SIGN ERECTOR lJ,..;... <-fl...r" 1/. \.":,~
rIlON!:
,1.DDl'J':SS
CITY LICENSE InP.iBER'
,ZIr
. .EXP. DATE
SIGN HANUFACTURER (IF OTHER THAN ERECTOR)
ADDRESS
'.
,PEOIlE
F:
DU1ENSIONS, I1ISTALLATIOIl & CONSTRUCTIon
TOT~ HEIGHT ABOVE GRADE . ~.. G)~~
VERTICAL DIMENSION OF SIGN
HORIZONTAL WIDnl OF SIGN
DIIIENSION FROM GRADE TO
BOTTOM OF SIGN
TlIICKllESS OR DEPTH
G. EXISTING SIGNS
ARE THERE ANY EXISTI!IG ~IGNfi? _YES A.110
1!UlIBEP. SIZE IN SO, FTG,
ALL ~~ISTING SIGNS
FOR BUSINESS, ETC,
DOES SIGN PROJECT BEYOND
PROPERTY LINE? _YES
IF YE~. DIIIENSION BEYOND
PROPERTY LINE
NOTE: IF PROJECTIOn IS !lORE THAN 1Z"
OVER PUBLIC PROPERTY TEE SIGN ERECTOR
truST FILE WInl THE BUILDING DIVISION
COPIES OF HIS/HF.R LIABILITY AND PP.OP-
ERTY D~~GE INSURANCE POLICIES.
~O
H. HI~L SIGN HAVE ELECTRICAL IHRIllG? ~
IF YES. WHICE APPLY? ELECTRICAL SIGN
__ILLUHINATED (INDIP~CTtY LIGETED)
ELECTRICAL COllIRACTOR
ADDRESS
LISC, NUMBER PEONE
I. DESCRIBE TYPE OR fo'ATERIALS SIGN IS
CONsrl~~~ OF.
. -'. ..
J. SITE INFOP1~TIorl (LAND USF.) -_ EXISTING USE
OF ~~R LAND (IJR LAST USE IF .VACANT) '.
bl'-e~c.~~ ,
/U~V/~G""Sn9'f1'V -~
~NDOOR BUSINESS ~UTDOO~ MERCHANDISING
PROPOSED USE OF BUILDING OR LAND:
,(~#l-S~"~
~
K'VALUE OF SIGN: tt>~_,.,T"l
I
L. I HAVE CAREFULLY ~IINED the completed application for permit and do hereby certify that all
informacion 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
Sorin~field and all other Ordinances of the City of Sprin~field and the laws of the State of
Ore~on pertaininR to t~e worl; describea n~~~Ln. I further certify tha~ my S~r,~ Co~tr3ctor Li-
cense with the City of Sprin~field is in full force and effect as re~uired by SprinRfield Codes
8-2-6(3) and 9-7-20(2), I will request all required sign inspections listed on the ap?roved
permit.
NAME (PLEASE \PRjINT) t-\...ll. '\A-.2WIS"~ I fM),/<t. \"
SIGNATURE ::"tLJ.. ~ - \. -.j.sc.S2._
,- U-()
,DATE
~/i /85
....-..-
.
.
.
PLEASE READ
1)
Seoarate 5120 Aoolicatlon:
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. Illumi.nated signs (both internally
and externally) must conform to Sections 9-7-4 (4) & (5) and 9-7-18 of the Springfield Sign Or-
dinance. '
A separate application is required for each separate sign as defined
2)
I
4)
3) Plans Reouired: This application is to be submitted with evo 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 sup~ort framing, bracing and footings; ~aterials
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.
~en 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 t~e Building Divi-
sion Office.
Plans of insufficient clarity or detail wil; 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., .'
Insoections:
-I
S)
6)
7)
8)
9)
a) Site Inseection - to be made before the sign is placed, Usually, the Footin~ Inseection
(1t appi1cable) may be made at the same time as the Site Inspection. The Foot1ng Inspec-
tion is to be made after hole(s) is ~avat~ci, bue prior to the placement of concrete.
b) Final Inseection,- to be made upon completion of all work.
c) ~lectrical - all electrical signs must be inspected for,elec~ical hook up after the eign
1s erected and before the sign is turned on.
CALL FOR THE REQUIRED INSPECTIONS ON THE 24 HOUR INSPECTION LINE AT 726-3769
REOUIRED INSPECTIONS:
FOR OFFICE USE UNLI
SIGN DISTRICT /' ,tJJ.tfl, ZONE DISTRICT M ", '
TOTAL SQUARE FOOTAGE OF SIGN ande~ fl CJ tzJ
QI- .3 '1 ~r t'rlt.t tt./ /
FOOTING OR METHOD OF ATTACHMENT
:;;;INAL
JOB IJ
fSGJ ?4 W
SIGN PERMIT ,9!E:
. . ;0 -<go, (}?)
___SITE/LOCATION
4.<::ELECTRICAL
___OTHER
ELECTRICAL PERMIT FEE:
-r9-
4'1: STATE
SURCHARGE:
-rr-
~ i. cr- tf()
I
TOTAL :
DATE
RECEIPT
,l-
I
j
CLERK
SPECIAL CONDITIONS TO BE SATISFIED BEFORE ERECTION OF SIGN:
ADDITIONAL INFORMATION NEEDED BEFORE PERMIT MAY BE ISSUED:
SECTION:
BY: J]:1/
9--/!- ?
/"
APPROVED
)
DATE
7'.- b'-' f(s
--'-
SPRINGFIELD SIGN ORDINANCE
..-.... -
.