HomeMy WebLinkAboutPermit Sidewalk 2007-11-13
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 725 A ST
ASSESSOR'S PARCEL NO.: 1703354204900
PROJECT DESCRIPTION: Sidewalk repair
Owner: PACIFIC WESTERN BANK
Address: PO BOX 15144 DEPT KEY
WORCESTER MA 01615
Contractor Type
Contractor
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Description
Type of Construction
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2007-01663
ISSUED: 11/13/2007
APPLIED: 11/0912007
EXPIRES: 05/09/2008
VALUE:
Springfield TYPE OF WORK:
TYPE OF USE:
ATTr.:"'TIf'\~,. ,..... I
f . ' -'.. ~. ~:::!v,' a,v 1~\..fUHt:lS you to .',
I CONTRACTO~S~ORM:iT,'iQ~~llh by the ,oregon Utility
in OAR 952-001-001 0 t~rS~~U es are set forth
0090., You~~S?%~ain c~~~~Wr~~e~. Phone
calling the center. (NotA' thA tolo....h..."? y
BUILDING INF8fu\1rii6~I' Oregon Utility Notific~tion
IS 1-800-332-2344).
# of Stories: Lot Size:
Height of Structure Sq Ft 1st Floor:
Type of Heat: Sq Ft 2nd Floor:
Water Type: Sq Ft Basement:
Range Type: Sq Ft Garage/Carport
Energy Path: Sq Ft Other:
Sprink]r.af'BJiil<ling: n/a Occupant Load:
rut..:" IOI.ubGl
I DEVELOPMEN:i:JNF:Q.RNlA~\ioNtiXPIRE IF THE WORK
, '., 'v, "'-L.L Ulvucti-rHIS PERMIT I~WYtIRED PARKING
COMMENCED OR IS ABANDO
Overla,~rmstf NED FQfbtal:
# Street TreesBRqg~y PERIOD. Handicapped:
Paved Drive Rqd: Compact:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Sidewalk Type:
Downspouts/Drains:
I Valuation Description I
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount '
Value
Date Calculated
Pal?:e 1 of2
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2007-01663
ISSUED: 11/13/2007
APPLIED: 11/09/2007
EXPIRES: 05/0912008
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 5% Technology Fee
Sidewalk Repair Permit
Amount Paid
Date Paid
Receipt Number
$0.75
$15.00
11/9/07
11/9/07
2200700000000001695
2200700000000001695
Total Amount Paid
$15.75
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspections requested before 7:00
a.m. will be made the same working day, inspections requested after 7:00 a.m. will be made the following
work day.
Reouired Insnections ,
By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all
information hereon is true and correct, and I further certify that any and all work performed shall be done in accordance with
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, that the permit card is located at the front of the property, and the approved set of plans will remain on the site at all
times during construction.
Owner or Contractors Signature
Date
Pa2e 2 of 2
Ornll"UrlCLU, UnCUUl" 'dILlII,
. ,,0;; ENG!NEER/NG DIVISION
OFFICE TELEPHONE (503) 726-3753
APPLICATION DATE: t t -1
IIL~
0,
PERMIT NUMBE~LtroI "Ot &&3
DATE ISSUED: '1,.- ~ /" Of
SITE INFORMATION: .
LOCAT'ONOFWORK:~ ~. k , /i'}.-5, f4
APPLICANT' . efl_ ~ll',1 If ~ 1)f\ ~+nJc-hDY\
ADDRESS: .1>0 '0("\ OX '2. t) C::)~ J
CllY~ .e)1~STATE .01<-. ZIP:
SUBDIVISION:
OWNER
<S+- / ~'v1t(}.JcU.K ~o./V)
PHONE, 5' fi. Coy 1 - '1--04- 'Z--
TAX MAP:
I~- ,/ /1 ?.-- TAX LOT:
~/
PHONE:
ADDRESS:
CllY
STATE:
ZIP:
,
REQUESTED PERMITS:
o SIDEWALK: .........................................................................................$ 85.00 .......................... = $
AMOUNT OF SIDEWALK IN EXCESS OF 90FT. @$0.08 SF. = $
0'8IDEWALK REPAIR: ....................;.....................................,.................$ 15.00............................ = $
} 5. DO
,0 CURB CUT/DRIVEWAY: NUMBER OF DRIVEWAYS
x .......................$ 85.00...1st Cut = $
o MULTIPLE PERMIT DISCOUNT EA: .:......,{MAX 2) ...........................$40.00 .$45,OO...2nd Cut =$J
(MULTI PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION nNI Y
APPLIES TO 2nd AND 3rd PERMITS ONLY. NOT SIDEWALK REPAIRl ' =$
o 5% Technology Fee $ TOTAL DUE WITH PERMIT $
o PROOF OF INSURANCE: $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER
CONTRACTOR INFORMATION:
Lo.e.- f;wl-f- ~S+-n/~(-ko,\
ADDRESS: p () ~ l() ~ 7 - ~s-~: 7
CONTRACTOR REGISTRATIOJ ~ r I 5' () (f ! 1. '
PROJECT SUPERVISOR: V-i! i' ~ k h(1fY\
INSPECTIONS:
CONTRACTOR:
EXPIRATION DATE:
PHONE: fry~' Jtll fz,
'B /4- '2--'0 lO .
PHONE:~< t..\: - ~2-0r.
(
AN INSPECTION REOuEST SHOULD BE MADE PRIOR TO POURING CONCRETE, AFTER THE PROPOSED WORK HAS BEEN FO RMED AND MADE READYTO
POUR. CURB CUT AND SIDEWALK INSPECTIONS CALL 726,3769 (RECORDER) STATE YOUR DESIGINATED ellY JOB
NUMBER/PERMIT NUMBER, JOB ADDRESS, lYPE OF INSPECTION REOUESTED, AND WHEN YOU WILL BE READY FOR INS PECTION, CONTRACTOR'S OR
OWNER'S NAME AND PHONE NUMBER, REOUESTS RECEIVED BEFORE 7:00 AM. WILL BE MADE THE
SAME DAY, REOUESTS AFTER 700 A.M, 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.
o
SIGNATURE: /~~
\ f
AMOUNT RECEIVEJ
YOU ARE REQUIRED TO CALL
THE LANE UTILITIES COORDINATING COUNCIL'S
1l0NE CALL NUMBERIl 1-800-332-2344
48 HOURS BEFORE DIGGING
x.-'
",
---
. .
RECEIPT NO:
DATE PAID:
RECEIVED BY:
By signature, I state and agree, that I have carefully examined the completed application and do he reby certify that all information herein is true
and correct and' further certifY thai af1Y and all work performed shall bll done in accordance with Ihe Ordinances 01
the City of Springfield. applicaole City Standard specifications and DrawinQs, and the laws of the State of Oregon pertaining to the work described herein. I further
certify fhat .only contractors and employees who are in compliance with ORS 701.055 will be used
on thiS prolecl, ' '
The City may inspect the work site described in this permit at any time during a one year period fo 1I0wing the receipt by the City of notice of completion 01 the
described work and specify, at the City's sole discretion, any additional resloration work reqUired 10 relurn Ihe site 10 a standard accep.table to the City. The
permillee will be notified in writing of any work required and will have thirty days (30) from the date 01 the notice to complete Ihe work. Work not completed at the end
of the thirty days will be performed by tlie City and the costs will be billed to llie permillee. .. '
I further agree to ensure that all reql,lired in~pections ~lfe reQu~sted at the proper tiITle, that proj ect address is readable from Ihe
street, and the aooroved sel of olans will remam on Ihe site at all tsme.~ Ol J/lno r.onslfl.r.hon '
22S'Fiftb Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2007-01663
COM2007-01663
Payments:
Type of Payment
Check
Cash
Job/Journal Number
COM2007-01663
COM2007-01663
Payments:
Type of Payment
Check
Cash
cReceintl
RECEIPT #:
Description
Sidewalk Repair Permit
+ 5% Technology Fee
Paid By
LEE BUILT
LEE BUILT
Description
Sidewalk Repair Permit
+ 5% Technology Fee
Paid By
LEE BUILT
LEE BUILT
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200700000000001695
Date: 11/09/2007
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
ew
ew
2796
In Person
In Person
Payment Total:
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
ew
ew
2796
In Person
In Person
Payment Total:
Page 1 of 1
10:40:31AM
Amount Due
15.00
0.75
$15.75
Amount Paid
$15.00
$0.75
$15.75
Amount Due
15.00
0.75
$15.75
Amount Paid
$15.00
$0.75
$15.75
11/9/2007