HomeMy WebLinkAboutPermit Signage 2010-6-9
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CITY OF SPRINGFIELD, OREGON
225 FWfH STREET. SPRINGFIELD, OR 97477 . PH:(341)7Z6-3753 . FAX: (541)726-3689
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CilyJobNumber COW'! z:c,/D -007 ~ 7
Job Location
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02100
Assessors Map-' 70 :3 Z b s (
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OWller
Owner of Property
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Address 20 b '7
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COlltmctor/hutaller
. Contractor
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Address
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Phonp.
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State
De-
Tax Lot
'Zip
CIO'737
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Phone:- ',----?
State ~ZiP
City
Construction. Contractors License #
Description
7>A-NNhL.
Date of Installation
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Date of Removal
7-2. -( 0
Expire<
Permit lice: $225.00 including $11111.110 Deposit anll applicable fees.
By signature, I state and agree that I have carefully complete'd this application and hereby certify t
all information herein is true and corrccl. I further agree and understand that the above described
banncr(s) and/or pOltable sign(s) is not larger than 60 square feet, and will be removed within 30 day
from the date listed above. Ifthe banner(s) and/or portable sign is not removed within the timelinc
specified, 1 will forfeit the $100.00 deposit. 1 also understand that this special permit can be issued
only twice per calendar year per development area. I also agree .to call the inspection line at 726-37(
by the end of the 30th day to request an inspection to verify the removal of the banner(s) and/o~ porta
sign(s). This inspection will begin the process to return the $100.00 deposit if the banner(s) and/or
portable sign(s) has been removed.
Signaturp rya~ 'OVt. ~1tdr 6
Date of Application
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Job # C/o -00 7 ~ 7 Receipt # /2-01- b 3 (
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Issued By
For Office Use
Amount Collected
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Shared Drive (T:YBuilding Fomu/Balmer]ortablc Sign Pennil CSD 7-08.doc
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 199 Q ST
ASSESSOR'S PARCEL NO.: 1703263102100
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00737
ISSUED: 06/09/2010
APPLIED: 06/09/2010
EXPIRES: 07/02/2010
VALUE:
Springfield TYPE OF WORK: Banner
Commercial
TYPE OF USE: New
PROJECT DESCRIPTION: Banner - install 060210 removal date 070210. REF: COD2010-00565
Owner:
Address: ,
Q STREET PROPERTIES LLC
2069 CEDAR CRT
NORTH BEND OR 97459
Contractor Type
Sign
Contractor
OWNER
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I CONTRACTOR INFORMATION I
BUILDING INFORMATION ~
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fof Stories:
Height of Structure
Type of Heat:
Water Type:
,Range Type:
Energy Path:
Spriukled Building:
License
Expiration Date Phone
n/a
Lot Size:
Sq Ft f st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
I DEVELOPMENT INFORMATION I
Front yard Set hack:
Side I Setback:
Side 2 Setback:
Rearyard Sethack:
Solar Setbacks:
Street Improvements:
Storm Sewer Availahle:
Special Instruction :
Notes:
Description
Tvpe of Construction '
Overlay Dist: .
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
I PUBLIC IMPROVEMENTS I
,:,"
I Valuation Description ~
$ Per Sq Ft
or multiplier
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
Downspouts/Drains:
Sqnare Footage
or Bid Amount
Date Calculated
~a2e I of 2
Value
Status
Issued
225 Fifth Street, Springtield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
***+ 100/0 Administrative Fee***
+ 5% Technology Fee
Banner Special Permit
Deposit
Total Amount Paid
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,,-~~;'~;f: : -#. ~~::~'.:. ,"
',.; ;'1. ,_' ,
""".Total Value of Project
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LFees Paid .
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00737
ISSUED: 06/0912010
APPLIED: 06/09/2010
EXPIRES: 07/02/2010
VALUE:
Amount Paid Date Paid Receipt Number
$20.00 6/9/10 1201000000000000631
$5.00 6/9/10 1201000000000000631
$100.00 6/9/10 1201000000000000631
$100.00 6/9/10 1201000000000000631
$225.00
I. Plan Reviews I
To Request an inspection calrthe 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. .
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Re.?:~~ed In~nections ~
By signature, I state and agree, that 1 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 described herein, and
that NO OCCUPANCY will he 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 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
times during construction. ! '.:;:," .,
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Owner or Contractors Signature
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Paee 2 of 2
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Date
City of Springfield Official Receipt
Development Services Department
Public Works Department
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
RECEIPT #:
1201000000000000631
Date: 06/09/2010
9:26:33AM
Job/Journal Number
COM20 I 0-00737
COM2010-00737
COM20 I 0-00737
COM2010-00737
Payments:
Type of Payment
CreditCard
;
cRcccintl
Description
Banner Special Permit
Deposit
+ 5% Technology Fee
***+ 10% Administrative Fee***
Amount Due
100.00
100.00
5.00
20.00
$225.00
Paid By
VAL KO
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
djb 03544g In Person
Payment Total:
$225.00
$225.00
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