HomeMy WebLinkAboutPermit Signage 2004-09-27Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2004-01190ISSUED: 0912712004APPLIEDz 0912712004
EXPIREST 0312712005
VALUE:
SITE ADDRESS: 1350 MOHAWK BLYD Springfield TYPE OF WORK: Banner
ASSESSOR'S PARCEL NO.: 1703253310000
TYPE OF USE:
PROJECT DESCRIPTION: Banner & pennant permit for warning citation
Owner: COUCHpOTATO
Address: 1350 MOHAWK SPRINGFIELD 97477
Contractor Type Contractor
Phone Number: 741-8286
License Expiration Date Phone
)RMATION
# 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:
law requlres you to
Utility
Notification Center.set forth
i n OAR 952-00 1 -00 lDdhryghtgBR$2-OO't -
0090. You may obtain copies of the rules by
calling the center. (Note: the telephone
nurnber for the Oregon Utility Notification
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
oh of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARI(NG
Total:
Handicapped:
Compact:
nla
/ .I8U DAY PERIOD
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
T INFORMATION
Description Type of Construction
Total Value of Project
Value Date Calculated
LI
LUI\ lI(ALTUK rNrUryJ
Valuation Description I
Status Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676Fax
541-7 26-37 69 Inspection Line
Building/Combination Permit
PERMIT NO: COM2004-01190ISSUED: 0912712004APPLIEDz 0912712004EXPIRESz 0312712005
VALUE:
Fees Paid
Fee Description Amount Paid
$0.00
Date Paid Receipt Number
Total Amount Paid
Plan Reviews
To Request an inspection call the24 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.
Reouired Insnections
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 of any 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.
0-ov
Owner or Signature Date
Pase2 of2
q
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
-tty of Springfield Official Receipt
- evelopment Services Department
Public Works Department
RECEIPT #: 2200400000000001209 Date: 0912712004 e:41:20AM
Job/Journal Number
coM2004-01190
coM2004-01190
Description
Banner Special Permit
+ 7o/o State Surcharge
Amount Due
80.00
8.00
Item Total:$88.00
Payments:
Type of Payment Paid By
CheckNumber Authorization
Received By Batch Number Number How Received Amount Paid
Check DAVENHILL HOME
FURNISHINGS
lkw s 106 In Person
Payment Total:
$88.00
$88.00
9/2712004 Page I of I
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