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Home My WebLink AboutPermit Signage 2011-2-1 225 FIfTIi STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~ . I _ ~c:r ..~ City Job Number >!\>fl cal( -0 c:> I ..~ . ~. -6iJ }It kiN 01'. ~ Job Location ~ ~ ..5i )~ ...."".4 OcZ3")~\ Ql ~ G\Ql Owner ..~ "'?rf7l.} S?(LIA/C, (:l(v ( ~ Address"> -r -, e. ~ G\Ql City rtIJJ ~ .. ~ Contractor 8 i .~ ':'-...l' , .-~ I, I, '. ..~ G\Ql ~\. ~q ~: ~ ...~ rtIJJ G\Ql ~ .JQ. ~ ~ o ~\t{ ~ ~ ~ M ?J:=F: LOt." -oaoL{ ( . - .... .,. . '<,,,. "~ ..'" . ,.,.--,,~, ~", ,':~ ,: CrrynFtSRRINOFIEEiD~ OREGON}f':~ ~w:,: ' .,;.'" ~. ,.' ~ #, f" ~ " _,', ~,' < . , .. f. {)5,CXJO Phone ~('L G- (::,..1' C o-t.. 97110\ state Zip Address -.----- --" --"Phon" City ~ -"'State / Expire~ Zip Construction Contractors License # Description "-t?l"i N/1/e-rL.. I !lq III . I Date of Removal 1/1 /20 /I I ' Date of Installation S\'1~,~ Permit Fee: $225.00 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 banner(s) and/or portable sign(s) is not larger than 60 square feet, and will be removed 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 of the 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. Signatur . tllUl z/' III n;~~~i!~;;ri~T Date of Application 2. I -1:::,4 Job # Sf~Z.OI(-M~J~ Receipt#20/(~OOZOY Issued By Amount Collected 7_25 -- Shared Drive (T:)fBuilding FormsIBanner]ortable Sign Permit CSD 7-08.doc ;J:.l - ';'; SrR1N G.F. IE~.-. .t .....~~~ ~. ~~~.J:T\. OREGON CITY OF SPRINGFIELD Building I Sign Permit PERMIT NO: 811-SPR2011-00159 IVR Number: 811100742793 www.ci.springfield.or.us 225 Fifth SI Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 02/01/2011 ISSUED: APPLIED: 02/01/2011 02/01/2011 EXPIRES: VALUE: 03/01/2011 $0.00 SITE ADDRESS: 5650 MAIN ST, Springfield, OR 97478-6250 ASSESOR'S PARCEL NO: 1702334103000 SCOPE: Banner, Portable Sign WORK INVOLVED: New TYPE OF STRUCTURE: Commercial Banner. install 012911 removal date 030111. ref:COD11-00047 PROJECT DESCRIPTION: Phone Number: OWNER: ADDRESS: PSMMR LLC 3474 SPRING BLVD EUGENE OR 97405 Contractor Type Sign Contractor Contractor Name OWNER CONTRACTOR INFORMATION I Lie Type OWNER BUILDING INFORMATION I # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: # of Units: o # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: Electrical Specialty Code Edition: Springfield Fire Code Edition: Mechanical Specialty Code Edition: Municipal I Development Code: Plumbing Specialty Code Edition: Residential Specialty Code Edition: Structural Specialty Code Edition: Lic No 0000000 Lie Exp 08/12/2025 Phone Lot Size: Sq Ft 1st Floor: Sq Fl2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: o Site Information I Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit 2/1/2011 2:15:29PM Page 1 of 3 >-:. .. SpR IN.GFIE~D .; . ;, -. ^~ ^~ .^r::'-& OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Sign Permit PERMIT NO: 811-SPR2011-00159 IVR Number: 811100742793 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 permitcenter@ci.springlield.or.us PROJECT STATUS: STATUS DATE: Issued 02/01/2011 ISSUED: APPLIED: 02/01/2011 02/01/2011 EXPIRES: VALUE: 03/01/2011 $0.00 SITE ADDRESS: 5650 MAIN sT, Springfield, OR 97478-6250 AssESOR's PARCEL NO: 1702334103000 PROJECT DESCRIPTION: SCOPE: Banner, Portable Sign WORK INVOLVED: New TYPE OF STRUCTURE: Commercial Banner - install 012911 removal date 030111. ref:COD11-00047 Frontyard Setback: Interior Setback: sideyard Setback: Rearyard Setback: Solar Setback: DEVELOPMENT INFORMATION ~ Overlay Dist: # Street Trees Reqd: Paved Drive Reqd: % of Lot Coverage: Highest point on structure to north property line: REQUIRED PARKING Total: Handicapped: Compact: PUBLIC IMPROVEMENTS ~ Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description I Descriotion Tvoe of Construction Unit Amount Unit TVDe Unit Cost Value FEES PAID I Description Admin fee (10% of applicable fees) Technology fee (5% of permit total) Banner, Portable Banner, Portable Deposit Total Amount Paid Amount Paid $20.00 $5.00 $100.00 $100.00 $225.00 Date Pa id 02/01/2011 02/01/2011 02/01/2011 02/01/2011 Reciot # 2011000204 2011000204 2011000204 2011000204 Springfield Building Permit 2W2D11 2:15:29PM Page 2 of 3 ......:.J- '. CITY OF SPRINGFIELD Building I Sign Permit PERMIT NO: 811-SPR2011-00159 IVR Number: 811100742793 www.ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 02/01/2011 ISSUED: APPLIED: 02/01/2011 02/01/2011 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 pennitcenter@ci.springfield.or.us EXPIRES: VALUE: 03/01/2011 $0.00 SITE ADDRESS: 5650 MAIN ST, Springfield, OR 97478-6250 ASSESOR'S PARCEL NO: 1702334103000 SCOPE: Banner, Portable Sign WORK INVOLVED: New TYPE OF STRUCTURE: Commercial Banner - install 012911 removal dale 030111. ref:COD11-00047 PROJECT DESCRIPTION: Plan Review I Deoartment Application Acceptance Received Due Date Comoleted Result 02/01/2011 02/01/2011 02/01/2011 Over the Counter Permit Issuance 02/01/2011 02/01/2011 02/01/2011 Issued Reviewer David Bowlsby David Bowlsby INSPECTIONS REQUIRED I Inspections, 6972 Banner Removal Banner Removal: To be requested the day following the expiration of the permit. If inspection is not requested, the applicant may fortiet 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 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, Buildjng 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 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. 2/ I1I1 J Date Springfield Building Permit 2/1/2011 2:15:29PM Page 3 of 3 TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth Sl Springfield,OR 97477 541-726-3753 www.ci.springfield.or.U5 811-SPR2011-00159 5650 MAIN ST permitcenler@ci.springfield.or.us ,.~.~ 0*:;;is,s;~~llttf': 7;S:,,'At.c,6:UN:t~C:0t)Ei'"<':-:;'t~~~.-~ t":.-?.2 224-00000-426605 224-00000-425602 821-00000-215500 1 00-00000-425605 TOTAL DUE: l~;PAYnn.:~~i'Ti~~'i::/cdg;'Tp,e:~iQR' ;"cAsHu:R;'DB6wLsBy~~~~~:ETj>~>CCiMM_~,NI~'~~~P7~~z':T :J._.~:" -,~. . < Credit Card br tax services lie RECEIPT NO: 2011000204 lDESCR,,:j:TION':,i{,'."1C~~*:'~r":'7'~" '" Admin fee (10% of applicable fees) Banner, Portable Banner, Portable Deposit Technology fee (5% of permit total) RECORD NO: 811-SPR2011.00159 DATE: 02/01/2011 ''':'AMOUNT~lil:rE~:'C - 20.00 100.00 100.00 5.00 225.00 AMOUNTipAID'~_---~-:;..i..: '.;J 225.00 J 017008 TOTAL PAID: 225.00