HomeMy WebLinkAboutPermit Sidewalk 2007-4-18
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.CITY OF ~rK11~\j1'1I'.,LU.
Status
Issued
Building/Combination Permit
PERMIT NO: COM2007-00567
ISSUED: 04/18/2007
APPLIED: 04/18/2007
EXPIRES: 10/18/2007
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 2341 DON ST
ASSESSOR'S PARCEL NO.: 1703272102400
Springfield
TYPE OF WORK: Sidewalk
TYPE OF USE:
PROJECT DESCRIPTION: Sidewalk Repair
Owner:
Address:
COLEMAN CYNTHIA S & BRADFORD C
2341 DON ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Contractor
License
Expiration Date Phone,
BUILDING INFORMATION I
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Sfructure:
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupanf Load:
n/a
I DEVELOPMENT INFORMATION I
Frontyard Sethack:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
'. I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
DownspoutslDrains:
Notes: Owner was directed by Art ofspfld maint dept repair was necessary. Owner doing work their selves. JLP
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or mnltiplier
Square Footage
or Bid Amount
Value
Date Calcnlated
Pace I of2
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. CITY OF SPRINGFIELD
Building/Combination Permit
'PERMIT NO: COM2007-00567
ISSUED: 04/18/2007
APPLIED: 04/18/2007
EXPIRES: 10/18/2007
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
F"". p",\lU
Fee Descripfion
Sidewalk Permit
Amount Paid
Date Paid
$10.00
4/18/07
Receipt Number
2200700000000000551
Total Amount Paid
$10.00
I Plan Reviews I
Public Works Review
04/18/2007
04/18/2007
APP JLP
Owner was directed by Art of spnd
maint dept repair was necessary.
Owner doing work their selves. J LP
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.
L..f.eouired lusnp.~tions I
By signafure, I state and agree, that I have carefully examined the complefed 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 ofany 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
streef, that fhe permit card is located at the front of fbe property, and the approved set of plans will remain on the site at all
times during construction.
(I~ S~~>v'''''
Owner or Co.iJactors Signature
4/1,?)O,
Date
Paee 2 of2
225 Fiftb Street
SJf'ringfield, Oregon 97477
541-726-3759 Phone
RECEIPT #:
Job/Journal Number Description
COM2007-00567 Sidewalk Permit
Payments:
Type of Payment
Check
Paid By
CINDY COLEMAN
cReceintl
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~.,-; ~
<A of Springfield Official Receipt
_Iopment Services Department
Public Works Department
2200700000000000551
Date: 04/18/2007
1:33: 11 PM
Item Total:
<':heck Number Authorization
Received By Batch Number Number How Received
Amount Due
10,00
$1O.UU
Amount Paid
jlp
4075
In Person
Payment Total:
$10.00
$IU.UU
Page I of 1
4/18/2007
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225 FIFTH STREET 8P,:O:,LD :l1li
SPRINGFIELD, OREGON 97477 ~
ENGINEERING DIVISION
OFFICE TELEPHONE (503) 726.3753 ~
APPLICATION DATE: t+11 B I 07
PERMIT NUMBER:
DATE ISSUED:
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SITE INFORMATION:
APPLICANT
APDRESS:
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CllY: ~Y'i~~tSTATE: oYL-
SUBDIVISION:
~'Y\-{)G+-1-f'j ()(
PHONE -, Lj "1 :...... fS-V~1
LOCATION OF WORK:
TAX MAP:
ZIP: C\'l L\ 11
TAX LOT:
OWNER:
ADDRESS:
~~ "!
PHONE:
alY:
STATE:
ZIP:
REQUESTED PERMITS:
o SIDEWALK: ..........,....: ............'............................,
AMOUNT OF SIDEWALK IN EXCESS OF 90FT,
~IDEWALK REPAIR: ........, ,.................. ,
......................$ 80,00 ,.............. ..,......, = $
@$O,08 SF, = $
....................,....$ 10,00 ......,...................., = $
jo~
o CURB CUT/DRIVEWAY: NUMBER OF DRIVEWAYS
x ..,....,..............,$ 80,00..,:.........., = $
o MULTIPLE PERMIT DISCOUNT EA: ,....,..,(MAX 2) ........................,..$ 30,00, ........,..,..........,..=$_(-
(MUL 11 PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECllON .illILY
APPLIES TO 2nd AND 3rd PERMITS ONLY, NOT SIDEWALK REPAIR)
TOTAL DUE WITH PERMIT $
o PROOF OF INSURANCE: $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER
CONTRACTOR INFORMATION:
/0 ~-
CONTRACTOR:
fu RJ----
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ADDRESS:
CONTRACTOR REGISTRA llON NO:
PROJECT SUPERVISOR:
PHONE:
EXPIRA llON DATE:
v
PHONE:
INSPECTIONS:
AN INSPECTION REOUEST SHOULD BE MAPE PRIOR TO POURING CONCRETE, AFTER THE PROPOSED WORK HAS BEEN FO RMEP ANP MADE READY TO
POUR, CURB CUT AND SIDEWALK INSPECllONS CALL 726-3769 (RECORDER) STATE YOUR DESIGINATED CllY JOB
NUMBERIPERMIT 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 A,M, WILL BE MADE THE
SAME DAY, REOUESTS AFTER 7:ooA,M, WILL BE MADE THE NEXT WORKING DAY, INSPECllONS ARE TO BE CAlLED IN
AFTER EXCAVAllONS 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 DIGGING
AMOUNT RECEIVED:
RECEIPT NO:
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DATE PAlP:
RECEIVEP BY:
Y/;f'/O';
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SIGNATURE:
By signature. I stale and agree, that I have carefully examined the completed application and do he r~ certily that all information herein is true
and correct and I further certifY that an'y and all work performed shall be done in accordance with the Ordinances 01
the City 01 Springfield, applicaOle City Standard spealications and DrawinQs, and the laws of the State 01 Oregon pertaining 10 lhe work described herein, Ilur1her
certify thal.only contractors and employees who are in compliance with ORS 701.055 will be used
on thiS pl'Oj8ct.
The Oty may inspect the work site described in this permit at any lime during a one year period fo lIowing Ihe receipt by the City of notice 01 com~elion of Ihe
described work and s~Gify. al the City's sole discretion, any additional resloration work r~ulred 10 return the site 10 a slandard acceptable 10 the Ci . The
permillee will be notified 10 writing of any work required and will have thir!)' days (30) from Ihe date ollhe notice 10 complete the work. Work not camp eled allhe end
of the thirty days will be performea by ltie City and the costs will be billed to ltie permillee.
Ilurlher agree to ensure that all required inspections are requested at the proper time, Ihat proj eel address is readable trem the
street, and the approved sel of plans 'Nill remain on the site al aU times during construction.
Signature
~ lAAo S ' f --K.hvv:l-
Date
J.-I-/' ()jf} 07