HomeMy WebLinkAboutPermit Sidewalk 2013-4- •
SPRINGFIELD 225 Fifth St
, CITY OF SPRINGFIELD Springfield,OR97477
tier Phone: 541-726-3753
Building / Public Works Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-PW2013-00064
www.springfeld-or.gov permitcenter springfield-ar.gov
PROJECT STATUS: Issued ISSUED: 04/15/2013 EXPIRES: 10/12/2013
STATUS DATE: 04/15/2013 APPLIED: 04/15/2013
SITE ADDRESS: 538 MILL ST,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703352304800 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: Sidewalk repair
OWNER: VIDOS TAMARA LOUISE Phone Number
ADDRESS: 538 MILL ST •
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
INSPECTIONS REQUIRED
Inspections
9506 Sidewalk-Setback Sidewalk-Setback: After forms are erected but prior to placement of concrete.
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, 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
constr,��on.
Owner o ontractor Signature Date
)VOTICE; ATTENTION; Oregon law requires you to
HIS P . follow rules adopted by the Oregon Utility
i HDRIZE)T SHALL EXPIRE IF Notification Center. Those rules are set forth
O UNDER THIS p THE WORK in OAR 952-001-0010 through OAR 952-001-
'ti7ENCED OR IS ABAND NEDIF IS NOT 0090.c ;;lit/ the center.floral(Note1etheftelephone by
80 DAY PERIOD. OR nuiiiber for the Oregon Utility Notification
• Center is 1-800-332-2344).
•
Springfield Building Permit 4/15/2013 2:26:56PM Page 1 of 1
SPRINGFIELD CITY OF SPRINGFIELD
'i - 225 Fifth St
‘OREGON TRANSACTION RECEIPT Springfield,OR97477
541-726-3753
811-PW2013-00064
www.springfield-or.gov 538 MILL ST permitcenter @spdngfieldor.gov
RECEIPT NO: 2013000745 RECORD NO: 811-PW2013-00064 DATE:04/15/2013
DESCRIPTION ..o __r'_.r__ ty'` tACCOUNT CODE/iRANStCODE �u=kI AMOUNTcDUE-d
Sidewalk up though 90 Feet 201-00000-428060 1142 102.00
Technology fee(5%of permit total) 100-00000-425605 2099 5.10
TOTAL DUE: 107.10
. PAYMENTYTYP.E flit
Credit Card Rod Cummins Contracting 538 Mill Street 107.10
040838
TOTAL PAID: 107.10