HomeMy WebLinkAboutPermit Signage 2006-4-10
225 F1ITH STREET. SPRINGFIELD, OR 97477 . PH:(541)72G.375~' . FAX: (541)72G.3689
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Contractor
Address
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City
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Construction Contractors License #
SPRINGFIELD e::."tt!.:lw::!J'"
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Expirp<
Description 131..".(/\1(91..
DateofInstallation :s/z rb DateofRemoval~~~:-Ob
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Banner Permit Fee $45.00 + Required~9-~posit $1~l\outd!~~(Y'l'~llilyp.~trative Fee
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By signature, I state and agree that [ have'\llH':;-~~\,:tT\Jl1~~!hiSJl~~On and hereby certify that
all information herein is true and correct. I filfiI\~~r ~'tah~~d,&~and that the above described
banner(s) and/or portable sign(s) is not larger m~h ~~ ,~tl].'lffid'will be removed within 30 days
from the date listed above, [fthe banner(s) an ~l\!JlebS\gn is not removed within the timeline
specified, [ will forfeit the $100,00 deposit. [al naerstand that this special permit can be issued .
only twice per calendar year per development area, [also agree to call the inspection line at 726-3769
by the end of the 30th day to request an inspection to verify the removal of the banner(s) and/or portable
sign(s), This inspection will begin the process to return the $100.00 deposit if the banner(s) and/or
portable Signt.(SS))~ ~ ~ remo~.
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ForOjJice Use
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Job # COIMZoOb'OO
, Amount Collected
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Receipt #
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Shared Drive (T:VBuildi"!; Forms/Banner_Portable SiJ;ll Permit CSD S-05.doc
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.CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2006-00425
ISSUED: 04/10/2006
APPLIED: 04/10/2006
EXPIRES: 10/10/2006
VALUE:
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541.726.3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 528 Harlow Rd
ASSESSOR'S PARCEL NO,: 1703220002607
Springfield TYPE OF WORK: Banner
TYPE OF USE: New
PROJECT DESCRIPTION: Banner. Caffe Gourmet. install 032906 removal date 042806
Commercial
Owner: DlENS REV LVG TR 'reS 'loll to
Address: 42130 SE 149TH PL Ofl \a\N re~ll\ Ofl U\\I\\'I
NORTH BEND W A 98045 t>.IIEN1'\ON~?:~~ed b'l th~ ,?::;re set I?~;~,
10\\0\N ru\"'~-, ..of '\ flUO~ ' "k ('\1>.1-1 'd;)~ ., \i'l
NO\\I\(I<(lONTRACcTOR\1NFORMA'F10N'1 ~
'fI 01'-1'1 \l""-~- obta\fI <.;u...'~ t\V' \ele?' IV, "(\
Contractor Type Contractor \0090, 'loll rna;eflter, \NO\e'ti\\\~L,i~_eriselUo Expiration Date Phone
Sign OWNER ..."I\\fl9 the d_~ ('\reQofl U_~ "",41\).
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l\1I"BUlLDlNG llNFORMA TlON I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Coustruction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Fronlyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Total:
Hand~<;.;'tped:
Co~\
So \~~ S ~'\)
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I PUBLIC IMPROVEM!,;Il'lS.1 ~ <o~\'.~~~ \~\~~~'\)~'(..v
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\'.'0,\'(1. :\:.~c,~~~\lbtS/Drains:
c,'\)~~'O\) \)~
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Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
I Valuation Descriotion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of2
.
. CITY OF SPRINGFIELD'
Building/Combination Permit
Status
Issued
PERMIT NO: COM2006-00425
ISSUED: 04/10/2006
APPLIED: 04/10/2006
EXPIRES: 10/10/2006
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Ff>f>"~
Fee Description
+ 10% Administrative Fee
Banner Special Permit
Deposit
Amount Paid
Date Paid
Receipt Number
$14,50
$45,00
$100,00
4/10/06
4/10/06
4/10/06
2200600000000000443
2200600000000000443
2200600000000000443
Total Amount Paid
$159,50
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.
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Sign Final: After all required inspections are conducted and approved and tbe sign installation is completed,
By signature, 1 state and agree, tbat I bave carefully examined the completed application and do bereby 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 tbe Laws of tbe State of 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.
1 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
timesduringconstrucw U c!J4/tJ00
Owner or Contractors Signature
Date
Paee 2 of2
225 Fiftb Street
Springfield, Oregon 97477
54I-726-37~9.Pbone
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Caof Springfield Official Receipt
_Iopment Services Department
Public Works Department
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RECEIPT #:
2200600000000000443
Date: 04110/2006
2:06:02PM
Paid By
CAFFE GOURMET
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
14.50
100,00
45.00
$159,5U
Job/Journal Number
COM2006-00425
COM2006-00425
COM2006-00425
Description
+ 10% Administrative Fee
Deposit
Banner Special Permit
Payments:
Type of Payment
Check
Amount Paid
djb
4038
In Person
Payment Total:
$159,50
$159,5U
cReceintl
Page I of I
4/10/2006