HomeMy WebLinkAboutMiscellaneous Miscellaneous 2001-7-17
--
.. City of Springfi.
Voucher
Report ID : SPRA 103
Voucher 10 : 00034959
Handling Code: RE
Thurston Medical Clinic
5781 Main St.
Springfield, OR 97478
Oescriotion
Account Fund OrQ
Refund of Banner permit
215500 821
Comments:
Banner refund of job number 01-00569-01
Ok'd by Bob Barnhart
51~(
~
Vendor Number: 0000006685
Invoice Date: Ju117,2001
Invoice # : 7-17-2001
Approver : Puent,Oavid
Operator: WILS5940
Gross Amount: 100.00
SubClass BY Proi/Grant Amount
2001 100.00
*
,...
,
.,
I Job# 01-00569-01 I
-
Page 1 of2
CITY OF SPRINGFIELD, OREGON
COMMERCIAL PERMIT
City Of Springfield
Community Services Division
Building Safety
Job Number: 01-00569-01
225 North Fifth Street
Springfield, OR 97477
Office: 726-3759
Inspection Line: 726-3769
Location Of Proposed Site: 5781 Main St Spr
Assessors Map#: 17023341
Lot: Block: Addition:
Tax Lot #: 03500
Subdivision:
>>.
,
Owner:
Francis Carrington
PO Box 1328
Phone Number:
Address:
City/State/Zip:
New
Eureka, CA 95502
Value: $0
Scope Of Work: Banner
Thurston Medical Clinic
Contractor Type
Sign Contr
Contractor
Signs Now
1570 West 7th Avenue, Eugene, OR
97102
Registration # Expiration Date
Phone
Quad Area:
# Of Units:
Constr. Type:
Water Heater:
Office Use
Land Use:
Zoning Code:
Bedrooms:
Range:
# Of Buildings:
Occupancy Group:
Heat Source:
Sq. Footage:
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
working day.
Final Sign
Required Inspections
I SiRn I
-After all required inspections are conducted and approved and the sign installation is complete.
Construction Types:
Occupancy Groups:
# Of Buildings:
# Of Bedrooms:
Handicap Access? 0
rArea (Sq. Feet)
Main: Accessory:
# Of Stories:
Current Units:
Census Code: Does not apply
Height (feet):
Proposed Units:
Total:
D
3:
--< --<
""''"'
;ODD
::J;;r1~
0..#
("') ..~..
D I'JC:O
Ci) :z:.....,.
:c ... I
......("') 00
1'T1:I:"""'010
;::O::Dco 0
.. ::ZOI'.Jl.n
om- 00-.
0lT100o-.
U'l"OI-'-W
../
,\
1
I
Job# 01-00569-01
Type of Sign:
.
Page 2 of 2
Face Type:
, Sign District:
,Sign Di. ,. ~i~" ~
I Vertical:
Height (Above Grade):
Sqr. Footage:
Illumination? D
Comments:
Horizontal:
Thickness:
From Grade To Bottom:
Sign Material:
Fee Paid On Receipt# Value/Quantity Fee Amount
Silln
Banner Permit 06/05/2001 5668 1 $80.00
Deposit for Banner/Blimp/etc 06/05/2001 5668 1 $100.00
Total Sign $180.00
Grand Total $180.00
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 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 $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 14th day to request an inspection
to verify the removal of the banner. This inspection will begin the process to return the $100.00
deposit if the banner has been removed.
Signature
Date
:\
JUnlD4-01 03:36P
.---
I
.
P.02
SPRINGFIELD
225 FIFTH STREET
SPRINGFIELD. OR 97477
(541) 726-3753
FAX (541) 726-3689
BANNER PERMIT
COMMUNITY SERVICES DIVISION
225 Fifth Street
Springfield, Oregon 97477
,/!iannerLocation: 5181 '1Q1\~ .')h..+
-r.""'r""\ or- \
AS!lelBon Map II: ." 1'\'l0.;r:I.i\.\ . . .: - ""'"'
<,
vOwner of Property: v-. Jro/V\, J'" ~ ',;,.,,,, tun
v Address: ~D ~ \~f)-<6 J
...c;ty: r 11r:e..to..~
,)~~'" 1~.)
Address: /57LIAl "I ~ ..L,!_'t:lJ..!.L.
City: 9.bYt'
ve;;;.tractorlInstalIer:
Constmction Contractors Registration Number:
VDesCriPtiOn~ f\1\olt)
Date of installation: \...Q . \. ()\
Banner Permit Fee S80.00
Office: 726-3753
INSPECTION LINE: 726-3769
Tu Lot ()~}:2lJ)
~e/l:
i--State:~ ~: Q~
Phone /I:
State: beB~ t>>J
Zip: qgi/tJ.;l
Expires :
Date of Removal:
\0.\4.0\
Deposit Required S100.00
By signature, I lIate and agree that I have carefuIly completed this application and hereby certify that all
information herein is true and correct. I fmther agree and understand that the above described banner (s) is not
larger than 60 square feet, and will be removed within 14 days from the date listed above. lfthe banner(s)
is not removed within the timeline specified, I will forfeit the SIOO.OO 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
126.J76Q by the end of the 14th day to req1ICSI an inspection to verify the removal of the banner(s). This
inspection will begin the process to return the SIOO.OO delXlsit if the balUler(s) has been removed.
r?~'~"~
C9Lt lodol
Date .
OFFICE USE
Date of A'("lication: l<2. ~ . () \
1j00:~l3IHS\i::J IssuedBY:U~ CNroO{? .J
: 39N\iH::J . '-J \ \
OO'OBt $ G:G::J3~ lW\i
tOOG 90 Nnr:31\iG
B99IjOOO-tO:~SN\i~1
JUN-04-2001 03:56PM
TEU
Job II: \)\ .t~ Receipt #: '6 \.a. 'u, ~
Amount Collected: \ ~D .00
IDlTHURSTON MEDICAL
PAGE:002 R=98%