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HomeMy WebLinkAboutPermit Signage 2006-4-10 225 F1ITH STREET. SPRINGFIELD, OR 97477 . PH:(541)72G.375~' . FAX: (541)72G.3689 ~, z,"-- ~' C'tyJbN b c.O........-u:>ob-C>c4 ~ ~ I 0 urn er . ::~; Job Location S2' l-hn-lo'-...J~d ..~. 170~ 2-20-0 Assessors M~r fll c:(d.ll ~ Owner of Property ~ ...~~ ~ ~j ~ .~ f, :~> "~(' ~~ ~~ ~j i"='~: ,-- , --. .-, ~, .....1 ~ Q I) I~ ...~j ~. ~' i ~-. ~i ~ f'':''li ~, ~(hJ ...~1 ~ (1!)J ',. -"I~ .Ji:;J) ~. l~~ ~I Q; r:')' Ii ----. ~; (1!)j ~: ~i ~: .!) ~l . . , Tax Lo' V r. ' OU \0 D/~""~ ~V lvC.- .o~it&~I\\I\I\~. , _ ~C\(I\hl..~ o,egv' . ~\ \01\1' Address 4 Z ( "'1 0 5> s>.,,<;\o~.. ~~\e~J j .\~~u\es ~r:In~~\)'~':1 f>.1 ,~. le"'''''V-- \(lV-.~' ,.. ~3" ~ 1\0'l'l IU ce(l\0\.. !'\ \n10u(\ , ,e 1 (Ie Cit.. NCJ(l.,!r\-. 13~.... J \0 _,,(1(1 .' (If)State _.../ ~.I 0 7.iP- , >.'O\I\lV- ,,"-2'\)V' "\'3-1\\ '-C' ,\'(1"'- ,;\\C'3-\Ifi> \~ f>.\'\ ,=,C> ;oj ov I~O\0', ~O\' \(10 " '{ou \\'loa: e(l\el, , (I \.I\,\\t'j "-ol.ol.). \)09v' \ne C ole~o 2:'2:" ' c:> v.-'" ~ r:.'3-\'iI(l~ . In' \~e., ,~.r:,'0.o'~?) . (lu\\'IU'" ce(l\el " Owner CO/ltractor/lnswlLer Contractor Address Phon~ City '>tate Construction Contractors License # SPRINGFIELD e::."tt!.:lw::!J'" " ~ ~ fA ~I:~ 1 rll;P..'\'!!~J'~, .,rl""';'~ ,It, "'," ;'" .._,..;n;.v.J:':-~ (~.yi)}'r."l1"~~' -.'~ ;.,.....w;., :;.-(....__ . ....,.. ".j"~'~'''~O(',f''''''''~ll~1 ",\);l'\., 'Ij:1"'<~.' ., <"'~' ';'f:"A'i"'Ii,~~1 ,.....~,.,~. ~.~b'&1~.@id~:ta. r t..;~ oZbo7 0; 8d-{ S~ Zip Expirp< Description 131..".(/\1(91.. DateofInstallation :s/z rb DateofRemoval~~~:-Ob ( m.. \'t \~ \"" ~(Ji. Banner Permit Fee $45.00 + Required~9-~posit $1~l\outd!~~(Y'l'~llilyp.~trative Fee .\C\U~'t7;".\'"'[ ..,,\t, :\\'\'''' \~u ' . 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~. Signatur/'~~ L--.'"i.~/ . Da,p/P410 ok ForOjJice Use 0", or APPI;~ti=:ft1o b Issued By ~ Job # COIMZoOb'OO , Amount Collected , Receipt # /5' e- Shared Drive (T:VBuildi"!; Forms/Banner_Portable SiJ;ll Permit CSD S-05.doc . .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\(I<(lONTRACcTOR\1NFORMA'F10N'1 ~ 'fI 01'-1'1 \l""-~- obta\fI <.;u...'~ t\V' \ele?' IV, "(\ Contractor Type Contractor \0090, 'loll rna;eflter, \NO\e'ti\\\~L,i~_eriselUo Expiration Date Phone Sign OWNER ..."I\\fl9 the d_~ ('\reQofl U_~ "",41\). , _r.." .. ~'" ._. '....._ 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 ~'\) (_"-\l\\\~~~~~ ~(\\\ I PUBLIC IMPROVEM!,;Il'lS.1 ~ <o~\'.~~~ \~\~~~'\)~'(..v ~\l:<o \lSI"\~~\)S)if~Wlilktt'r.,e: '\~\ \J\\\~ \:\ '\)1" '~(\\). \'.'0,\'(1. :\:.~c,~~~\lbtS/Drains: c,'\)~~'O\) \)~ \'.~ 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. IRf>f]IJ~ 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 ..~.. Caof Springfield Official Receipt _Iopment Services Department Public Works Department ~ 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