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HomeMy WebLinkAboutPermit Signage 2014-1-28 SPRINGFIELD" 225 Fifth St CITY OF SPRINGFIELD Springfield,OR 97477 '�t � Phone: 541-726-3753 oaEGON Building / Sign Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-SPR2014-00172 www.springfield-or.gov pe rmitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 01/28/2014 EXPIRES: 02/27/2014 STATUS DATE: 01/28/2014 APPLIED: 01/28/2014 SITE ADDRESS: 5892 MAIN ST 7,Springfield,OR 97478 SCOPE: Banner,Portable Sign ASSESOR'S PARCEL NO: 1702343200511 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Banner permit-REFUND TO GREGORY ELLSWORTH @ 5892 MAIN#7-EXPIRES/REMOVAL DATE 2127/14 OWNER: ROBBINS SCOTT B&LISA C Phone Number: ADDRESS: 59805 MEDICINE HAT LN BEND OR 97702 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone _ INSPECTIONS REQUIRED Inspections 6972 Banner Removal Banner Removal: To be requested the day following the expiration of the permit. If inspection is not requested,the applicant may forfiet the deposit. 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. • Owner or Contractor Signature Date • • Springfield Building Permit 1/28/2014 2:29:58PM Page 1 of 1 jSPRINGFIEL® :;�5� = CITY OF SPRINGFIELD, OREGON 225 FIFTH STREET • SFRINGH D,OR 97477 • PH.(541)726-3753 •FAX: (541)726-3689 - -; - J _ Oj City Job Number '' — 6O/7> ",,,,'""34 Job Location �c�'/9� V �t 7 /9y f%.,ea( Chi. 9797 • ; Assessors Map Tax Lot •�i F--ly Business Name /7/://-1777,7 j/' 1 Ca Business Contact Name e; (�-jy./.."7,/X Phone ,j-y/ -7y7 67x7 .) •., Owner of Property ?(pff to Address Phone I Va City „Igall State Let. Zip •, 1 Contractor/Installer Z4 �t Address Phone _4 City State Zip E( 0) Construction Contractors License # Expires c J--� Description /P5r iar� /5,..s7Er Se7.,y 6zperirat4Q.,s/X. a1.4.1-7..«015 4 •.-4 ^ 'V ElDate of Installation L/„ ,,,Aa t, —2 7,20.1i Date of Removal �L i�� ,Zp/4,2‘,/x i Permit Fee: $225.00 including $100.00 Deposit and applicable fees. j 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 ) 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 ...>!--",- a area. I also agree to call the inspection line at(541)-726-3769 by the end of the 30`s day to request an k•'(i inspection to verify the removal of the temporary sign(s). This inspection will begin the process to return the $100.00 deposit if the temporary sign(s) have been removed. i Qj Property Owner Signature Date ( 1 S( For Office Use Date of Application //2q/ 47 Job # S/7- / 7 Receipt# 20/1/OVV/TI :Hit Issued By0 Amount Collected 72 5- Shared Drive(T:Budding Forms/Temporary Sign Permit CSD 3-12.doc • SPRINGFIELD CITY OF SPRINGFIELD 225 Fifth St TRANSACTION RECEIPT Springfield,OR 97477 1- OR ` 591-726-3753 * OREGON 811-SPR2014-00172 www.springfield-er.gov 5892 MAIN ST 7 permitcenter©springfield-or.gov RECEIPT NO: 2014000181 RECORD NO: 811-SPR2014.00172 DATE:01/28/2014 !DESCRIPTION _ _ -_w . -ACCOUNT CODE/TRANS'CODE, AMOUNTDUEr',+ 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 'PAYMENT TYPE PAYOR�aaswER:CCARPENTER -"" COMMENTS� ..AMOUNT;PAID: _ Credit Card GregoryEllsworth 225.00 853975 TOTAL PAID: 225.00