HomeMy WebLinkAboutPermit Signage 2010-5-24
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225 FIITH STREET. SPRINGFIElD, OR 97477 . PH:(54I)726.3753 . FAX: (541)726.3689
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City Job Number
Job Location .111[/ (7'N .LLJRj
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Assessors Map
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Address /!;/1L/ 14TU-<-JAy ,(IJ})fJ
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Zip
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State
ContractorlInstaller
Address
Phone
City
State
Zip
Expires
Construction Contractors License #
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Description /0 .s ~ c-~.1 ~ !rr,
Date of Installation ~ /,.;( t/ / / u ' Date of Removal
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$202.00 including $100.00 Deposit and applicable fees.
By signature, I state and agree that I have carefully completed this application and hereby certif'y that all
information herein is true and correct. I further agree and understand that the above described display will be'
removed within fourteen (14) days from the date listed as the date of installation above. If the 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 calendar year per development area. I also agree to call the inspection line at
726-3769 by the end of the 14th day to request an inspection to verifY the removal of the display. This inspection
will begin the process turn the $100,00 deposit if the display has been removed. '
Date ;9"/ d- C;;iJ u -
Signature
For Office Use
Date of Application s,/ ;2 L( / I U
C-<:,.-Z-
Issued By
Job# f2J tJ - c//'" / Receipt#
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Amount Collected L-U --.-
Shared Drive(T:}fBuilding FonnsIBlimp]ennants_Balloons 7-08.doc
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00661
ISSUED: OS/24/2010
APPLIED: OS/24/2010
EXPIRES: 06/07/2010
VALUE:
Status
Issued
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SITE ADDRESS: 1174 Gateway Lp
ASSESSOR'S PARCEL NO.: 1703222002410
Springfield TYPE OF WORK: Blimp, Portable Sign, Etc.
TYPE OF USE: New
Commercial
PROJECT DESCRIPTION: Balloon permit Remo<:ar'date'june 6:
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Owner:
Address:
SHEILA S LLC
3194 GATEWAY LP
SPRINGFIELD OR 97477
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Contractor Type
Contractor
I CONTRACTOR INFORMATION ~
License
Expiration Date Phone
BUILDING INFORMATION ~
# 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:
n/a
I DEVELOPMENT INFORMATION ~
Fron!yard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
:_:~~;. !~r~ ~~ ",:' ,"
,'OVerlay'Dist:
#'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:
Downspouts/Drains:
, ;, 1-" '~
,~~ . \'; .'
Notes:
. .J
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00661
ISSUED: OS/24/2010
APPLIED: OS/24/2010
EXPIRES: 06/07/2010
VALUE:
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Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value Of Project
: I Fees Paid .
Fee Description
***+ 100/0 Administrative Fee***
+ 5% Technology Fee
Blimp + Special Permit
Deposit
Amount Paid
Date Paid
Receipt Number
Total Amount Paid
$18.00
$4.00
$80.00
$100.00..
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,
5/24/10
5/24/10
5/24/10
5/24/10
2201000000000000560
2201000000000000560
2201000000000000560
2201000000000000560
$202.00
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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.'
Reauired InsDectio~s ~
Banner Removal: To be requested the day following the expiration ofthe permit. If inspection is not requested,
the applicant may forfiet the deposit.
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] 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 structu~.e'Yithout permissi~n of the Community Services Division, Building Safety.
I further certify that only contractors and employees,vl](; Jre in compliilllce with ORS 701.005 will be used on this project.
] further agree to ensure that all required inspections are reque'sted 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
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Owner or Contractors Signature Date
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225.Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
City of Springfield Official Receipt
Development Services Department
Publie Works Department
RECEIPT #:
2201000000000000560
Date: OS/24/2010
9:53:25AM
Job/Journal Number
COM2010-00661
COM20 I 0-00661
COM2010-00661
COM20 1 0-00661
Description
Deposit
Blimp + Special Penn it
+ 5% Technology Fee
***+ 10% Administrative Fee1:*'
Payments:
Type of Payment
CreditCard
P. id By
MICHEAL SCHWARTZ
Item Total:
Check N umber Authorization
Received By Batch Number Number How Received
Amount Due
100,00
80,00
4,00
18,00
$202.00
Amount Paid
cjc
09096p In Person
Payment Total:
$202,00
$202.00
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5/24/2010