HomeMy WebLinkAboutPermit Sidewalk 2013-5-7 SPRINGFIELD - • 225 Fifth St
in% • CITY OF SPRINGFIELD Springfeld,OR97477
t? _ Phone: 541-726-3753
OREGON Building / Public Works Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676 •
PERMIT NO: 811-PW2013-00083
www.springfield-cr.gov permitcenter @springfeldor.gov
PROJECT STATUS: Issued ISSUED: 05/07/2013 EXPIRES: 11/03/2013
STATUS DATE: 05/07/2013 APPLIED: 05/07/2013
SITE ADDRESS: 1382 WIMBLEDON PL,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703342200806 TYPE OF STRUCTURE:
•
PROJECT DESCRIPTION: Sidewalk replacement
OWNER: SAMMONS RONALD A 8 CAROL R Phone Number:
ADDRESS: 1382 WIMBLEDON PL
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 Contractor Signature Date
•
•
•
•
•
Springfield Building Permit 5/7/2013 8:10:59AM Page 1 of 1
—t z— w —`
City o f Springfield •� ,. c r '
Driveway/Sidewalk Permit Applicationry
Application Date:I S — 7— /3 SPRINGFIELD
--- 225 Fifth Street,Springfield,Oregon 97477
5L� _ew�t3 _ annsRortation&Engineering Section,Public Works Department i .- 'e _,,,,,. -sai
Permit Number r
Phone: 541726-3753 /ej_
Issue Date: 15/7/ 2_6� �
-f- • OREGON
SITE INFORMATION
Location of Work: 1 ?j-) Z 'lM11A' L-1Z 17. OtJ G LA-c-€
Applicant: RE:tiL 5,rn40Ap F 5
Phone:
Address: S ri kS f ,oV
Tax Map
City: 502.0,146, State: art_ ZIP: 970-77
Tax Lot
Subdivision
Owner: S Phone:
Address: 'I
City: State: ZIP:
REQUESTED PERMITS:
Fees
❑ Sidewalk Amount of sidewalk in excess of 90 feet $102.00 @$0.09 SF
F{-Sidewalk Repair Z $18.00
Ei Curb Cut/Driveway: Number of Driveways X$102.00 1st Cut X$54 2nd Cut
▪ Multiple Permit Discount each:(Maximum 2) $35
Multi permit discount good for one site and one site inspection only
applies to 2nd and 3rd permits only. Not sidewalk repairs
5%Technology fee
r Proof of Insurance: $500,000 Minimum if work is done by property owner. Total due with permit$ / , 7 6
CONTRACTOR'S INFORMATION
Name: WAuit , CJS'hw. - z*4i s Phone: 541-6,63-(035
Address: Z&-3 IZzV -Sitt.JAtUL Lam?
City: (-WC State: 01 . ZIP: ? 790/
Contractor Registration# Expiration date:
Project Supervisor 1PAoL iLu ►{� Phone: 54)-'5C'—&53j.
INSPECTIONS:
An inspection request should be made prior to pouring concrete,after the proposed work has been formed and made ready to pour.
Curb cut and sidewalk inspections call: 541 726-3769(recording)State your designated City job number/permit number,job address,
type of inspection requested,and when you will be ready for inspection. Contractor's or Owner's name and phone number. Requested
received before 7:00 am will be made the same day,requests after 7:00 am will be made the next working day. Inspections are to be
called in after excavations are made and form work is in place,but prior to pouring concrete.
You are required to call: The Lane Utilities Coordinating Council's"One Call Number" 1-800-332-2344,
48 hours before before digging.
SIGNATURE'