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HomeMy WebLinkAboutPermit Signage 2009-6-5 " 225 FIITH STREIT. SPRJNGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ..~ City Job Number {\ ,Q-PJXJ "~ Job Location . ,--?XlhO k ~:(' AJ.. ,~ . ..~ Assessors Map VVJoLL-.UJ L{-ax Lot m?::CC> r~~ Fi;;'-.~;F~>l~~~0';;M7.[.~'~i~:I~tt~i{f~~(j>~~&"i"'''''''''i~r:tvrf.j~~~~:J~~~~~;;'~~~~7:lSn~~~~,;.~?\n-~r~I~;;'~"'_;":~3~"tli ~;P~!i~[i0Ei~~~lJl;~~~ri:ZI~~~1{"h~t:dti~;\d~~PZ:bt02~i.;'~\;~:';:,iiJ~i.::~~:~~~l ,<':';,,;~~~;~1~~~~(~,Jr~1;-<~;~'1~ ~ ownerofProperty-ffiJi'r\C.1= \P~ ~ ..~ AddreSs~D/Sl \~'l Q'\e l(6) . p~on"h'{f~~/OD i City <;' D~ r-..Q . State DR- zir:97Lf()d-.... ~ f;[:ffn1fifif!};iiitlidm~1l~~~!~.klJr~;?i!1fifli~'~~~~!~Jf~~~tJl~~;~~IjL~'t~~I~t,~,~R"~0~f~ ~ Li:'.:... ~..&;-.i~.~~-;E;~:-~+.' "'7"'~~~~2ig~~~~~~~\ '.~S;~.""..:::~,::"I{?t:';"&-:{~;"1f.iff}.bt'~~ltit~.:::1:iit:, ,-).',,"#$;:;ts:J"~='''';~'~;'';~::~;:U~''':'E;'l1 .. ~~ ~i ~ ~ I 8 ..... ~ ...' II J. '. ..~ ~ ~~ $SJ ~li)) -. .,..-1( ~ ~ ~i .~ E~ .~ ~~ 1 ~ M Contractpr Addres< SA-mf' A~ Ab['\\ W Pho~f" City ~tate Zin Construction Contractors License # Expirp< - ~('O . Descriptinn 7'\.):1 r'-D Date of Installatin~ 3L:>"-.P - ~ ~ KDden I (')0j \1e~lrow 4'/.7 I . Date of Removal 3",')\,-\ (}'" t ('J~. 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 bannerCs) 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) and/or portable sign(s). This' tion' begin the proce return the $100.00 deposit if the banner(s) and/or portable sign s) h ~ re ",,;,J. / Co~~~d0 Signafurf" Dr tp /. ~ -- ~ i" --' ,- ..t"1?!/-"'~""._.,)" .,,' "X1W.' "4K'" ~:"" /"":. r ""',," '~~^ ~, ~.... _~ ~',,' '" _ "~ - '=~ , . -. "," ~< ~~ " 1. ~. 'lJ ".... ~ \ ,,"" ~.(~Z,~:.tSf;i;"'~"hr~:_{'.)+"~3:;,-t),{~. "~~,~,~.~ ~,;''''',Ji;:.t!\ "i~~'S!I7' _v-Q:!.~h rli-w~ TT 1~'~~;{':I:tf, _~14;;~1J ",n:i~I)~\"",2.-.-0" "f~\- .t:;;"., ,.\'"-J-q,.~l\.D\;; r:'..;:$;;,"",.,~:.,,_. .':,-",,_ ,+; y'" ,-~J,";; &!}, ;);'ii"'-",o: wy.'~. ~~Ot; 'J.~ce uSet;;:...J oft0N ,- / l. :r ~ ",~'-'.";..,c. . '." ;.~ .c.$!;_ e .....~:::', '" ('~~::.~; ~;:;i:~:;::.~t~ . ~ -:-oq":"~~:~'~"i'tq' ;zg~.~<w." ~'.{~~ecei;~:{lilit: ~t1 Issued BY\ ~ l k \ '(" Amount Collected~) j7~6. csoJ Shared Drive (T:)lBuilding FonnsIBanncr]ortable Sign Permit eso 7-08.doc: 22;'5 Fifttt Street Springfield, Oregon 97477 541-726-3759 Phone ~~Q~~fj.." " JIi:.. ~ - ,.,-: ..........."._. ...---~..-.' - City of Springfield Official Receipt Development Services Department Public Works Department Job/Journal Number COM2009-00798 COM2009-00798 COM2009-00798 COM2009-00798 COM2009-00799 COM2009-00799 COM2009-00799 COM2009-00799 <;9M2009=0081J0_ -:s GOM2009'00800 CCOM2009-00800.J ::-:COMZ009'0080P Payments: Type of Payment Check cReceint I RECEIPT #: 2200900000000000617 Date: 06/0512009 Description Banner Special Permit Deposit + 5% Technology Fee ***+ 10% Administrative Fee*** Banner Special Permit Deposit + 5% Technology Fee ***+ 10%" Administrative Fee"** Banner Special Permit Depos it + 5% Technology Fee ***+ 10% Administrative Fee*** Paid By OREGON HORSE CENTER Item Total: Check Number Authorization Received By Batch Number Number How Received 4096 In Person Payment Total: nJffi Page I of I 2:03:28PM Amount Due 100.00 100.00 5.00 20.00 100.00 100.00 5.00 20.00 100.00 100.00 5.00 20.00 $675.00 Amount Paid $675.00 $675.00 '6/5/2009