HomeMy WebLinkAboutPermit Signage 2010-4-19
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. ': ~1.GlmW-nF SPRINGFIELD, OREGON' ';
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225 FIITH STREET. SPRINGFIELD, OR g7477 . PH:(54I)726-:n53 . FAX: (541)726-3689
FIREWORKS SALES LOT/CHRISTMAS TREE WT Banner/Portable Sign Permit
City Job Number rO,..v\. LOt C -0 D 4 ~o
Job Location
AI "/7 OIYl'1rpic 51- 5orl'~(((iJ.
,
/703, ZSLlL-.
Tax Lot
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DR i '17'-177
Assessors Map
Owner
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Address ;J.jt:tl O/'rI>1f/~ s+ 5pr,,,,,f'rrdd. OR.
Owner of Property
Phone
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97477
City
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Zip
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State
ntractorllnstaller
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Phone ~/-cPB& - 3 if 73
Address
City <;p/~-e/J
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Zip q7477
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Construction Contractors License #
Description (lrewor/{$ &nIlU$
Date of Installation G/W/)/)/D
Date of Removal 7//01')OID
Permit Fee: $115.00
Permit is valid for 30 days from date of Installation
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.
Signature
k /J 1.
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51 v.> AN ,I?, Lb "'"
For Office Use
Job# C/O -ooL(gO
Receipt # \ Zo\ - 0 3.b I
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Date
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Date of Application
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Issued By
Amount Collected
Shared Drive (T:)lBuilding Forms/Fireworks/Christmas Tree Banner-Portable Sign Permit 1-2010.doc
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00480
ISSUED: 04/1912010
APPLIED: 04/19/2010
EXPIRES: 07/1012010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2197 OLYMPIC ST
ASSESSOR'S PARCEL NO.: 1703254201202
Springlield TYPE OF WORK: Banner
TYPE OF USE: New
PROJECT DESCRIPTION: Banner/portable signs, Firewoi"k sales. install 062010 removal date 071010
Commercial
Owner: POLEN DEVELOPMENT LLC
Address: 2197 OLYMPIC
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
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:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
ilIa
I DEVELOPMENT INFORMATION I
I
Front yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
. OverlafDist:
# Street Trees Rqd:
Paved Drive Rqd: "
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
_;,~. I
Downspouts/Drains:
, ,
Notes:
I Valuation Description ~
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM201O-00480
ISSUED: 04/19/2010
APPLIED: 04/19/2010
EXPIRES: 07/10/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
***+ 100/Q Administrative Fee***
+ 5% Technology Fee
Banner Special Permit
Amount Paid "
In; ,;', ~
$10.00 ',.'c" "",n,'
$5.00
$100.00'
Date Paid
4/19/10
4/19/10
4/19/10
Receipt Number
1201000000000000361
1201000000000000361
1201000000000000361
Total Amount Paid
$115.00
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.
I Reouired Insnect~
Banner Removal: To be requested tbe day following the expiration of the permit. If inspection is not requested,
the applicant may forfiet the deposit.
By signature, [ state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and co~rect, and I furthe'r,~J~rtit;y iliat any ,and all work pel~formed shall be done in accord~lIIce with
the Ordinances of the City of Springficld and the Laws of the State of Oregon pertaining to the work described herein, and
tbat NO OCCUPANCY will be made of any structuie without permission of the Community Services Division, Building Safety.
1 fnrther certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 fnrther 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, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Page 2 01'2
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.~y,
225 FLfth Slreet
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000361
Date: 04/19/20]0
2:54: I3PM
Job/Journal Number
COM20 I 0-00480
COM20 1 0-00480
COM20 I 0-00480
Description
+ 5% Technology Fee
***+ 10% Administrative Fee***
Banner Special Permit
Paid By
CROSSFIRE WORLD
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
5.00
10.00
100.00
$] ]5.00
Payments:
Type of Payment
Check
Amount Paid
djb
3152
In Person
Payment Total:
$115.00
$]] 5.00
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