HomeMy WebLinkAboutPermit Sidewalk 2013-4- SPRINGFIELD 225 Fifth St
- CITY OF SPRINGFIELD Springfield,OR97477
Phone: 541-726-3753
"\OREGON Building / Public Works Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-PW2013-00077
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www.springfield-er.gov perm itcenterQspringfield-or.gov •
PROJECT STATUS: Issued ISSUED: 04/24/2013 EXPIRES: 10/21/2013
STATUS DATE: 04/24/2013 APPLIED: 04/24/2013
SITE ADDRESS: 610 CENTENNIAL BLVD,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703264311200 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: Sidewalk Repair
OWNER: HENRY MULDUNE S&MONA M Phone Number:
ADDRESS: 610 CENTENNIAL BLVD
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
INSPECTIONS REQUIRED
Inspections
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. ?
Owner or Contract>r jignature Date
'o NOTICE:
''! THIS PERMIT SHALL EXPIRE IF THE WORK
h AUTHORIZED UNDER THIS PERMIT IS NOT
in OAR S -.-..-D1 COMMENCED OR IS ABANDONED FOR
0090. You may eel—. r - ^f/ ANY 180 DAY PERIOD.
calling the center. t h.,r:: . to ,e .t. o:o
number Oregon Utility
2344)Ification
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Springfield Building Permit 4/24/2013 2:15:33PM • Page 1 of 1