HomeMy WebLinkAboutPermit Sidewalk 2014-3-31 •
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SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
Phone: 541-726-3753
fl' " EGON Building / Public Works Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-PW2014-00044
www.springfield-or.gov permitcenter @springfield-or.gov •
PROJECT STATUS: Issued ISSUED: 03/3112014 EXPIRES: 09/27/2014
- STATUS DATE: 03/31/2014 APPLIED: 03/31/2014
SITE ADDRESS: 915 MCKENZIE CREST DR,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703234300300 TYPE OF STRUCTURE:
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PROJECT DESCRIPTION: Sidewalk repair
OWNER: JACKSON LINDA L Phone Number:
ADDRESS: 915 MCKENZIE CREST DR
SPRINGFIELD OR 97477 •
OWNER: TAGUCHI RODNEY Phone Number:
ADDRESS: 915 MCKENZIE CREST DR
SPRINGFIELD OR 97477 •
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lic Type Lic No Lic Exp Phone
OWNER COB 000000 08/01/2025
INSPECTIONS REQUIRED
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Inspections
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. •
Owner or Contractor ; ature Date
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ATTENTION: Oregon law requires you to •
follow rules adopted by the Oregon Utility
Notification Center. Those rules are set forth IV4'TICE:
E IF THE WORK •
in OAR 952-001-0010 through OAR 952-001- THIS_PERMIT SHALL EXPIR
0090. You may obtain copies of the rules by AUTHORIZED UNDER (HIS E IF T PERMIT IS NOT
calling the center. (Note: the telephone COM11/1ENCED OR 'IS ABANDONED FOR
number for the he Oregon N
regon Utility Notification
Center is 1-800-332-2344). ANY 180 DAY PERIOD.
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Springfield Building Permit 3/31/2014 1:35:45PM• Page 1 of 1
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SPRINGFIELD - CITY OF SPRINGFIELD
225 Fifth$t
TRANSACTION RECEIPT 225 Fifield,OR 97477
`�"'� 541-726-3753
OREGON 811-PW2014-00044
www.springfeld-ar.gov 915 MCKENZIE CREST DR permitcenter @spdngfield-or.gov
RECEIPT NO: 2014000694 RECORD NO: 811-PW2014-00044 DATE:03/31/2014
1eL*14.plr.MRIo1� F a ' W1 `; an-V e_-?/FACCOUNT`CODE/TRANS'CODE C rC" F lAMOUNTDUE'``
Sidewalk up though 90 Feet 201-00000-428060 1142 102.00
Technology fee(5%of permit total) 100-00000-425605 2099 5.10
TOTAL DUE: 107.10
4 PAYMENTTYPE..i_'ye PATOR raiieyR rier ,;o1 IFT COMMENTS p'u"' -. .,K AMOUNT PAIDi`,j ,; ±y,;0
Credit Card Rod Taguchi - Sidewalk Repair 107.10
025694
TOTAL PAID: 107.10
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Application Date: SPRINGFIELD` ` 1
-- ------ 225 Fifth Street,Springfield,Oregon 97477
Permit Number
Transportation&Engineering Section, Public Works Department 1 d r ,
Phone: 541726-3753
ir
Issue Date: OREGON
SITE INFORMATION �`
Location ofWork: 1 2�2 J�`•te- "n -'o.n\-- . I�a(je
Applicant 2d-c-\ Phone: 19/f 7_0G "3397-
Address: 9/5" /eGfl/9 2F'e Cve5t �( ( e Tax Map
City: Spc-iin5 elc4 State: PR ZIP: pl7y77
Tax Lot
Subdivision
Owner: �0 r\ ' t/ GVv Phone: 5W 2� ' 3'8`!
Address: �cj vflQ "(1S �G�6ryZ;e. Crest- D7ft� I City: '3 c r.- State: V Z. ZIP: 17' 1
REQUESTED PERMITS:
Fees
fI Sidewalk Amount of sidewalk in excess of 90 feet $102.00 @$0.09 SF
?<4idewalk Repair $18.00
PI Curb Cut/Driveway: Number of Driveways X$102.00 1st Cut X$54 2nd Cut
n 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
ri 5%Technology fee
Fri Proof of Insurance: $500,000 Minimum if work is done by property owner. Total due with permit$
CONTRACTOR'S INFORMATION
Name: - Phone:
Address:
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.
You are required to call: The Lane Utilities Coordinating Council's"One Call Number" 1-800-332-2344,
48 hours before before digging.
SIGNATURE: