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Home My WebLink AboutPermit Signage 2010-11-3 225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~. 'E~ ..- - ~ ~-- : ~. ~" , . ' . l.:_..~; ~i ~i ~'~ . .,._-1': .",1 ~" ~; o. t:l( ~; ~.! 001 , r:/lJ.; ~; ~; \;"J..1 ~, \;"",Ii =' .-_1, ..__.-1; ~; fN{"I. , ~l -----, ~j ~, ~, ~1 ~j ~! ~j ~.l ~; -Y f/!'\, . ~-~ -:.......... f?"'I, E~' 1'--1 ,- 'j -;I 'r--'~ __--1\ ~l ~,,;~,';(;:: :~';'@L~i ()itspRtNGFIEEll~: OREGON' ;:~>. .;', ':,. . ,;./.::.. ~.-. \~~~ H'~ f;:, l:' :~ ',.,J,...:t "';t. fr' -v _ l.~'....::j. _.; I'" .,'. "n"'. if, '3/\QO\D '00%\ S. PRINGFIELD 1;;''', '3::J",,']~ r~ h ^ /1;'" ' , -d2L ....-- A..d;' '> 1 '-':S;:~"~ ;" '.' ":;i;;' ....'A.;."':';~;;.. ~ ':"" ~iI~_:LL~~'::~ ~JW City Job Number 5/0- ~5) /g3 Q <7/ Job Location Assessors Map~\ Tax Lot ()'2. \0"1 Owner of Property 17r>// l1~j 7~.JC1k ... ~(\1)\ 1) ~L(fl d~ Add= n~ ~\( t'nJLex- ~ Ph,", city~{d fI State1fl-. ZiP~\~\ ContractorlInstaller Address Phone City State Zip Construction Contractors License # Expires P:l/t! 10,;,.('\ Date ofInstallation /0 J 7 / Iv I I Description Date of Removal /~/1zfo ~I4AN~ "" l-<TI"L.o ~~.s ,1'>)_ /'iI,!6 Q $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 only be issued twice 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 if the display has been removed. Signature ~/-:~ Date Irlj3jl(J)J ~ . For Office Use Date of Application I ~/ ~JI 0 Issued By C-~--c.- Job# :;;:'0 - 4 \/ Receipt#;2o 10 rJ" 0 '17 / 2"1'-{02,. Amount Collected Shared Drive(f:)/Building FormslBlimp_Pennants_Balloons 7-08.doc .. www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Sign Permit PERMIT NO: 811-SPR2010-00451 IVR Number: 811129586952 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 5~~~:-. FIE~ .(~ ;""}."OREGON permitcenter@ci.springfield.or.uS PROJECT STATUS: Issued STATUS DATE: 10/6/2010 ISSUED: APPLIED: 10/6/10 EXPIRES: 4/4/2011 VALUE: $0.00. SITE ADDRESS: 183 Q ST, Springfield, OR 97477-2190 ASSESOR'S PARCEL NO: 1703263102107 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: PROJECT DESCRIPTION: Balloon - Removal date Nav 3rd - Refund to Little ~easars Pizza @ 183 Q st OWNER: ADDRESS: EDWARDS PAUL D 1771 CAMP BAKER RD MEDFORD OR 97501 Phone Number: Contractor Type Contractor Name CONTRACTOR INFORMATION ~ Lie Type Lie No Lie Exp Phone BUILDING INFORMATION ~ # of Units: o # of Stories: I Heig~t of Structure: Type of Heat: Water Type: Range Type: Hazmat: Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Base,ment: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: . # of Bedrooms: Sprinkled Building: Fire Alarms: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal" Development Code: Plumbing Specially Code Edition: Residential Specially Code Edition: Structural Specialty Cod.e Edition: Energy Path: Site Information ~ Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Spr}ngfield Building Permit 10/6/2010 2:55:27PM Page 1 of 3 sp~. ~\N~.: IE.~~ ~...~ "'3'i:.~ . ,"; "' OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Sign Permit PERMIT NO: 811-SPR2010-00451 IVR Number: 811129586952 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenler@ci.springfield.or.us PROJECT STATUS: Issued STATUS DATE: 10/6/2010 ISSUED: APPLIED: 10/6/10 EXPIRES: 4/4/2011 VALUE: $0.00 SITE ADDRESS: 183 Q ST, Springfield, OR 97477-2190 ASSESOR'S PARCEL NO: 1703263102107 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: PROJECT DESCRIPTION: Balloon - Removal date Nav 3rd - Refund to Little Ceasars Pizza @ 183 a st DEVELOPMENT INFORMA TION ~ REQUIRED PARKING Frontyard Setback: Interior Setback: Sideyard Setback: RearYard Setback: Solar Setback: Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description ~ Descriotion Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value I: ~'.";0:~T,,, 'P"'l.;- -IJ;;F;;~~:::'"~::::~40;:;;;"'"~+i'F~~"~';C Y~w1'!ii;;':':'-',";' _ ~-;;- ""'-c~~"t-fc':4l",,"'-'IID";7~fB'i '~'-.7IT y, --'X <:-'~TiITY;-l. "jr:'~' - ."..- -,','-' _...'__\':....-c..>.';:;-"w fW0'~ P/' il ~ ~.... j/" - '.~_-,..""'tt<;-'. .":ah:!:0J;_~s-':s:zg; \,'. ~ 'f~ - I:, .,u,Pj,0;,;:;:' --If:'itl'.f:ji~FEE$lB~lP'Pf~.;i-~21'tyxi?i#")" ! ~~i~~''',<!t~~;<:;a!ibY'Er _ {[:<"";,:,, :~:" >\',:4. .', ' ",' i _',~l Descriotion Amount Paid Date Paid Receiot # Blimp, Balloon, Searchlight $160.00 10/06/2010 374513 Blimp, Balloon, Searchlight Deposit $100.00 10/06/2010 374513 Admin fee (10% of applicabl':.fee~~. $26.00 10/06/2010 374513 Technology fee (5% of_permit total) $8.00 10/06/2010 374513 Total Amount Paid $294.00 Springfield Building Permit 10/6/2010 2:55:27PM Page 2 of3 www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Sign Permit PERMIT NO: 811-SPR2010-00451 IVR Number: 811129586952 225 Fifth St Springfield, OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 Sr~~~G:.IEL,~ .i~ . ~;:L0' OREGON permitcenter@ci.springfield.or.us PROJECT STATUS: Issued STATUS DATE: 10/6/2010 ISSUED: APPLIED: 10/6/10 EXPIRES: 4/4/2011 VALUE: $0.00 SITE ADDRESS: 183 Q ST, Springfield, OR 97477-2190 ASSES OR'S PARCEL NO: 1703263102107 SCOPE: WORK INVOLVED: TYPE OF STRUCTURE: PROJECT DESCRIPTION: Balloon - Removal date Nov 3rd - Refund to Liltle Ceasars Pizza @ 183 Q st r~r:-,:~~ ':~,~L,~-'T:'~~4!~~~~:~r>;!~"/'ut-l~.{,~~t{:~~~';P~n'R~Cj;~~:~~:~:. ~':_'~~~,~f~~~;=:~~::;>t~c-:l" ~"" e: .;<c'"" ,~ Reviewer Chris Carpenter Chris Carpenter Chris Carpenter 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 or 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 SCifety. 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 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. Owner or Contractor Signature Date Springfield Buiiding Permit 10f6/2010 2:55:27PM Page 3 of 3