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HomeMy WebLinkAboutPermit Sidewalk 2002-4-23 , . I Job# 02-00366-01 I . f~- '.....-. .' Page 1 of 2 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00366-01 225 Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Addition: Tax Lot #: Subdivision: 03300 * Location Of Proposed Site: 6838 Assessors Map#: 18020314 Lot: Block: Jessica Dr Spr Owner: Judy and Larry Knox 93198 Ewing Road Phone Number: City/State/Zip: Springfield, OR 97478 New Value: $0 Address: Scope Of Work: Sidewalk Sidewalk only Quad Area: # Of Units: Constr. Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: 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 working day, SW-Curbside Required Inspections I Public Works I -After forms are erected but prior to placement of concrete Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? 0 ,Area (Sq. r ..1) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Fee Paid On Receipt# I Public Works 04/23/2002 8709 Value/Quantity Fee Amount New Sidewalk Total Public Works Grand Total 111 $76.47 $76.47 $76.47 .i-.,,/ .... . . I Job# 02-00366-01 I Page 2 of 2 By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information 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, applicable City Standard Specifications and Drawings, and the laws of the State of Oregon pertaining to the work described herein. I further certify that only contractors and employees who are in compliance with ORS 701,055 will be used on this project. I also understand the City may inspect the work described on this permit any time during a one year period following notice of completion, at the City's descrs~n. (\ ~~~ Signature /~ - 2. 'S ~ 0 2.... Date ::0 ::;: --; -n::, ::::0 ::0::0 ::u -I :z: rrlrrlUJ CJ.. # C":J OD" D ..-00 CfJ ,....J ;:0 I-'- :c I l-t("')-EH-f...:lQ fI1 ::c (....J C) ;:0 ::D -.J 0 ... :z: 0". f..) m DG'). 0-.:] cr-. rr1..j:::-. 01-'- f'o.J... -J 1'"'..:) I-'-