HomeMy WebLinkAboutPermit Sidewalk 2005-01-27Building/Combination Permit
Status Pending
225 Fitth Street, Springfield, OR
s41-726-3753 Phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
the Oregon UtililBRtt[T NO: COM2005-00109
Notification Center.Those rules are set fqg5gBp;
h OAB 952-00r{010 through OAR 9s2-00ppLrED:
0090. You may obtain copies of the rulesEIpIRES:
calling the center. (Note: the tetephonflAlUE:
0U27t2005
SITE ADDRESS: 2268 9TH ST Springfield TYPE OF WORK: Sidewalk
ASSESSOR'SPARCELNO.: 1703261201007
TYPE OF USE: use initials
PROJECT DESCRIPTION: Sidewalk replace City Contractor : inspected by Art Ireland (maintenance)
Residential
Owner:
Address:
Contractor Type
Applicant
BURNS CHARLES LEE & P E
2268 N 9TH
SPRINGFIELD OR 97477
Contractor
THOMAS ROGGE
License Expiration Date Phone
CONTRACTOR INFORMATION
# 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:
# of Stories:
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinkled Building:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
%o ofLot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
REQUIRED PARKTNG
Total:
Handicapped:
Compact:
Curbside 5'
nla
Fully Improved
Notes:City Contractor no fee inspected by Art Ireland (maintenance)
$ Per Sq Ft
or multiplier
Sidewalk Type:
Downspouts/Drains:
Square Footage
or Bid Amount
Description Type of Construction
Page I of2
Value Date Calculated
ttL, I Il
Status Pending
225 Fifth Street, SPringfield' OR
541-126-3753 Phone
541-726-3676Bax
541-7 26-37 69 InsPection Line
Fee Description
Total Amount Paid
Total Value of Project
Date Paid
Building/C ombination Permit
PERMIT NO:coM200s-00109
NSUED:
APPLIED:
EXPIRES:
VALUE:
01/2712005
Receipt NumberAmount Paid
$0.00
Plan
To Request an inspection call the24 hour recording at 726-3769. All inspection 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.
nsnections
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.
| -)'? -os*\
Owner or Contractors Date
Pase2 of2
UOOD STOVE/INSERT INSPECTION APPLICATION
CITY OF SPRINGFIELD
BUILDING SAFETI DIVISION
225 Fifth Street
Springfield, Oregon 97 471.
SPFINGFIELO
I
0ffice:
INSPECTION LINE:
726-3759
126-3769
IaITCTTY OF
Job Location:2.
Assessors Map *:
Ovner:
Address:
Ci ty:
VaIue of Uood Stove
€
S tate:
Tax Lot *:
Phone *: 2 2L
F72 zipz ??i<-22
t(pr ease circle appropri ate app ance
Preliminary rnspection is $15.00 (prior to instarration of insl*rood stove/perlet/rnsert permii -i"
srs.00 + $10.00 rssuance +
ert)
W
state surcharge.
Type of Inspection Requested:
Con t rac tor:
Address:
Ci ty:
Phone #:
S tate:<T zio: 72?>Construction Contractors Registration #:ires: ,b
By signing this permit/application, I agree to call for an insp ection(s) as required(726-3769). r s tate that all infornat ion on this appli ca t ion/permit is correct andthat I vas provi ded vith the l,lood St ove Safety information for vood burningappliances and preliminary inspecti on standards. I further sta te that the applianceI am installi ng meets smoke emissi on standards as set by the 0r egon Department ofEnvi ronmen taI Quality or the Fede ral Environmental pro tection Agency and f agree toprovide the te sting approval num ber to the inspector a t the time of ins pection. Ialso underst and that if I am requesting a preliminary inspection, the vaIl coveringmayrutoved
ture 3-rz- r z
Date
FOR OPFICE USE
REQUIRED INSpEcTToN(S): TJOODSTOVE ).PRELIMINARY /Y
Date of Application:I
=Job #:
Total Amount Collected:
Receipt #:
Checked for Delinquencies:
fssued By:
for Historical Status:
ol Te