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HomeMy WebLinkAboutPermit Signage 1996-10-3 ;,1-- -r .. . . SIGN PERMIT APPLICATION . JOB!BER '9(; IO<~" ., ." . Inspection Line: 726-3769 Ollice: 726.3759 TAX LOT: r - ' n:.l.~)1 OWNER: PHONE: 71t/- 6'!O-t.? Clot) ADDRESS: CITY: STATE: ZIP: Cf.!?&>66( :." BUSINESS NAME, FIRM EtC.: DESCRIPTION OF, PROPOSED SIGN(S): Iplease check and complete all appropriate information) :..J(. Wall L Single Face _ Freestanding _ Projecting Roof Marquee Square Footage: Double Face I:/?d Billboard Other Total Height above Grade: 18' Vertical Dimension of sign or enclosure: S ' hi/IX. Material Sign is constructed of: -/sl/,p' f:;tft3l;;r /J? tff/H.. - Electrical Installatio (If yes additional elect' al ,dth of sign or enclosure: :KJ 'Pf~, Dimension from Grade to bottom of Sign Enclosure: VALUE OF SIGN: ~~OO\!!:. 1I(!1!4f{/e, - A.J~ it List ALL existing Signa~~ and ottech 0 photogroph of eeC~SI . , (al Type Sq. Ftg. (b ype Icl Type Sq. Ftg. I Type Sq. Ftg, Sq. Ftg, CONTRACTORnNSTALLER: ml1-t2:lin J.3~.5 ADDRESS: ,;:)()t/ ft?1Tt3l2&J71 St. CITY: Wt!..eAu. (j CONSTRUCTION CONTRACTORS REGISTRATION NUMBER: ~ PHONE: 3'fd-/7b9 STATE: 6L/6;8' (9.,zetf/'Y7 ZIP: Q1VO"2- EXPIRES: 3/":;:?-- ~ ,q ,q, EXPIRES: ~ (ofgJ/q'l CITY BUSINESS L1CENS~ NUMBER: Q;X;3 ~b Sign Permit Fcc: OFFICE USE land Use: 5~() Quad~ea: Code Section: 'I Pr~7~'!~'J Approved By: ~l ,~J:~) \~J\llJ Sign Dist~ict:~{(\1nJl.... Zoning: ~ ~~p.J DATE: ~.qy, REQUIRED INSPECTIONS: , Site ..,.. to be made prior to ,sill", placement Footing prior to placement of concrete v/ Attachment after fasteners are Installed/prior to cover -1.l..-. Electrical prior to energizing electrical Installation _, V Final completion of sign Installation , Additional Comments andlor Conditions: r, ---- .~-_. By ,signature. I state and agree. that I have carefullv examined the completed application and do hereb'( 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 the City of Springfield, -and the Laws of the State of Oregon pertaining to the work described herein" I further certlfy.that only contractors and employees who arc in compliance with ORS 701,055 will be used on this project. I fulther agree to ensure that all required Inspections arc requested at the proper time, that project address is readable Irom the street, that the p,ermit card 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 of the 'siOnls). Sign8tur~ /2~~rM f\ V.'H \ Amount Received: V\ f'\ {J.J Receipt Number: ()~~c.o(// I Date Vj ~ Zo- pt/n ValidatidO: . 'I" Date Paid: i 0 - 3 - q &7 Received By: (\. - (Y)r~CJ.,6-e'-'O