HomeMy WebLinkAboutPermit Signage 2010-7-27
225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689
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SPRINGFIELD
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Tax Lot
Owner of Property ~<Z.j.fI~' /4- ~ <0...tU.7/h?.-:t:s.
Address ;3)/9</ &1L-~ (/Y7yJ Phone
City - <:'~j7Lo State c)z
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Contractor/Installer
Address
Phone
72Co-lP2.z...J
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City
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Zip
Construction Contractors License #
7</} U/~ S/-k:~,IJ
Date of InstaUation ~ ~ $-:;1/ ()
Description
Expires
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5/'/7 /1"0
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Date of Removal
$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 Gan 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 to return the $100.00 deposit' e display has been removed.
Signa
Date
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For Office Use
Date of Application ?/2"7,// {}
Issued By C ~
Job# Ci 0-11' 9'
Receipt#
Amount Collected J,' \7
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Shared Drive(T:)lBuilding FormsIBlimp]ennants_Balloons 7-08.doc
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"., I Building/Combination Permit
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Status Iss u ed PERMIT NO: COM2010-00999
225 Fifth Street, Springfield, OR ISSUED: 07/27/2010
54]-726-3753 Phone APPLIED: 07/27/2010
54] -726-3676 Fax EXPIRES: 08/10/2010
, VALUE:
54]-726-3769 Inspection Line
SITE ADDRESS: 1162 Gateway Lp Springfield TYPE OF WORK: Blimp, Portable Sign, Etc.
ASSESSOR'S PARCEL NO.: ]70322200240]
TYPE 9F USE: New Commercial
PROJECT DESCRIPTION: Balloon permit removal date 08/]0/20]0
Owner: SHEILA S LLC
Address: 3]90 GATEWAY LP "' . ,,)\:':y,.' :
SPRINGFIELD OR 97477 \'-'~""
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I CON'fRACTOR INFORMATION I
Contractor Type Contractor License Expiration Date Phone
I BUILDING INFORMATION I
# of Units: # of Stories: Lot Size:
Primary Occupancy Group: Height of Structure Sq Ft ]st Floor:
Secondary Occupancy Group: Type of Heat: , Sq Ft 2nd Floor:
Primary Construction Type Water Type: Sq Ft Basement:
Secondary Construction Type: . Rillige Type:: , . Sq Ft Garage/Carport
# of Bedrooms: ..'.' .~"'. . E'"ergy Path': Sq Fl Other:
Sprinkled Building: n/a Occupant Load:
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Setback: Overlay Dist: Total:
Side] Setback: # Street Trees Rqd: Handicapped:
Side 2 Setback: ~~1Xed.pr~y.~.Rqd: Compact:
Rearyard Setback: . %,'of Lot Coverage:
Solar Setbacks: .......'~,'"'~,. '.."".;"
''''<'';'' ....,..,..,.
I PUBLIC IMPROVEMENTS I
Street Improvements: Sidewalk Type:
Storm Sewer Available: DownspontslDrains:
Special Instruction:
Notes:
I Valuatiori Description I
Description Tvpe of Construction $I>(;r S"IFt Square Footage Valne Date Calculated
or multiplier or Bid Amount
Page I of2
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CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM20]0-00999
ISSUED: 07/27/20]0
APPLIED: 07/27/20]0
EXPIRES: 08/10/20]0
VALUE:
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Status
Issued
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225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
.:Total Value..of Project
l'iFe~sepliidt"
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Fee Description
***+ 100/0 Administrative Fee***
+5% Technology Fee
Blimp + Special Permit
Deposit
Amount Paid Date Paid Receipt Number
$18.00 7/27/10 2201000000000000892
$4.00 7/27/10 2201000000000000892
$80.00 7/27/10 2201000000000000892
$100.00 7/27/10 2201000000000000892
Total Amount Paid
$202.00;~:;::~-:~', i~';i;,?l::.::',:' ';.h
I ,,!'J!\n R~"iews ~
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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.
L Reauired InsDect~
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Banner Removal: To be requested tbe day fop<iwing the. expiration of tbe permit. If inspection is not requested,
the applicant may fortiet the deposit. .
By signature, I state aud agree, that I have carefully examined the completed application and do herehy certify that all
information hereon is true and correct, and I fnrther 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 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 inspection's;ai'e)r~(rl"~s.ted'at the proper time, that each address is readable from the
street, that the permit card is located at the fro ~',' ~~p('ope~~ty~ arid 'the approved set of plans will remain on the site at all
times durin ruction. .- ," - .' 'C:1~~~~,1' ;'
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Page 2 of2
225, F.if..h Street
Springfield, Oregon 97477
541-726-3759 Phone
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City of Springfield Official Receipt
Development Services Department
Public Works Department
RECEIPT #:
2201000000000000892
Date: 07/27/2010
3:01 :56PM
Job/Journal Number
COM20 I 0-00999
COM20 I 0-00999
COM20 I 0-00999
COM20 I 0-00999
Payments:
Type of Payment
CreditCard
cReceintl
Description
Blimp + Special Permit
Deposit
+ 5% Technology Fee
***+ 10% Administrative Fee***
Paid By
MICHAEL SCHWARTZ
Check Number
Received By .. Batch Number
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Page 1 of1
Item Total:
Authorization
Number How Received
Amount Due
80,00
100,00
4,00
18,00
$202.00
Amount Paid
04121p In Person
Payment Total:
$202,00
$202.00
7/27/2010