HomeMy WebLinkAboutPermit Signage 2009-10-28
225 Firm STREET. SPRINGFIElD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
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Constru~tion Contractors License #
Expirf'O
. Description
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Date of Installation
Date of Removal
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, 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 renioved 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 wil~egin the process to return the $100,00 deposit if the banner(s) and/or
portable~'gn(S be~n r ~ved.
SignatHT" f- ~- Dat" /0 jg /0 <]
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Date of Applicati""
ltecei pt #
Issued By
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Amount Collected'
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Shared Drive (T:)lBuilding FonnsIBanner_Portable Sign Permit CSD 7-08.doc
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:; 225 Fifth Street;:Sprlngfield, OR:,
, 54i-726-3753 'p6()nei:'!;;~ic,'f~:E;:~ji;;: .
541-726-3676 Fax ". ..' J,r',,'
541-726-3769 Inspection Line "f,'
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CITY OF SPRII~\.Jt< lELD
Building/Combination Permit
PERMIT NO: COM2009-01586
ISSUED: 10/28/2009
APPLIED: 10~28/2009
EXPIRES: 12/02/2009
VALUE:
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SITE ADDRESS:;,/li62 ii;'S'rf(i1ii!l{~ ' .
ASSESSOR'S PARCEe;NO~:';1703351416400
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Springfield TYPE OF WORK: Banner
TYPE OF USE: New
Commercial
'PROJECI: DE$CRlfTION: Bllnner - 110209 removal date 120209
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Owner:
Address:
TRiNITY BAPTIsldnJRC"H
1162 B ST
SPRINGFIELD OR' 97477 ,'.
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<;:ontractor TiP"e~f.. ~~Contractor
Sign . ',.'1"'1 "'1.;'OWNER ..
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# of Units:
Primary Occupancy Group: :S' ;!l' .
Secondary Occupan~y Group: .'
Primary Constiuction'Type
Secondary Construction,Type:
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#'ofBedrooms:'1f~~~-;:""<--;~+, - -= rr; ,i
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Frontyard Setback: 1'''''''''-' ,'.,. - .:' 'h-' ,.
Side 1 Setback:~i , (" ;:, . !
Side 2 Setback:'; " :.
Rearyard Setha~k:,]': ,;".
Solar Setbacks: I, . . '
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Street Improvements: :'... \~l
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Storm Sewer Availahle:;..-......" ."'."".~,
Special Instructjon: I' :~. .', '\
Notes:
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Description ), Typ~ ~f Construction
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I <;;ONTRAC~OR INFORMATION'
License
Expiration Date Phone
B~ILD~~G INFORMA!lON'
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# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION ,..
REQUIRED PARKING
Overlay Dist:
# Street Trees Rqd: '
Paved Drive Rqd:
% of Lot Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS ~
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Sidewalk Type:
Downspoutsmrains:
.
I Valuation Descriotion .1
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$ Per Sq Ft
or multiplier
Square Footage
or Bid Amouut
Value
Date Calculated
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CITY OF SPRINGFIJ'.LU
225 Fifth Street, Springfield; OR,:::!ii ;.
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541-726-3769 Inspectloo'Line", ',.
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Building/Combination Permit
PERMIT NO: COM2009-01586
ISSUED: 10/28/2009
APPLIED: 10/28/2009
EXPIRES: 12/02/2009
VALUE:
Status
Issued '
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Total Value of Project
F~e DescriPtioj~Nf;;~~0~f:f;iij:;ii211!~~J;t~Lnt:aid
***+ 10% Adniinistnitive Fee*** $20.00
+ 5% Technology Fee ,'" $5.00
Banner Special Permit: . $100.00
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Deposit !' , $100.00
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10128/09
10128109
10/28109
10/28109
Receipt Number
1200900000000001206
1200900000000001206
1200900000000001206
1200900000000001206
Date Paid
Total Amount Paid $225.00
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'.f~:!:,~,*-,,!':A,~( < 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 working day, inspections requested after 7:00 a.m. will be made the following
work day. ,)
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Reouir,ed Tnsnections I
Banner ~emo;val: To he requested the day following the expiration of the permit. If inspection is not requested,
the applic,mt:may forfiet the deposit.
.
By signature, I state and agree, that I have carefully examined the comp_leted application and do h~f'eby certify that all
Information hereon is true and correct, and.I further certify that any and all work performed shall he done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described hereiu, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
1 further certify:thafonly contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree !.o en~ure that all required inspections are requested at the proper time, that each address is readable from the
. s~reet, that th~ P.~f'!!'4i~i!fd~10~!'te~ at the front of the property, and the approved set ofplan~ will remain on the site at all
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Owner or Contractors Signature..,;;"_.. . Date
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225 Fifth Street" , "'. .: . ." : ,,",it.
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Springfield, O;'egon:?7477\,~:>>;::
541-!26-3759P4olit;:y .",. "
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City of Springfield Official Receipt
Development Services Department
Public Works Department
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;'N:);';1~;JliEc~i~Ti#;' , : 1200900000000001206
Date: 10/28/2009
3:17:22PM
Job/Journal Number. ~: Desc~iption <" .r ~~~ . -;:
COM2009-0 1586 ,', Banner Special Pefl!lit
COM2009-01586 ,"' ~Deposit,,'>:;';:;o(,
C01\;l2009-0i586; 1!:;:;~f~~~~f~shriRj~~f~e '.
'COM2009-01586Xi>i;,;i*,":(!:JO% Administrative Fee'"
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Item Total:
Amount Due
100.00
100.00
5.00
20.00
$225.00
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Pay.ments:"... '.'t<::~:':':~hi~;;~~:f:.~j'j_?'7
Type oCPayment' <~aid:,By~.:::.\:
CreditCard TIMOTHY CLARK";
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<":heck Number Authorization
Received By Batch Number Number How Received
djb ' 054285 In Person
Payment Total:
Amount Paid
$225.00
$225.UU
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