HomeMy WebLinkAboutPermit Signage 2009-12-28
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\ CITY OF SPRINGFIELD, OREGON
SPRINGFIELD \",
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225 rIml STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
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City Job Numbe' (0""-'1 2.<=> c::> Y _ e::. ( y~ f
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1703Z S-:S:S
Tax Lot
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State
Contractor/Installer
Contracto'
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City
Statp
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Construction Contractors License #
Expirp<
Description
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Date of Installation' I 2- f ~ 0 .,
Date of Removal 0 ( I !? 10
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Permit ~5.0'!.J!iJlluding $100.00 Deposit and applicable fees.
. By signature, 1 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, [ 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 I begin the process to return the $100.00 deposit if the banner(s) and/or
portable sign(s) has b emoved.>
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Date of Application I z;/zr '
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For Office Use
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Receipt #
Issued By
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Amount Collected
Shan::d Drive (f:YI3uilding FormslBanner_Portable Sign Pennit CSD 7-08.doc
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01838
ISSUED: 12/28/2009
APPLIED: 12/28/2009
EXPIRES: 01118/2010
VALUE:
225 Fifth Street, Springfield, OR
541c 726-3753 Phone
541- 726-3676 Fax
541- 726-3769 Inspection Line
SITE ADDRESS: 1300 Mohawk Blvd
ASSESSOR'S PARCEL NO.: 1703253310200
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Springfield TYPE OF WORK: Banner
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Banner. 121809 removal date 011810.
REF: C0D2009-00833
Owner: ,JAMES M BROWN REVOCABLE TRUST
Address: 1406 MOHAWK BLVD 175
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATlO~ I
Contractor Type
Sign
Contractor
OWNER
, License
Expiration Date Phone
B,V1LDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Constrnction Type:
# of Bedrooms:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sp'rinkled' Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lof Coverage:
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Str-eet Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation Descrintion I
Description
Type of Construction
$ Per Sq:Ft
or multiplier
Square Footage
or Bid Amonnt
Value
Date Calculated
Pa2e I on
._~~y!I~~F;I~4?,'
1
Status
Issued
CITY OF ~t'Klj~GFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01838
ISSUED: 12/28/2009
APPLIED: 12/28/2009
EXPIRES: 01118/2010
VALUE:
225 Fifth Street, Springfield, OR
541- 726-3753 Phone
541- 726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
" Fees ~~id .
Fec Descriotion
***+ 100,10 Administrative Fee***
+ 5% Technology Fee
Banner Special Permit
Deposit
Amount Paid Date Paid Receipt Number
$20.00 ' 12/28/09 2200900000000001432
$5.00 12/28/09 2200900000000001432
$100,00 12/28/09 2200900000000001432
$100.00 12/28/09 2200900000000001432
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. . .
Reouired Insneetions.
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Banner Removal: To be requested the day foliowing 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 carefully examined the completed application and do hereby certify that all
information hereon is true and correct, aud f further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and fhe 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 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 agr to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that I permit card is located at the front of the property, and the approved set of plans will remain on the site at all
timesduri g onstr~o,nL 1!yj~(jtlf
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Del' or Contractors Signature Date
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Pa2e ,2 of 2
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225 Fifth'Street
Spr.ingfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
Jobl.Journlll. Number
COM2009-0 1838
COM2009-01838
COM2009-0 1838
COM2009-0 1838
Payments:
Type of Pa)'ment
Check
cReceintl
RECEIPT #:
2200900000000001432
Date: 12/28/2009
Description
Depo~it
Banner Special Penn it
+ 5% Technology Fee
***+ 10% Administrative Fee***
Paid By
BIG SKY HOSPITALITY INC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
djb
3961
In Person
Payment Total:
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Page 1 of 1
11 :58:4IAM
Amount Due
100,00
100,00
5,00
20.00
$225.00
Amount Paid
$225,00
$225.00
12/28/2009