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HomeMy WebLinkAboutPermit Signage 2009-10-22 225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~ r. ,AA 1"/)0 O( _01 S-S Z "~ CityJObNumber',OVVf r..-L/_ ..~ Job Location .! 0! n Pc s+~ ( t A ~ . "'"""'"~ Assessors Ma!J \ ~ rf?fl..L:2..r") Q ~ _, ~ Owner of Property ~ Address Ie L (j ?Cl<t-Q \ ~ Cit" '5 ,/,\, I -" -1 -\- " d J ~ Il~~- '-~"~j ~ "J:",~~ 'Contractor. ns ~ ?,2;.!!S!,%Y~~f')C:;:.;;:t1ff:",,'. ,.~: :~ Contractor <; p Arlr1rp~~ ~ ~ ~ 0 r.J) 'j II I~ '. *"!~ @ ~ ~ gj ~ ..,~ ~ ~ i ~ ~ ~ ~ a ~ 'e .~ ... L,-,j I Tax Lot (j)J.DC12- t A ')0-..'-/ I State ~ 5'i/-7'fLf-IB'17:>) .7 Z. cr. 7 (/ 7 7 IJ: Pho!!''' n (2....., phonp City <;;;tate 7.ip Construction Contractors License # Expirpo . Descriptirm Date of Installation f) - )>-- L.} - ,(') '7 Date of Removal );) - ;).4 -P'J'l 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, I will forfeit the $100.00 deposit. 1 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 $100.00 deposit if the banner(s) and/or Portatign(s~b~een remO\/~ /12 _ Signaturl" /' )------71/ j/-:;;J'::ej/\__-- IOft..-e.~ '7 - ...-. , . Date of Application Tob# CCJ -O/~SL _ Receipt # 2ZS- Issued By /:::>/"<: Amount Collecterl Shared Drive (T)/Building FormslBanncr ]ortable Sign Permit eSD 7-08.doc Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-0I552 ISSUED: 10/23/2009 APPLIED: 10/22/2009 EXPIRES: 12/24/2009 VALUE: SITE ADDRESS: 1010 POSTAL WAY ASSESSOR'S PARCEL NO.: 1703222002602 Springfield TYPE OF WORK: Banner PROJECT DESCRIPTION: Banner - 112409 removal date 122409 TYPE OF USE: New' Commercial Owner: DOUBLE S FOODS Address: 302 SHELLEY ST STE 2 ATTN SIZZLER SPRINGFIELD OR 97477 Contractor Type ) Sign Contractor OWNER # of Units: Primary Occupancy Group: Secondary Occnpancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: Frontyard Sethack: Side 1 Setback: Side 2 Sctback; Rearyard Set hack: Solar Setbacks: Street Improvements: Storm Sewer Available: Special Instruction: Notes: Description Type of Construction 1 CONTRAnOR INFORMATION' License I. BUILDING INFORMATION I # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: . Sprinkled Building: n/a I DEVELOPMENT INFORMATION I Overlay Dist: # Street Trees Rqd:' Paved Drive Rqd: % of LotCoverage: I PUBLIC IMP~OVEMENTS I I Valuation Descriotion I $ Per Sq Ft or multiplier Square Footage or Bid Amount Expiration Date' Phone Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compacl: Sidewalk Type: Downspouts/Drains: Paee I of2 / Value Date Calculated I: ~ t: .J ,.Jj CITY OF ~rJ:(11'l\JFIELD 'Building/Combination Permit PERMIT NO: COM2009-01552 ISSUED: 10/23/2009 APPLIED: 10/22/2009 EXPIRES: 12/24/2009 VALUE: Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Paid I Fce Description ***+ 100/0 Administrative Fee*** + 5% Technology Fee Banner Special Permit Deposit Amount Paid Date Paid r Receipt Numbcr '1200900000000001183 1200900000000001183 1200900000000001183 1200900000000001183 $20.00 $5.00 $100.00 $100.00 10123/09 10/23/09 10/23/09 10/23/09 Total Amount Paid $225.00 I Plan Reviews I 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 R'~m; i-I'd Insoectioos I IllIlf 1111 I 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. By signature, 1 state and agree, that 1 have carefully examined the completed application and do hereby certify that all information hereon is true and correct, and 1 further certify that any and all work performed shall be done in accordance with the Ordinances ofthe City of Springfield and the Laws of the State of Oregon pertainiug 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, that each address is readahle 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 construction. Owner or Contractors Signature Date Pa2e 2 on 225 Fifth ~treet Springfield;Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-01552 COM2009-01552 COM2009-01552 COM2009-0 1552 Payments: Type of Payment Check cReceintJ RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department 1200900000000001183 Date: 10/23/2009 Description Banner Special Permit Deposit + 5% Technology Fee '***+ 10% Administrative Fee*** Paid By DAN M BEGIN Item Total: Check Number Authorization Received By Batch Number Number How Received djb In Person Payment Total: 9557 Page I of I 2:57:58PM Amount Due 100.00 100.00 5.00 20.00 $225.UU Amount Paid $225,00 $225.UU 10/2312009