Loading...
HomeMy WebLinkAboutPermit Signage 2010-2-10 225 FIITH STREET . SPRlNGFIEID,OR97477 . PH:(54I)726-3753 . FAX: (541)726-3689 ~j '. '~"\13( .,~, City Job Nnmber COWl 7.0 ( 0 - 0 '-' ~~ ~ ~ Job Locatior ~ Assessors Man ~ "" Owner of Property ?o\e~ Th\Je\rJfM(:>o("\-t- I L(_ ,,...oSl Address 2-.\~\ (')\.\.I~{);(, s+ ~ I' ____ ~_~ _ City -,?~'\:.:(\2' ~\d._ ' ~ ContractorlInstaIlPt - \\0..\\ [)()V'"\ (').-, 2 Address ,~ ~ City TlI11 Construction Contraetors License # -............ "EA-l\oc....... ~ Description g' Date :f~~u~ti~~~,~~ ~\! I i.'JT6 0> ~ . ~ ~. ~ ~ := ~ i ~ Date of Application .a~". 'ed Issu :By . ..,' ...~ ~ ~ '.. 02/04/10 THU 13:00 FAX 5417263689 141001 " CITY OF SPRINGFIELD )Z.Ef": COt>Z.OlO. 00 OZ'Z 'S '\ CiC\ trio. ~ 'l\ S -\y of t'. 1- 1702 3"S4 ( s~ ()\( ~lL{l&" -~\~ Lo+S Ol?OP I Tax Lot Statp ()e. '.- - ....-,.- 4')C\~ ....IJ}I~ .;.- I I I I Zi C1h'-1l1 _<'C- '_ P.... """"'-i'. ,.~. ___ , ~ Phone l'hoDP State Zip PVl'ires i i I , Date ofRe~o~;;;' ,':,;.\ 'I~' . . . ."<'C. $202.00 including $100.00 Deposit and applicable fees. I ! 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 describ~d display will be removed within fourteen (14) days from the date listed as the date of installation above, If tllli display 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 once per;caIendaryear per development area I also agree to call/he inspection line at 726-3769 by the end of the 14th day to reqnest an inspection to verify the removal ofthe display. This inspection will begin the process to return the $ I?O deposit if the display has been removed. : Signature Ie T)ate 2..l) 411 ()- U)Q 1M 'I \I'v\ "? () \{ V'\ For Office Use . z)';}o . btr Job# CIO -00 I '$ I' Receipt#z,zor - 0 I 33 · Ain~JhtCi>llect';-';-- , '1 L ' ShaiOO. Drive(T:)/Building FannslBlimp_ 'e:nnaDts_BallOODS 1...oS.doc i.""i' CITY OF~rt(JNvf<JJ!.LD Building/Combination Permit PERMIT NO: COM2010-00181 ISSUED: 02/10/2010 APPLIED: 02/10/2010 EXPIRES: 02/10/2010 VALUE: Status Finaled 225 Fifth Slreet, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 5790 MAIN ST ,ASSESSOR'S PARCEL NO,: 1702334JOJ900 Springtield TYPE OF WORK: Blimp, Portable Sign, Etc, TYPE OF USE: New Commercial PROJECT DESCRIPTION: Balloon: ref':COD201O-00022 Owner: POLEN DEVELOPMENT LLC Address: 21970LYMPfC SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I 1._'-:' Contractor Type Sign Contractor OWNER License Expiration Date Phone BUILDING INFORMATION I # of' Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Heighl of Structure Type of Heat: Waler Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: nla I DEVELOPMENT INFORMATION I REQUIRED PARKING Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Serbacks: Overlay Dist: # Streel Trees Rqd: Paved Drive Rqd: % of Lot Coverage: Total: Handicapped: Compacr: . I.PUBLICIMPROVEMENTS I Streellmprovements: Slorm Sewer Available: Special Inslruction: "..: Sidewalk'Type: DownspoutslDrains: Noles: I.Valuation DescriDtion I Description Type of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Page I of2 Status Finaled 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line. \ ' .) ,,<,' Total Value of Project Fees, Paid' Fee Description ***+ 100/0 Administrative Fee*** + 5% Technulogy Fee Blimp + Special Permit Amount Paid Date Paid $8,00 $4,00 $80,00 2/JO/JO 2/10/10 2/10/JO Total Amount Paid $92,00 I Plan Reviews I CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00181 ISSUED: 02/10/2010 APPLIED: 02/10/2010 EXPIRES: 02/10/2010 VALUE: ., Receipt Number 220JOOOOOOOOOOOOl33 2201000000000000133 2201000000000000133 To Request an inspection call the 24 hour re(:,ordingat 726-3769. All inspections requested before 7:00 w,.,.>I ,.r~ ~." a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following work day. Re,,"i,~e~ Ins'1~~tions.1 By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all informalion hereon is true and correct, and I further certify that any and all work performed shall be done in accordance wilh rhe Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and thaI NO OCCUPANCY will be made of any slructure wilhout permission of lhe Community Services Division, Building Safety: I further certify that only contraclors and employees who are in compliance with ORS 701.005 will be used on this project. I furlher agree to ensure that all required inspections are requested at the proper time, that each address is readable from lhe , street, that the permit card is located al the front of lhe property, and lhe approved set of plans will remain on the sire alall times:r:::Slr:::~A-~'e ~ llfl r'r"o Owner or Contractors Signature I Date Co d t! Co......" h~ :';1: t. : '.~ t 'i,,'; ," .; ~; ,.', I, Pace 2 of2 225,Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM20 1 0-00 181 COM20 1 0-00 181 COM20 I 0-00 181 Payments: Type of Payment Check cReceintl RECEIPT #: City of Springfield Official Receipt Development Services Department Public Works Department 2201000000000000133 Date: 02/10/2010 2:46: 12PM' Item Total: Check Number Authorization Received By Batch Number Number How Received djb 7315 In Person Payment Total: Amount Due 80,00 4,00 8.00 $92.00 Description Blimp + Special Pennil + 5% Technology Fec ***+ 10% Administrative Fee*** Paid By POLEN DEVELOPMENT LLC Amount Paid $92,00 $92.00 Page 1 of I 2/10/2010