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HomeMy WebLinkAboutPermit Sidewalk 2013-11-19 • SPRINGFIELD - 225 Fifth St • CITY OF SPRINGFIELD Springfield,OR 97477 '`OREGON Phone: 541-726-3753 Building / Public Works Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-PW2013-00220 • www.springfield-ar.gov permitcenter @springfeld-or.gov PROJECT STATUS: Issued ISSUED: 11/19/2013 EXPIRES: 05/18/2014 STATUS DATE: 11/19/2013 APPLIED? 11/19/2013 SITE ADDRESS: 540 21ST ST,Springfield,OR 97477 SCOPE: ASSESOR'S PARCEL NO: 1703361307600 TYPE OF STRUCTURE: PROJECT DESCRIPTION: Weep hole in curb OWNER: JOLLIE ENTERPRISES LLC Phone Number: • ADDRESS: 8050 SW 146TH TER BEAVERTON OR 97007 CONTRACTOR INFORMATION Contractor Type Contractor Name - Lic Type Lic No Lic Exp Phone • INSPECTIONS REQUIRED - Inspections 9510 Curb and Gutter • 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 construction.// . l �' (/ Owner or Contractor Signature . [Date • • • Springfield Building Permit . 11/19/201 11:25:29AM Page 1 of 1 SPRINGFIELD- CITY OF SPRINGFIELD :`"A4 atte,. - 225 Fifth St (l,�, TRANSACTION RECEIPT Springfield,OR 97477 �j S.,411 GON 541-726-3753 811-PW2013-00220 www.springfeld-or.gov 540 21ST ST permitcenter©springfield-or.gov RECEIPT NO: 2013002525 RECORD NO:811-PW2013-00220 DATE: 11/19/2013 je]4io1:71: dory 1'I=. .s'c ed_.-_::'-..-:A,A .,c__as: ?`'r`UACCOUNT CODE/TRANS CODE _ V =AMOUNT-DUE^') Curb Cut/Driveway 1st Cut 201-00000-428060 1141 102.00 Sidewalk Repair 201-00000-428060 1142 17.00 Technology fee(5%of permit total) 100-00000-425605 2099 5.95 TOTAL DUE: 124.95 i„.PAYMr MEN7nTYP.EW; -:PAYORVEA'slitirKWILSON F_ it::J.A.7 COMMENTS %- ."_aLf. _mz,;t 7.!4MOUNTCPQID_,a���_;�;k-:4 Credit Card Kaminski 540 21st curbcut and sidewalk 124.95 09133J repair TOTAL PAID: 124.95 • • • • • • • CityofSpnngfield Ni i r . s ^tV -y ' p P , t ' '' s"-1"` tr`1 jr"I pfYSp i + a y 41 �. f ((♦ y 3 < li ! . 7 1i 3 #` @,� >•ik L i b d �Y>mii;;;'; 2r"°'ti,t^ i'k i P i"4 ,Y YH C: b'4 9 ' m G y : y °xaw s- .x „ r i Ft'R n y# -.a i z-i '9 a ` t'3 �� . t ,., i �-;,,a +° 1t a5t"' "" - yj iJ .,Y p �k ✓S Uvd Pik !k ��� �t#' Jt .fn { 1 ; � d.Jvl J ���4 S i t�4� i 1• l � r ''""''''''''''D z-s --, riveway/Sidle 4MkiPer,m�it App:Iicaition v� Application Date:l_ — 225 Fifth Street,Springfield,Oregon 97477 SPRINGFIELD- Transportation&Engineering Section,Public Works Department lit ii.,'Z.,,,.(';r j. Permit Number I Phone: 541 726-3753 , . ''TMTMh - `OREGON Issue Date: SITE INFORMATION Location of Work: 9/0 ��//. /S74-_�,� / Applicant: J�R4uvSC'e Ct�t57 ` GL� Phone: , �3l7Pf g Address: F 7n( Mod, • <, q a Tax Map City: State: On ZIP: / ,77/4V Tax Lot Subdivision Owner: Phone:) Address: City: State: ZIP: REQUESTED PERMITS: Fees eirk Sidewalk Amount of sidewalk in excess of 90 feet $102.00 @$0.09 SF Fr Sidewalk Repair $18.00 l Curb Cut/Driveway: Number of Driveways X $102.00 1st Cut X$54 2nd Cut pi 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 (j 5%Technology fee FT Proof of Insurance: $500,000 Minimum if work is done by property owner. Total due with permit$ CONTRACTOR'S INFORMATION Name: A/LJ/r1/5/�r dd Phone: /-5:5l/127(pS Address: X793.2- Aide 'M City: State: eff ZIP: J7/0„?--- Contractor Registration#" 7/ Qp22. Expiration date: Project Supervisor '.41is /j/a 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. You are required to call: The Lane Utilities Coordinating Council's"One Call Number" 1-800-332-2344, 48 hours before before digging. SIGNATURE: