HomeMy WebLinkAboutPermit Sidewalk 2013-9-25 SPRINGFIELD--- • 225 Fifth St
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CITY OF SPRINGFIELD Springfield,OR 97477
qt.to, "''? Phone: 541-726-3753
OREGON Building / Public Works Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-PW2013-00186
www.springfield-or.gov permitcenterQspringfield-or.gov
PROJECT STATUS: Issued ISSUED: 09/25/2013 EXPIRES: 03/24/2014
STATUS DATE: 09/25/2013 APPLIED: 09/25/2013
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SITE ADDRESS: 422 S 37TH ST ADU,Springfield,OR 97478 SCOPE:
ASSESOR'S PARCEL NO: 1702314302701 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: Sidewalk and curb cut for weephole installation for ADU storm.
OWNER: PARKER CLAY D II&KATIE D Phone Number:
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ADDRESS: 422 S 37TH ST
SPRINGFIELD OR 97478
CONTRACTOR INFORMATION _ A
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
INSPECTIONS REQUIRED
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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 ma.- • - ructure without permission of the Community Services Division, Building Safety. I further
certify that only co• .ctors and employ-, who are in compliance with ORS 701.005 will be used on this project. I further agree
to ensure -3 re.uired inspections are re.uested at the proper time,that each address is readable from the street, that the
permit c- ated at the fron • •- prope , and the approved set of plans will remain on the site at all times during
constr y'ig41i
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Springfield Building Permit 9/25/2013 1:16:10PM Page 1 of 1
SPRINGFIELD —, CITY OF SPRINGFIELD
225 Fifth St
<`o EGON TRANSACTION RECEIPT Spdngfie1d.OR 97477
541-726-3753
811-P W2013-00186
www.springfieldor.gov 422 S 37TH ST ADU permitcenter @springtield-or.gov
RECEIPT NO: 2013002138 RECORD NO: 811-PW2013-00186 DATE:09/25/2013
!1n1I:Ir[o]:Nnaltie,:it?hn: '��'�1kf:4•n x55_ s-'r .: s"ACCOUNTCODERRANS'.CODE"acw.I`AMOUNTDUEir.
Curb Cut/Driveway 1st Cut 201-00000-428060 1141 102.00
Multiple Permit Discount(Max 2) 201-00000-428060 1148 -35.00
Sidewalk Repair 201-00000-428060 1142 17.00
Technology fee(5%of permit total) 100-00000-425605 2099 4.20
TOTAL DUE: 88.20
PAYIliatinYPE P.AYOR ,CASNIER:.RGREENE IMMOMMEATS- (. , ,$ AMOUNT1 PAID-
Cash Clay Parker 88.20
TOTAL PAID: 88.20
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CityofSpringfield ` ,
•Driveway/Sidew_a�lk� Permit Application
Application Date:l_qH f 20 13 SPRINGFIELD
225 Fifth Street,Springfield,Oregon 97477
Transportation&Engineering Section,Public Works Department 3t=
Permit Number I gll-`Pw2o3-co g? Phone: 541726-3753 � •; ,. v
Issue Date: 4 9/zo 13 ,, OREGON
SITE INFORMATION
Location of Work: 142(9\ O 3 7 ft"
Applicant: Ow v P,/- la,,
—`CQr
e Phone: s q .670. 3.SPt
Address: L122 $o u L 7 O�+ S�
Tax Map
City: \
f,v�,? AS__State: S9 r- ZIP: ` ?L-� d7 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
Sidewalk Repair $18.00
Curb Cut/Driveway: Number of Driveways X$102.00 1st Cut X$54 2nd Cut
in 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
Technology fee
fl Proof of Insurance: $500,000 Minimum if work is done by property owner. Total due with permit$
CONTRACTOR'S INFORMATION
Name: Mec. nQ Savu a vcafej -�, Phone:
Address: UY
City: State: ZIP:
Contractor Registration# Expiration date:
Project Supervisor Phone:
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.
—Y.are required to call: The L3ne.Utilities Coordinating Council's"One Call Number" 1-800-332-2344,
48 hours before before digging.
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