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Permit Signage 2013-11-20
4 7 SPRINGFIELD 1 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 � ''. >( t fr Phone: 541-726-3753 OREGON Building / Sign Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2013-02399 www.springfield-or.gov pe rm itcenter @springfield-or.gov PROJECT STATUS: Issued ISSUED: 11/20/2013 EXPIRES: 05/19/2014 STATUS DATE: 11/20/2013 APPLIED: 10/28/2013 SITE ADDRESS: 440 MAIN ST,Springfield,OR 97477 SCOPE: Sign ASSESOR'S PARCEL NO: 1703353107800 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Sign for Trash-N-Treasures OWNER: SETERA CAROLYN Phone Number: ADDRESS: 2788 CASTLE RD SPRINGFIELD OR 97477 L CONTRACTOR INFORMATION II Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone Sign Contractor OWNER CCB 000000 08/01/2025 INSPECTIONS REQUIRED Inspections 6999 Final Sign Sign Final: After all required inspections are conducted and approved and the sign . installation is completed. 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. r ? ifil /1 —d1 ' (-3 Owner or Contractor Signature Date ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth NOTICE: in OAR 952-001-0010 through OAR 952-001- THIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by • calling the center. (Note: the telephone COMMENCED ORS BANDON DI FORNOT number for the Oregon Utility Notification Center is 1-800-332-2344). ANY 180 DAY PERIOD. Springfield Building Permit 11/20/201 12:53:29PM Page 1 of 1 Y SPRINGFIELD CITY OP SPRINGFIELD >♦n :+Rr.., 225 Fifth St (`C�°v`OREGON TRANSACTION RECEIPT Springfield,OR97477 541-726-3753 811-SPR2013-02399 www.springfield-or.gov 440 MAIN ST permitcenter @springfield-or.gov RECEIPT NO: 2013002544 RECORD NO: 811-SPR2013.02399 DATE: 11/20/2013 LDESCRIP_TION '. 'ACCOUN •CODEITRANSCODE ___AMOUNT DUE.J Admin fee(10%of applicable fees) 224-00000-426605 1098 8.00 Signs: 0-35 Square Feet 224-00000-425602 1007 80.00 Technology fee(5%of permit total) 100-00000-425605 2099 4.00 TOTAL DUE: 92.00 LPAYMENT TYPE PAYOR CASHIER:JLARSOR _ 7 1.--- dO_MMENTS . - • . . AMOUNT PAID Check Glenn Myers 90.00 1338 Check Glenn Myers 2.00 31•, :Check Glenn Myers 90.00 1338 U O \ TOTAL PAID: 7112.Q0 7 Z In ky -f-✓t"SuC..ku.. V./.S Crnccclica o.-r II/s-- qY. 54.7 It 540✓«/ ,i .-1 recrr/'+. `r'in...AK‘ ra-<rt1ti. . 11 - 1. SPRINGFIELD - CITY OF SPRINGFIELD ..�...,; - ;. 225 Fifth St TRANSACTION RECEIPT Spnngfield,OR 97477 OREGON 541-726-3753 811-SPR2013-02399 www.spnngfield-or.gov 440 MAIN ST permitcenter @spdngfield-or.gov RECEIPT NO: 2013002372 RECORD NO:811-SPR2013-02399 DATE: 10/28/2013 c, I C' R ION ���",-� �;"s�L� � 'r'',F :�-=�'AMOUNT�DUE _-F• .. t t _ ,.,�"_:,�N �� r. �- ACCOUNT-CODE/TRANSICODE�.� Sign Plan Review 224-00000-425602 1018 42.00 TOTAL DUE: 42.00 ' P.AYMENTTYPETYPE t':*.i PAYOR -CASHIER:JLARSON 'Ar COMMENTS, .,,a_'t.w+l-A2.` -tea{ AMOUNT Check Glenn Myers 42.00 1328 TOTAL PAID: 42.00 SCI�TFY ®F SPRI GEIERI OREGON tiC. e 225 FIFTH STREET • SPRINGFIELD, OR 97477 • PH:(54l)726-3753 • FAX: (541)726-3689 0r- ,, C �` City Job Numbers 3 O Z 3 ? Plan Review Fee of$42 per sign is due with application. -44D Maio.) SC 1, 11 '' Site Address: 1 VP Assessors Map .70 3 3 5 3 Tax Lot: 0 7 e p tress + u Owner: G/44o IJ N rtAY 12S Phone: Ste l - �� `965 UI Address: 44o rid- (0 Sr. ,,,,fff�'''''''��' X111` City SP2r/JG�•(-(5(,./ , �C^ State 0� Zip el -14 -1 Iw"'�i Business Name, Firm, etc. ` CAGN -'N- ! REASU pI--l Description of Proposed Sign(s): (Please check and complete all appropriate information) 1 Wall Freestanding Projecting 1/ Roof Marquee F_`.( Single Face Double Face Billboard Other Square Footage: I '2_ Total Height above Grade: I I t i Vertical Dimension of Sign or Enclosure: S I Horizontal Width of Sign or Enclosure: � t Dimension from Grade to Bottom of Sign Enclosure ( Electrical Installation_Yes No (If yes additional electrical permit required) oD 01 Material Sign is Constructe f LA Al (N ATLTh tom` A cum (NONt Value of Sign: 700 IirrO T i List ALL existing signage and attach a photograph of each sign:(a) Type Sq. Ftg. (b) Type Sq. Ftg. i • (c) Type Sq. Ftg. (d) Type Sq. Ftg. Contractor/Installer: A/ / S IP-,c /NicNLJ f-L . /ZIC(CG.1/2b Phone: S il!'-S-20-S3?/ Address:1.3 3 3 1441k) S Tom✓ Pig City: _S'r It 1 Al G�•Z.Aitr) State: C71Z _ Zip q �� t. Construction Contractors Registration Number: Expires: / OFFICE USE / n - . Sign District: ( Zoning: C� 9 O By signature, I state and agree,that I have carefully examined the completed application and do hereby certify that all ! information herein is true and correct, and I further certify that any and all work performed shall be done in accordance with a the Ordinances of the City of Springfield, and the Laws of the State of Oregon pertaining to the work described herein. I 1} further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. 174 ' . I further agree to ensure that all required inspections are requested at the proper time,that project address is readable from•the 1 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 • ( Aj times during the installation 'f the sign(s). q I Signature Led.:•/_ Date — � — )3 Shared Drivr(T9/Ruildino Forma/Sion Permit Annliratinni AP dor A ® DATE(MM/DD&YYY) CERTIFICATE OF LIABILITY INSURANCE 11/14/2013 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AFFIRMATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED REPRESENTATIVE OR PRODUCER, AND THE CERTIFICATE HOLDER. IMPORTANT: If the certificate holder is an ADDITIONAL INSURED,the policy(ies)must be endorsed. If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy,certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder In lieu of such endorsement(s). PRODUCER LUNIACI NAME: ALL OCCASION INSURANCE PHAX 655 A Street Ste E EONE MAIL FA E:n: (541) 726-0555 No:(541) 988-4678 mmREs&aoia@comcast.net Springfield, OR 97477 INSUREFBS) AFFORDING COVERAGE NAIL. • INSURER A:MUtUal of Enumclaw INSURED TNT Antiques & Collectibles INSURER B: Glenn Myers dba INSURER C: 440 Main Street INSURERD: Springfield, OR 97477 INSURERE: INSURER F: COVERAGES CERTIFICATE NUMBER: REVISION NUMBER: THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS _ CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY-THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR A TYPE OF INSURANCE INSR MND POLICY NUMBER. (MM//D IYYYY) (M POLICY/D /YYYY) LIMITS GENERAL LIABILITY EACH OCCURRENCE $ 300,000 X COMMERCIAL GENERAL LIABILITY PREMISES(Ea occurrrrence) $ 300,000 CLAIMS-MADE TI OCCUR ' MED EXP(Any one person) $ 10,000 A CPP000563902 06/01/13 06/01/14 PERSONAL BADV INJURY $ 300,000 • GENERAL AGGREGATE $ 600,000 GEN'L AGGREGATE LIMIT APPLIES PER: PRODUCTS.COMP/OP AGG $ 600,000 I POLICY PE n LOC I$ AUTOMOBILE LIABILITY COMBINED SINGLE LIMIT(E _ a accident) $ ANY AUTO BODILY INJURY(Per person) $ — ALL OWNED SCHEDULED BODILY INJURY(Per accident) $ AUTOS NON OWNED PROPERTY DAMAGE $ HIRED AUTOS AUTOS (Per accident) FS— UMBRELLA LIAB _ OCCUR EACH OCCURRENCE $ EXCESS LIAR CLAIMS-MADE • AGGREGATE $ DED RETENTION$ $ WORKERS COMPENSATION WCSTATU- OTH- AND EMPLOYERS'LIABILITY YIN TORY LIMITS ER ANY PROPRIETOR/PARTNER/EXECUTIVE NIA E.L.EACH ACCIDENT $ I OFFICER/MEMBER EXCLUDED? (Mandatory In NMI E.L.DISEASE-EA EMPLOYEE$ I(yes,desuibe under DESCRIPTION OF OPERATIONS below E.L.DISEASE-POLICY LIMIT $ • DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES (Attach ACORD 101,Additional Remarks Schedule,if more space is required) ® COPY CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE City of Springfield THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN 225 5th Street ACCORDANCE WITH THE POLICY PROVISIONS. Springfield, OR 97477 AUTHORIZED R1EPRE - . I _arm I- ©1988-201 i••CORD CORPORATION. All rights reserved. ACORD25(2010/05) The ACORD name and logo are regl - ed marks of ACORD