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HomeMy WebLinkAboutPermit Signage 2011-3-21 ~ "~ ..~ ~ -e ,__Ii (Q) tfO}..l ~ "~ e: ~ ~ ~ ...~ 81 I 8 II I. '. '.~ taj ~ ~, = ~'0J .<:.~< ~ ~ ~ ! ~ ~ ~ 1 M .'C 'i (1\-"'- ~ ~. " .~. ,.'"fd" .' . ~.:". . - . .."". -".~" "'~'~~"Z' , '>t;'U?I;TM..mrSERINGFIELD, OREGON~: :'~:," . '''_-M;-__r , ~'"~.~-,;~. 'J;/~9!:i\'."-:f ',,"".-1:. 1:l"'J:. - ." "_'_"'. ~ ' 1.. ~ 225 FIFTH STREET. SPRINGFIElD, OR 97477 . PH:(541)726.3753 . FAX: (541)726-3689 City Job Number S?Itz.cIl~OO L.I S- S- ~'S' cJ~l- a "'S t- /70327/0 c Job Location 'oJyca Assessors Map Tax Lot "~:erofPr~~:~-"-P1 (}_-TM~_'~ iA\:~'7;--"~'-"'='~'M LJ,__,.~... . ".......n ...... w.. sf- Address--.lY 84 cke-c...l<- City SflL\-..~ 1!.~td PhODe State oIL. Zip 97C(77 Contractor Address tz) e~ PhODP >"1 f- {, Cf;?r/ / (( if"? Y?7 d.-<;s- -S ~,,< "(~' ~ 1 oJ Construction Contractors Lic e # ()K City State Zip Expire. PC) \'" -t--0 ~ \-r 3-~1-/( r -(2.1- t ( . Description ~CO Date of Removal Date of Installation 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 tirneline specified, I will forfeit the $100.00 deposit. I also understand that this special pennit 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). Tbis inspection will begin the process to return the $100.00 deposit if the banner(s) and/or portable sign(s) has b e' oved. Date of Application Issued By D~ Amount Collected Shared Drive (T:)'Building Fonns/Banne:r]ortable Sign Permit CSD 7-08.doc .. . SP~:~.~L~ ."~ >""-::;~ OREGON www.ci.springfield.or.us TRANSACTION RECEIPT 811-SPR2011-00455 28 W Q ST C CITY OF SPRINGFIELD 225 Fifth St Springfleld,OR 97477 541-726-3753 permilcenter@ci.springfieJd.or.us ~'e~.'fOOE;N:rjX~I;:~~' , ,"'" -. '15 ~iQB~6',C"ASHi-ER:'D'B'OW'LS"BygJ~~'~'~~ Check robert timmons 29148 RECEIPT NO: 2011000516 RECORD NO: 811-SPR2011-00455 DATE: 03/21/2011 [OESCRIe:TION' , -. '., -~,.,. "J ;;~ct; .~:-. ;;';::;:;;;;:;;';,3';;'" . --.'AC:CQUNf..cODE-~;;~-';'";:~AMQUNT;OUE .>.;;;.:"~ Admin fee (10% of applicable fees) 224-00000-426605 20.00 _Ban~!'c~ortable 224-00000-425602 100.00 .~n..n~c!:orta~e Deposit 821-00000-215500 100.00 _ TeEhnolo~y fee (5% of perm~. total) 100-00000-425605 5.00 TOTAL DUE: 225.00 .. COMMgNTs::;.:t:;'-.; '~/.."f.>'_ "'\.3;AMOUNT.PAID. return deposit to: robert timmons 225.00 28 w q street unit c, springfield or TOTAL PAID: 225.00