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Home My WebLink AboutPermit Sidewalk 2013-7-24 • • SPRINGFIELD 225 Fifth St • CITY OF SPRINGFIELD Springfield,OR 97477 Phone: 541-726-3753 Building / Public Works Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-PW2013-00148 www.springfield-or.gav • permitcenter@springfield-or.gov PROJECT STATUS: Issued ISSUED: 07/24/2013 EXPIRES: 01/19/2014 STATUS DATE: 07/24/2013 APPLIED: 07/24/2013 SITE ADDRESS: 764 SUNSET DR,Springfield,OR 97477 SCOPE: ASSESOR'S PARCEL NO: 1703341409600 TYPE OF STRUCTURE: PROJECT DESCRIPTION: Sidewalk Repair OWNER: CRISMAN MICHELLE A Phone Number: ADDRESS: 764 SUNSET DR SPRINGFIELD OR 97477 • CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone r INSPECTIONS REQUIRED 1 Inspections 9508 Sidewalk 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 con truction. Owner or Contracto ignature e 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 PERMIT IF THE IS WORK AUTHORIZED UNDER THIS in OAR 952-001-0010 through OAR 952-001- NOT 0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR calling the center. (Note: the telephc;e - ANY 180 DAY PERIOD. number for the Oregon Utility Notification Center is 1-800-332-2344). • Springfield Building Permit 7/24/2013 10:09:49AM Page 1 of 1 SPRINGFIELD -- CITY OF SPRINGFIELD • r1 225 Fifth St ice.Lte TRANSACTION RECEIPT Springfield,OR97477 'OREGON 541-726-3753 811-PW2013-00148 www.springfieldor.gov 764 SUNSET DR permitcenter@springtield-or gov RECEIPT NO: 2013001624 RECORD NO:811-PW2013-00148 DATE:07/24/2013 ]ei i-41n:A1 41111 A:7+ ii:I _ 5L,tiw'w-_.*.::�liSi 'ACCOUNT CODE/TRANStODE'"_:r7 ___AMOUNT DUE1S1 Sidewalk Repair 201-00000-428060 1142 68.00 Technology fee(5%of permit total) 100-00000-425605 2099 3.40 TOTAL DUE: 71.40 *PAYMENTaYPE P,AYOR Ergirg:.1 wa}sDN, , 'm AMOUNT PAID .COMMENTS ;. �. _ �. NOM S Check Michelle Crisman Sidewalk Repair 71.40 734 TOTAL PAID: 71.40 • • • City ol3pringfield • Driveway/Sidewalk Permit Application Application Date:I _ SPRINGFIELD 225 Fifth Street,Springfield,Oregon 97477 Transportation&Engineering Section,Public Works Department Permit Number ( Phone: 541 726-3753 Olall Issue Date: OREGON SITE INFORMATION Location of Work: 3 / Applicant M I( h L lie nib mot phone: I3c/7 7/9 99 /, Address: -76 q L,;\ S P �" b r Tax Map City: 175Sc,'q jrA State: Or. ZIP: 77Cf ( Tax Lot Subdivision Owner: • Phone: Address: - --- -- --- --- City:: State: ZIP: REQUESTED PERMITS: Fees ✓ Sidewalk Amount of sidewalk in excess of 90 feet $102.00 @$0.09 SF fidewalk Repair $18.00 ✓ 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 Et 5%Technology fee ✓ Proof of Insurance: $500,000 Minimum if work is done by property owner. Total due with permit$ CONTRACTOR'S INFORMATION Name: Phone: Address: City: State: ZIP: Contractor Registration t1 Expiration date: Project Supervisor C COR(k e { m k 1( Phone:TLL/ 91.3 chO r 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: