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Permit Sidewalk 2013-4-
SPRINGFIELD I' c CITY OF SPRINGFIELD 225 Fifth St Springfield,OR97477 Phone: 541-726-3753 R EGON Building / Public Works Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-PW2013-00059 www.springfeld-or.gov permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 04/10/2013 EXPIRES: 10/07/2013 STATUS DATE: 04/10/2013 APPLIED: 04/10/2013 . SITE ADDRESS: 5303 MAIN ST,Springfield,OR 97478 SCOPE: ASSESOR'S PARCEL NO: 1702333107303 TYPE OF STRUCTURE: PROJECT DESCRIPTION: City sidewalk Repair . OWNER: ARM CHAIR HOLDING CO LLC Phone Number: ADDRESS: 38533 JASPER LOWELL RD FALL CREEK OR 97438 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone ROGGE CONCRETE LLC CCB 183518 08/11/2014 541-513-1075 INSPECTIONS REQUIRED II 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 construction. 9-20 —\3 Owner or Contractor Signatu Date 1'EN PION: Oregon law req follow rules adopted by uires you to A the Oregon Utility 'It)TICE: .r ; Notification Center. Those rules are set forth HIS PERMIT SHALL EXPIRE IF THE WORK In OAR 952-001-OOtOthroughOAR 952 401-ules by 'JTHORIZED UNDER THIS PERMIT IS NOT : 0090. You may obtain copies of the r ;�nM ENCED OR IS ABANDONED FOR calling the center. (Nte the telephone number for the Oregon Utility o Notification ':Y 180 DAY PERIOD. Center Is 1-800-332'2344). Springfield Building Permit 4/10/2013 9:33:53AM Page 1 of 1