HomeMy WebLinkAboutAPPLICATION & DOCS 2 - 14-00167 - Maverik - Rigby Pole Sign35 N. 1sr E.
Rexburg, tD 83440
P I a n ni n g Zo n i n g @ re x b urg. o rg
www.rexburg.org
Sign Permit Application
City of Rexburg
Phone: 208.359.3020
Fax: 208 359.3022
FixedSignage
c\L/
t\merica\ F*nily (
Applicant Information
Owner Name:
Site Address:
Mailing Address:
Telephone:
Contractor Information
Contractor's Name:
Contractor's Address:
Contractor's phone:
Contractor's Name:
Contractor's Address:
Contractor's phone:
Electrical/specialty contractor Information (for powered or tishted sisns)Contractor Information
eir",'iF URO
citv/state/zip: /)Sai* .h,9., LtT F qos/
Mobile:
Date: -Contractor's Signature:
Sign Information
801 -487-8481 TelePhone
801 -464-6466 Direct
801-330-0851 Cellular I801-485-3003Fax I
E-mail: dleatherman@vesco.cont
1
1605 South Gramercy Road
salt Lake city, utah 84104
UT Conracto/s License No. 7232280"5551
Iighting ond typ Custom Electric Signs""
code) (sign must be in legol zone for lighting ond type)
of completed sign.
Initials:-*An extra s65.00 charge wilr be appried to any powered or righted sign.
Initials:-*Electrical inspection of sign must be completed with sign contractor present to verify risting and rabering within interior of the sign.
Signature of Appficant, D.t",
Note: This document is for application proposes ontv-.^(!!" legar sign permit form must be signed by city officiats before sign is opproved)See Sign Ordinance 1027 at www.iexbure.ore for regulation information
Sign Area t1tt, Sign Height ffromsround), la
,*< ,,
sign Description: rtve"st' ' / *
6l veseo
WAIL SIGNS
! A) Sa. FooTAG
!- B) EX|ST|NG St(
Ir C) NEW stGN &
I D) LOCATTON q
r E) ts stGN L|GH.
APR 2 4 zot4
I
al|
\w
r's
-t--+.9x.IU
LJ
L*n
-C
-H
L*
LL]
U-^n
fi
\-/
- lt
a'rriillrl'{a- I
*-t
*,
u
CLAIM FORM
VENDOR #
VENDOR NAME
2nd LINE NAME
ADDRESS
CITY, STATE, ZIP
V ( sA* DATE
DH APPROVAL
tl4/25/z-otq
au
Arn e r i ffi's F tzmilY Ca *rmun itY
f.w't'u*-* tLlcc tb'J
Wtwi'k-&4t'X0&9Y' " ,
g f 't!.yo stf r,t/f, *L
,':;'1'q
^ l- ' ,'Ll
\v\rrY ,,( Attt 'r,,lrl
ur^ \ tr,
lJuY, ,+_z lLl'
'
\J
4',''
"An-r'L L*rntt'' { t'44!ru1--^-
CLAIMANT OR HIS AGENT SIGN HERE
1l 4
ffiI{W-qffq*, " citY of Rexburg
fotal Amount Due:
Total Payment:
(BURG_Recpt 1 7 65 24 J ]0 | 4 _elainem
Receipt#: 1765
Date:4/24/2014
165.00
165.00
Tender Amo[nt\-necK
Sub Total:
165.00
165.00
SIGN-PERM- Sisn Permit Fee
CITY
o
OF
REXBIJRG
cb, -**-***
An erica! Fa mi ly Co m w unity
Community Development Department
Phone (208)359-3020
I nspection Hotl i ne : (208137 2-2944
INSPECTION
REPORT
Inspection Tvpe
ELECTRICAL
Buildinq Tvpe
SIGN-R
Inspection
ELEFINAL-S
Permit Number:
14-00167
Address: 200 East Main, Rigby
Proiect:
Maverik - Rigby Pole Sign
Inspection Date
9t19t2014
Inspection Result: PASS
ETL listed and labeled.Sign itself is listed and labeted. 600.3
power was existing or licensed
electrical contractor must wire ahead of
disconnect to source.
Approved for a final.
COMPLETED
COMPLETED
COMPLETEDAdded gas price numbers to existing
sign-as per sign contractor used existing
wiring and no new circuits were added.
Numbers on existing sign only inspected.
Inspector: Bret Stoddard
(itrt' ot,. Rtc+tt y SraN prruvrr
158 West Fremont Rigby, ldaho 83442 Phone (2o8) 745-8t I I xl9 Fax (208) 745-71 | I
Please Complete ALL Applicable tnformatlon
Application o^te 3.L . /4
Project Address &00 Sosl /ilah
Class of Job ,^/A,r*/- pnih;/doa- "^ f4 $n
Newtr AdditionE Replacement E
Materiaf Used: LEo Pricn-trl- +crs, itia/
, 1 . . - ItHeisht: | / Q.
SquareFootage: /f.3
owner or nsent ///are/ikt f nr,
Lot #Block#
Subdivision Name
Division or Phase
Contractor:
Address:
11" o< 3" Ara*,oraf .Sa-z.y' /a-l-.r/fi f(tay
Phone: LA /, ?6 {, t 4b 6
Contact name: L)aa,nn-te, / n ol-f ,, nrart
AppraisalValue V,qh5,O O "
By lnitiallng each ltem, you agre€ to these terms & condlfions:
Any damage done !o the city infrasttuctu.€ during construction is tho responslblllty of the appllcant or hl8 agent to repalrrreplace.
Copy of pormlt shall be dlsplayed on slte.
No con8tructlon equlprnent shall occupy a clty street.
Thls ls a Permlt for the constructlon of a slgn only. Permite are obtained from the Gity of Rigby at 15E westFremont Avenue, Rigby, lDg3442 :
Setbacks:
Front
Back ' ,'
Left side
Right side
.irii:liiii
;;rii::;]ll
Attach plot plan specifications
I hereby acknowledge that I have read this applicaiion andslate the above is correct and I agree to comply wtth ali lppilcableCig Ordinances, City Zoning LaG and, Stati & Federal larraMether specified herein or not.I have contacted Dlgnne at ,-900-342-lSgS on any dwngover a l5 lnch depth.
ii u'riffiiiiliti
r.1i
*CITY ORDINANCE $'1.3 COMPLIANCE WITH AMERICANS WITH DISABILITIES ACTNOTICE: All new conslruction of commercial facilities and public accommodations as defined by law must comply with theconstruction requirements of the Americans with Disabilities Act, as such Act is amended.
PLEASE NorE: ISSUANCE oF THIS pERMtr DoEs NoT lNsuRE coMpLrANcE wrrH FAIRHouslNc tAw AND/OR ANY OTTIER LAWS; NoR DoEs tr GUARANTEE pRopERTy LrNEsPermltl erplre one year from date oflssua No orccptions.
Daytime Contacl Phone Numbe(s) r;I
tro Lr 1 "=l !r-*kr S{r..t
Owner Address
vrr
::s#i
xi..
(j
!*
{:}*
I
;;
{jJ
Ll._"1
bf)
rn
\-/
{
(
I
^
--!
l
.f-
{
VT(r.s-b
r(
ld
,9@oB
:
$
["'rd
l{ll'*ll
|{.3u ! |llE lil+-,---ll!ftiil____ll !
!" t-l-lrIt-
tt:-i 99-iti-tr-
t-
t-t-
'f,
lilffi
:lil;l
-l
IIt=
t4l=
x, 15"l EIF5t3Hl=
ola*!il -
EIEel=
HIB
5ffit
Ectct
=
=c,
C'
ttl
(t=
ut