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HomeMy WebLinkAboutPermit Sidewalk 2013-10-22 , , SPRINGFIELD.... 225 Fifth St htHC‘...ktOtisREGON 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-PW2013-00205 www.springfield-or.gov permitcenter©springfield-or.gov PROJECT STATUS: Issued ISSUED: 10/22/2013 EXPIRES: 04/20/2014 STATUS DATE: 10/22/2013 APPLIED: 10/21/2013 • SITE ADDRESS: 1306 CENTENNIAL BLVD,Springfield,OR 97477 SCOPE: ASSESOR'S PARCEL NO: 1703253307000 TYPE OF STRUCTURE: • PROJECT DESCRIPTION: Sidewalk Repair • OWNER: GRAY SHIRLEY M TE Phone Number: ADDRESS: 1306 CENTENNIAL BLVD SPRINGFIELD OR 97477 OWNER: SHIRLEY M GRAY TRUST Phone Number: ADDRESS: 1306 CENTENNIAL BLVD 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 Inspections 9508 Sidewalk 1 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 construucctionn.. • Owner or Contractor$ lure Date • - - sires you to a-. , 'h: Grogan Utility i SPRINGFIELD--- CITY OF SPRINGFIELD "-3ac.• ' 225 Fifth St t E�oN TRANSACTION RECEIPT Springfield,OR 97477 541-726-3753 811-PW2013-00205 www.sprngfieltlar.gov 1306 CENTENNIAL BLVD permitcenter©springfield-ar.gov - RECEIPT NO: 2013002321 RECORD NO:811-PW2013-00205 DATE: 10/22/2013 ..i `-'ACCOUNTCODE/rRANS.CODE_ _ ' '.'AMOUNTDUE''9' Sidewalk Repair 201-00000-428060 1142 17.00 Technology fee(5%of permit total) 100-00000-425605 2099 0.85 TOTAL DUE: 17.85 s. PAYMENT-TYPE r. PAYORPg`':'cASNIEnARsONZ13.4y=. .ka COMMENTS' "`= ahu,IfOr„;AMOUNTPAID_"t, Cash Tom Rogge 17.85 • TOTAL PAID: 17.85