HomeMy WebLinkAboutPermit Signage 2005-5-19 (2)
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.
. CITY 0.. M'1UIOljljI'lJ1..LD
Building/Combination Permit
PERMIT NO: COM2005-00591
ISSUED: 05/19/2005
APPLIED: 05/19/2005
EXPIRES: 06/09/2005
VALUE:
SITE ADDRESS: 526 Harlow Rd
ASSESSOR'S PARCEL NO.: 1703220002607
Springfield TYPE OF WORK: Blimp, Portable Sign, Etc.
TYPE OF USE: New
PROJECT DESCRIPTION: Blimp -install 5/27/05 removal date 6/9/05
Owner:
Address:
DIENS REV L VG TR
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 I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
--"'e5 yoU to
9f€st'" tll'N ""I.... 'l""'"
,.~_! IV'" ,.~" t'1I ;i1.e Yltl\j""" forth
'0' MIlIUl~IQNli:Q~M""'...l. 00.
1 II ... , I "" I. .-
Notiflcauon ~, ,.-" 0 \hrough U,.....l ---
In OAR 9SZ-001.()01 'n copie~1:tIliS{!.l\es ~piration Date
\I obtai lep\1one
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F<BUILl)lNG~.mMroN'\~""-"
I1J{,IJ_1 .. l.uJ-.JJ.! ,J.. ).
("..enter IS I-ll
# M~torIes:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Commercial
Phone
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
, DEVELOPMENT INFORMATION I
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
.. ~, ,r: 1~lnRK
I PUBLIOiMfiioV,EMENffSlt- UJ'~~~RM\{ IS NOl
I' ,,- n UNucR 1\11 ..,.- coR
^'ITuORIIE.u S ^QSidewlilk:11yjie:
/,\u1fl 0 OR \ /,\U/,\IW-
COMME.NCE. ~ I'E.RIOO. Downspouts/Drains:
I\N"{ 1BO 01\
I Valuation DescriDtion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Date Calculated
Page I of2
Value
.
. LIlY OF ~rKll'\juJ<l~LD
Building/Combination Permit
PERMIT NO: COM2005-00591
ISSUED: 05/19/2005
APPLIED: 05/19/2005
EXPIRES: 06/09/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37691nspection Line
Total Value of Project
F....s P3id I
Fee Description
+ 10% Administrative Fee
Blimp + Special Permit
Deposit
Amount Paid
Date Paid
$18.00
$80.00
$100.00
5/19/05
5/19/05
5/19/05
Receipt Number
1200500000000000641
1200500000000000641
1200500000000000641
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.
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 wltb
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.
~~;; ~~~
Owner or Contractors Signature
.-/
.s;/q /,..,r
Date / ~-
Page 2 of2
225 Fifth Street
\ .
Slmngfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2005-0059I
COM2005-0059 I
COM2005-0059I
Payments:
Type of Payment
CreditCard
. r
.)
5/19/2005
.
RECEIPT #:
Descrlptlon
+ 10% Administrative Fee
Blimp + Special Permit
Deposit
Paid By
DAVID DIENS
inI. GJ;II!LD ,
it"'-' ".'~ '.'.."'.'......,...'.'.......
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.~~ .. i-:llt ."
~ty of Springfield Official Receipt
.velopment Services Department
Public Works Department
1200500000000000641
Date: 05/19/2005
Item Total:
Check Number Authorization
Received By Batcb Nnmber Number How Received
djb 453785 In Person
Payment Total:
Page 1 of 1
9:17:25AM
Amount Due
18.00
80.00
100.00
$198.UU
Amount Paid
$198.00
$198.UU
225 nfm ~1'REET . SfRINGrIELD, OR 97477" fH:(541)726-3753 . FAX: (541)726<,689
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Zip
State
Phone
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Zip~1
Construction Contractors Registration #
State _t:J...J?_
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Date of Installation _r'\It~
Date of Removal_;!UV\.P - q~
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Permit Fee $80.00 + Required Deposit $100.00 + 10% Administrative Fee
By signature, I state and agree that I have carefully completed this application and hereby certify that all
infonnation herein is true and correct. I further agree and understand that the above described display will be
removed within fourteen (14) days from the date listed as the date of installation above. I f the display 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 once 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 display. This inspection
will begin the process to return the $100.00 deposit if the display has been removed.
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nate
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For Office Use
, S; ~ , 5 -6 r
Date of Application
Job# Ct>w\'Z.oor,~S-'.{eceipt#
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':bot(
Amount Collected
Shared Drivc(T:)'Building FomlSlRlimp ]Or1ablcSigl1S_B:lIloonsl -03.doc
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.
LETTER 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. I 49th PI.
Northbend Wa. 98045
Phone number
425 888 5849
<f-/J.-O'f
Robert Diens
Date
&~J ~
Diane Diens
4-/2 - oct-
Date