HomeMy WebLinkAboutPermit Signage 2014-08-07SPRINGFIAEG
225 Fifth St
f -
CITY OF SPRINGFIELD
Springfield,OR 97477
Phone: 541-726-3753
ORON
Building / Sign Permit
Inspection Phone: 641-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01707
v wv .spnngfield-orgov
permitcenler@springfield-or.gov
PROJECT STATUS:
Issued ISSUED: 08/0712014
EXPIRES: 09/07/2014
STATUS DATE: '
08/07/2014 APPLIED: 08/07/2014
SITE ADDRESS: 4136 MAIN ST, Springfield, OR 97478
SCOPE: Banner, Portable Sign
ASSESOR'S PARCEL NO:
1702323201400 TYPE OF STRUCTURE:
Commercial
OWNER: FRISENDAHL RONALD & MARIE F
ADDRESS: 475 RIVERVIEW BLVD
Phone Number:
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie 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.
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Owner or Cotr cte ' a re Date
Springfield Building Permit 80/2014 10:13:46AM Page 1 of 1
LNELD CI"PY OF SPRINGFIELD225 FAth St
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TRANSACTION RECEIPT Spn gfield,OR97477
OREGON 541-726-3753
811-SPR2014-01707
mm.spnngfield-or.gov 4136 MAIN ST permitcenter@spnngfield-or.gov
RECEIPT NO: 2014001711 RECORD NO: 811-SPR2014.01707 DATE: 08/07/2014
DESCRIPTION ACCOUNT CODE/TRANS CODE AMOUNT DUE
Admin fee (10% of applicable fees) 224-00000-426605 1098 20.00
Banner, Portable
Banner, Portable Deposit
224-00000-425602 1065
821-00000-215500 1049
100.00
100.00
Technology fee (5% of permit total) 100-00000-425605 2099 5.00
TOTAL DUE: 225.00
' PAYMENT TYPE PAYOR CASHIER: CCARPENTER COMMENTS AMOUNT PAID
Check Outback auto repair REFUND CHECK TO OUTBACK 225.00
1172 AUTO @ 4136 Main
TOTAL PAID: 225.00
225 FIFFH STREET • SPRINGFIELD,OR 97477 • PH:(541)726-3753 • FAX: (541)726-3659
City Job Numbers/6/ /%d,
Job Location
Assessors Map
Business Name
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Tax Lot
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Address Phone
City State Zip
Construction Contractors License # Expires
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Description
Date of Installation Date of Removal
Permit Fee: $225.00 including $100.00 Deposit and applicable fees.
By signature, I state and agree that I have carefully completed this application and hereby certify that
all information herein is true and correct. I further agree and understand that individual banners and
portable signs subject to this pernit 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
area. I also agree to call the inspection line at (541)-726-3769 by the end of the 30rh day to request an
inspection to verify the removal of the temporary sign(s). This inspection will begin the process to
return the $100.00 deposit if the ry sign(s) have been removed.
Properly Owner Signature - _ `� Date
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For Office Use
Date of Application % l Job # 7 Receipt #
Issued By Atnomit Collected ���