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Home My WebLink AboutPermit Signage 2009-5-26 ZZ5 FIrm STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~~ Ii\ (]' ~ ..~ City Job Nnmber l~'. ~~ - -"\ lo ..;~l J~b Location 8\ ~ ~ ..~ Assessors Man \n~4 ~ . '\ - . .--l Owner c:tJ)] ~ Owner of Property ~} ..~ ~ ~ ~, ...~~ ~: ~. II l~ ..~( ~ ~: ~ (f)-Ij .;'!!!!Il ~J 1Q:{i)) ..~~ ~ ~ ~I'-~ """ l --- ~ ~ $;""jl ~ & ~ Ml ::~ CITY OF SPRINGFIELD, OREGON L~ .....~.~ , W1U\ ~r Tax Lot CtR:D\ f\\\lf\~U~ s 'S \-.-tR...- -\ Phonp :;4\=1wl~-\lS '" Zir Cj J Lj 1 Y Addrp<< S'I 'J..,", \J\ C>..\."'- City<'~/~"\ ~t\h ,ContractorllnstaJ#~ \J. ~} Contractor ~ State 0'1<.. .~ ~ ---------- Phonp Addres< -------- Zin "'tate \\' (\J Cit" ~ontractors License # Expirp< Description m~ 5.~~.oq I I'\S.~ Date of Removal (") a U- '1 Date of Installation 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) andlor portable sign(s) is not larger than60 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 time line 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 ofthe banner(s) andlor portable sign(s). This inspection will begin the process to return the $100.00 deposit if the banner(s) and/or portable sign(s) has been remov~d. ./ ' . Signatu'p . ~v'~ ~~L.- . D~tp 5- 2(.,-7 ()CJ '1 V / For Office Use . DateofARflicati?n 5 ~(O.cli-JOb# (\t{-\~LD ~eceiPt#WL11\..~ Issued By ~ Amount Collected 0 ~1~~ (jJ "..",,, . \,,; Shared Drive (T:)IBuilding FonnsIBimncr_POrk1ble Sign Permit CSD 7-08.doc _$I!!I1lII!l!:llii1lfil~,. j '. ,~ . :~. Status Iss u ed CITY OF SPRINGFIELD Building/Combination Permit RERMIT NO: COM2009-00736 ISSUED: OS/26/2009 APPLIED: OS/26/2009 EXPIRES: 06/25/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5733 MAIN ST ASSESSOR'S PARCEL NO.: 1702334400801 Springfield TYPE OF WORK: Banner TYPE OF USE: Addition Commercial PROJECT DESCRIPTION: Banner 5/25/2009 through 6/25/2009 Owner: Address: . NEW ALBERTSONS INC PO BOX.20 BOISE ID 83726 Contractor Type Contractor I ,CONTRACTOR INFORMATION 1 _ License . Expiration Date Phone BUILDING INFORMATION 1 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Constr~ction 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 GaragelCarport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION ,I Front yard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: . Handicapped: Compact: I PUBLIC IMPROVEMENTS I Street Improvements; Storm Sewer Available: Special Instruction: Sidewalk Type: . 1 Downspouts/Drains: Notes: I Valuation Descrintion I Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Pa2e I of 2 Status Iss u I'd CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00736 ISSUED: OS/26/2009 APPLIED: OS/26/2009 EXPIRES: 06/25/2009 VALUE: 225 Fifth Street, Springfield, OR 541~ 726-3753 .Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fee~ P~ig I Fee Description ***+ 100/0 Administrative Fee*** + 5% TechnologyFee Banner Special Permit Deposit Amount Paid Date Paid Receipt Number $20.00 $5.00 $100.00 $100.00 5/26109 . 5/26109 5/26/09 5/26/09 2200900000000000564 2200900000000000564 2200900000000000564 2200900000000000564 Total Amount Paid $225.00 I Plan Reviews I' To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before7:00 a.m. will be made the same working day, inspections requested after 7:00a.m. will be made the following work day. I Reoui"ed I nsnections " .1 II 1 Banner Removal: To be reqnested the day following the expiration of the permit. If inspection is not requested, the applicant may forfiet the deposit. By signature, I state,and a'gree, that I have carefully ex"amined the completed application and do hereby certify that all information hereon is true and correct, and I further certify that any and all w~rk performed shall be done in accordance with the Ordinances of the City of Springtield 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. f Owner or Contractors Signature Date Pa2e 2 of2 r ReceZ No: 2200900000000000564 ~ Line Items: .Job/Journal Numb Tran Cod COM2009-00736 COM2009-00736 COM2009-00736 COM2009-00736 Payments: Method Check 1065 1049 2099 1098 Paid By ALBERT SONS Transaction Log For Date: OS/26/2009 Oescrintinn Banner Special Permit Deposit j + 5% Technology Fee ***+ 10% Administrative Fee*** Received Check ~~ n... , IIh 45901 Page 14 of 19 5/2712009 8:30:47AM City of Springfield Development Services Department Public Works Department Revenue Account No Amount Paid $100.00 $100.00 $5.00 $20.00 $225.00 224-00000-425602 . 821-00000-215500 100-00000-425605 224-00000-426605 Line Item Total: Anproval # How IWu-I In Person $225.00 . $225.00 Amount Paid Payment Total: . cTransactionLog.rpt