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HomeMy WebLinkAboutPermit Signage 2011-4-12 s::l" ~, ,"-" ...~; qJ; ...~! ;;?;. ...~~ 0) q)J (]:).J ~) -1I 'r=l~ ~~ L.I, ~; ~) ~, J..--_\'; ..o~' ~i ~, ~, I~~ .,- ~ ;:~ '.- i , e: . 'Ii V) =- IJ J,~ "~l .' .-, ~ e-1i ~l ~,11'1 ~, .... 'r--l,.' 00) ~ -' <1:)) '. ---l~ ~) ro' \~ -, eJ ~'.Ij --- Llj ~) g:: gj ~j ~\ ~) . .'~. ., SPRINGFIELD ~. .".'.: A', , ' " ; V ..,::, ~ OwT ~y<;;. 9 225 FIfTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 FIREWORKS SALES LOT/CHRISTMAS TREE LOT Banner/Portable Sign Permit CityJobNumber sffLZJ::::,//-<50 72."7 Job Location .3'1;.40 ~,,^.,,\...W' j/oZ 31 L{ I ~\,(~":)~Jd, 61-Cj1<Jl~ otboa Tax Lot Assessors Map Owner OwnerofProperty ~\....k """-~^:J'::." ""e.b,^i':~ ~G..~ V~J.LLL Address t/o'V....a..fM.rN< LJ 11 0 \)i\\d.~ e. ~a.. CDO~hone et' -c; 'O;tt -tfll~'1 City EvOW'-t.- State nit. Zip q 7 Ljd Cunllul.lu'III1:"(II)~1 ~I'~{~ Contractor sw1'1 \\u.....~" Address Lfo'S'''; <;;O(sy .\\..;.... City ~<t~t\J o'jlv"'\" r 5\..-wt Phon" 'Sll1-lZq-SSl.lJ o~ Zip~1'ilc(. State Construction Contractors License # ItI/t.... Expire' Description ~>A~ ~r~ rJ-..,\....\v, ~ ~Yt.u.')oJ\c..<). '&~ ~\\...ok.\ -k <..Jc\a... tl~ -kt Date ofInstallation ~'>At '2.3.,J Date of Removal ~')\y (/,'" Permit Fee: $115.00 Permit is valid for 30 days from date of Installation By signature, 1 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. Signatur" ~ Date Lf!.z. /', I Date of Application 5/2-/;1 I / ~~ For Office Use 9/-00 7 z.. 7 Receipt # Z6//--Dc:::)5S 'Z.. liS- Job # Issued By Amount Collected Shared Drive (T:}fBuilding FormsIFireworkslChnstmas Tree Banner-Portable Sign Permit 1-2010.doc .} ._~ l TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth 8t Springfield, OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-00727 3890 MAIN ST permitcenler@cLspringfield.or.us RECEIPT NO: 2011000852 I.DESCRIP..tI6NO""\.~':: ':.",5::\:'2" .!ldmin fee (10% of a~plicable fees) Banner, Portable Technology fee (5% of permil lotal) RECORD NO: 811-SPR2011-00727 DATE: 05/02/2011 . '"V '~1." . -cP. :--'., ":.'".ACCQUNJ:CODE:;;' ",;22 ";;';;JLAMOUNJ~DUE 224-00000-426605 10.00 224.00000-425602 100.00 100-00000-425605 5.00 TOTAL DUE: 115.00 .:'.; "ct.:.;.i.kP..-r;;:.; .~MOUNT PAID: 115.00 '-1 1< ;P~:ailJ~_NiTYPE Check 30007320 ~""': ::"','''-' ,": ,~" ''''h''',;,';.,;' ~ ",%t ,'cr",', ,~,' 'r"'",-,!:"'" ":1 ~',r:_ ,~, PAYOR.;. CASHIER,DBOWLSBY~::"- .::~!~, COMMEt!JS: american promotional events northwest ~",,""~ TOTAL PAID: 115.00