HomeMy WebLinkAboutPermit Signage 2009-6-10
225 FIrm STREET . SPRlNGFIEW, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
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Address
City
~tate
Zip
Construction Contractors License #
Expirf"<
, Descriptio'
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Date of Installation l' 0 uaf () '1
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Permit Fee: $225.00 including $100.00 Deposit and applicable fees.
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By signature, I sta.te and agrljli1taHkf1:tl~I~I~~~tt41~e~ication and hereby certify that
all information herein is true aJA<blf?-I5CfBh~b ~ffi1~ mm\mtwt!hat the above described
banner(s) and/or portable sign(~bt~~aw ~ 1A<a~~HWfNi45fdW Wlll be removed within 30 days
from the date listed above. If t ~lafWJ15M'~illRMortiible sign IS not removed within the timeline
specified, I will forfeit the $1 OJ:OO depOSIt. t 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 inspection will begin the process to return the $100,00 deposit if the banner(s) and/or
portable sign~ has been removed. (J " , ,
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Tob # C 7 - g J <( Receipt # I-. <; Z-
-? "7,00
Amount Collected /_/_)
Date of Removal
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Date of Application
Issued By 't,.J'(
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Shared Drive (T:)1Building Forms/Banner ]ortable SigD Permit CSD 7-Q8.doc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541.726-3676 Fax
541-726-3769 Inspection Line
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00834
ISSUED: 06/10/2009
APPLIED: 06/10/2009
EXPIRES: 07/13/2009
VALUE:
SITE ADDRESS: 3032 GA TEW A Y ST
ASSESSOR'S PARCEL NO.: 1703220002200
Springfield TYPE OF WORK: Banner
TYPE OF USE: New
PROJECT DESCRIPTION: Banner - install 061209 removal date 071309
Commercial
Owner: GATEWAY MALL PARTNERS
Address: PO BOX 617905
CHICAGO IL 60661-7905
I CONTRACTOR INFORMATION'
quires you to
Contractor -'ITION' Oregon laW re 0 gon U,l!;ioense,
~I II.: .' the re ,..'-,
OWNE~ '[._,,"' ,.,les adopte~, by _ ,..'no ~rp. set lorth
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NotificatIOn r;BUILJDINGilNF0RMATION.,
in OAR 952-, 'n CO[J,t:, v' ".. ' ,
0090 You may ob#taf, S '-''-' 'he telephone
, n- ~o fOl1les:' .' t' n
calling the ce . ,p. " ' ""jt\l Notlhca 10
b r lor the He.ghtlbf,Strnctnrr
num e ';.1 ~ar.f'Hn"2.r..:;"'1I'
Center 1~'J'pe 0 e...
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Contractor Type
Sign
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storrn Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
Expiration Date Phone
n/a
Lot Size:
Sq Ftlst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION'
REQUIRED PARKING
Total:
Handicapped:
Compact:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Covcrage:
~I J\ltB"tG IMPROVEMENTS I '
THIS PERMIT SHALL EXPIRE IF Tijid~m.w<-rype:
AUTHORIZED UNDER THIS PERMIIJ~~!uts/Drains:
COMMENCED OR IS ABANDONED~ut1
ANY 180 DAY PERIOD.
I Valuation Descriotion "I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-00834
ISSUED: 06/10/2009
APPLIED: 06/10/2009
EXPIRES: 07/13/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
***+ 100/0 Administrative Fee***
+ 5% Technology Fee
Banner Special Permit
Deposit
Amount Paid
Date Paid
Receipt Nnmber
$20.00
$5.00
$100.00
$100.00
6/10/09
6/10109
6/10/09
6/10/09
1200900000000000652
1200900000000000652
1200900000000000652
1200900000000000652,
Total Amount Paid
$225.00
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 Relluired Insne~tions I
Banner Removal: To be requested the day following the expiration of the permit. If inspectioo is not requested,
the applicant may forfict the deposit.
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 I 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 without 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.
1 fnrther 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
';..,~::::~~~ &/;0/ oq
owne~6ontractors Signatnre-t:7 Date
Page 2 of 2
225 Fifth Street
Sprihgfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009.00834
COM2009-00834
COM2009.00834
COM2009-00834
Payments:
Type of ,Payment
CreditCard
cReceintl
RECEIPT #:
iEjr4
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000000652
Date: 06/10/2009
Description
Banner Special Penn it
Deposit
+ 5% Technology Fee
***+ 10% Administrative Fee***
Paid By
JCK RESTAURANTS INC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb 0 I 0399 In Person
Payment Total:
Page I of I
10:52:38AM
Amount Due
100,00
100,00
5,00
20,00
$225.UU
Amount Paid
$225,00
$225,00
6/1 0/2009