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Home My WebLink AboutPermit Signage 2011-7-11 225 FIITH STREET. SPRINGFIEW, OR 9.7477 . PH:(541)726-3753 . FAX: (541)726-3689 l~ ..~ City Job Number ~ ~\ l~ ~) ..~ ~ ('Q) ~ ~J ~ ~ l o o :: :1 ~ m ~ rttal I~ ~ a Signature ~ ~ ~ Date of Application ~ ~ Issued By ..~ ~ M , \ ,'~-~'~'j'>"~"'~~'~.'!-7":>~l. .c,-:~ , _~,"", ~:;'"~'=..~"'-1kt::::'_, . ~ !,;.'}>::1ff;'~"""'~$,.;Ii:.~",.", '.I~:'- ~i;~tl~Tt~< 't:!~~I:M:~j9~~~fgl~J~E}~~!?/~.Q~~~0~t!~~~:'~~~~~~~~;," 51{-0 /72- Z- Job Location /1 ~ z.. (;,11 :I e~ if. Assessors Map /76 S Z z.. LO Tax Lot Owner of Property St",.la c)aJ1I.J.X2rfz.. Address /11''11/ Gd cw c'-'J Lp City f/pf lof Co~tractor/Installer '<)""1j Address 31 eft-( 0J-uv~ L.f City ~{)'p!j State rm phone(/(qj) 7 Z (, -(; Z 21) Zip o/P/ ~'7 Phone (S-"i!) 7 2& -(p 2 Z / 07f- Zip C;; 7477 State Construction Contractors License # Expires Description GiCvJ- tlcrW <</I g<-Uf' Date of Installation 7,1(( /, ( I I Date of Removal 7h~/~( I I $202.00 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 uriderstand that the above described display will be removed within fourteen (14) days from the date listed as the date of installation above. If the display 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 once per calendar year per development area. I also agree to call the inspection line at 726-3769 by the end of the 14th day to request an inspection to verifY the removal of the display. This inspection will begin the process to return the $100.00 deposit if the display has been removed. ~ 5~j7 Date ?~;/ I For Office Use 51/-D/72 Z- Receipt# ;:?OI {- 0 f '1 L( L( 202 - Job# Amount Collected Shared Drive(T:)lBuilding FormslBlimp_Pennants_Balloons 7-08.doc .. SPA:~G.,~E.l~ Ii~~~ ^ ,~- OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Sign Permit PERMIT NO: 811-SPR2011-01722 IVR Number: 811175957640 225 Fifth St Springfield,OR 97477 Phone: 541.726.3753 Inspection Phone: 541.726.3769 Fax: 541.726.3676 permitcenler@ci.springfield.or.us PROJECT STATUS: STATUS DATE: Issued 07/11/2011 ISSUED: APPLIED: 07/11/2011 07/11/2011 EXPIRES: VALUE: 07/25/2011 $0,00 SITE ADDRESS: 1162 GATEWAY LOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703222002404 PROJECT DESCRIPTION: SCOPE: Blimp, etc. WORK INVOLVED: New TYPE OF STRUCTURE: Commercial Balloon . Install 071111 removal date 072511 Phone Number: OWNER: ADDRESS: SHEILA S LLC 3190 GATEWAY LOOP SPRINGFIELD OR 97477 Contractor Type Sign Contractor # of Units: # of Bedrooms: Sprinkled Building: Fire Alarms: Energy Path: CONTRACTOR INFORMATION I Lie Type OWNER BUILDING INFORMATION I # of Stories: Height of Structure: Type of Heat: Water Type: Range Type: Hazmat: Contractor Name OWNER o 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 lic Exp 08/12/2025 Phone Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage: Sq Ft Carport: Sq Ft Other: Occupancy Load: o Engineered Fill: Fill Volume: Flood Hazard Area: Land Hazard Area: Retaining Wall: Soils Report Required: Springfield Building Permit Site Information 7/11/2011 11:05:51AM I Page 1 of 3 . '. S~~~N~:.IE.L~ ..~.. OREGON www.ci.springfield.or.us CITY OF SPRINGFIELD Building I Sign Permit PERMIT NO: 811-SPR2011-01722 IVR Number: 811175957640 225 Fifth St 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 0711112011 ISSUED: APPLIED: 07/11/2011 07/11/2011 EXPIRES: VALUE: 07125/2011 $0.00 SITE ADDRESS: 1162 GATEWAY lOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703222002404 SCOPE: Blimp, etc. WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Frontyard Setback: Interior Setback: Sideyard Setback: Rearyard Setback: Solar Setback: Balloon. Install 071111 removal date 072511 DEVELOPMENT INFORMA TION ~ 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 I Street Improvements: Storm Sewer: Storm Sewer Available: Speciallnstructon: Subdivision Accepted: Notes: Sidewalk Type: Downspout/Drains: Valuation Description I Descriotion Tvpe of Construction Unit Amount Unit Tvpe Unit Cost Value FEES PAID I DescriDtion Amount Paid $4.00 ----. $100.00 ------.. ..._._-----,,_._~._-,,-"-- -..--.------.- $80.00 ......,,-.-.----.. --.-. ---- - --. +----.-- ---.- $18.00 $202.00 Technology fee (5Yo of permit total) ~_I~+~.:._~a.l+I?~'~..:~..:~~~9..~.!.E~Eosit Blimp, ~ail5'~n,S.':.a.rch~g.ht.. ",_.__. ~~~:l].9!o of a~~~~b~e~~s) Total Amount Paid Date Paid 07/11/2011 07/11/2011 07/11/2011 07/11/2011 ReciDt # 2011001944 2011001944 2011001944 2011001944 Springfield Building Permit 7/11/2011 11 :05:51AM Page 2 of3 . S~i:~::~ L:~~ ~.OREGON www.cLspringfield.or.us CITY OF SPRINGFIELD Building I Sign Permit PERMIT NO: 811-SPR2011-01722 IVR Number: 811175957640 225 Fifth St Springfield,OR 97477 Phone: 541-726-3753 Inspection Phone: 541-726-3769 Fax: 541-726-3676 perm itcenter@ci.springfield.or,us PROJECT STATUS: STATUS DATE: Issued 07/11/2011 ISSUED: APPLIED: 07/11/2011 07/11/2011 EXPIRES: VALUE: 07/25/2011 $0.00 SITE ADDRESS:, 1162 GATEWAY LOOP, Springfield, OR 97477 ASSESOR'S PARCEL NO: 1703222002404 SCOPE: Blimp, etc, WORK INVOLVED: New TYPE OF STRUCTURE: Commercial PROJECT DESCRIPTION: Balloon -Install 071111 removal date 072511 Plan Review , DeDartment Permit Issuance Received Due Date Comoleted Result 07/11/2011 07/11/2011 07/11/2011 'ssued Reviewer David Bowlsby Application Acceptance 07/11/2011 07/11/2011 07/11/2011 Over the Counter David Bowlsby INSPECTIONS REQUIRED ~ Inspections 6971 Blimp, etc. Removal 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 1 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, Building 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. ' f~~ ,~i) ?I/);/ / Date Owner or Contractor Signature Springfield Building Permit 7/11/2011 11:05:51AM Page 3 of 3 ~ ~SP:~NGFIELD ~~ ~ ~ .~~.lt ~, }y,- OREGON TRANSACTION RECEIPT CITY OF SPRINGFIELD 225 Fifth St Springfleld,OR 97477 541-726-3753 www.ci.springfield.or.us 811-SPR2011-01722 1162 GATEWAY LOOP permitcenter@ci,springfield.or.us RECEIPT NO: 2011001944 RECORDNO:811~SPR2011~01722 DATE: 07/11/2011 lDESCRIPTI6Ni::;~..." '~L\..,;.t.L;;::'.~~ACCOlJNLCODE<: . ,'''LiLk; AMOUN~LDUE~' {',I Admin fee (10% of applicable fees) 224-00000-426605 18.00 Blimp, Balloon, Searchlight 224-00000.425602 80.00 ~rl1f?:.~Searchlight Del?o~_ 821-00000-215500 ,~~__ 100.00 ---1echnolo.gy fee (5% of permit total) 100-00000-425605 4.00 TOTAL DUE: 202.00 b-!'.f.,(M~.!:(tfYe!';,,'::-P..e.yqB.4' c-"J'ASH}ER:~i3J3.~!N[SBY {,::.....colVllVl,gNfs_._.:~}: ,'., AMOUNTg,Alb:';' "",5:::1 Credit Card michael schwartz refund to: michael schwartz $202.00 04626d 3194 gateway loop, springfield or 97477 TOTAL PAID: $202.00