HomeMy WebLinkAboutALL DOCS -12-00284 - 160 W 2nd S #205 - Sassy Flowers - SignFixed Signage
Contractot's Telcphone:
Electrical/specialty contactor rnformation (For powered or lighted signs)
Contractot's Name: LDnuu fuqrto contractor's License Numbe,,C: I ?llf-_!g' 814*- ,{l c-tsfl
Contracto/sAddrerr, l )Ciry/Stzte/zip, B/rc,fu , n 9.32>l
Contractor's Tel upt-t"(Mobile:
Applicant Information
OwncrName:
Site Ad&ess:
Contmctot Information
Contractor's Narne:
Contractor's Add"ress:
Engineer stamped if rcquir,ed
EREE STANDING SICN
o Plot Plan to scale showing
o a) Buildbglocation
o b) Iot size
o c) Newsign location
c d) Dirnensions to sigp from propetylirres
o e) Parling lot e:rbances
o f) Distance of sign from rigtrt of way
o g) Existing Signs location & area
Signature of A
Contractods
Sign Information
Sign area sq. ft:Sign Hcight (from ground):
Sign Descriprions:
WALL SIGNS
o a) Sq. fiootage of rvatl (sign on)
o b) Esisti.g signs & area
$c) Nevr sign & atea- n d) location of sign on sall
,dg t. sign ligfuted? Ye s (rilrt! ttteet ttatc cleaiu! codc)' (tigu nnst bc in hgal iorcfor lQhthganl yp)
a h) Is sign r-ighted? Yes (atnt nu state crccrricar wtrQ ftiy nnst bc in regar ioacJw-rigfttirtgaad ryp)Fee: 9100.00+ - $?5.00 reftndable at dme of linal inspection "oa pnoro orcompteted sign.*An extra $40.00 charge will be applied to any powered or lighted sign.
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tr{ailingAddreo., Sfrit4F- -Crrtt ntrt, furLunJ-, ZD 83/4O
Telephone ,$1 - //l / rr{obite:
Mobire: Stn - qt V q
Fot a Sign Permit it is mandato{y that you havc the fonowing infornation:
? s*s of eleyationdrawing sigrr &$ltjlafLit_@i@bb)
Drarvn to scale with dimensions and complite ioo*tn .tioo -aterialsFootings if applicable
Notc This doorncnt I
(no. 102?) at )r'\r\'.reslnrr€/.drg for regulation information
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lnspecrion Reguesr Rccd By N\tN , orr.
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Inspector's Report O Res.Comm.
rNsPEcrED rrcMs coxponu 16'trY Dx
DFINALf] DISAPPROVED
fJ NOTAPPLTCABLE D on NOTTNSPECTr. \ _ LJ uru NUI INJPECTACTToN REeUIRED: l\Or.sg_.
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n'1..r Xt\\\ t \L,,\N'r\ ..,p.fli, *, mnaa,.ss \[ ,J \AirS "TrL $ I rt'Vifi'n
Inspection tt*
Dayffime neq. f - 1\- \ L- _A \t 7;f-
Rec'l Acknowledged
lVhir - Ottc Copy
F-FtF.coqt lblor . JoD Copy Pr* - |'|rproo'|Co9r
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CLAIM FORM.
VENDOR #
VENDOR NAME
2nd LINE NAME
ADDRESS
CITY, STATE, ZIP
\lrs oo DATE iihltz-
DH APPROVAL
CC APPROVAL
CITY OF
REXBIIRG
Americab Family Community
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CLAIMANT OR HIS AGENT SIGN HERE
, tprTr Bill Pay - Payment fessing Page l of I
City of Rexburg
35 Northlst East
Rexburg, lD 83{d0
208-35S-3020
40 col. Printer lA ItwffiFE-.rt
EXBURG
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iiri ri*lilt (.irDrr",t,rr.
r Transagtlon detail for payment to City of Rexburg.Date: 08115/2012 - 10:14:43 AttJl
Transac0on Nurnber: 15734766PT
Mastercard - XXXX-XXp(-XXXX-643{
Status: Successful
Descriptlon Refer6nce #Amt perltem I ltems Total Amt
PZ PROCESSING FEE $25.00 3 s75.O0
Notes: sign permlt 12 00?86\r\nand 1PACZ,AS and Vlni200284
PZ SIGN DEPOSIT $7s.(x)3 s225.OA
ELECTRICAL PERMIT $40.00 3 sr 20.00
Not€s: sing permits '12 0846 and 12 0lE5 and V1n12 0094
Transactlon taken by: marianna
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4tl Cai,
to Ctty of Rexbur Date: 08/13/201 2 - 11:21:O7 AM
Transaction Number: 1647 2SS29I'Mastercard - XXXX-XXXX-XXXX-S434
Status: Refunded - Refunded
s-225.AA
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W
PZ SIGN DEPOSIT
Billing lnformation
Justin Stedman
, 84109
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] Ir.a.E1cJ!_o_n !,to!es: REFUND stcN DEpostr pERMtrs 12oo2a4 sAssy FowERs, 12oo28s ATRtuM,; NAMESTE1200286
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Transaction taken by: marianna
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.\:Prrrrtet l:J ; F/int*f l:irrnat
details.php?trans id:MTg0MTI2NTg%3D glt3l20t2
Receipt Number:
35 North 1st East / Rexburg, tD. g3440
ra-$ei4, r I I
Phone (208) 359-3020 I Fax(2OB)3Sg_3022
$140.00