HomeMy WebLinkAboutPermit Signage 2009-9-22
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SPRINGFIELD.
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City Job Number Co IM\ ZO,C '7 - 0 I LJ e s:
Job Location 2. d'{' :R <)/ /?,c ~r ~g;7) , /'5 7?
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Assessors Man /7- c>';3 - :3. ~-;2 - 3 - ! 3~ Tax Lot I 3 .o{
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Addrpoo
Phopp
City
State
Zip
Construction Contractors License #
Expirf"<
Description
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Date of Removal
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Date of InstaIlatior
Pemlit Fee: S225.00 including S100.00 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 3bove 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 Wl.'ll begin thJocess to return the $100.00 deposit ifthe'banner(s) and/or
portable Sign(~) een removyd.;/
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Date of Application VZ;o/V Job# cry 014&-,5 Receipt#--+! ') ')
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.6~ Amount Collected / / J-
Issued By
shared Drive (T;)IBuil~ FOffi\lI/Banner ]ortabl~ Sign Permit CSD 7..o8.doc
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Status Finale!!.
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, 225 Fifth Street;:Springfield, OR' "
541-726-3753 Phone '
541-726-3676 Fax.
541-726-3769 Inspection Line
SITE ADDRESS: , :l'246 B'ST ,<)i,
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ASSESSOR'S PARCEL NO,: 1703352313601
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: (WM2009-01485
ISSUED: 10/08/2009
APPLIED: iO/08/2009
EXPIRES: 04/08/2010
VALUE:
Springfield TYPE OF WORK: Banner
.' ......
, PROJECT DES,CRIPTION:, Banner - REF: C0D2009-00662
Owne"
Address:
ROBERT L JURGENS REV TRUST
13347 MEEKER BLVD
SUN CITY WEST AZ"85375
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Contractor Ttpeii .;,;. Contractor
Sign OWNER
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Coustruction Type
, Secondary Construc~ion Type:
# of Bedrooms:
TYPE OF USE: New
Commercial
I CONTRACTOR INFORMATION I
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I Pl!BLIC IMPROVEMENTS I
I Valuation Descriotion I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
BUILDING INFORMATION I
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Euergy Path:
Sprinkled Building:
License
Expiration Date Phone
:1
nla
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft <!arage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMA nON I
Froutyard Sethack:;'
Side I Setback: ,
Side 2 Setback: ,i
Rearyard Sethack: ,ii ' ,'1,
Solar Setbacks:
Street Improvements:
Storm Sewer Available: .
Special Instruction:
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Notes:
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Description
Tvpe of Construction
Page I of2
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk'Type:
Downspouts/Drains:
Value
Date Calculated
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CITY OF SPRINGFIELD'
Building/C9mbination Permit
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax", ",' ".;;
541-726-3769In~pecti';ii'Line
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PERMIT NO: COM2009-0I485
ISSUED: 10/0812009
APPLIED: 10/0812009
EXPIRES: 04/08/2010
VALUE: .
Status
Finaled
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Total Value of Project
Fee~ Paid I
,
Fee De.scription'; :i,"~C'
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***+ 100/0 Ad~inisirative Fee***
+ 5% Technology Fee,
Banner Special Permit
'Amount Paid
Date Paid
Receipt Number
, $10,00
$5,00
$100.00
10/8/09
10/8/09
10/8/09
2200900000000001155
2200900000000001155
2200900000000001155
Total Amount Paid
- .
$115,00
I Plan Reviews I
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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 wo,rking day, inspections requested after 7:00 a.m: will be made the following
work day.
I .~ell~i.re~In.~nections I
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By signature, I state and agree, that I 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 Servites Division, Building Safety,
I further certify that only contractors and employees who are in compliance with ORS 70\.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 front of the property, and the approved set of plans will remain on the site at all
times dU~ng :.oJ:~r;cti~n, (;--\tJ tJ.-,..V A (ft.'" \;- () /,., . /
VIII w~~L._' ~'-.\"", or- fJ I; off/o .,
Owner or Contractors Signature ~~ Date I.
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Paee 2 of 2
225 Fif.th Street .
Spririgfield, Oregon:~?1F::"
541-726-3759 Phone"
Job/Journal Number
COM2009-0 1485
COM2009-0 1485
COM2009-0 1485
Payments:
Type,of Payment
Check
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cReceilltl
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'.'RECEIPT#:
2200900000000001155
. Description
Banner Special Pennit
, + 5% TechnqlogyFee
. ,..;.~*,*.+ 10% Administrative Fee***
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'"Paid;By:' .
ROBERT JURGENS
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<;heck Number
Received By. Batch Number
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Page I of 1
City of Springfield Official Receipt
Development Services Department
Public Works Department
Date: 10/08/2009
Item Total:
Authorization
Number How'Received
4546
In Person
Payment Total:
7:54:39AM
Amount Due
100,00
5,00
10,00
$115,00
Amount Paid
$115,00
$115,UU
10/8/2009