HomeMy WebLinkAboutPermit Signage 2010-3-22
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Jack in the Box 7133
5417363861
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225 FIITH STREIT . SPRINGfIELD, OR 97477 . PH:(54I)7Z6-3753 . FAX: (541)7Z6.3689
City Job Number C\\D...t\ \<0
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Job Location :;) f:YC}:.-# (n .J-1v, &>4 '
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Assessors Map~~JQ .D
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TaxLot ~
Owner. ....
Owner of Property ~iV\"
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Address .?- L\3-J M>( t:h2J4 b+-'
City ~p VI'V1j -PIP /d
State
Phone 5ZIl~ l3(p ~ 7 ( G, 8",
Of? Zip 97LJ77
.' Contractor/Instal/er
Contractor
Address
PhoD("
City
State
Zip
Construction Contractors License #
Expire.
Description VIJ"{h\p1! J ,:::,1 (?~ '
Date of Installation y )~ ~Ol D
Date of Removal 5}; vOl D .
Permit Fee: $225.00 including $100.00 Deposit and applicable fees.
~' 6 1 S- 00
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) andJor 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. I also understand that this special permit can be issued
only twiee 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 begin the process to return the $100.00 deposit if the banner(s) and/or
portable sign(s) has bee ove .
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Dat"
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For Office Use
Job # C1;7;11 '-z-.o J.....& -1.1--0 Receipt #
Amount COllectl'z.-.0.9fJ- dL:tt-~~
ShamlDrive (T:)'BuildingForms.lBa.Jmc:7_Pmtable SignPc:nnit eso 7-08.doo
Status
Issued
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 3491 HUTTON ST
ASSESSOR'S PARCEL NO.: 1703222000804
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," iSpringlield TYPE OF WORK: Sign
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00418
ISSUED: 04/05/2010
APPLIED: 04/05/2010
EXPIRES: 10/05/2010
VALUE:
TYPE OF USE: Commercial
PROJECT DESCRIPTION: Portable Sign- Removal Date 5/5/10. Refund to Vin Mehta, 4150 Paciflic Hwy, Suite B,
Medford, OR 97501.
Owner:
Address:
SYCAN B CORPORATION
9330 BALBOA AVE
SAN DIEGO CA 92123
SYCAN B CORPORATION
9330 BALBOA AVE
SAN DIEGO CA 92123
Owner:
Address:
Contractor Type
Contractor
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
A2
'(l>fIS~-~OOIN B! ISlu90
UO!l1!OfJ!lON Al!l!In U06910 elll 101 JeqwnlD
eUOlld9191 elll :aION) 'Jeluao elll 6uIII8O
Aq SainI alii 10 se!do:> UlBlqo ABW nOA "0600
-100-ZQA ~\fn U6nOJIJ1 nl n('-r Q~i~i ~8 '.
1IIJOI1~~ ale se~~?r~~A~*~~!I~~~
. =aJ~:NOI1N311"
License ~xpiration Date Phone
BUILDING INFORMATION ~
#,of Sturiys:
':'l:Ieigh!:oliS tructu re
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 .
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd: '
0/0 of Lot Coverage:
I PUBLIC IMPROVEMENTS I
. .,.('
'::~~';~' ,t'.. '.". ~ )
Paee I of 2
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutslDrains:
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20I0-00418
ISSUED: 04/05/2010
APPLIED: 04/0512010
EXPIRES: 10/0512010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
I Valuation Description I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
", Total Value of Project
'Fees Paid _
Fee Description
***+ 100/0 Administrative Fee***
+ 5% Technology Fee
Banner Special Permit
Deposit
Amount Paid Date Paid Receipt Number
$20.00 4/5/10 2201000000000000321
$5.00 4/5/1 0 2201000000000000321
$100.00 4/5/1 0 2201000000000000321
$100.00 4/5/1 0 2201000000000000321
Total Amount Paid
$225.00
I Plan Reviews ~
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.
Reoliired'IfisDections I
;,
Bauner Removal: To be requested the day following the expiration of the permit. If iuspection 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 of the City of Springfield and the 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.
1 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 readable from the
street, that the permit card is located at the front of the property"aud the approved set of pia us will remain un the site at all
times dur.ing co struction._
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Owner or Contractors Signature
Page 2 of2
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225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000321
Date: 04/05/2010
11:44:14AM
Job/Journal Number
COM2010-00418
COM20 I 0-004 I 8
COM2010-00418
COM20 I 0-00418
Description
Banner Special Permit
Deposit
+ 5% Technology Fee
***+ 10% Administrative Fee***
Payments:
Type of Payment
Check
Paid By
VRINC
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
KLK 27049 KLK In Person
Payment Total:
Amount Due
100,00
100,00
5,00
20,00
$225.00
Amount Paid
$225,00
$225.00
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Page I of 1
4/5/2010