HomeMy WebLinkAboutPermit Sidewalk 2014-08-14VN
F'IE
OREGON
Building / Public Works Permit
PERMIT NO: 811-PW2014-00119
w .springfieldor.gov
PROJECT STATUS; Issued
STATUS DATE: 08/14/2014
SITE ADDRESS: 618 D ST, Springfield, OR 97477
ASSESOR'S PARCEL NO: 1703352407800
OWNER: KALLUNKI LIVING TRUST
ADDRESS: 618 D ST
225 Fifth St
Springfield,OR 97477
Phone: 541-726-3753
Inspection Phone: 541-726-3769
Fax: 541-726-3676
permitcenter@spdngfield-or.gov
ISSUED: 08/14/2014 EXPIRES: 02/09/2015
APPLIED: 08/14/2014
SCOPE:
TYPE OF STRUCTURE:
Phone Number:
SPRINGFIELD OR 97477
CONTRACTOR INFORMATION
Contractor Type Contractor Name Lie Type Lie No Lie Exp Phone
INSPECTIONS REQUIRED
Inspections
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.
ILOwner or Contractor Signature Date
Springfield Building Permit 8/14/2014 11:55:07AM Page 1 of 1
Application Date: ' '
225 Fifth Street, Springfield, Oregon 97477
Permit Number O (� ��j�01e� �pTransportation & Engineering Section, Public Works Department
U \ Phone: 541726-3753
Issue Date: 1 61 W 12011
SITE INFORMATION
Location of Work: l 1 7 L d S Qr c n 5 1 1
Applicant:
Address: C9 l SZ roe
City:
Subdivision _
Owner: _
Address:
City:
REQUESTED PERMITS:
NZ
State: ZIP:
❑ Sidewalk Amount of sidewalk in excess of 90 feet
aSidewalkRepair7$ Sy F(u�tS
n Curb Cut/Driveway: Number of Driveways
❑ 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
011% Technology fee
n Proof of Insurance: $500,000 Minimum if work is done by property owner.
CONTRACTOR'S INFORMATION
04.00
19.00
$104.00 1st Cut
Phone: s' -7yt •,g�
Tax Lot
Phone:
Fees
@$0.09 SF
X $67 2nd Cut
Total due with permit $ �? `(' , !� (D
Name: KI (L bc d(0SIC/ U\ -D C-0-\S(�y�(
Address: V C e- A L I J C. \
City: I,-0 �e —1 Stater 9, ZIP: I p y
Contractor Registration # (� �� Expiration date:
Project Supervisor M cr 1
INSPECTIONS:
Phone: SC) I - S l'- `J Y GO
Phone: S cl ) — C 17—`! V00
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 call: The Lane Utilities Coordinating Council's "One
48 hours before before digging.
SIGNATURE: e& 0-