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HomeMy WebLinkAboutPermit Curb Cut 2002-07-08SPRIiIGFIELD Job# 02-00806-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety 0u Page 1 of 2 225 Fifth Street Springfield, OR97477 Location Of Proposed Site: 2118 00006th St Spr AssessorsMap#: 17032621 Lot: Block: Addition: Job Number: 02-00806-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 02217 Subdivision: clTY oF SPRTNGF7ELD, OREGON Owner: Kathy Jensen Address: 21 1B 6th Street Scope Of Work: Curbcut Phone Number: City/State/Zip: New removing existing approach and replacing with new approach. 541-747-8101 Springfield, OR97477 Value: $0 Contractor Type Contractor - ROW Gontractor Scott Brown Construction lnc 7245 North A St, Springfield, OR 97478 Registration # 64344 Expiration Date 911012003 Phone 541-726-7706 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. Required lnspections Public Works GC-Standard -After forms are erected but prior to placement of concrete Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? Area (Sq. Main: # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Accessory:Total: Job# 02-00806-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Public Works 0710812002 9851 1New Curbcut Total Public Works $75.00 $75.00 Grand Total By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information herein is true and corect, and I further certify that any and atl 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. The City may inspect the work site described in this permit at any time during a one year period following the receipt by the City of Springfield notice of completion of the described work and specify, at the City's sole descression, any additional restoration work required to return the site to a standard acceptable to the City. The permittee will be notified in writing of any work required and will have thirty (30) days from the date of the notice to complete the work. Work not completed at the end of the thirty days will be performed by the City and the costs will be billed to the permittee. I further agree to ensure that all required inspections are requested at the proper time, that the address readable from the street, and the approved set of plans will remain on the site at all during ature Date $7s.00 project times :T:lEl *i =: 'irff1 "i-f-l c) f:)L'fr: l.-{m;fi fi1 ts. _r t.._., .>