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Home My WebLink AboutPermit Signage 2009-6-29 ~ ..~ ~l ~4 .~ ~~ ~ ,Jlj ~ ..~ ~ "~ ~ ~ rtiJJ ~ !1 e; e; ~( ,a; ~l -............: ~ I~ .~ , ~. 8 ~ ~ ~ ~ e . .4,~~ ~ ~ 225 FIrm STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ., City Joh Number COW'! Z.OO ? . oc> 9)"0 JobLociLtion 4t-fC16 M"IVI $+ SDr,,,S,e,ld ~ Assessors M~r ) 7() Z S Ze 0 nR 01471:'6' " 'e> o<.{oo Tax Lot Owner of Property Vecic:e I~-€.U\ lih Address 12s 1,,-de.rV10L~VJc.1 l-Ja1 Cit" ~Orl v1C.J\~ I; . , ~ Phonp O~ Z' it IP" qrY77 Statt' Contnictor/lnstallpT C:>WNC""7\./ / Address ~ Phonp MIICI'.llVI\I. ur~YUlllctVV I t::4U11t::>::i YUU'lO follow rules adopted bv the Oregon Utility ...... .. - , -. "tate' .. .. I"U~"''''''~UVII ,-",;ii' I\vl. 111\..............' o..llv~ ClII:;; .:;II;;~ IV1 ~II in OAR 952-001-0010 through OAR 952-001- Cqnstruction Con1ractors,LicenSe~#J. Y("'ol'r hHl~/ nnbin "'f"1:,io~ nftho rldo~ E}'.pires calling the,.s.3nlIElr. (Note: the telephone Description b '" C; l< qi~r1b<t: for~~.tJfW:QI11Utilitv Notification Center is 1-800-332-2344). '7 !b'j':. 0 Cj Date ofInstallation /,/ L q /0 c; Date of Remon , I , Ci~' Zip $202.00 including $100.00 Deposit and applicable fee~. By signature, I state and agree that i have carefully completed this application and Iiereby certifY that all information herein is true and correct. I further agree and understand that the above described display will be . . '0 " 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 $100.00 deposit. I also unders.tand that this special permit can be issued only once 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 oftj1e display. Thisinspection will begin the process to return the $ 700 deposit if the display has been removed. . Signaturp ~ . / ~ T)ate ?/ZC1,/d) NrmtE: . . Date of Application t(z.~~ ~ ll-:.:r AI nUTI"HF~~_I~ffi~~rAUs~ tTXHt-'I~Kpt ~~ I Ht WU~I\ dnl/rl/ 111v lrt< "rRMIT Ie; ~lnT ~~'~~J~~~e.~~~~~ED FO~eceipt# 72-<; rlllj r I uv iJnl r L.nIUL! ., ~ount Collected 2-62. --. Issued By Shared Drive(T:)lBuilding FonrislBlimp]ennants_ Balloons 7-OS.doc CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00950 ISSUED: 0"6/29/2009 APPLIED: 06129/2009 EXPIRES: 07/06/2009 VALUE: -~~.~!i!~I~I,Q~: ' .il~., . , ~:E Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541"726-3769 Inspection Line SITE ADDRESS: 4490 MAIN ST ASSESSOR'S PARCEL NO.: 1702320000400 Springlield TYPE OF WORK: Blim,p,Portable Sign, Etc. PROJECT DESCRIPTION: Balloon - 062909 removal date 070609 TYPE OF USE': New Commercial Owner: PEACE HEAL TH Address: 770 E 11TH AVE EUGENE OR 97401 I CONTRACTOR INFORMATION 1 Contractor Type Sign Contractor OWNER License . N' 0 on lal"BUllJDINGlINFORMATlON' ATTENTIO ' re? d by the oregon 'UlllllY' ' # of Units: follow rUlescadOtePr eThose rul(#jollStcWles:rth . . -tl"tlfll'-'::ltlon en . '.~ ,...~r. ~nL PrImary Occupancy .6roup:"52_001-001 0 through He.ght.ofStructure S d 0 In eAt." . 'F"'--fH'c "y e~on ary ccupa?~rf'.ai 'I)'du may obtain cOPlets, 'Yl'~~~T~-,,';,aJ: PrImary ConstructlOn-1vpe the center. (Note: I ;Water~ yp.e: . r.r:.qOq U 'I.t t>.l,..hf"~~i'lnn Secondary ConstructIOn TYI!e: for the Oregon tll Range Type: nUllll.:itH 332 ~~A/l\ # of Bedrooms: Center is 1-800- . Energy Path: Sprinkled Building: n/a I DEVELOPMENT INFORMATION 1 Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: . Paved Drive Rqd: % of Lot Coverage: Expirati,on Date Phone Lot Size: Sq Ft I'st Floor: Sq Ft 2,nd Floor: Sq Ft ~asement: Sq Ft Garage/Carport Sq f1t Other: Occupant Load: 'I , REQUIRED PARKING .' Total: . Handicapped: Compact: Street Improvements: Storm Sewer Available: Special Instruction: . I PUBLIC IMPROVEMENTS I , NO IIl"t:. Sidewalk Type: " THIS PERMIT SHALL EXPIRE IF THE wnR~. AUTHORIZED UNDER THIS PERMIT l~b~8fouts/Dra,~ns: COMMENCED OR IS ABANDONED FOR ANY 180 DAY PERIOD. Notes: I Valuation ~escriDtion I Description $ Per Sq Ft or multiplier Square Footage or Bid Amonnt Tvpe of Construction Paee I of 2 , Value " Date Calculated Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Fee Description ***+ 100/0 Administrative Fee*** + 5% Technology Fee Blimp + Special Permit Deposit Total Amount Paid Total Value of Project "I Fe,es ~,~i~, I Amount Paid Date Paid CITY VI' ~rKlJ~GFIELD Building/C~mbination Permit " PERMIT NO: COM2009-00950 ISSUED: 0'6/29/2009 APPLIED: 06/29/2009 EXPIRES: 07/06/2009 VALUE: Receipt Number 6/29/09 6/29/09 6/29/09 6/29/09 2200900000000000725 2200900000000000725 2200900000000000725 2200900000000000725 $18.00 $4.00 $80.00 $100.00 $202.00 I Plan Reviews , 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. wiWbe made the following work day. I, Rell,uired !nsnections 1 Banner Removal: To be requested the day following the expiration of the permit. If inspection is not requested, , the applicant may forfiet the deposit. By signatur~, I state and agree, that I have carefully examined the completed application and do h~reby 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 Servi~es Division, BuildingSafety. 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 a'ddress 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 construclion,/ /" / '~ ,/1 tV~ h/zr/oJ, .. Owner or Contra~tors Signatu~ Paee 2 of2 Date ( 225 Fifth Street . . Springfield, Oregon 97477 541-726-3759 Phone f~lr~~ELO..;id. ,.'.'..'..... jr.. 4Jig . c_~. .- ~,..m ._ ....>...."...,~--,. ..... . City of Springfield Official Receipt Developmeht Services Department Public Works Department Job/Journal Numbe-r COM2009-00950 COM2009-00950 COM2009-00950 COM2009-00950 Payments: Type of Payment Check cReccint 1 RECEIPT #: 2200900000000000725 Date: 06;29/2009 Description Blimp + Special Permit Deposit + 5% Technology Fee ***+ 10% Administrative Fee*** Paid By CROSSFIRE WORLD OUTREACH Item Total: Check Number Authorization Received By Batch Number Number How Received djb 8152 In Person Payment Total: Page 1 of 1 1:20:0IPM Amount Due 80.00 100,00 4,00 18,00 $202.00 Amount Paid $202,00 $202.00 6/29/2009