HomeMy WebLinkAboutPermit Sidewalk 2014-2-28 •
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SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Spnngfield,OR97477
hr��`conecoN Phone: 541-726-3753 ,
Building / Public Works Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-PW2014-00023
www.springfield-a.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 02/28/2014 EXPIRES: 08/27/2014
STATUS DATE: 02/28/2014 APPLIED: 02/28/2014
SITE ADDRESS: 918 NORTHRIDGE AVE,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703261204312 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: Sidewalk replacement
OWNER: TERRELL ROLAND Phone Number:
ADDRESS: 1708 1ST
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
INSPECTIONS REQUIRED
Inspections
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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
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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 cars is located at the front of the property,and the approved set of plans will remain on the site at all times during
constru ! " ""' .
2- 2EC-7y
Owner or Contractor Signature Date
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ATTENTION: Oregon law requires you to NOTICE:
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth THIS PERMIT SHALL EXPIRE IF THE WORK
in OAR 952-001-0010 through OAR 952-001- AUTHORIZED UNDER THIS PERMIT IS NOT
0090. You may obtain copies of the rules by COMMENCED OR IS ABANDONED FOR
calling the center. (Note: the telephone ANY 180 DAY PERIOD.
number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 2/28/2014 10:40:48AM Page 1 of 1