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HomeMy WebLinkAboutPermit Signage 2013-10-4 SPRINGFIELD � OREGON - 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 ' + Phone: 541-726-3753 < Building / Sign Permit Inspection Phone: 541-726-3769 ' Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02232 www.springfield-ar.gov permitcenter @springfield-or.gov PROJECT STATUS: Issued • ISSUED: 10/04/2013 EXPIRES: 11/04/2013 STATUS DATE: 10/04/2013 APPLIED: 10/04/2013 SITE ADDRESS: 28 W 0 ST C,Springfield,OR 97477 SCOPE: Banner, Portable Sign ASSESOR'S PARCEL NO: 1703271003500 TYPE OF STRUCTURE: Commercial . PROJECT DESCRIPTION: Temp sign-install 100413 removal date 110413 . OWNER: MALCOLM BOSISTO REV TR Phone Number: ADDRESS: 1484 CHECK ST . SPRINGFIELD OR 97477 • L CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No , Lic Exp Phone Sign Contractor OWNER COB 000000 08/01/2025 • INSPECTIONS REQUIRED Inspections By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all information hereon is true and correct,and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield and the Laws of the State or Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety. I further ' certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project. I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the street,that the permit card is located at the front of the property,and the approved set of plans will remain on the site at all times during construction. 4*'— c . • Owner or Co :ctor Signature D. e • • Springfield Building Permit 10/4/2013 1:47:08PM Page 1 of 1 • SPRINGFIELD"- CITY OF SPRINGFIELD �„ r , 225 Fifth St ,,OREGON TRANSACTION RECEIPT Sp nngfield,OR 97477 541-726-3753 811-SPR2013-02232 www.spnngfield-ar.gov 28 W Q ST C permitcenter©tspnngfield-or.gov RECEIPT NO: 2013002217 RECORD NO:811-SPR2013-02232 DATE: 10/04/2013 iv n«sa.;Cant— ' a°�`ftar±:y-rte'�s* i;J•'AGCOUNTICODE(TRANS CODE lt" ! _r` , 'AMOUNT DUE'. ! Admin fee(10%of applicable fees) - 224-00000-426605 1098 20.00 Banner, Portable 224-00000-425602 1065 100.00 Banner, Portable Deposit 821-00000-215500 1049 100.00 Technology fee(5%of permit total) 100-00000-425605 2099 5.00 TOTAL DUE: 225.00 P I ENT-RPE -=PAYOR DASNIER:-0130weSET COMMENTS s aj„,„. Ti? QID _ Credit Card robert timmons - refund to: 225.00 059847 robert timmons 28 W Q Street Suite C Springfield, OR 97477 TOTAL PAID: 225.00 • • • • • • SPRINGFIELD - t'4 CITY•OF¢SPRINGFIELD, OREGON ..=.4:.- �� „y ,;.,30,44,..i. t ,v° a+ �1 7 p E '. ..- ^r_i�..r-;7,r...7- .-. ..._.•—...., f...__ A c 'y- i• 225 FIFTH STREET • SFRINGFIELD,OR 97477 • FH:(541)726-3753 • FAX: (541)726-3689 d)� - _` - +?�,1' "' 7/ ' t City Job Number .5/3 -07Z-72_ 0s L -, --- Job Location Z$ (,L\ e-S l �,> Assessors Map \ 7O 3 Z.7( C7 Tax Lot b 3 c 6 e \ Business Name Cyj,_,4- Lie_ai ,-,:v..-k,:w--ai F/.: Business Contact Name ((.1 VII yLl Oil L Phone a> U- f •,. ; Owner of Property (tf/� �j� s-(-frG co i Address / 1( 1(( Ctt�`` S11— Phone ) r City 5 0 State O(t_ Zip r 7 41 7 7 Contractor/Installer �- ; Address Phone E' City State Zip Construction Contractors License # Expires r /� Ig 764141e S� t'� / ,!! cn + S Description / • + /O 4 / /3 Date of Removal i( 'Ott ( r Date of Installation I Permit Fee: $225.00 including $100.00 Deposit and ap licable fees. a9; By signature, I state and agree that I have carefully completed this application and hereby certify that •��i all information herein is true and correct. I further agree and understand that individual banners and �' portable signs subject to this permit may not be larger than 60 square feet. I also agree and understand s er �i- that temporary signs shall be removed within 30 days from the date listed above. If the temporary ) sign(s) are not removed within the timeline specified, I will forfeit the $100.00 deposit. I also understand that this special permit can only be issued four (4) times per calendar year per development 1 area. I also agree to call the inspection line at (541)-726-3769 by the end of the 30`h day to request an i inspection to verify the removal of the - porary sign(s). This inspection will begin the process to return the $100.00 deposit if the tem•e • .i t n(s ave been removed. 0.• Property Owner Signature ia—4.4� Date (�y (i " or• Office Use Date of Application /e) Job # S/3 "O22Z.._ 013 -oZ217 �, Receipt# ' Issued By �� Amount Collected 22 S Shared Drive(T pudding Forms/Temporary Sign Permit CSD 3-12 doe