HomeMy WebLinkAboutALL DOCS - 13-00396 - 160 W Main - Crossfit - SignSign Permil APPlicqlion
City of Rexburg
35 N. lsr E. PlonningZoning@rexburg.org
Rexburg, ID 83440 www.rexburg-org
Phone:208.
Fox:208.
oeT 0 3 z0t3
City/State/Zip:
REXBURGc\'- -*'- -""
im e ri ca\ FamilY CommuuitY
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CITY Or-
Fixed Signage j
Applicant Information C rosslit
Owner Name:
Site Address:
Mailing Address:
Telephone:Mobile:
Contractor Information
Contractor's Name:
Contractor's Address:
Contractor's Phone: (- 4l ata- dct6 |
ElectricaUspecialty Contractor Information (for powered or lighted signs)
Contractor I nformation
Contractor's Name:
City/State/Zip:
Mobile: *1O6
Contractor's Address:City/State/Zip:
Contractor's Phone:Mobile:
Contractor's Signature:
Sign lnformation
Date:
Sign Area sq ft: 2f
Sign Description:
For a sisn Permit it is mandatory that you have the following information:
1. 2 Sets of elevation drawings of a sign a @e!-PbEil-spp!i9sh!9)
2. Drawn to scale with dimensions and complete construction materials
3. Footings if aPPlicable
4. Engineer stamped if required
FREE STANDING SIGN
D PLOT PLAN TO SCALE SHOWING:
n A) BUILDING LOCATION
WAIL SIGNS
! A) SQ. FOOTAGE OF WALL (that the sign is
D B) EXISTING SIGNS & AREA
! B) LOT SIZE ! c) NEW SIGN & AREA
u c) NEW SIGN LOCATIOp tl D) LOCATION OF SIGN ON WALL
u D) DIMENStoNs ro stGN FRoM pRopERTy LtNEs n E) ts stGN LTGHTED? YES No (must meet state electricol code)
! E) PARKING LOT ENTRANCES (sign must be in legol zone for lighting ond type)
1] F) DISTANCE OF SIGN FROM RIGHT OF WAY
n G) EXISTING SIGNS LOCATION & AREA
I H) ls slGN LTGHTED? yEs No (must meet stote electricol code) (sign must be in legol zone for lighting ond type)
Fee: S10O* - 575.00 refundable at time of final inspection and photo of completed sign'
Initials:_*An extra s65.OO charge will be applied to any powered or lighted sign.
Initials:_*Electrical inspection of sign must be completed with sign contractor present to verlfi listing and labeling within interior of the sign'
_.'J
signature of Applican t, e1 L- Date:It -t ' 2"!3-
Note: This document is for application proposes only. (the legat sign permitform must be signed by city officiols before sign is opproved)
see sign ordinance 1027 at www,rexburs.orq for regulation information.
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CLAIM FORM
VENDOR #
VENDOR NAME
2nd LINE NAME
ADDRESS
CITY, STATE, ZIP
',r':4 th;-,\ ., ; :t J
DATE
DH APPROVAL
CC APPROVAL
CIT'Y OF
RT,XBURG
Am e r i c a! Famity Co mm wnity
r._ '..1i_, !f_r.. ,,/ l. {,t_. e, t l.. _ --_*
CLAIMANT OR HIS,AGENT SIGN HERE
. fntess Bill Pav - Pavmenllocessins Page i.oF 2
Billing lnformation
JOELLE EINERSON
,83440
1.. I 1.Y d.! f
Rf,XFURG
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A*r'ri?r;l Sretr|: {;xxit*tat*' t
Payment Service Provided By www'xpress bi I I pay. com
Copyright @ Xpress Bill Pay 2013 - All Rights Reserved
City af Rexburg
35 Northlst East
Rexburg, lD 83440
208€59€020
TOTAL:St to.ao
Transaction taken bY: shellie
4[ 4ol, Frinter
l Transaction detail for payment to City of Rexburg-Date: 10/03/2013 - 4:17:12 PM
Transaction Number: 22568032PT
Visa - XXXX-XXXX-XXXX{01 I
Status: Successful
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Page I ofl
City of Rexburg (10006)
,-11:3.!j''n!u' & j, Frinrer Forrn&t
Date:'12i,18120,13 - 1 :53:10
'
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TOTAL:s-75.00
Transaction
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Transaction detail for
!Account #1 -' -"- --"
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1,..,...
Billing Information
JOELLE EINERSON
,83440
Ii Transaction Notes: sign permit deposit refund for Crossfit
Transaction Num ber: 2371 236BpTVisa - XXXX.XXXX.XXXX.S01 9
https ://www.xpressbillpay.com/common/trans details.php?transid:MjU2MzI2ODy%3... 12/tB/2013
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**n*o*City ofRexburg Receip#:498
Date: l0/3D013
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CREDIT- Crcdit Cad
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Code: REXBURG_R€cpt498_3_l 0_?01 3_ddaem
100,00
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