HomeMy WebLinkAboutPermit Sidewalk 2014-1-29 SPRINGFIELD 225 Fifth St
CITY OF SPRINGFIELD Springfield,OR 97477
hiliC % Phone: 541-726-3753
OREGON Building / Public Works Permit Inspection Phone: 541-726-3769
Fax: 541-726-3676
PERMIT NO: 811-PW2014-00012
www.springfeld-or.gov permitcenter @springfield-or.gov
PROJECT STATUS: Issued ISSUED: 01/29/2014 EXPIRES: 07/28/2014
STATUS DATE: 01/29/2014 APPLIED: 01/29/2014
SITE ADDRESS: 2095 7TH ST,Springfield,OR 97477 SCOPE:
ASSESOR'S PARCEL NO: 1703261301217 TYPE OF STRUCTURE:
PROJECT DESCRIPTION: 25 feet of City sidewalk repair
OWNER: MEDFORD FAMILY TRUST Phone Number:
ADDRESS: 2556 DUMAS DR
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
9506 Sidewalk-Setback Sidewalk-Setback: After forms are erected but prior to placement of concrete.
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 ' nature Date
NOTICE:
ATTENTION: Oregon law requires you to
OTICE:
follow rules adopted by the Oregon Utility
THIS PERMIT SHALL Notification Center. Those rules are set forth
lr
AUTHORIZED UNp EXPIRE IF THE WORK in OAR 952-001-0010 through OAR 952-001-
AN M 80NCED OR IS T HI S P NRMIT IS NOT
0090.calling gothe center. (Note1e the ftelephone
by •
D4y PERIOD ED FOR number for the Oregon Utility Notification
Center is 1-800-332-2344).
Springfield Building Permit 1/29/2014 10:13:54AM Page 1 of 1