HomeMy WebLinkAboutPermit Sidewalk 2013-5-9 SPRINGFIELD - - 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
• ' Phone: 541-726-3753
OREGON Building / Public Works Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-PW2013-00089
wwwspringtield-ar.gov permitcenter @spring field-ar.gov
PROJECT STATUS: Issued ISSUED: 05/09/2013 EXPIRES: 11/04/2013
STATUS DATE: 05/09/2013 APPLIED: 05/09/2013
SITE ADDRESS: 960 16TH ST,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703362204603 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: Replace 4 sidewalk panels
OWNER: MCKENZIE MEDICAL LLC • Phone Number:
ADDRESS: 541 WILLAMETTE ST STE 109
EUGENE OR 97401
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.
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or Contractor Signature Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility NOTICE:
Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK
In OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain copies of the rules by •
calling the center. (Note: the telephone 3OMMENCED OR IS ABANDONED FOR
number for the Oregon Utility Notification \NY 180 DAY PERIOD.
Center is 1-800-332-2344).
Springfield Building Permit 5/9/2013 9:27:48AM Page 1 of 1