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Home My WebLink AboutPermit Signage 2010-4-16 +=l C cd Cj ~ (j) e;' oat: of AP--P;:~:~~::~jlt'o (=.... . :,...,;" ......... H Issued By ~17 i-' ~ ~~ ~ CO ~ . 1=9 S ~ 1) ~ ..j-l ~ '.-=\ OJ) . ..... "......, M ,-_. Q ~ c\j ([) rJJ -........, r.f) ~ o o ~ ~..oJ:l1i, cd CO ,".... CIJ- . ' , . C-\()-+:D~ r.~~{~f)~~7~~~1~~;;fi~1~~1W~?F~ i' Co;":. -t ""', ", ';i\,Cl,.:U;,;tJl~j)i~])'},~~ r; ~..r _&~_.:~t}::;.1';:.:'~~; ':,.;.:-:.. "d...)'~...a .j:":":~~::'1' .gK,"'7if~[!'f~"f':~;';;"'4~;J::'-~c'<t" '0" Xl 1f,';'i~~:<l1c~~J1~}-\;1,~\I4.\"1 :'];<}<H' .,:, . ~\...f~\roiQt.;:.~:e.-L;:' -!...z.;"L-_~ ,;-;_.;:-.:.1",-,-~~~:::.c: "':':' J 225 FIlTH STREH . SrRINCFI!:LD, OR 97477 . I'H:(;;41)72G<H53 . rAX: (541)72G.3G8~) C Ot.'\A ZC:> 10 - 0 0 ~""t) ~ City Job Number fib Job Location & Luz.-no"!:. 379/ - :2-/55 Assessors Map 1705. Z-Sl.{ 2... o L ~ l'Yl PIc.. :J-r R f..€- T 0' 2.00 Tax Lot '"j) 0 L C 1\1 'ST Owner of Property W f6N D'\..f Address;2l en 6'1 t- \'V\ P I Q... City , .5 P lZ-1 ^>~ I € L- D State <:) 'R, Contractor!1 nstal ler ,4/!C A D 7 fe.o m 0"11. 0 "-l S Address/O,S"O.;2 C-omm€ec,E, 'i<OLO,:'i"~ .qOoPhone C)3CD .,5f?.:2.' 793C!:J City h'20A:>-r&-bW'l e.t2. Lf State .,-"" Zip 1135" (0 Phone S<l/-7l/f.4.. - LA. qv ~ Zip ~ 7 '-I 77 Construction Contractors License U Ex pires Description ,(). 0'1. /5 c..o L-D 14-/ ~ Date of Installation I.{f/ q //0 I , :r.o'F~1 c Date of Removal C'\S/tJ':2-li 0 f ( S202.nn including SlnO,ilO Dl'jlllSit allt! illlpliclIhle fce,;. Ily 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 display will be removed withio fOLuieen (14) days from the date listed as the date of installation above. If the display is not removcd within the time line specified. I will forfeit the $100.00 deposit. I also understand that this special permit can be issued only once per calendar year per development area. I also agree to call the inspection line at 726-3769 by the elld or tile 14th day to request an inspection to veritY the removal orthe display. This inspection will begin the process to return the $100.00 deposit if the display has been removed. Signature ~QA' 'b~ () Date ,1//lJ/IO I I For Officc Use Job!! C/iJ -00 5"0] Rcceiptl! I Z-OJ - 03 7'" ZD2-- Amount Collected Sllnl'cd Drivc(T:)/BllildillJ) FOlmslf~lill\p_PCllllm115_f3nlloons 7-011,doc CITY OF SPRINGFIELD Building/Combination Permit Status Issued PERMIT NO: COM2010-00503 ISSUED: 04/23/20'10 APPLIED: 04/23/2010 EXPIRES: 05/02/2010 VALUE: 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 2155 OL YMPIC ST ASSESSOR'S PARCEL NO.: 1703254201200 Springtield TYPE OF WORK: Blimp, Portable Sign, Etc. TYPE OF USE: New PROJECT DESCRIPTION: Blimp - install 041910 removal date 050210 Commercia) Owner: POLEN DEVELOPMENT LLC Address: 2197 OLYMPIC SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION ~ Contractor Type Sign Contractor OWNER License Expiration Date Phone BUILDING INFORMATION ~ # of Units: Primary Occnpancy Gronp: Secondary Occnpancy Gronp: Primary Constrnction Type Secondary Construction Type: # of Bedrooms: # of Stories: Heightof Structure Type of Heat: Water Type: . R'ailge TYpe: Energy Path: Sprinkled Building: Lot Size: Sq Ffl st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMENT INFORMATlO~ Front yard Setback: Side] Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Dist: # Street Trees Rqd: Paved D,.;ve Rqd: % of Lot Coverage: REQUIRED PARKING Total: Handicapped: Compact: I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special Instruction: Sidewalk Type: Downspoutsffirains: Notes: I V alu~t;on 'D~scriPtion ~ Description Tvpe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Valne Date Calculated Page I on Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00503 ISSUED: 04/23/2010 APPLIED: 04/23/2010 EXPIRES: 05/02/2010 VALUE: 225 Fifth Street, Springlield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line ''':'f.otafv~ru'e of Project LFees Paid I Fee Description ***+ 100/0 Administrative Fee*** + 5% Technology Fee Blimp + Special Permit Deposit Amonnt Paid Date Paid Receipt Number $18.00 4/23/10 1201000000000000379 $4.00 4/23/10 1201000000000000379 $80.00 4/23/1 0 120]000000000000379 $100.00 4/23/10 1201000000000000379 Total Amount Paid $202.00 .1. 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. L Remiired'lnsnections I ",!i"'f". .'->"" ,:.....'t~ .~.;" .,".: : Banner Removal: To be requested the day foiiowing the expiration of the permit. If inspection is not requested, the applicant may forfiet the deposit. By signature, I state and agree, that [ have carefully examined the completed application and do hereby certif:y that all information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with tbe 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 permiss!on 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. [further agree to ensnre 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. I' '. ,< Owner or Contractors Signature Date Page 2 of2 225 Fifth Street A SIJringfield, Oregon 97477 541-726-3759 Phone City of Springfield Official Receipt Development Services Department Publie Works Department RECEIPT #: 1201000000000000379 1O:05:I3AM Date: 04/23/2010 Job/Journal Number COM20 1 0-00503 COM20 1 0-00503 COM20 I 0-00503 COM2010-00503 Payments: Type of Payment Check cReceintl Item Total: Check Number Authorization Received By Batch Number Number How Received djb 7092 In Person Payment Total: Amount Due 80.00 100.00 4.00 18.00 $202.00 Description Blimp + Special Penn it Deposit + 5% Technology Fee ***+ 10% Administrative Fee***.']~,l' Paid By KGR PROMOTIONS INC Amount Paid $202.00 $202.00 -,,'" Page I of I 4/23/20 I 0