HomeMy WebLinkAboutPermit Sidewalk 2013-8-28 SPRINGFIELD
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CITY OF SPRINGFIELD 225 Fifth St Springfield,OR97477
L� Phone: 541-726-3753
OREGON Building / Public Works Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
• PERMIT NO: 811-PW2013-00169
www.spnngfield-or.gov permitcenter @springfield.or.gov
PROJECT STATUS: Issued ISSUED: 08/28/2013 EXPIRES: 02/23/2014
STATUS DATE: 08/28/2013 APPLIED: 08/28/2013
SITE ADDRESS: 1114 QUINALT ST,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703264100700 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: City Sidewalk repair of 15 feet set back sidewalk
OWNER: LOPEZ JESUS A&BLANCA NI Phone Number:
ADDRESS: 1114 QUINALT ST
SPRINGFIELD OR 97477 •
1. 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
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
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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Owner or Contractor Signatur Date
•
ATTENTION: Oregon law requires you to
follow rules adopted by the Oregon Utility
,;;E: Notification Center. Those rules are set forth
PERMIT SHALL EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001-
HORIZED UNDER THIS PERMIT IS NOT 0090. You may obtain copies of the rules by
.;!vMENCED OR IS ABANDONED FOR calling the center. (Note: the telephone
number for the Oregon Utility Notification
i&D DAY PERIOD. Center is 1-800-332-2344).
Springfield Building Permit 8/28/2013 8:56:11AM Page 1 of 1