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HomeMy WebLinkAboutPermit Sidewalk 2014-08-19SPRINGFIELD 225 Fifth St ' CITY OF SPRINGFIELD Springfield,OR97477 Phone: 541-726-3753 Building / Public Works Permit Inspection Phone: 541-726-3769 Fax: 541-726-3676 PERMIT NO: 811-PW2014,00125 w .spnngfieldor-gov permito nter@spdngfield-ocgov PROJECT STATUS: Issued ISSUED: 08/19/2014 EXPIRES: 0211412015 STATUS DATE: 08/19/2014 APPLIED: 08/19/2014 SITE ADDRESS: 3823 WINSLOW AVE, Springfield, OR 97477 SCOPE: ASSESOR'S PARCEL NO: 1702194101900 TYPE OF STRUCTURE: -PROJECT -DESCRIPTION: New Approach OWNER: JORGENSON MATTHEW L Phone Number: ADDRESS: 3823 WINSLOW AVE SPRINGFIELD OR 97477 OWNER: JORGENSON TAMI Phone Number: ADDRESS: 3823 WINSLOW AVE SPRINGFIELD OR 97477 CONTRACTOR INFORMATION Contractor Type Contractor Name Lic Type Lie No Lie Exp Phone WALTER A DREWS III CCB 124842 09/09/2015 541-513-8241 INSPECTIONS REQUIRED Inspections 9504 Curbcut — Standard 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 Safely. 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. i Owner Date 009 , rf 952 001. er, Those r ®®reg0n Utll(a 0 you 0010 utes calling t,r aYObtalnt�o°ugh pq�95 tf0 y nu/nber lar ihenpr (Notethe f t he ru esbf. Oenter is 1. 1`1111 tole 00 332 23 q�df/paot0� Y Gla. I'RhINT SHALL EXPIRE IF THE WORK I'IZED UNDER THIS PERMIT IS NOT ["('LD OR IS ABANDONED FOR ) DAY PERIOD. Springfield Building Permit 8/19/2014 9:01:18AM Page 1 of 1 Application Date: SITE INFORMATION Location of Work: _ Applicant: W4A`N Address: ' City: -------------------------- Subdivision Owner: MA 225 Fifth Street, Springfield, Oregon 97477 Transportation & Engineering Section, Public Works Department Phone: 541 726-3753 Address: City: SSP nd\\r�Q\9 State:(*, ZIP:f REQUESTED PERMITS: sidewalk Amount of sidewalk in excess of 90 feet Sidewalk Repair W,urbCut/Driveway: Number of Driveways E] Multiple Permit Discount each: (Maximum 2) Multi permit discount good for one site and one site Inspection only applies to 2nd and 3rd permits only. Not sidewalk repairs S%Technology fee D Proof of Insurance: $500,000 Minimum if work is done by property owner. Phone: <�u I, <;67 L( Tax Lot Phone: I Go (I4q ^ �a 04.00 9.00 $104.00 1st Gut Total due with permit $ Fees @$0.09 SF X $67 2nd Cut CONTRACTOR'S INFORMATION '� n Name: ��1ti\� �1J-C>lrS \IJI���YyC�6h Phone: Address: n le) `T\r %rte A nr PNinA 0 \0 City: �-V kt-, State: OQ ZIP: !�r) C I -t Contractor Registration f k 3 -LI 7) )-19 Expiration date: Project Supervisor INSPECTIONS: q.°I, ( 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 Cityjob 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. are required to SIGNATURE: 48 hours before before digging. -800-332-2344,