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Home My WebLink AboutPermit Signage 2010-5-25 CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2010-00610 ISSUED: OS/25/2010 APPLIED: 05/14/2010 EXPIRES: ll/25/2010 VALUE: $ 400.00 , , ,i;. Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 155 S 5TH ST ASSESSOR'S PARCEL NO,: 1703353110400 Springlield TYPE OF WORK: Sign PROJECT DESCRIPTION: Sign for Mpnlse Store TYPE OF USE: New Commercial Owner: Address: ROY AL BUILDING L TD P ~~~~;;n'law' req~lres you to PO BOX 24608 . foil les'~iiopleCl by Ihe Oregon Utility EUGENE OR 97402 Not~~~rorlcenter. TlioserUleB~resetforth In OAR 95Z.;.uUl-UU I U I.Il1u~~11 el, iR Bria 0'01 0090.~NIllJAl~~ calli \II" .....11. urny N,olilicatlon Contractor number for Ihe, Oregon 11~,cense EUGENE SIGN & AWNi\Q~r IS 1-800-332- . BUILDING INFORM A TlON ~ Contractor Type Sign # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Constrnction Type Secondary Construction Type: # of Bedrooms: iI of Stories: '0":. -, . Height of Structure Type of Heat: . Water Type: . ... .' . :. :.~.~' ,j - >, Range Type: . ..... NOTICE: KI 'r!.\!'lRE IFTHE WORK ~~~ PERMIT In ['T~~'\lmMIT IS NQil ,........ Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: COM! ~lJ ANY 180 DA pv_~r1ay ,Dist; , " ';'#~,ireet '1;r'~es Rqd: <P:!ved'Ddve Rqd: %'of Lot Coverage: -" I PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer Available: Special Instruction : Expiration Date Phone 541-485-5546 Lot Size: . Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: REQUIRED PARKING Total: Handicapped: Compact: Sidewalk Type: Downsponts/Drains: Notes: , , I V aluiati~n Description ~ Description $ Per Sq Ft or multiplier Square Footage or Bid Amount Type of Construction Paee I of 2 ~,'. ~ ','::~,;J,F -.:El. iii ,:" r Value Date Calculated Status Issued i:'; . p'; CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM20]0-006]0 ISSUED: OS/25/2010 APPLIED: 05/]4/20]0 EXPIRES: 11125/20]0 VALUE: $ 400.00 225 Fifth Street, Springtield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-37691nspection Line Total Value of Project Fees Paid__., . ,~ : Fee Description Sign Plan Review ***+ 100/0 Administrative Fee*** + 5% Technology Fee Sign 0-35 Square Feet Amount Paid.. Date Paid Receipt Numher $42.00 $8.00 $4.00 $80.00 5/14/10 5/25/10 5/25/10 5/25/1 0 1201000000000000449 1201000000000000552 1201000000000000552 1201000000000000552 Total Amount Paid $134.00 .. ..,~,' '.".' ',' !.~J~n.R:~yiews , Sign Review OS/24/2010 " " ~ OSi24/2010 APP DJB 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. Reauired Inimec~ Sign Attachment: Method of mounting the sig~;to' a str~cthre or pole. Method of attachment of bolts or welds. Sign Final: After all required inspections,are conducted and approved and the sign installation is completed. 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, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springtield and the Laws of the State of Oregon pertaining to the work descrihed 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 agree to ensure that all required inspectioll,~, are, ~egues,ted at t,he proper time, that each address is readable from the street, that the permit card is located at the front onlle' priiperty;ahd:the approved set of plans will remain on the site at all ... . ,'.)l", ",:'" ;'\' . times dunng constructIOn. ,'_'::.;,...t' ..l '..!t.,' " ~l';.f.,i:',1i1:l . \:rd', .,.; . '> 'i~'J , .' s- 2- 5-/0 Date 'I' ."',1' , ,. Pa2e 2 of 2 :: '..1 ~'.:J. ~~.~ ~\.o ..lo \D \&'.\tj':> t), ~ ACORD~ CERTIFICATE OF LIABILITY INSURANCE I DATE (MMIDOIYYYY) OS/21/2010 PROOUCER Phone: (541)687-1911 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION JK PRATT & COMPANY INSURANCE ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR PO BOX 40880 ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. EUGENE, OR 97404 INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: AMERICAN ECONOMY INSURANCE CO. TRAVIS BURCHAM DBA: MPUlSE INSURER B: 1666 RIVER RD INSURER C: ,EUGENE, OR 97404 INSURER D INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENTVVlTH RESPECT TO \lVHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHO'MJ MAY HAVE BEEN REDUCED BY PAID CLAIMS. I~~ ~ -- POLlCY NUMBER POLICY EFFECTIVE POUCY EXPIRATION LIMITS A ~NERAL LIABILITY 02-BP-893794-1 04/28/2010 04/28/2011 EACH OCCURRENCE $ 2 000 000 ~ 3MERClAL GENERAL L1ABIUTY ~~~~~J9E~~~\ $ 2 000,000 f- CLAIMS MAOE IX] OCCUR MED EXP'........one~\ $ 10000 PERSONAL & AOV INJURY $ 2 000 000 GENERAL AGGREGATE $ 4 000 000 ~.~ AGG~n UMIT APnS PER: PRODUCTS. CQMPIOP AGG $ 4 000 000 X POUCY PRo. LOC ~TOMOBlLE LIABILITY COMBINED SINGLE LIMIT $ I- ANY AUTO (Ea accident) I- All Q'MIIED AUTOS BODILY INJURY $ SCHEDULED AUTOS (Per person) f- - HIRED AUTOS BOOIL Y INJURY (Peracddenl} $ - NQN-OVvNED AUTOS PROPERTY DAMAGE $ (PeraWdent) ~~GE L1A",L1TV AUTO ONLY. EA ACCIDENT $ ANY AUTO OTHER THAN EA ACC $ AUTO ONLY: AGG $ EXCESSJUMBRELLA LIABILITY EACH OCCURRENCE $ ~"OCCUR D CLAIMS MADE AGGREGATE $ $ =i ~EOUCTIBlE $ RETENTION $ $ WORKERS COMPENSATION AND ~\\C STATU., I IOJJ;'- CRY. LIMITS EMPLOYERS' LIABILITY ANY PROPRIETORIPARTNERlEXECUlIVE EL EACH ACCIDENT $ OFFICER/MEMBER EXCLUDED? E.L OISEASE - EA EMPlOYE $ ~.l~h~~V~NSbelow E.L OISEASE. POLICY LIMIT $ OrnER DESCRIPTION OF OPERATIONS I LOCATIONS 'VEHICLES I EXCLUSIONS ADDEO BY ENDORSEMENT I SPECIAL PROVISIONS ALL OPERATIONS OF THE NAMED INSURED IN ACCORDANCE WITH THE POLICY TERMS AND CONDITIONS. /~~ - (('(CERTlFICATE HOLDER (CITY OF SPRINGFIELD COMMUNITY SERVICES DIVISION 225 FIFTH STREET \. SPRINGFIELD, OR 97477 ACORD 25 (2001 (08) ~ ~ CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL .1L DAYS INRllTEN NOTICE TO THE CERTIFICATE HOlDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHAll IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE_ ~l-'/-'::~.}.j! 1".- l~J, DEB @ ACORD CORPORATION 1988 Printed by DEB on May 21, 2010 at 02:58PM ) /rr.~ IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the policy(ies) must be endorsed. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement. A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s). DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or. negatively amend, extend or alter the coverage afforded by the policies listed thereon. ACORD 25 (2001/08) Printed by DEB on May 21, 2010 at 02:58PM 225 Fifth Street Springfield, Oregon 97477 541'.726-3759 Phone I City of Springfield Official Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000552 Date: OS/25/2010 9:50:38AM Job/Journal Number COM2010-0061O COM2010-00610 COM20 I 0-0061 0 Description Sign 0-35 Square Feet + 5% Technology Fee ,..,::i::':O. , d"'- ***+ 10% Administrative Fee**.'!'.,~:~_": -, ';>;.;:.' " ' ',;} Item Total: Amount Due 80.00 4.00 8.00 $92,00 Payments: Type of Payment CreditCard Paid By TRA VIS BURCHAM Check Number Authorization Received By Batch Number Number How Received cJc 04590c In Person Payment Total: Amount Paid $92.00 $92.00 . .L ,- ~{ l . ....;:: .;;' , ' ~~~~;, ;, ';;',11 \.~ ~~ cReccintl Page I of I 5/25/20] 0 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone City of Springfield OffiCial Receipt Development Services Department Public Works Department RECEIPT #: 1201000000000000449 Date: 05/1412010 10:56:57 AM Job/Journal Number' COM2010-00610 Payments: Type of Payment CreditCard cReceiotl Description Sign Plan Review Paid By TRA VIS BURCHAM Item Total: ',Ch~ck N umber Authorization Received By 'Batch Number Number How Received nJm 05562c 05562c In Person Payment Total: Amount Due 42.00 $42.00 Amount Paid $42.00 $42.00 1;~;1;~;;lll ..1t:i' ....~\ ~, ,;:,. . '\ II "....", ',y'l.('" .,......>1 Page I of I . 5/1412010