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Home My WebLink AboutPermit Signage 2005-5-19 ;;ia. . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line SITE ADDRESS: 526 Harlow Rd ASSESSOR'S PARCEL NO.: 1703220002607 . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00590 ISSUED: 05/19/2005 APPLIED: 05/19/2005 EXPIRES: 06/09/2005 VALUE: Springfield TYPE OF WORK: Banner , TYPE OF USE: New , PROJECT DESCRIPTION: Banner- install 5/27/05 removal date 6/9/05 ' Owner: DIENS REV LVG TR Address: 42130 SE 149TH PL NORTH BEND W A 98045 Contractor Type Sign Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type . Secondary Construction Type: # of Bedrooms: Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction Commercial I CONTRACTOR INFORMATION I O\l\O leQu\le5 'I \l\iliW O~. Oleg<Ei~~s o,elJ!ti'p'1~~lI Date Phone o.iiE~~),,,~ ~rlOote~~> rI,leS al~ ~".nq1. BUILDING'INEORM)ffION'toUgn ~~ne f\)les '0'1 MW.!, 5Z-OU1!,! . cOpiesO' epnone # '"'St~? ",a~ ob\al" ~ote: \\'Ieii~n Helgtl'illilf ~W'\$JJ9otel. ~ on UtWI\'I ~ !I Ft 1st Floor: Type af,til ~Ol t\'le.0(611)-332- ifFt 2nd Floor: Wate'liIlY\l't~ <16,,\8' IS' Sq Ft Basement: Range Type: Sq Ft Garage/Carport Energy Path: Sq Ft Other: Sprinkled Building: .... nla Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Total: Handicapped: Compact: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS I iHr. WORK l'tU "v-' U^l\ cXPIRr. IF NOi U\" pco'^li S,," SIdewalkif~pe:i IS iTl" ,-"WI OUI lH\~ rL.,~" r i\\JiHOfl,IIr.O U~R \5'l'-.~\!,~@titSroiai~W ~~~~i~~~~ Pr.fl,\OO.. I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paeelof2 . . CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2005-00590 ISSUED: 05/19/2005 APPLIED: 05/19/2005 EXPIRES: 06/09/2005 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project F.....PfolW Fee Description + 10% Administrative Fee Banner Special Permit Deposit Amount Paid Date Paid Receipt Number $18.00 $80.00 .$100.00 5/19/05 5/19/05 5/19/05 1200500000000000640 1200500000000000640 1200500000000000640 Total Amount Paid $198.00 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspection requested before 7:00 a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. I R..nlJir..1I In.n..,,uaw Sign Final: After all required inspections are conducted and approved and the sign Installation is completed. 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 of Oregon pertaining to the work described herein, and that NO OCCUPANCY will be made ofany 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. -~--- 'D~ LJ ,,- - Owner or Contractors Signature S-//'/ /",s- Date / / Paee 2 of2 I 225 Fifth Street Springfield, Oregon 97477 54i-726-3759 Phone ') Job/Journal Number COM2005-00590 COM2005-00590 COM2005-00590 Payments: Type of Payment CreditCard , \ , '! , \ " " .'.~ i. ! 5/19/2005 . RECEIPT #: Description + 10% Administrative Fee Deposit Banner Special Permit Paid By DAVID DIENS ....~A1NQFlIlU> , 1Illi'" ,-- ...~ "....-...... . ........ '. 1 ., , , , . ~.~_., ,- .1 i. i.'; ",' ..... ,', C.,..,.. .C) '""w.".;!!: ',-' lllliiiity of Springfield Official Receipt .velopment Services Department Public Works Department 1200500000000000640 Date: 05/19/2005 Item Total: Check Number Authorization Received By Batch Number Number How Received djb 453785 In Person Payment Total: Page I of! 9:16:11AM Amount Due 18.00 100.00 80.00 S 198.00 Amount Paid $198.00 S 198.00 ~; OJ " ..:':11 r:{J1 .""r-If ~ -,,) ,.-I~ 0\ r:{JJ ~ rQ) '.~I ~ ~! ~ ~l ~J l,__~ ., .,-It ~t ~l .~ el ~l e~l ...--1 .--! ~ U Ij l~ .'~i ,i -! ~ f.!!"I\ ' ~j ~! ~) ~! ~! ~! ~l d'G' . !l ~l . . SPRINGFIELD: ' , , ^ CITY OF SPRINGFIELD, OREGON -~~.'---,' ZZ5 F1ITH STREIT. SrRlNGflELD, OR 97477 . rH:(541)72G-37,,:~ . FAX: (541)7ZG-:~(;89 . rA.".,,.,,... ....-- 00 '5:'10 CIty Job Number I..-VVV\ ~ ~ Banner Location 52€- ~(t1W 1<.0 Assessors Map---L/ 0 S 2. '2.. '^(:)t'J 7~c... :;-; 02607 Tax Lot Owner Owner of Property R.. ~b~+- D~~h, ~ Address~ /) 5~_ IL/;~-k... PL Phonp Ll'~. S- - ~ fs' 8 - Q 'fCt CityJ:J ~Ff-l.. ~e.H; State lAJA Zir QgD2s=. , Contractor/Installer '\)~- Address ~. t). Ub'-L. City_~ I B~iA.,p Contraclor <[)~ ~~..c; 7'~ (') -,7 Phonp ~g-q27'-1 ~Q Zip Cl7"iOI <;tate Description ('av- vIA-- I LU CL ~L... 0 P f= Af ';>. 1..-Ih Zt::t)rDate of Removal :1~ ' 2'"~ Construction Contractors Registration # Ex pi rpo 1\1'1' \'\.M -p,v q-fk Date ofInstallation~ Banner Permit Fee $80.00 + Required Deposit $100.00 + 10% Administrative Fee , , By signature, 1 state and agree that I have carefully completed this application and hereby certify that all information herein is lrue and correct. I further agree and understand that the above described banner(s) is not larger than 60 square feet, and will be removed within 14 days from Ihe date listed above. If the banner(s) is not removed within 'the timeline specified, I will forfeit the $100.00 deposit. I also understand that this special permit can be issued only twice per calendar year per development area. I also agree to call the inspection line at 726-3769 by the end of the 14th day to request an inspection to verify the removal of the banner(s). This inspection will begin Ihe process to return the $100.00 deposit if the banner(s) has been removed. Signaturp~, ~e' .- )~, ~ -- Date t5: LJ~l-1-/) '" / Date of Application S"-{' -0)' l:::.~ For Office Use. Job # .cOlMz..oo}...~S-'D Receipt # Issued By Amount Collected I~S~ Shared Drive (f: )IDuilding FonnsfBanncr J'cmlil CSDI.{)3.doc . . . . LEITER OF AUTHORIZATION This letter is to authorize our son David Diens to act on and sign any necessary papers in our behalf concerning the construction of a car wash on property located on Harlow Road in Springfield Oregon (parcel 2 Plat# 2000-P1384.) We The Diens Family Trust own the property under the names of Robert Diens and Diane Diens. Our address: 42130 S.E. l49th PI. Northbend Wa. 98045 Phone number 425 888 5849 'Y-/J- 0 'f Robert Diens Date 01~J ~ Diane Diens 4-/2 - 0<1 Date