HomeMy WebLinkAboutPermit Signage 2010-7-26
~/. :-ff...
:/ : ...
'~~1~5~__
225 FIITH STREET 0 SPRINGI1ELD,OR97477 0 PH:(541)726-S75S o FAX: (541)726-S689
~
o. ,~~ City Job Number t. 10 -0 c:,:) 9 t' J
E Job Location Z 77 0 G A- fF"W v't-y
~ Assessors Map / 70 J Z ZOO Tax Lot c> Z. Je:> r
~ .
~ ownerofProperty-WuoJ) qYOwth '~~'eS Lnc...
',a Address d~30 _q~ Phone .
~~ City ,Spn ~ Stat~ nj2 Zip q74-77
~ Contractor/Installer },j
.~ y
~ Address .
~~
,~ City
~
7fIJJ
-........
~ Date of Installation
o
o
:: ;:
~
~l
~
~
l~
~i
~
=
~
~\
~ Date of Application 7
. ~~
~; Issued By
~
o<~~
~
~1
SFRENGFiELO 1>"5~"'~~."")~
~ J
fi.! A". . .&.~", ,
= ~Q,-~.~~;~
--~ ~..~~
tate
Phone f1::il....la Er& ,.c96lJ I
o...r2.- Zip Cf7 40 /
Construction Contractors License #
Expires
Description lS:'.Allo-.-.. ~h.. .
7/27/10
~ ,
-
Date of Removal
Q/JO /10
$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 of the 14lh day to request an inspection to verify the removal of the display. This inspection
will begin th~the $100.00 deposit if the display has been removed.
Signature ~ Date 7/;L(/fO
For Office Use
't b- / (..)
~~
Job# C/O -00 9f'
Receipt# 2W/. 0 ~i ~
Z 0"2 -
Amount Collected
Shared Drive(T:)IBuilding FonnsIBlimp]ennants_Balloons 7-OS.doc
l;...
:)~i"
, -
"
,
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00981
ISSUED: 07/26/2010
APPLIED: 07/26/2010
EXPIRES: 08/10/2010
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
54]-726-3753 Phone
54] -726-3676 Fax
54]-726-3769 Inspection Line
. :.: ~
SITE ADDRESS: 2730 GA TEW A Y ST
ASSESSOR'S PARCEL NO.: ]703220002305
Springfield TYPE OF WORK:
TYPE OF USE:
PROJECT DESCRIPTION: Balloons etc. - install 072710 removal date 08]010
Owner: GA TEW A Y MALL PARTNERS
Address: PO BOX 6] 7905
CHICAGO IL 6066]-7905
I CONTRACTOR INFORMATION ~
Contractor Type
Sign
Contractor
OWNER
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
""'. . H.,
Type of Heat:
,..water Type:
"Ra'iige 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 ~
Frontyard Setback:
Side] Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
',.,,, ,., .. ,,,,.L,
REQUIRED PARKING
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS ~
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downsponts/Drains:
Notes:
~. ,
} ~ .,,' ' " " " ','"t, _" ,
;:~~<:'
,." .,
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of2
"
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2010-00981
ISSUED: 07/26/2010
APPLIED: 07/26/2010
EXPJ.RES: 08/10/2010
VALUE:
,
Status
Issued
..-.....
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
;';
,.
,},lotal,V~.Ioe of Project
",,-,,'-' "
U~e~P~id .
<ii:?!''':'. ;
Fee Description
***+ 100/0 Administrative Fee***
+ 5% Technology Fee
Blimp + Special Permit
Deposit
Amount Paid Date Paid Receipt Number
$18.00 7/26/[0 2201000000000000873
$4.00 7/26/10 2201000000000000873
$80.00 7/26/10 2201000000000000873
$100.00 7/26/10 2201000000000000873
Total Amount Paid
$202.00
I flail. Revie.\ys. ~
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.
Reuu'iFed:lnsDections .
:::l~~t ~:':::-l.,~;;l:~.'; .,'" '"
.,f"'I' .1."'1'
Banner Removal: To be requested the day fol~~'~irig;the"expiration of the 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 structure without permission of the Community Services Division, Building Safet)'.
[ further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
[ further agree to ensure that all required inspections are requested at the propel' time, that each address is readable from the
street, that the permit card is located at the front of the property,.an'd the approved set of plans will remain on the site at all
times during construction. "-...'t ~.." r h-\~~
" ",.:t.' r, ; .., I~
~
7 /CJto/ \0
I
Date
.,U;l:' ,l,r--i')ilh _ ~ .
'''~~~' ~i;j;e'.L~.J\t.'~:'lj>;' i,l ,,\
1_;.;~1:.t1' ,: l~.~ ~ ~ I~' .
~", ,
f1tWH, :,' ~j~~. ..
..-t:(J:',
Paee 2 of 2
225 Fifth Street
Springfield, Oregon 97477
541-72(r-3'759 Phone
City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000873
Date: 07/26/2010
10:49:48AM
Job/Journal Number
COM20 1 0-00981
COM20 I 0-00981
COM20 I 0-00981
COM20 I 0-00981
Description
***+ 10% Administrative Fee***
Blimp + Special Penn it
Deposit
+ 5% Technology Fee
".
,':.
Item Total:
Amount Due
18.00
80.00
100,00
4,00
$202,00
Payments:
Type of Payment
Check
Check
Paid By
L1THlA AUTO STORES
L1THIA AUTO STORES
Check Number Authorization
Received By Batch Number Number How Received
djb
djb
51145
53112
Amount Paid
In Person
In Person
Payment Total:
$100,00
$102,00
$202.00
Job/Journal Number
C0M2010-0098 I
COM20 I 0-00981
COM2010-00981
COM20 I 0-00981
Payments:
Type of Payment
Check
Check
cReceintl
Description
***+ 10% Administrative Fee***
Blimp + Special Permit
Deposit
+ 5% Technology Fee
Paid By
L1THIA AUTO STORES
L1THIA AUTO STORES
, f
i,"tl.~~~:i . ~';T~~ !~~~.~.. :'
. m.H~' '..~ ,"
~;j~~:.~~ ~i.:~iji;~ (~. .
';,}';t''J,
Received By
Check Number
Batch Number
djb
djb
..~-~
"
"
.(~, J
"~ ~:i(li
J;~'j;;;"
:1~}':'~\"
,!;'~.
'}?;~r}~~~~;' ,
. i :~':~ J i"
Page I of I
51145
53112
Item Total:
Authorization
Number How Received
Amount Due
18.00
80.00
100.00
4.00
$202.00
Amount Paid
In Person
In Person
Payment Total:
$100.00
$102.00
$202.00
7/26/20 I 0