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HomeMy WebLinkAboutPermit Signage 2009-10-6 225 FIFI1-I STREET. SPRINGFIELD; OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 5! ..~ ..~ ~ n Assessors Ma~ ~ / .. ~ Owner of Property _ ,/~Y1 t; ~ Cit:, ~ ~. Contr~ptnr ....~ ~ i a Ii I, '> ..~ e ~ ~ ~ ~1hJ ...~ rt#)J ~ ! o ~ I ~ . -D L(7( City Job Number CO""" wo 7 { Job Location Ih/J h/'Ju.J IL.. (V) c..DOV1&f Id, 5> 170~Z5.:s( ISbY pUoI-fAWK. () f>Po 0 Tax Lot Address ! S {, t; 1YJ6 t, a LlJ IL. (;f/ll1t ~'.eIJ 14!ud PJ-,,'"P 7L/6 - 7't56' Zit: "I i'-l7 7 State 6A. Addreoo phonp City State 7.ip Construction Contractors License # Expip>o , Descriptinn 14"",,,, -e I' Date of Installation J" - "6~ "'1 //- "6 - " 9 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 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 banner(s) and/or portable sign is not removed within the timeline specified, lwill 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). Thisinspection will begin the process to return the $100.00 deposit if the banner(s) and/or portable sign(s) has been removed. Signaturp \;)4s"".JL S ->~V\ d~av D~tp 16- Dt- 09 Date of Application /0 -{;, - 0 Tob# Receipt # ZZs:-- Issued By pC{ Amount Collected Shared Drive (T:)lBuilding FmmslBanncr_Portable SignPcnnit eSD 7.;.Q8.doc Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01471 ISSUED: 10/06/2009 APPLIED: . 10/06/2009 EXPIRES: 11/06/2009 VALUE: 225 Fifth Street, Springfield, OR';..,':,:. . 541-726-3753 Phone:' . :....,:,.:,i :;'<~. ;. : ~1:.':;.~,. ":,,.:..~'~.~.:.:'.-.. 541-726-3676 F~x ''.:.".3;'''', . ',( .....:.,.'."; 541-726.3769 hisp'eciion Line . , '.~~ . '. }:..; ,\ .~: " .' SITE ADDRESS: ~'1565 KioH:\\VK BLVD ASSESSOR'S PARCEL NO.: 1703253106800 Springfield TYPE OF WORK: Banner TYPE OF USE: New PROJECT DESCRIPTION:.. B~n~er" install 100609 removal date 110609 ;":'> '. /"::: ,-~;': ,.::;. -/~~r;~~);':.,':. ?.... Commercial . Owner: ;, Address: MtDoNAIns CORP 036-0023 1565 MOHAWK BLVD "SPRiNGFIELD OR 97477 . I , , ICONTRACTOR INFORMATION I Contractor Type Sign ~~ 11 " Contractor ,~. OWNER :'; " License Expiration Date Phone -::.' ...~, .~':l...-~, ~" ~. ": {. . . ;, t BUILDING INFORMATION I " ,.! ~ :, '. # of Units: C" "jhl"-' ,::' Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: .-, # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: .......f.~ , " .;., . tA', '.. },"}.j>.. "{to . if: .;.! l' '~} HI -:.,', .~. . \ I;l~'!' - .... \ n/a : ! I:, { ~ : ~ ,. \ . .1i~,:il-f+') . ~:: :t -'j' '~' I DEVELOPMENT INFORMATION I Frontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: ii . ;, . ;i' ~ . 1.' . . .. , Overlay Dist: # Street Trees Rqd: Paved Drive Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: .. :;, o .....~-:1:7"-..... ." . '~i ~ \ '. . Street Improvements: .:' I PUBLIC IMPROVEMENTS I . Sidewalk Type: DownspoutslDrains: " Storm Sewer Available: Special Instruction: . ," ~ 'J" Notes: ::.-\.o. . . I'B.. ~ ~,_rr Description' ;f; .1'1I_!' ~ \ . A ~ \' I . '. . . t ll.f.I;'.....l .... .1r:.~' t! .' i. Type of Construction . ,. I Valuation Description I ',"r:.' ,. $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated " .h.~.. !. ~,~ i .;: , '. ... l~to" t.;, Pa2e 1 of2 '~r .:: ~~ .. to' I' .:: ..;:' , CITY OF SPRINGFIELD Building/Combination Permit : ," '/, :'1;, /"-',~, . . Status Is~~~d(',' ., . . :"'IS<' . .. \~25 Fifth Stre~t;:Springfield,.OR'i 541-726-3753 Pii'one'f;:)i{!.H:Vi;:~;. ,... 541-726-3676 Fax .' ... "'.~!'it . 541-726-3769 Inspection Line PERMIT NO: COM2009-01471 ISSUED: 10/06/2009 APPLIED: 10/06/2009 EXPIRES: 11/06/2009 VALUE: Fee Description. ***+ 10% Administrative Fee*** + 5% Technology Fee . .' . ,". Banner Special Permit " ." ,;.~ Depos't ..t :! ., ;.~~'r.:' .f-; '.-( .:-4~' I ;~/\;;:;:~~~Ji~l:~' !:. '.,' 'r 'l' -..t,. '. "1;,. ~ .t,. . l'.' " .. ~ . Total'Amount Paid -t ,~H. 1.' C~:- .'.~r.<-l. ,. Total Value of Project Fee. Paid I 'Amount Paid :" Date Paid Receipt Number $20.00 .;:, $5.00 $100.00 $100.00 10/6/09 10/6/09 10/6/09 10/6/09 2200900000000001138 2200900000000001138 2200900000000001138 2200900000000001138 $225.00 .j, ';". . " '~\' .,,. I Plan Reviews , t) To Request an in~pection calf the 24 hour recording at 726-3769. All inspections requested before 7:00 a,m. will be made the same wo~king day, inspections requested after 7:00 a.m. will be made the following . workday; . .+,' \".' . I ' , ;~r"1~.i! :Ll. I. , I . Reouired T ".oectio", I Banner Removal: To be requested the day following the expiration of the permit. If inspection is not requested, the applicant may forfiet the deposit. .' _~, :~f' ~. , " '; By signature:i ~t~ie'~~d agree, that I have carefully examined the completed application and do hereby certify that all' informati"n, he!il!'.!. i~. tr,ue and correct, and I further certify that any and all work performed shall be done in accordance with the Ordinances of t1i~ ,City. of Springfield and the Laws of the State of Oregon pertaining to the work descrihed 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, that each address is readable from the street, that the permit card is located at the iront'of the property, and the approved set of plans will remain on the site at all . , .' ..<t-..... - . . times during construction. . i :;;L ...! " ~! . ,,;;) jl '.. " ~'i _~..'!I"",.~"", f:., j.t. ';':~a/ (;). c:; < ,~ '.., ..,-'r ','0' ; Owner.or Contracto'rs Sig~ature~__ .~ /b" {- "'1 Dafe .\.i t ,', 1: .;,~ :,:~~~~ r ' : :. ..:l. . :{~. t :ik~;;J~, < . . :H! .1.5; ::::~'\'. .to j:{:' , ,. Page 2 01'2 225 Fifth Street.ll ' ij "ell " ; -;, .>. Sptingfield,Oregon'97477 541-726-3759 Phone Iii ,,:,;... .' :1 , \ City of Springfield Official Receipt Development Services Department Public Works Department ",'. ,i RECEI~T#: .,C 2200900000000001138 Date: 10/06/2009 10:11:46AM Job/Journal Number;. .~escriptiori . :;:~:c.:~~..~( ,;' . COM2009-0 1471 . ::.-,. :Baimer.Speclall!ennit COM2009~0 14 7r!*~!'-;;;;1?,fMsif:;C;;;;i;W'J~~:{" .' COM2009-0 1411,:.:f;'}:'(f+:S%Te'chn~logy Fee "}",-,:,"""., COM2009,01471 'c.:,!"." ,?~;~+ 10% Administrative Fee*** . '~;ri:~~,:":' ". ':' "';,)~:'i'~~:~+2C;:F11~;~;:~;:?i>~.' <i .:.;"' . Item Total: Amount Due 100.00 100.00 5.00 20.00 $225.00 Payments: Type of Payment 'Paid 'By . Check Number Authorization Received By Batch Number Number How Received Amount Paid CreditCard 'SANDHARCO,RP.S .' ,:;~;~;~'~t~,;)'"~}';!;%~Ws!,::;" ;': djb 006618 In Person Payment Total: $225.00 $225.00 ".1. ". i' ~...;~,<, '. ..,. ',,..',::)'.':r,.~:, , " ..i',', ; '<f' ,i'l, ;. .,: " "1::-') r:;t\' .... 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