HomeMy WebLinkAboutPermit Signage 2010-11-9
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225 FIITH SI'REET . SPRINGFIElD, OR 97477 . PH:(541)7Z6-3753 . FAX: (541)726-3689
llREWORKS SALES LOT/CHRISTMAS TREE LOT Banner/Portable Sign Pennit
City Job Number .$ f>d.e~( C-C':I G 70 Z
Job Location r;1l-r~tUo/ 1lJ1f'-L '2 77 0 Q/Jt---ew4y Sr - YR;A;(jF/~, ae.
- '97,/ 7)
Assessors Map \ 10'3 -Z 2' Cs c..:::" Tax Lot () 2' 30 G
Owner
Owner of Property C;~p- ~ffEtv4i ;/J/9-u- A ,J...(!.. -,,(/RLS7i~d-~i!. _
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Address j3cJ t90 &:#rEi/J1j 5-T/:!.B=-r PhoD" /-SL//- 71/7- 6 ~y
City ~PR/~Fi~~)) State ~;t Zip '17'1-77
Contractorllnstllller ~ /I, I " -n
Contractor ;1f/c: /J ') L-fI-,t!Q;@ 7J-S ~ec---.::;;. ,
Address c2 ~O I fez; f!..t -/9- SrR ee-r
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City
State
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Zip
Construction Contractors License #
IJIA
Expireo
D .. 7 fi77 p tf ' X' f I P)..<-MtJ~
escnptIon ,L.:-
Date of Installation /)- ;J..,/- /0
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Date of Removal
Permit Fee: $115.00
Permit is valid for 30 days from date ofInstaUation
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 po~ble sign(s) is not largertJ.um 60 square feet. _~/4;t/ I~ ;3 d-' s.B. ;::'/ {.
~/-,,(jtv()tJj) Win+- McJ!o'1 ~R1S(/I171-5 /;('e:-c":::' tl /l..J .-Lr, /!-771Ie.J/E:D ()
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Signa~;td0~~ /ltr!-{j'-t' (
Dat"
/1-9-/0
Date of Application / (It z.;lo
For Office Use
Job# SIO -0 ~ 70 g
Receipt# 701V- ~I <J
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Issued By
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Amount Collected
Shared Drive (T:)lBnilding FormsIFireworksfCbrist Tree Banner-Portable Sign Permit 1-2010.doc
www.cLspringfield.or.us
TRANSACTION RECEIPT
811-SPR2010-00708
2770 GATEWAY ST
CITY OF SPRINGFIELD
225 Fifth St
Springfield,OR 97477
541-726-3753
permitcenler@cLspringfield,or.us
RECORD NO: 81'-SPR2010-00708
DATE: 11/12/2010
RECEIPT NO: 20 I 00008] 9
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LDE~CRIPTION~"-,,;'-"-:' . :,:....,;;
Banner, Portable
Technology fee (5% of permit total)
Admin fee (10% of applicable fees)
CPAYJ~j:NU.'(EE'. ,-.: P.A'iOR.'
Check
1161
. .... ~';.-- - -'.", :.:3.;'= ',' 'ACq~U:N:r~C.o[)E~_'" :iAM6ou~~tQl.IE'- :"
224-00000-425602 $100,00
100-00000-425605 $5,00
224-00000-426605 $10,00
TOTAL DUE: $115.00
:.cAst'iIER-DI'OWLSBY;. '0 "CQM.r.jENis.f:~--..:':'''--::_~-''_-' ;; :-,AMOUNT PAID'- - -:. --,
$115.00
mccoy christmas trees
$115.00