HomeMy WebLinkAboutPermit Signage 2010-7-16
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CITY OF SPRINGFIELD, OREGON
225 FIrm STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
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Owner
Tax Lot
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Owner of Property
Address b-'Vl rA(M,vfl>w Rd-
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COlltractor/lnsta/ler /
Contractor S BI <r.. .I) bi t9 res
Address /
City
Construction Contractors License #
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State
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SPRINGFIELD
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Zip
97'1-77
Zip
Expireo
Description
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Date of Installation
7-"-/0
Date of Removal
Permit Fee: $J25.00 including $100.00 Deposit and applicable fees;
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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
banner(s) and/or portable sign(s) is not larger than 60 square feet, and will be rerilOved within 30 days
from the date listed above. If the banner(s) and/or portable sign 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 twice per calendar year per development area. I also agree to call the inspection line at 726-3769
by the end ofthe 30th day to request an inspection to verifY the removal of the banner(s) and/or portable
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 J.. ~ Wo~
For Office U.~e
Job# (JO c; )3
Date of Application (! I u ( I 0
IssuedBy ~
Date
7- /b -I'D
Receipt #
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Amount Collected ~
Shared Drive (T:YBuilding FonnsIBanner]ortable Sign Permit CSD 7-08.doc
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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: COM2010-00953
ISSUED: 07/16/2010
APPLIED: 07/16/2010
EXPIRES: 08/14/2010
VALUE:
Status
Iss u ed
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SITE ADDRESS: 697 HARLOW RD
ASSESSOR'S PARCEL NO.: 1703271202900
Springfield TYPE OF WORK: Sign
TYPE OF USE: New Commercial
PROJECT DESCRIPTION: Banner permit- ref COD2010-00600- Removal Date 8/14/2010- Refund to Bookkeepers
Unlimited "." '
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Owner:
Address:
FAIRCHILD DONALD
PO BOX 788
SPRINGFIELD OR 97477
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I CONTRACTOR INFORMA nON ,
Contractor Type
Contractor
License
Expiration Date Phone
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
BUILDING INFORMATION I
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# of Stories,: '"
.I"t'eight of Structure
,. 'Type of Heal:
Water Type:
Range Type:
Energy Path:
Sprinkled Building: n/a
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq FI Basement:
Sq FI Garage/Carporl
Sq Ft Other:
Occupanl Load:
I DEVELOPMENT INFORMATION ~
,;. ~
REQUIRED PARKING
Total:
Handicapped:
Compact:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
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'''Ov'erIW Dis/: '..'
"#'StreetTrees Rqd:
. "P~~ed 6;fveRqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS ~
Street Improvements:
Storm Sewer Available:
Special Instruction:
,
Sidewalk Type:
Downspouts/Drains:
, ,
Notes:
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I Va;u'lition Description 1\
Description
Type of Construction
$ Per Sq FI
or mulliplier
Square Foolage
or Bid Amounl'
Value
Date Calculated
Paee I of2
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00953
ISSUED: 07/1612010
APPLIED: 07/16/2010
EXPIRES: 08/1412010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total VafiJe'of Project
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"f' Fees P~id-'
Fee Description
***+ 100/0 Administrative Fee***
+ 5% Technology Fee
Banner Special Permit
Deposit
Amount Paid
Date Paid
Receipt Numher
$20.00
$5.00
$100.00
$100,OjL_ '_',"."_'
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7/16/10
7/16/10
7/16/10
7/16/10
1201000000000000827
1201000000000000827
1201000000000000827
1201000000000000827
Total Amount Paid
$225.00, /,,'
I ~lan 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. ' , ...
lJeauired Ins'Dections ~
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Banner Removal: To he requested the day following the expiration of the permit. If inspection is not requested,
the applicant may forfiel 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 I 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 structure without permission of the Community Services Division, Building Safety.
I further certify that only coutractors and employee-;\';;.h~;~reH.n;co';"pliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections 'are req~ested at the proper time, that each address is readable from the
street, that the permit card is located at the front ot.~he property', and the approved set of plans will remain on Ihe site at all
times during construction. 'fl. ..
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Owner or Contractors Signature
Date
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Page 2 of2
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 #:
1201000000000000827
Date: 07/16/2010
2:17:09PM
Job/Journal Number
COM20 1 0-00953
COM20 I 0-00953
COM20 1 0-00953
COM20 1 0-00953
Payments:
Type of Payment
CreditCard
cRcceintl
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Amount Due
100.00
100.00
5.00
20.00
$225.00
Description
Banner Special Permit
Deposit _",.. ".
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+ 5% Technology Fee ,if)
***+ 10% Administrative Fee***
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Paid By
DOLORIS BLACK
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
cjc 01624z In Person
Payment Total:
$225.00
$225.00
Amount Paid
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7116/2010