HomeMy WebLinkAboutPermit Sidewalk 2013-8-21 SPRINGFIELD i •
-W225 Fifth St
�'- CITY OF SPRINGFIELD Springfield,OR 97477
`t'v-' Phone:541-726-3753 •
OREGON Building / Public Works Permit Inspection Phone:541-726-3769
Fax:541-726-3676
PERMIT NO: 811-PW2013-00165 •
www.springfield-ocgov permitcentengspringfieldor.gov
PROJECT STATUS: Issued ISSUED: 08/21/2013 EXPIRES: 02/16/2014
STATUS DATE: 08/21/2013 ' APPLIED: 08/21/2013
SITE ADDRESS: .809 NORTHRIDGE AVE,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703261201214 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: City sidewalk repair of 10 feet
OWNER: LARRY&KATHY CARNINE LIVING TRUST Phone Number:
ADDRESS: 809 NORTHRIDGE AVE
SPRINGFIELD OR 97477
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 li
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
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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 e will remain on the site at all times during
construction. D �
Owner or Contractor Signatu Date
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth
OTICE: in OAR 952-001-0010 through OAR 952-001-
HIS PERMIT SHALL EXPIRE IF THE WORK 0090. You may obtain copies of the rules by
UTHORIZED UNDER THIS PERMIT IS NOT number for the Oregor°Utility Notifr Notification
,OMMENCED OR IS ABANDONED FOR Center is 1-800-332-2344).
ANY 180 DAY PERIOD.
Springfield Building Permit 8/21/2013 9:11:28AM Page 1 of 1