HomeMy WebLinkAboutPermit Signage 2014-1-8 SPRINGFIELD 225 Fifth St
"4 CITY OF SPRINGFIELD Springfield,OR 97477
Ar
adiiii
4$
Phone: 541-726-3753
:IS... OREGON Building / Sign Permit Inspection Phone: 541-726-3769 •
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-00039
www.springfield-or.g ov pe rmitce nter @s pringfield-or.gov
PROJECT STATUS: Closed ISSUED: EXPIRES: 07/07/2014
STATUS DATE: 01/08/2014 APPLIED: 01/08/2014
SITE ADDRESS: 3626 OLYMPIC ST,Springfield,OR 97478 SCOPE: Banner,Portable Sign
ASSESOR'S PARCEL NO: 1702300001903 TYPE OF STRUCTURE: Commercial
PROJECT DESCRIPTION: Temp sign permit for compliance-COD2014-00020
OWNER: CHANEY NICHOLAS A Phone Number:
ADDRESS: 48570 MCKENZIE HWY
VIDA OR 97488
. CONTRACTOR INFORMATION `
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
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.
Ow er or Contractor Signature Date
Springfield Building Permit 1/8/2014 2:11:00PM Page 1 of 1
•
SPRINGFIELD • CITY OF SPRINGFIELD
•t A ia..ii 225 Fifth St
CO OREGON TRANSACTION RECEIPT 5pringfield,OR 97477
541-726-3753
811-SPR2014-00039
www.springfield-or.gov 3626 OLYMPIC ST permitcenter@springfield-or.gov
RECEIPT NO: 2014000034 RECORD NO: 811-SPR2014-00039 DATE:01/08/2014
(DESCRIPTION - • _,• • ACCOUNT CODE/TRANS CODE , ' ^ AMOUNTDUE
Admin fee(10% of applicable fees) 224-00000-426605 1098 10.00
Banner, Portable 224-00000-425602 1065 100.00
Technology fee(5%of permit total) 100-00000-425605 2099 5.00
TOTAL DUE: 115.00
LI PAYMENT TYPE PAYOR'CASHIER:DBOWLSBY . . --,COMMENTS e; „ y ' AMOUNT
Check northwest gallery 115.00
1096
TOTAL PAID: 115.00
•
•
•
7_5; co4IH -00020
SPRINGFIELD :-::;+- _ -
in CITY OF SPRINGFIELD, OREGON'j` 1
..t v F w• V _ '�? �'....4.i. .. .. .. 1 ` .- e A_r r :,;,,�5:Bd. u m � ,.j
225 FIFTH STREET • SPRINGFIELD,OR 97477q•• PH:(541)726-3753 • FAX (541)726-3689 ..a- t 4•3
City Job Number Sig'o�03 1
's O4 Job Location 36Z G ocy�,,,,. C
C/0)
( Assessors Map 1-7O L3 6 O e Tax Lot 61 701
Phi Business Name L)O,r-gi. Lt)fST Crcei
Business Contact Name L,to 1 e LTA j.t
vl e' �
[ ve -5 Phone 5y/ o 'v0.32
J f /
•.,U-tq Owner of Property 11AIckLiP-i ckaw.e.A.)1 / A/ CMQ+te' y
Address/0 5-70, Ill,', ,i Z/,c) We-ay Phone c 1 22 Z 94'8/
City i/4 State Cr-40 Zip f 7Z'Ye?
r
Contractor/Installer O C 114(eC _
tg
7i Address Phone
K;-Ij City State Zip
0'
0- l� Construction Contractors License# Expires
r�
'i Description .re P si G,WS /cot- cosAltdowter
.---4
Date of Installation NA- Date of Removal /��
4
�4 Permit Fee: mg .00 Depose and applicable f ii S��
J
ail By signature, I state and agree that I have carefully completed this application and hereby certify that
4 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
�i") that temporary signs shall be removed within 30 days from the date listed above. If the temporary
jsign(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
�, area. I also agree to call the inspection line at (541)-726-3769 by the end of the 30th day to request an
X44 inspection to verify the removal of the temporary sign(s). This inspection will begin the process to
W-) return the $100.00 deposit if the m orary sign(s) have been removed.
' � 8 / N
Q) Property Owner Signature the
Date /�
t For Office Use 7 �/
El
4 Date of Application �8�y Job# f/ll/r6eb7 / Receipt# nil'0°43
{ Issued By I5 Amount Collected //C
Shared Drive(T:}Buiiding Forms/Temporary Sign Permit CSD 3-12.doc