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HomeMy WebLinkAboutPermit Sidewalk 2002-7-16 . . '1~ I Job# 02-00844-01 I ~ Page 1 of2 CITY OF SPRINGFIELD, OREGON COMMERCIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 02-00844-01 225 Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 3620 Gateway St Spr Assessors Map#: 17031533 Lot: Block: Addition: Tax Lot #: 00300 Subdivision: Owner: Address: ODOT 640 A Street , Phone Number: 541-726-2552 City/StatelZip: springfield, OR 97477 Repair Value: $0 Scope Of Work: Sidewalk Repairing two panels of sidewalk Contractor Type Contractor - ROW Contractor Perales General Contracting Inc Po Box 705, Creswell, OR 97426 Registration # 135807 Expiration Date 1 0/20/2002 Phone 541-953-2177 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 rArea (Sq, Feet) Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: . " Job# 02-00844-01 Paid On Recelpt# Public Works 07/16/2002 9955 " Fee Sidewalk Repair Total Public Works Grand Total . Page 2 of 2 Value/Quantity Fee Amount 1 $10.00 $10,00 $10,00 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 descression, /7 ~,-~/""V8-l.1 Signature ." 1'J7-1t,.02 Date I> "" -i -i '=' ;;0 I> I> ;:0 -~ Z rt1 f1l (I') C"J.. # C"J O~.. J::. ..c::o co .........1......... :c I t-i('"Jii:flI-lO rf1::t: 0--.0 ;oDf-I- c) "ZON-<J ClG). 0....0 RJ,:::,g~~ .,.,