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Permit Signage 2014-5-13
• SPRINGFIELD- 225 Fifth St A CITY OF SPRINGFIELD Springfeld,OR 97477 y'*t OREGON Phone: 541-726-3753 Building / Sign Permit Inspection Phone:541-726-3769 • Fax: 541-726-3676 PERMIT NO: 811-SPR2014-01026 www.springfeld-or.gov permitcenter©springfield-or.gov • PROJECT STATUS: Issued ISSUED: 05/13/2014 EXPIRES: 06/07/2014 STATUS DATE: 05/13/2014 APPLIED: 05/09/2014 SITE ADDRESS: 2816 MAIN ST,Springfield,OR 97478 SCOPE: Banner, Portable Sign ASSESOR'S PARCEL NO: 1702310002800 TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Banner permit-REF C14-00304 OWNER: SHAMA FAMILY TRUST Phone Number: • ADDRESS: 90567 LURE LN LEABURG OR 97489 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 ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility • N TICE: Notification Center. Those rules are set forth , iH ■ PER T ALL EXP • : IF T WO K in OAR 952-001-0010 through OAR 952-001- U 10RIZ I D U DER TH P R T IS N1 0090. You may obtain copies of the rules by calling the center. (Note: the telephone 1 OP N.90 D 0' IS ABS ND. • 1 FOR number for the Oregon Utility Notification , At 180 lAY PER ! I., Center is 1-800-332-2344). • • V ' v • Springfield Building Permit 5/13/2014 10:14:55AM Page 1 of 1 • SPRINGFIELD -- CITY OF SPRINGFIELD 225 Fiflh St `OREGON TRANSACTION RECEIPT SpnngfiS OR 97477 541-726-3753 811-SPR2014-01026 www.spnngfieldor.gov 2816 MAIN ST permitcenter@springfieldocgov RECEIPT NO: 2014001042 RECORD NO:811 SPR2014-01026 DATE:05/13/2014 [elf-'4:11ammudW fl„h'_ I; 11 4,L;°. 1..._ :_. _:,`1 ACCOUNT CODEITRANS CODE.. = Rnrr_'AMOUNTDUE 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 INWYMENWYTRIMIPTA7fORIMIcAsEuER7ccALAMOMNT:RAIDAIN Check . Marilee Brown REFUND TO MARILEE BROWN 225.00 1209 AT 2816 MAIN St. TOTAL PAID: 225.00 • SPRINGFIELD a - .' ' CITY OF SPRINGFIELD, OREGON " -v-- - ' 225 FIFTH STREET • SFRINGFIELD,OR 97477 • PH:(541)726-3753 • FAX: (541)726-3689 -- 4y City Job Number 5/ 41 " //oat. cD) _'4 Job Location `2, ----i L �A ler fir •,,. �(d. Assessors Map /707— '?'/Q C) 0 —r j O Tax Lot F ) Business Name/ f 171/4"--9/� // ,�, Cp 1 Business Contact Name ffid /7&€. ✓ 4 - Phone.rjL//���� O d Clipe •® Owner of Property _i 4/ <�(2inmQ l b 'it C Lip p<i'C� Phone ��— ( Address I City�p(L State C/OL Zip q 7 87 .„.�--.�IId Contractor/Installer T/2..Q� d 1 Address OR 57 ' .44-- Se Phone d 1 City a State CAL Zip 97 y?8, Construction Contractors License # Expires-- rrrrl} p p 11 Descripti.t / 6 L(1.i.P ' / Iii III _ . I - °i/i l& Date of Installation! n 7/ a Date of Removal rite' 7 jj7-/ t b ( Permit Fee: $225.00 including $100.00 Deposit and plicable fees. J 1 By signature,I state and agree that I have carefully completed this application and hereby certify that e...-44 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 ,e' ,j), 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 area. I also agree to call the inspection line at (541)-726-3769 by the end of the 30th day to request an d 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. Q. Property Owner Signature Date For Office Use d Date of Application Y/V/�V Job# Sl y— /0 ZO Receipt# 2O/t/&J/OYL ( Issued By C-- Amount Collected 22,--Cov Shared Drive(T:yBuilding Forms/Temporary Sign Permit CSD 3-12.doc