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