HomeMy WebLinkAboutPermit Signage 2014-08-22SPRINGFIELD
225 Fifth St
' CITY OF SPRINGFIELD
Springlield,OR 97477
.(
Phone: 541-726-3753
- '"' OREGON Building / Sign Permit
Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-SPR2014-01829
www.spdngfield-ocgov,
permits nter@spdngfield-ocgov
PROJECT STATUS: Finaled ISSUED:
EXPIRES: 02117/2015
STATUS DATE: 08/22/2014 APPLIED: 08/22/2014
SITE ADDRESS: 5658 MAIN ST, Springfield, OR 97478
SCOPE: Banner, Portable Sign
ASSESOR'S PARCEL NO: 1702334103000 TYPE OF STRUCTURE: Commercial
—P ROJ EGfDES CRI P-TIO Nva nn er-fo rc-om pliance—ha s-be a n-re move d(n o-Deposit)
OWNER: PSMMR LLC
Phone Number:
ADDRESS: 3474 SPRING BLVD
EUGENE OR 97405
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type
Lic No Lie Exp Phone
INSPECTIONS REQUIRED
Inspections
By signature, I slate 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 Stale 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. 1 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 8122/2014 8:51:58AM Page 1 of 1
5PRINGFIELD CITY OF SPRINGFIELD
t 225 Fifth Sl
TRANSACTION RECEIPT Springfield,OR 97477
OREGON 641-726-3753
811-S P R2014.01829
www.spdngfield-ocgov 5658 MAIN ST permits nter@spdngfield-ocgov
RECEIPT NO: 2014001852 RECORD NO: 811-SPR2014-01829 DATE: 08/22/2014
DESCRIPTION ACCOUNT CODEITRANS CODE AMOUNT DUE
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
PAYMFNT TVPF PAVOR CASRIER:CCARPENTER COMMENTS AMOUNT PAID
Check George Conway
115.00
TOTAL PAID: 115.00
H
225 FIFIT-I STREET e SPRRVGFIELD,ORR9774777 • PH:(541)726-3753 • FAX: (541)726-3659
City Job Number S�4 L /
Job Location
Assessors Map
Business Frame
Tax Lot
Business Contact NameCMzr'Co0VJ�1 Phone`JZYf
•,. Owner of Property
c Address �L( *I
City u�P tV _ State,_O�L_ Zip t-1 L105
Contractor/Installer
Address
Construction Contractors License #
Date of
State Zip
Expires
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 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
area. I also agree to call the inspection line at (541)-726-3769 by the end of the 30th 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 temporary sign(s) have been removed.
Proper -0) Owner Signature
Date
For Office Use
Date of Application Job #
Issued By
Receipt # ?01"/ Ob / Pf z
Amount Collected
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