HomeMy WebLinkAboutALL DOCS - 12-00358 - Burger King - SignclTY (}r
Owner Name
Site Address:
Permit Applicqlion
C'ty of Rexburg
Phone: 208.359.30i0
.rexburg.org Fax:208.359.
Applicant Information
Fixed Signage
/rl.,"r. i./ilea.,l r i,i'dr"*
Mailing Addrer., 5r*t r; r'li Crty/State/Zp:_
Telephone: '-, >[ t i: ,i Mobile:
Contractor's Name:Contractor's License Number:
Contractor's Address:/State/Ztp:
Contractor's Telephone:Mobile:
Contractorts Signature:
Sign Information
Sign area sq. ft:Sign Height (from ground):
Sign Descriptions:
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Contractor Informatior
.. ,Contractor's x^^r, ,, ., ,, \ .\6-?i \,t C;fin
conrractor's Address: ^' - _,"'i t' -r4i.v :* "k(le Ciw/State/zpr@z ga
contractor's t.t.onon@ Mob'e:
Electtical/ specialty contractor Information (For powered or lighted signs)
Date:
l/R@
ililtl-.,.m'***
For a sign Permit it is mandatory that you have the folowing information:
2-sr:ts of elevation dtawings of a qigq u @ahaLLqpbLMLk)Drawn to scale with dimensions and -ompl.te construction materialstrootings if applicable
Engineer stamped if required
FREE STANDING SIGN
c Plot Plan to scale showing:
o a) Building location
n b) Lot size
I c) New sign location
n d) Dimensions to sign from property lines
n e) Parking lot entrances
a f) Distance of sign from right of way
n g) Existing Signs location & area
WALL SIGNS
a a) Sq. footage of waLl (tign on)
a b) Edsring signs & area
a c) New sign & area
c d) Location of sign on wall
o e) Is sign lighted? Yes (ma$ meet state electical code)
fttgn murt be in legal rynefor lighting and rypQ
o h) Is sign Ughted? Yes (yust nut ttate electical codt) (ttsu must be in legal qonefor ligbting anet rype)Fee: $100'00* - $75.00 tefundable at time of final inspe.tioo roJ photJ of completed sign.*An extra $40.00 charge will be applied to any powered or lighted sign.
Signatue of Applic
Note; rhis docme"U"'""1:tjx:::::-';:':1Tj9:
l"-*, .* o"$ rorm must be signed by city orficials berore sign is approved)See Sign Ordinance (no. fi27) * ****=lorg-g i;.;;;;;f;ff;:
Buitdingsarety@
City of Rexburg
'R.'ERT'ADDRBSS tbuqW
SUBDTYISION Permit# tl 003%
PI{AsE_Lor F
35 N. l.t E., Rexburg Id S3440
Phone - (208)359-3020/Hottine - g}s)372_2344 / F;x_ (ZoE3Sg_3022
OVTNER'S NAME
CITY Of
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Approved for temporary power
Approved for permanent power
Required!!!ELECTRICAL
ElectdcalContractor,sNr-. Der,l( (^lrlrv\ gusinessN"
"MAddtess city__ _ _*______s t^te .. . zipCell Phone 340 - -h l'I nusiness phone
(coMMERcIAL/rND-usTRrAL) Total cost of electtical'ystem (contactedAmo'nt) $-f:;'{&:;;X:{;;::;':f,#i:::i ;{f#;oin pars sppi',ng; rb;i; i;;; l,ii, ,r* iio*r* *p;;h;n ;}b ^ a,y awt a, ehct ;,it a,nilotio^
E Up to $10,000^^. ^. _ (toral "cost of svster4 x 0.02) + 60 = $n Between $10'001 - $100,000 ('(total cost of Fsteir - to.6oo) x 0.01) + g260 = gE ovetg10O001 ^ _ _ i6t^t_.o,torsF;;i06]'i0'0)x0.005) + g1,160= gsmall $/otks (contractors oNL$: $1b@g200 in cost r.rJrroiiooot ,irrg a change inservice connections. Does NOT tequite inspection. :
RESIDENTIAL
yr7;&:r{;:tr-#f**'inchdins dtlbuildings naith wiringbeing constntcted on eacb propetty. (*Based on l&ing space,
E up to 1.500 sq ft - $130 fl 1,501 to 2,500 sq ft _ g195tr 2.s0t to 3.s00iq ft- g260 Ei :,sor to d500 sq ft _ 9325tr
m :ru :1ru;:i lm;rrot each additionar 1,000 ss rLo, po,rio,, ,r,o."r i6rzi+ ($65 x # oradditionar
Nao.flnlt;latnily Danlling lConmids OAyl
LJ L,uplex Aparment 9260
Lr rhree or more multi-fatnity units: g130 per buil{inq dus g65 per unirtr Exieti.g Reeldencer-M"iru"t, ni*"iactuted
";t{;;i" fil-"",.od n"t""nJHop: g65 feeprus g10 petbranch circuiL up to the maximum of rhc co,rtesp-o_nding sq. n or n. uitaiog-fuE centtal HtttingTcotnifCy""--, ios rvl.o woT-p; o?r* r.ria*tial or Fryic pcftnit vith no additioner\0iring
,,,,P*)li;#:1.3?:.:"_l,1YryTgpoots:g65reeroreachtdptoinspectPunp2'water, Itigadon, santage (eacb .ot 7
E!r' qP (u unPccr
lJ 965 up to 25Hp og95 _ Z6io 200Hp og130 over 200 Hp
MISCELLAIVEOUS
E rempotaty constnrcdon Sctvices oNLY: 200 amp or less, one location (for a pedod nor to exce€d 1 year) - $65E Tempotaty Amusement: $65 fce plus g10 per dd., ioo.".rio' or gcne*torq r'igation Machine: $65 for ".nto pirrot plus $to per rower of ddve morotE TechhicalSsrvice g65pethout
tr PhnCheck g65perhout
E 7\.qu"sted Inslr€ction: 965
'",n4'"4uT:;#/nffi*:nu*"1'frim.*yn::::T*::x::":l,yb."t*:dforsreepinseatinscookinspn?oses. An uofinished bascment is conride.cd pa.i of th. lioing rp"...t^00sgrtt . t/ryfL ,,1 t,, l,Lilto.tol___-- rl"**.^r-u-lIEp. alt" f , Drt
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tltiF0nD PIIOTO
nApprovedAS tS
E Approved with changes
I hereby authorize Blaze Sign to proceed with lhe scope ofwork describedin this sketch. I am agreein! on design a cotor, sperrir'gl ".i'iilii,i"
Proof Date:8t13t12
525 W MapleAve.
Pocatello, ldaho 43201(208) 232-7735
08fl to Top of Sign
Date:
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Aue,21. 2012 10:27AMBLAZEoSicN POcAiELt020B-23 3-1332 No, 5947 p, 2o
l-he/6by.suthorlzo Blaze SIgn lo p/oce6d wlth the scope olwork deac4beoln rhraioxelch I Bm agrcein[ on d66tgn & cotor, opelinil,iijJiirJirrJ.-ffiu",#'uT{t$-"'
CLAIM FORM
VENDOR #
VENDOR NAME
2nd LINE NAME
ADDRESS
CITY, STATE, ZtP
nrlSluze )l an o
Sas wi;F@E
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DArE Z.l taiapt3
DH APPROVAL
?acu.tt-L.ln ,T D CC APPROVAL
cIl'Y OF
Am e r iu* r*a mi ly Co n m u n i
DESCRTPTION
-aao^ooQg'r*u'L& t a oo358
6^-rrf^tt,*"0 *W,
CLA|MANT OR Hls ncEr.rTGlol nenr
Receipt Number:1?s7s2 ,,35 North tst east I nE6G, tD. 83440Phone (208) 359-3020 | Fax(208)359_3022
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mqtory :' '"' A,hibttruf{C. - }.emtrn
12 00358
12 00358
12 00358
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RPRXBGAO3(
RPRXBCAO3(
Sign Deposit
Sign Permit
Permit - Electrical
$7s.00
$25.00
$65.00
Total:
$75.00
$25.00
$65.00
$0.00
$0.00
$0.00
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$r65.00
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;; l*::t:* ,1;,ilrii{i.; i.1,:,,."_ i.liiii ii'It-,f5i i+ itflT= Ft[:liil i J rii
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$ 165.00
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genpmtrreceipts
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