HomeMy WebLinkAboutPermit Signage 2010-6-28
225 FIfTH STREET. SPRINGFIELD, OR 97477 . PH:(541)7Z6-3753 . FAX: (541)726-3689
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City ,,:/5 jJ/,' (15 j}(L..-/J'.
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Zip
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State
Phone
State
Zip
Construction Contractors License #
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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 certify 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 ofthe 14th day to request an inspection to verifY the removal of the display. This inspection
will begin the process to return the $100,00 deposit if the display has been removed.
Signature4 #-/ ft ?P
Date
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For Office Use
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Shared Drive(T:YBuilding FormsIBlimp_Pennants ~ Balloons 7-08.doc
Status
Issued
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: COM2010-00747
ISSUED: 06/28/2010
APPLIED: 06/09/2010
EXPIRES: 07/24/2010
VALUE:
SITE ADDRESS: 3194 Gateway Lp Springfield TYPE OF WORK: Blimp, Portable Sign, Etc.
ASSESSOR'S PARCEL NO.: 1703222002501
, TYPE OF USE: New Commercial
. PROJECT DESCRIPTION: Balloon - install 060910 femo~al date~~ '
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Owner:
Address:
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SYLMA COMPANY
2390 LARIAT DR
EUGENE OR 97401
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I CONTRACTOR INFORMATION ~
Contractor Type
Sign
Contractor
OWNER
BUILDING INFORMATION ~
# of Units:
Primary Occnpancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
WofStories: "
'. 'Height of Structure
.. ': Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
License
n/a
I DEVELOPMENTlNFORMATION ~
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
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. 'Overla)i"Dist: ..,..
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# Street Trees Rqd:
f.'il';l," " ' ,
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS ~
Street Improvements:
Storm Sewer Available:
Special Instruction:
'I;
Notes:
. \"'"
I V a'lu~tion Description ~
Expiration Date Phone
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occnpant Load:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Sidewalk Type:
DownspoutsiDrains:
Description
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Type of Construction
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Value
Date Calculated
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00747
ISSUED: 06/28/2010
APPLIED: 06/09/2010
EXPIRES: 07/24/2010
VALUE:
. ''It
Status
Issued
225 Fifth Street, Springfield, OR '
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
, , Total Valne of Project
I Fees Paidj
Fee Description
***+ 100/0 Administrative Fee***
+ 5% Technology Fee
Blimp + Special Permit
Deposit
***+ 100/0 Administrative Fee***
+ 5% Technology Fee.
Blimp + Special Permit
Amonnt Paid
Date Paid
Receipt Nnmber
$18.00
$4.00
$80.00
$100.09:::.:"
$8.00.:""'"
$4.00i: !
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$80.00'" .
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6/9/10
6/9/10
6/9/10
...6/9/10
6/28/1 0
6/28/10
6/28/10 .
1201000000000000640
1201000000000000640
1201000000000000640
1201000000000000640
1201000000000000767
1201000000000000767
1201000000000000767
Total Amonnt Paid
$294.00
I 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 r,equested after 7:00 a.m. will be made the following
work day..,'"
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LReouired Inspections ~
Banner Removal: To be reqnested the day following the expiration of the permit. If inspection is not reqnested,
, the applicant may forfiet the deposit.
By signature, I state and agree, that I have carefully"e.~_aJl),i~~d,,!h~ completed application and do hereby certify that all
information hereon is true and correct, and I further.,'certity tliat any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the La";s of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safely.
1 further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 further 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.
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- wner Or" ontractors Signature
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Date
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Page 2 01'2
225' Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
1201000000000000767
Date: 06/28/2010
J J:34:57AM
Job/Journal Number
COM20 I 0-00747
COM2010-00747
COM20 10-00747
Payments:
Type of Payment
CreditCard
cReceiotJ
Description
Blimp + Special Permit
***+ 100/0 Administrative Fee***
+ 5% Technology Fee
Paid By
RICHARD SCHWARTZ
Received By
cjc
Check Number
Batch Number
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Page I of I
Item Total:
Authorization
Number How Received
Amount Due
80.00
8.00
4.00
$92.00.
Amount Paid
02779p In Person
Payment Total:
$92.00
$92.00
6/28/20 I 0