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Home My WebLink AboutPermit Signage 2009-4-14 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(54 1)726-375:~ . fAX: (541)726-%89 ~l. COWlZOO i -06 L("l6 ~ City Job Number "~JO C(- ('I( ...~ Job Location . f_ ( :> J ,I. '~'\" ;'( ~ 70" ~ J '. ?':i; Assessors Ma!, I ~ '2 s l.{ Z ~l ~J ~ ~) ..~4 .~ ~ Cit:' ~ ~ ....~~ ~j ;gj I:: -j -j ~j ~j -~ ~ U Ii I~ ..~( il ,j -j ~ ~j ~~ ~, ~::i)) ....~4 ~ ,~~ ~!--:~ . ; ""... , ~ ~ i Date of Application ~: -j ~j d . '.~ Issue By Ml '":l . CITY OF SPRINGFIELD, OREGON SPRINGFIELD - L~ ~.,'~ s-t-r-<- ~. T Tax Loi 0(200 OWller !t'" OwnerofProperty . ~ t-",<.., Uc-ve.lD-r~~+- Addrl'<< Z I ~ 7 0 (y~ l' L- S-}- Phon" S~r::;:"D Zir- '7 7Cf 7 7 State oL COlltractorllll:!!!#er "), . '__ Contr~c'n' y( C/o v {IO (G ( c c'.,-,'....... 0 Addres< '2_ tS~ 0 ( , , ~ -;:, .. c.. s +- I'hon~ "'-( 0 i, s-.s .3= c. ....J r AI I t:N IIUI~: uregon law re~lres you to . '-.-., _' . ('. (' (/1 follow rules adooted by ~ regon Uti~'tv C 7 c. ., 7 City /I/C, "J'h' G "_.;,,u^,__ C>-.. "tate___ ....'u _ __.., In 7.'/ / - \ r......."........""".........'..31'.I'I___r.............................., Il:1 . in OAR 952-001-0010 through OAR 952-001- Construction Contractors License #0090. You m"" "",,,,n nnnlA< nfthA "lle~i.,.< callino t)1e qenter. (Nnte' thA tAIAnhnno V I number for the Oregojl Utility NotificfitioQ/? . ::::::~l:;::~~~ 1'3" ~::::::~::::' ~U'?~ 7 Permit Fee: $225.00 including $100.00 Deposit and applicable fees. By signature, I state and agree that I have carefully completed this application and hereby certify that all information herein is true and correct. I further agree and understand that the above described banner(s) and/or portable sign(s) is not larger than 60 square feet, and will be removed within 30 days from the date listed above. If the banner(s) and/or portable sign 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 30th day to request an inspection to verify the removal of the banner(s) andlor portable sign(s). This inspection will begin the process to return the $100.00 deposit if the ba~er(s) and/or portable sign(s) hasle nJemoved. . NOi\CE: _, PIRE \f lHE \NOR -~..:J- .- /.4 S PERMll SHfi,\.\' E'I. IS PERMll \S ~q1 I U ___ 0 C1 SignaturE' j: -1 /( ~llrD \\\\\lIER lH - ""tw~OM - I ! / ~ ~ '-./ fi,U \ \1Un ~ OR IS fi,BI\\W"" , O omJ\~~~\'~ERIOO. t.f. Il(,~ '1 fi,lMO':ib1#80COf>;, - '1'1 ff' ;; ~O Receipt # b~ Amount Collected /I..r - Shared Drive (T:yBwlding FormslBanrser_Portable Sign Pe~il CSD 7-08.doc Status Finaled CITY OF SPRINGFIELD' Building/Combination Permit PERMIT NO: COM2009-00498 ISSUED: 04/14/2009 APPLIED: 04/14/2009 EXPIRES: 10/14/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2155 OLYMPIC ST ASSESSOR'S PARCEL NO.: 1703254201200 Springfield TYPE OF WORK: Banner TYPE OF USE: New Commercial PROJECT DESCRIPTION: Banner -REF:C0D2009-00277 Owner: POLEN DEVELOPMENT LLC Address: 2197 OLYMPIC SPRINGFIELD OR 97477 Contractor Type Sign Contractor OWNER I CONTRACTOR INFORMATION I License Expiration Date Phone # of Units: Primary Occupancy.Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: AII1lB1UJIlDIN&lNfORMATll=/N I folldw rUles ado ted b ' " L...I' you to NotificatiC#lQfiStQfw<T"h y the Oregon Utility . '. ."., ose rules are t f B In OAR 95aelibtClJJlttmctureh se orth 0090 v '. ,,,rv...g OAR 952-001_ . ,o'nm"ll'Qti:lt\~~I' . II' -"w. -~"' copies of the rules b . ca Ing tlwaterl!f,1'p'1Note: the tele h y number fw, fh.~ ()) . . , Pone C a..~, ~P.o;;;n Utility Notification fElleigy Ratli:<J-332.2344). Sprinkled Building: nla Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION I REQUIRED PARKING Front yard Sctback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Strect Trees Rqd: Paved Drive Rqd: % of Lot Covcrage: Total: Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: I PUBUruM~VEMENTS I lHI~ ~I:HIVIIT ~HALL EXPllSfulfu.lh!ErW,QRK AUTHORIZED UNDER THIS,eERMIT I~NOT COMMENCED OR IS ABAND'Bm'ffiHl1ralDs: ANY 180 DAY PERIOD. Notes: I Valuation Descriotion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Datc Calculated Page I of 2 Status Finaled CITY OF SPRINGFIELD. Building/Combination Permit PERMIT NO: COM2009-00498 ISSUED: 04/14/2009 APPLIED: 04/14/2009 EXPIRES: 10/14/2009 VALUE: "ii ~i -=..~.. . .~ , i ...~.. ...... ...... .- ..... 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project refs Paid I Fee Description ***+ 100/0 Administrative Fee*** + 5% Technology Fee Banner Special Permit Amount Paid Date Paid Receipt Number $10.00 $5.00 $100.00 4/14/09 4/14/09 4/14/09 2200900000000000380 2200900000000000380 2200900000000000380 Total Amount Paid $115.00 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. All inspections 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 Re,ouired Insnections I 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 Springlield 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 \-,,'ill remain 011 the sile at all timesd~ C ~ L/-r Lf -01 Owner or ~ntractors Signature "Date Page 2 of 2 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone ~4ij City of Springfield Official Rcceipt Development Scrvices Department Public Works Departmcnt Job/Jourmt) Number COM2009-00498 COM2009-00498 COM2009-00498 Payments: TYIJC of Payment Check cRcccinll RECEIPT #: 2200900000000000380 Date: 04/14/2009 Description Banner Special Penmit + 5% Technoiogy Fee ***+ 10% Administrative Fee*** Paid By QUIZNOS SUB Item Total: Check Number Authorization Received By Batch Number Number I-low Received djb 3759 I n Person Payment Total: Page i of i 1I:10:18AM Amount Due iOO.OO 5.00 10.00 $1I5.UU Amount Paid $115.00 $115.UU 4/1 4/2009