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HomeMy WebLinkAboutPermit Signage 2011-2-25 225 FIITH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~ 1/_ O~ sl/ ..~ City Job Number SPA.. 'Z.C ..~ Job Location ItpS7 Moh4-v1d< ..~ Assessors Map I 70] z S :5 ( Q ~J ~ ~ ..~ Address ~ City ~ ~ "~ ! I ,~ ,.. """_"'.Jt. II I. '. ..~ ~ F'" !4 ~ ~) "~ ~ ~ ~ ! (Q> ~ 1 ~ M (Obe' III I A~c..(!" ((:J/II"Y'" SPRINGFIELD ~0'\!":~W'" . ~"ii~::':<-, ,,' ~ ~ , ,'. ~.~, ". Qj) " , CITY OF SPRINGFIELD; OREGpN';' ':. ",',: B)vo! Tax Lot 05goo r-q;,;;J~:, ,': f;~~~b[;I:]:f;,:f:;'~];;tl:;.:-::~~f,I~;-,,;,!ti:: ~~~i;,j;'i::::;;:~::/~"L'j: ~ "':;E::~ ",:: " Owner of Property ;04"1.1I1\1\.e<L \)r~+Vt~' L.LL PO 1?OX Z2bb c.-v.- (,-WE Phone State (joR- 97'102. Zip I'c~nj~e~~~rlf~~i1lj~~:,~;f~~5~~::;~,ii~~~.~:~f~;~c~rl;[~:;i'~[;;;:~!{,~~~~l:~-' :~JJ~;Y":"'~~':~" Contractor ' OW I~C e, , Address Phon" City State ' Zip Construction Contractors License # Expire. Description "7lA-AlNr=tL /fL~~ Date of Installation 2ft 5" 11/ Date of Removal 2/2 S' /,' ~ / ' I I ! /$ Permit Fee:$2~_s.{)oin:luding $!9-0060Deposit 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 $100.00 deposit if the banner(s) and/or portable sign(s) has been removed, Signatur" ~ Q~ Dat" ~ft);jl [-~;--:';"" .::K .~~. ,:"T~~:':, .~:':':'-" ,F,or."Oliiifciil~~,:,:/f5:~:'-----;'J- ;-- ',-'-~;~~ ,':-,- ,:~;-,: ' , ~ate of ~p-p;ic~t::---21i-~~'---~~ob # s/7:o'6-Y; /r ~;ecei-p;~?OjT- -3 bT' / I "":b t.1 Amount Collected ) I S" - Issued By Sbared Drive (T:Y'Building F~]~le Sign Permit eso 7-08.doc 1 ..; "'-.. www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2011-00311 1657 MOHAWK BLVD CITY OF SPRINGFIELD 225 Fifth 51 Springfield,OR 97477 541-726-3753 permitcenler@cLspringfield.or,us 224-00000-426605 224-00000-425602 100.00000-425605 TOTAL DUE: f$t,;PAYlVfENTTYWE."~t,,~1,~.~PAYOR~':CASHiER:;DBOWLS~BYL'ii.~(.:t.~:~" :C6MJ~f~~T~;;$'ir.,.~~' ,~~ ~:~~ ;"0;0 ,~t{ Credit Card richard proulx 02518d RECEIPT NO: 2011000361 {DESCRIIH/ON..: ~'*" · --",co _::..:'~;,' Admin fee (10% of applicable fees) Banner, Portable Technology fee (5% of permit total) RECORD NO: 811.SPR2011.00311 DATE: 02/25/2011 ff . ~,:_, "'.~ ",,"ACCOUNt:CODEG-;-.L&':::::.'.'t::-./iJIIIOUNT.DUE.;.':.":.'. j 10.00 100.00 _ _~_"_w_ 5.00 115.00 AMOUNT PAID 115.00 . ~ TOTAL PAID: 115.00