HomeMy WebLinkAboutPermit Signage 2009-10-20
225 FIITli STREET . SPRlNGITELD,OR 97477 . PH:(5.41)726-3753 . fAX. (541l726-3689
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Construction Contractors License #
Expire"'
Description '"EA-MV~tZ.
DateofInstallatio' JY~~ 9 ,DateofRemovo1 /P0'
Permit Fee: 52.25.00 including $100,00 Deposit aod applicable fees.
By signatuJ:e, I state and agree that I have carefully completed this application and hereby certify that
all infonnation 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, ahd will be removed within 30 days
from the date listed above. If the banner(s) and/or portable sign is not removed within thetimeline
specified. I will forfeit the $100.00 deposit. I also understnnd 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 30tll day to request an inspection to verify the removal ofthebanner(s) and/or portable
sigu(s). This inspection will begin the process to return the $100.00 deposit if the banner(s) and/or
portable sign(s) has been removed.
SignaturP.# /t 2;;7', J%~r/",-- Dat.. /C..j;YbJ
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Shared Dri~ {f;Y9Wldmi Forms/B.mncIr]QrtItIlc Sian PJ:mJit CSD 7:0B,doo
Status
Iss u ed
CITY OF ~rKll~lIl'lj<,LD
Building/Combination Permit
PERMIT NO: COM2009-0]535
ISSUED: 10/20/2009
APPLIED: 10/20/2009
, EXPIRES: 1111612009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS:' 1650 CENTENNIAL BLVD
ASSESSOR'S PARCEL NO.: 1703253403900
Springfield TYPE OF WORK: Banner
TYPE OF USE: New
PROJECT DESCRIPTION: Banner - install 101609 removal date 111609
Commercial
Owner:
Address:
MERCURY DIME, LLC
PO BOX 26125
EUGENE OR 97402
I ~ONTRAC~OR INFORMATION'
Contractor Type
Sign
Contractor
OWNER
License
Expinition Date Phone
BUILDING INFORMATION'
# of Units:
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 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupa,nt Load:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS'
Street Improvements:
Storm Sewer Available:
Special Instruction: '
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation Descrijltion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Sq uare Footage
or Bid Amount
Value
Date Calculated
Page 1 on
L1 n' OF SPRINGFIELD
Building/Combination Permit
Status
Issued
PERMIT NO: COM2009-01535
ISSUED: 10/2012009
APPLIED: ]0/20/2009
EXPIRES: 11/]612009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line.
Total Value of Project
Fe~~ P!,irl I
Fee Description',
***+ 100,10 Administrative Fee***
+ 5% Technology Fee
Banner Special Permit
Deposit
Amount Paid
Date Paid
Receipt Number
$20.00
$5.00
$100.00
$100.00
10/20/09
10120/09
10120/09
10/20/09
2200900000000901200
2200900000000001200
2200900000000001200
2200900000000001200
Total Amount Paid
$225,00
"
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. will be made the following
work day.
R.elluirerl In,nection'l
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 signature, I state and agree, that I have carefulJy 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 he.rein, 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 front ofthe property, and the approved set of plans will remain on the site at all
times during construction.
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Owner or Contractors Signature
Date
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Page 2 of2
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'-. ....
225 Fifth Street'
, '
Springfield, -Oregon;~74 77
541-726-:3759 pJioii( Yr-
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
.2200900000000001200
Date: 10/20/2009
9:58:IIAM
Job/Journal Number:', De;cripti~n.:;..'~');'~~',,'
COM2009-0 1535 ,;\~,: ;ii3~i):nerSp~6i~iP~rmit
COM2009-0 1535 "'~Dep~sit'-' ,
COM2009-01535 ,.+ 5% Techn~logy Fee
COM2009-01535 "i*'~+l ?%,':'-dministrative Fee'"
Item Total:
Amount Due
100,00
100,00
5,00
20,00
$225.00
Payments:
Type of Payment
Cash
Paid By
BURL HAYES .,""
. . .; . ~;~;;:: '; :'::~?::': :.:::", "
Check Number Authorization
Received By Batch Number Number How Received
djb In Person
Payment Total:
Amount Paid
$225,00
$225.00
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cReceiotl
Page 1 of 1
10/20/2009