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HomeMy WebLinkAboutPermit Signage 2009-9-3 225 FIrm STREET. SPRINGFIELD, OR 97477 . PH:(541)726'3753 . FAX: (541)726-3689 ~ "".AAZoQC' 0 }30~ ~ City Job Number C.VVV' "( - ::~ Job Location /6 ? 0 I.AlflrttV ..~ AssessorsMalJ /7D33b4Z- (Qi ~ Owner of Property ,Su..,ftfL. ...~ I 9'70 ~ Addre~< D ~~ ~ City S?p'~ Statp e>{L ZiF ~ ". , '_~: ....,~~~'~~iA~:tj;;r~:;[~f0i,!',~~~~2::?Tf~~~~~;~1.~,-~~4~!~ff.4;1).~1l:'f~~J};sM~I;~~,;;A,;f:f[ft<6tj~X"'~4fk~0~~{.'~:,,:v,...,~t~'''::s!,'' /"'{;0~~'~7t'3?, ~ U Contracto.rn~tal!e.Tr,~'w~3Y;5j~i:'4'~'!~:1-::;~~1f2E~~i ~i~~E;;~;;~il{-~~~~tt~:fi~~i~~",q,~~ '~~;"iS~.:-';~ ,'f~Wt~'~; ;.".r~1'l"f>.' :-~.J.~ ~~ {~.;;::;-=-*4l:i2~;tfu1G.;"~:;;k~'1',' "~lf;~",....:~i:a'::~~"'''''''''--''-''''~'''''' -~d', ""'. .-~ ./<" .'~"""", ~~'j--_.".- .. .:.-i.....;."'~'~~-, """"'",,~ ,",,~'eI ..~: :; Contractor ~ N crt\.... ' ~ ~ Addre<< I Ciry '~ U II I, '. ..~ ~ ~ ,--j ~ ~:0) "~ ~ ..~ ~ ~ ~ ~ ---=-.: ' ~~ ~ a ~ ~ ':::)1 Tax LOt oof?oo J/II1 A I/tl 51 pj,cmp 17cf77 1>/1nrp ~tate Zip Construction Contractors License # Expup< . Description (>........,h&.L./c" Slf'^- ~ . g'~6'{,.' Date of Installatlnn I' '/ c:: 2..ef".' (c,)~zoor - ooS'<5b r~~ Date of Removal 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 agi-ee 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 banner(s) 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 inspection will begin the process to return the $]00.00 deposit if the banner(s) and/or . portable sign(s) has been removed. U ~Ocz.. Signaturp AMpy. ~ ( C-.. 9/3/09 Datp Date of Application Job# C r - 13.0~ Receipt # __/./') 0 c.j II 0( .-- Issued B~I ~ Amount Collected Shared Drive CT:)lBuilding FormsIBanner ]ortable Sign Permit CSD 7-08.doc Status ,Finaled 225 Fifth Street, Springfield, OR 54 I -726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1870 MAIN ST ASSESSOR'S PARCEL NO.: 1703364200800 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-0I309 ISSUED: 09/03/2009 APPLIED: 09/03/2009 EXPIRES: 03/03/20]0 VALUE: Springfield TYPE OF WORK: Banner PROJECT DESCRIPTION: Portable sign - ref:C0D2009-00586 Owner: SUPER POLLO GRILL LLC Address: 1870 MAIN ST SPRINGFIELD OR 97477 Contractor Type Sign Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: TYPE OF USE: New Commercial I CONTRACTORINFORMATION 1 Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: I PUBLIC IMPROVEMENTS 1 I V aluation DescriDtio~ , $ Per Sq Ft or multiplier License Expiration Date Phone BUILDING INFORMATION' # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: n/a Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: I DEVELOPMENT INFORMATION 1 Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: DownspoutslDrains: Sqnare Footage or Bid Amount Date Calculated Paee I of 2 Value Status Finaled 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, Banner Special Permit Total Amount Paid Amount Paid $10.00 $5.00 $100.00 $115.00 Total Value of Project Fees Prirl 1 Date Paid 9/3/09 9/3/09 9/3/09 Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-0I309 ISSUED: 09103/2009 APPLIED: 09/03/2009 EXPIRES: 03/03/20]0 VALUE: Receipt Number , 2200900000000001004 2200900000000001004 2200?00000000001004 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 Reollirerl Insneftion~ 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. 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, tbat eacb address is readable from the street, that the permircard is located at the front of the property, and the approved set of plans will remain on the site at all times during'construction. ~ (-, l~ OC~CA- CJ/3/0C, Owner or Contractors Signature Date " Paee 2 of 2 225 Fifth ,Street Springfield, Oregon 97477 54]-726-3759 Phone .. ", ---- .rinjf"~,!',,~ "~~''''''','; ai:~ '.- ",. . . ..' ....-- - .., _, ...t~,....._'-",",,- .<.. ..~f' ,J City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 220090000000000]004 Date: 09/03/2009 2:14:38PM Payments: Type of Payment ~aid By' Check .BURRITO BOY INC Item Total: Check Number Authorization Received By Batch Number Number How Received djb ' 1318 In Person Payment Total: Amount Due 100,00 5.00 10.00 $115.00 Job/Journal Number COM2009-0 1309 COM2009-01309 COM2009-0 I 309 Description Banner Special Pennit + 5% Technology Fee ***+ 10% Administrative Fee*** Amount Paid $115.00 $115.00 cReceintl Paee I of I 9/3/2009