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Home My WebLink AboutALL DOCS - 16-00653 - Madison Park Dental - Signq �'+a _ ci'rY of Submit by E-mail Sign Permit Applicatio --- - -- City of Rexbur DWD"81 35 N. Isr E. Phone: 208.359.3020 Rexburg, ID 83440 www.rexburg.org Fax: 208.359.3022 Fixed Signage Applicant Information Owner Name: Madison Park Dental Site Address: 345 N 2nd East Mailing Address: Rexburg City/State/Zip: Rexburg, ID 83440 Telephone: (208) 317-4865 Mobile: Contractor Information Contractor's Name: YESCO Contractor's Address: 1530 W. Sunnyside City/State/Zip: Idaho Falls, ID 93402 Contractor's Phone: 522-7558 Mobile: 589-4149 Electrical/Specialty Contractor Information (For powered or lighted signs) Contractor Information Contractor's Name: Existing power to sign will be used for new sign Contractor's Address: City/State/Zip: Contractor's Phone: Contractor's Signature: Mobile: Date: Sign Information Sign Area sq. ft: 52.73 (slightly less than existing) Sign Height (from ground): 16 Sign Description: One double face EMC and internally illuminated identification sign. For a sign Permit it is mandatory that you have the following information: 1. 2 Sets of elevation drawings of a sign & (plot olats if opolicable) 2. Drawn to scale with dimensions and complete construction materials 3. Footings if applicable 4. Engineer stamped if required FREE STANDING SIGN WALL SIGNS ❑ PLOT PLAN TO SCALE SHOWING ❑ A) 50, FOOTAGE OF WALL (SIGN ON) ❑A) BUILDING LOCATION ❑ B) EXISTING SIGNS &AREA ❑ B) LOT SIZE ❑ C) NEW SIGN & AREA ❑C) NEW SIGN LOCATION ❑ D) LOCATION OF SIGN ON WALL ❑D) DIMENSIONS TO SIGN FROM PROPERTY LINES ❑ E) IS SIGN LIGHTED? YES (must meet state electrical code) ❑ E) PARKING LOT ENTRANCES (sign must be in legal zone for lighting and type) ❑ F) DISTANCE OF SIGN FROM RIGHT OF WAY [I G) EXISTING SIGNS LOCATION & AREA ❑ H) 15 SIGN LIGHTED? YES (must meetstote electrical code) (sign must be in legal zone for lighting and type) Fee: $100* - $75.00 refundable at time of final inspection and photo of completed sign. *An extra $65.00 charge will be applied to any powered or lighted sign. Signature of Applicant: Justin Steadman Date: September 26, 2016 Note: This document is for application proposes only (the legal sign permit form must be signed by city officials before sign is approved) See Sign Ordinance 1027 at wwoisexburg.org for regulation information. For Office Use Only: Receipt Codes: (Regular) [ ] PZ= $25.00 [ ] PZSD= $75.00 (For Electrical Add) [ ] ELEC = $40.00 2/1/11 CLAIM FORM VENDOR # of Rexsaqq� CITY OF REX-BURG A Americas Family Community a��SHFO \0 VENDOR NAME ��D DATE ��a 7 Igo/ -7 2nd LINE NAME DH APPROVAL ADDRESS CITY, STATE, ZIP CC APPROVAL DESCRIPTION ACCT# ACCT DESCRIPTION AMOUNT R dt-Oe i -� A Z�Z�II� ll �'U 2� ,6b CLAIMANT OR HIS AGENT SIGN HERE {press Bill Piny - Payment Processing IZFhBtTRG XBP Confirmation Number: 22030979 hftps://secure.xpressbillpay.com/common/payment_process.php City of Rexburg 35 N 1st East I PO Box 280 Rexburg, ID 83440 208-359.3020 ub@rexburg.org Transaction detail for payment to City of Rexburg. Date: 09127/2016 - 10:24:28 Alt Transaction Number: 57651696PT Visa — XXXX-XXXX-XXXX-9853 Status: Successful Account# Item Quantity Item Amount 16-00653 PZ Sign Deposit 1 $75.00 Notes: Permit 16-00653 _ 16-00653 Electrical Permit 1 $65.00 Notes: Permit 16-00653 16-00653 PZSIGN- Sign Permit Revenue 1 $25.00 Notes: Permit 16-00653 Billing Information YESCO Justin Steadman 1530 W Sunnyside Idaho Falls, ID 83404 208-522-7558 of 1 TOTAL: $165.00 Transaction taken by: natalie 9/27/2016 10:24 AM Apress Bill Pay - Transaction Details Transaction Details CI T1' U F t REXBURG XBP Confirmation Number: 27148364 City of Rexburg 35 N 1st East I PO Box 280 Rexburg, ID 83440 Page 1 of 1 / Transaction detail for payment to City of Rexburg. Date: 02/27/2017 -11:01:27 AM Transaction Number: 64733342PT Visa — XXXX-XXXX-XXXX-9853 Status: Refunded Account # 16-00653 Item PZ Sign Deposit Transaction Notes: sign passed inspection permit # 16 00653 Billing Information YESCO Justin Steadman 1530 W Sunnyside Idaho Falls, ID 83404 208-522-7558 jsteadman@yesco.com Quantity Item Amount 1 $-75.00 TOTAL: $-75.00 Transaction taken by: marianna Email: jsteadman@yesco.com https://secure.xpressbillpay.comlcommonitrans_details.php?trans_id=NTE5MDM4Mzc%3D&conf num... 2/27/2017 Xpress Bill Pay - Payment Processing P r;l T\ O h REXBURG XBP Confirmation Number: 22030979 https:Hsecure.xpressbillpay.com/common/payment–Process.php City of Rexburg 35 N 1st East I PO Box 280 f Rexburg, ID 83440 208.359.3020 ub@rexburg.org 1 Transaction detail for payment to City of Rexburg. Date: 09127/2016 - 10:24:28 AM Transaction Number: 57651695PT Visa — XXXX-XXXX-XXXX-9853 Status: Successful Account # Item 16-00653 PZ Sign Deposit Notes: Permit 16-00653 16-00653 Electrical Permit Notes: Permit 16-00653 16-00653 PZSIGN- Sign Permit Revenue Notes: Permit 16-00653 Billing Information YESCO Justin Steadman 1530 W Sunnyside Idaho Falls, ID 83404 208-522-7558 1 of 1 Quantity Item Amount 1 $75.00 1 $65.00 1 $25.00 TOTAL: S165.00 Transaction taken by: natalie 9/27/2016 10:24 AM `�F µGX N U"' y is CITY O F REXBURG Cw Atnerica' Family Community Community Development Department PO Box 280 Rexburg, ID 83440 Date: 09 5467 16 Phone (208)359-3020 1 Fax (208)359-3022 Receipt #: 5467 Inspection Hotline (208)372-2344 By: YESCO Project: Madison Park Dental - Sign Permit # : 16-00653 er Type: CREDIT Permit Type: SIGN 'ence/ Check 4: Address: 345 North 2nd East SIGN -DEP Sign Permit Deposit 2822000 PZSD 75.00 SIGN-ELE Sign Electrical Fee 2832213 ELP 65.00 SIGN -PERM Sign Permit Fee 2832320 PZSIGN 25.00 Please contact the Building Department at (208)372-2341 for further questions about this receipt 24 Hour Notice for inspections Call inspection hotline at (208)372-2344 ***Credit card payments are accepted, but are subject to a 3% convenience fee on payment amounts over $500*** 1 F -t --r-{ Ho . ° Your smile is your -0 greeting to the World, make it dazzling'.'_ SEP 262016 REXQJ Marshall H. Merrell Optometric physician