HomeMy WebLinkAboutPermit Signage 2009-4-20
,1.1, .' ,t
~
..~~
@j
~
~1
,a
..~
~
~
.~
~
~
rtIJJ
~
Q
Q
01
~~
~
~
~l
~
~
I~
9
14....J~
e:
=
~
~~
~
=
..~
~
~
'7~ ("" - ("" cQc9 I
Zip 17tjD]
.=J:!J"::.::"'~ -
1l.,;y" .1__ ~__
/. - --..,
ZZ5 FIrm STREET. SPRINGFIEW; OR 97477 . PH:(541)7Z6-3753 . FAX: (541)726-3689
City Job Number (OW\. zc,c> ." ~ 00 s- z- y
Job Locatior //7 cj (CYJ4-7~~ Lec:;/J
Assessors !Vi":' /7032. 22-0 Tax Lot
Owner of Property r ~ ILl- r s: ;; .vrr/f2
Address ~ c3 '7 (:) 1.-4 J?, ).,. r
City Z~ '
Contractor/Installer ~ C::;;'__ff- ~ / 1--- ~ .;.-
Address ,-s/9L/ .I'.l':7---n .fo--n-,.., ~h
<- /. j ,
Citr....--C::P r- ~ '_.1 . k ~ leL\V'r~e. \!~l ;. "'Yz..:- Zip
/ 90(\ \a~ 01e90(\ I \Olln
Construction Contractors\L-ioenkQl~leA 'o~ I\;\e,~e. ale s~n nO.1-
. ~:<;,t:. :,\es id'o ,\;\0513 '~_. 01\1-' "~-\es b'/
-;'''\In\ll11v JCP'/IVi;I. \;\.AU( U
Description ,~.4d,l'1'f"(/!r"n\O\ Goo, .. _.rh6(\e
\,\O\O\'~-B. 9S?-\J~:1 ~'olaifl,\'";~\e'l\;\e ~~~\i\ica\\OI'
1(\ r" U ((\e I \. '\II~ \'
Date ofInstaUation .n" ,0 ^onW'. -~ ull r' ~')Date of Removal
.\JV' a\\1(\9 \\'V \\;\e 01"'" O_'3'3't-t.oJ'
c bel \01 '5 \c80
nU((\ ('onWI I
. Phone
State
D/t-
Phonp
Expires
o 28 ( 0
7c2c" -(0 27 j
i
72C/7;
. /
Ljho /c2ou /
'j /
$202.00 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 display will be
removed within fourteen (14) days from the date listed as the date of installation above. If the display is not
removed within the timeline specified, I will forfeit the $] 00.00 deposit. I also understand that this special
permit can be iss~ed only once per calendar year per development area. I also agree to call the inspection line at
726-3769 by the end of the ]4th day to request an inspection to verifY the removal of the display. This inspection
will begin~. e pro <u .~~urn the.$]OO.OO deposit if e display has been rem~_ i
~ &- /' {:? \\\\:. \f'i'"'\S ~Qi if <5 c,
Signatut~~ /f _ ,4 -\. / -. \ ~ _<2f:.? ~r_pJJ\\i -pate _,L/ .2V/ ( /
e--- ~ - C/ ~ \\0 \ ?~\\W\Y'i, ';)~;\:.\\ W\b ~Q~\:.\) TV! /
i\.l\~~~" \I,. _ .p.r:.~
. ~\.\~,",m:\C-~mt'i'-H ,.-.
'J"~' riE~~ . .
. \.IV"" \) \)1-\' , .
Date of Applicatior If -Z 0 - 0" r:.~'{ \~b# C f} - SZ t.f
Receipt#
Issued By
~
Amount Collectf',1 ?
271
9Z~
Shared Drive(T:}lBuilding Forms/Blimp]ennants_ Balloons 7-OS.doc
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00S24
ISSUED: ( 04/20/2009
APPLIED: 04/20/2009
EXPIRES: 10/20/2009
VALUE:
Status
Finaled
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: \I 74 Gateway Lp
ASSESSOR'S PARCEL NO.: 1703222002410
Springfield TYPE OF WORK: Blimp, Portable S'gn, Etc.
TYPE OF USE: New
PROJECT DESCRIPTION: Penuant - ref:COD2008-00644. Issued expired for code compliance.
_.t'('\~'f..
IPUBLlC IMPROVEME~TS I ~?\?-t. \r;~ \~ ~Q\
"'01\C\:.. .~\i ~\1,~\.""''t~IIi'WJro fQ\'l
\" ?'C.?\w' , \~\)'C.ts; Nf\Q\'1,,"~.
i\\\~ \\OI'SL'C.\) v O? \t?~(iouts/Dra,"s:
~\)i ~'C.~C'C.\) 'C.\'l\O\).
cQ~ ?JO \)1>.,/1'
I>.~'/'\
Owuer: SHEILA S LLC
Address: 3194GATEWAYLP
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Sign
License
__ 'IOU \0 .
....., '" - , 'l. "l~ I
I BUlLDlN(i}H.NFQRMJ\'flONl
I' II 'HIII
,\. U'V~ b~ ,,-- a\~ - O\l-
,\\IO'~' ~\e.c\' 0 {UleS "9"?'-
1'-,\10" xeS ac\C# ~tilt6f.ies:C\\;\ Ol'-r. IUle.s '0'/
\oll<B~ III 0(\ Ce(\ilijll''t,'il'A3~r.u501r~e \;\o(\e
\,\o\i\iCa~s?-oo\f)\p,~(lfffl;{\l~ \\;\e \e~~~lca\iOl\
i(\ Ol\?- '{ou ((\a\%~~r ~ ~ei.l\I\I\~ ~<\).
0090.. ,,\\;\e 'Ral1lleary ~"'3?-?'3
a\\I(\'" ill" "\-"
c \:leI \01 E,,~,\J!g~-P' :
{lUllI cel':5T>rinkled Building:
Contractor
OWNER
# of Units:.
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I DEVELOPMENT INFORMATION I
Froutyard Setback:
Side 1 Setback:
Side 2 Sethack:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees'Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Street Improvements:
Storm Sewer Available:
Special Instruction :
Notes:
I Valuation Descriotion .1
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
Page 1 of 2
Commercial
Expiration Date 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:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Value
Date Calculated
CITY OF SPRINGFIELD
Building/Combination Permit
Status
Finaled
PERMIT NO: COM2009-00524
ISSUED: 04/20/2009
APPLIED: 04/20/2009
EXPIRES: 10/20/2009
VALUE:
225 Fifth Street, Spriugfield, OR
541-726~3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
I, f~es ~~id J
Fee Description
***+ 100/0 Administrative Fee***
+ 5% Techuology Fee
Blimp + Special Permit
Amount Paid
Date Paid
Receipt Nnmber
$8.00
$4.00
$80.00
4/20/09
4/20/09
4120/09
1200900000000000279
1200900000000000279
1200900000000000279
Total Amonnt Paid
$92.00
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 R,~\IlJired In~rection~ I
By signature, I state and agree, that 1 have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and 1 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 withont 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.
I further agree to ensure that all required iuspections 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 durin'g constr c!!.on. .
1/110/6 1"
Dati j /
,
Owner or Contractors Signature
Pa~e 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00524
COM2009-00524
COM2009-00524
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000000279
Date: 04/20/2009
Description
Blimp + Special Permit
+ 5% Technology Fee
***+ 10% Administrative Fee***
Paid By
MICHAEL SCHWARTZ
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
08283d - In Person
Payment Total:
Page 1 of 1
1:31:19PM
Amount Due
80.00
4.00
8.00
$92.00
Amount Paid
$92.00
$92.00
,
4/20/2009