HomeMy WebLinkAboutPermit Sidewalk 2002-11-21TY PRINGFIELD
Status: Issued
225 Fifth Street, SpringfieH, OR
541.:726-3753 Phone
541-726-K76 Fax
541:726-37 69 Inspection Line
Building/C ombination Permit
PERMIT NO: COM2002-01315ISSUED: lll2ll2002APPLIEDz lll2ll2002E)GIRESz 0512112003
VALT]E:
SITE ADDRESS: 277 S 34TH ST
ASSESSOR'S PARCEL NO.: 1702313106700
PROJECTDESCRIPTION: Sidewalkrepair
Owner: WILLAMALANEpARK&RECREATION
Address: 200 S MILL ST SPRINGFELD OR 97477
Sidewalk
TYPE OF USE: Repair
Springfield TYPE OF
License
48631
Commercial
Phone Number: 541-736-4044
Phone Number: 541-736-4044
Contractor Type
General
Owner
Contractor
WILLAMALANE PARK & RECREATION
WILLAMALAIYE PARJ( & RECREATION
Expiration Date
Lu08t2004
Phone
541-7364048
541-7364044
CONTRACTOR INFORMATION
# of Buildings:
Primary Occupancy Group:
Secondary Occupancy
Primary Construction Type
Secondary Construction
# of Bedrooms:
AN YlBOD AY PER
NOTICE:
THIS PER MIT SHALI
AU lHORI ZED UNDE
EDORI
MIl IS NOT
D IOR
aw requ,rA
lf oYthe Qrs6
i??,:ilTtlfl
n copies
(Nota'rh
oa-ZJ4
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport:
Sq Ft Other:
Impervious Surface Area:
REQUIRED PARKING
Total:
Handicapped:
Compact:
CO Mh,lENC IBter type:
Range Type:
Energy Path:
SETBACKS
Frontyard Setback:
Side l Sethck:
Side 2 Setback:
Rearyard Setback:
Sohr Setbacks:
Street
Storm Sewer Arrailable:
Spechl Instruction:
Notes:
Descrbtion Tvpe of Construction $ Per Sq Ft Square Footage
Sidewalk Type:
DownspoutVDrains
DEVELO
lof2
Value Date Calculated
I?umberfor the
Valuation Descrintion I
FIELD
Buildin g/C ombination Permit
PERMIT NO: COM2002-01315ISSUED: lll2ll2002
APPLIEDz lll2ll2002E)GIRES: 0512112003
VALT]E:
Status: Issued
225 Fifth Street, SpringfieH, OR
541:726-3753 Phone
541-726-3676 Fax
541:726-37 69 Inspection Line
Fee Description
Sidewalk Repair Permit
Total Amount
Amount Paid
$r0.00
$10.00
TotalValue of Project
Date
tU2u02
Receipt Number
22002000000000002r5
Received By
gkw
tr'ees Paid
Plan Reviews
To Request an inspection call the24 hour recording at 726-3769. AII inspection requested before 7:00 a.m.
will be made the same working day, inspections requested after 7:00 a.m. will be made the following work
day.
1 Sidewalk - Setback After forms are erected but prior to placement of concrete.
Reouired Insnect
By signature, I state and agree, that I have carefully examined the completed application and do hereby certi$ 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,
BuiHing Safety. I further certiry that only contractors and employees who are in compliance with ORS 701.005 will be
used on this
I further agree that all required inspections are requested at the proper time, that each address is readable from
the street,the front of the property, and the of will remain on the site
at all times
Dateor
2of2
I
IIa
N I D Dt!D I D a1 I I o
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
oFFrcE TELEPHONE (503) 726-3753
SBRTNGFIELD
-1
)
/Zt a7-
ttvlZooz- OlPERMIT NUMBER:
DATE ISSUED:APPLICATION DATE: / I /2,
SITE INFORMATION:
ctry:,1T(NGFtF-LT> sr^rEt Ol-- apt g 7 q77 ' rAX Lor:
PHONE
rAX MAP: t7 Oa >t,3 I
baze I
STATE:CITY:ZIPl.
PHoNE: 7 3b''l O'1
LOCATION OF
ADDRESS: ,*D .c-a-r- * 1.4 , r-- 1-i*
APPLICANT
OWNERT
suBDrvrsroN
ADDRESS: AAM E-
REQUESTED PERMITS:
I uulrreLE pERMtr DlscoUNT EA: (MAX 2) $3o.oo
(MULTI PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION ONLY
APPLIES TO 2nd AND 3rd PERMITS ONLY. NOT SIDEWALK REPAIR)
TOTAL DUE WITH PERMIT $
fl nnoor oF INSURANcE: $500,000 MTNTMUM tF woRK rs DoNE By pRopERTy owNER
$ 75.00
@$0.07 sF
$ 10.00 . .
CURB CUT,DRIVEWAY: NUMBER OF DRIVEWAYS:$75.OO
: $_(-
o(}
$
u
a
tr
og
I STDEWALK:
AMOUNT OF SIDEWALK IN EXCESS OF gOLF
g[ sroeweLK REPATR:
=$
=$
CONTRACTOR INFORMAT!ON :
EXPIRATION DATE:
I)r+ >< -T-F:-rz L-E r-PHoNE: 1; -ls;l
M L
PHONE:
nla lo aztq h3 t
PROJECT SUPERVISOR
; C0NTRACTOR REGISTRATI0N N0
ADDRESS:
CONTRACTOR:
INSPECTIONS
AN INSPECTION REQUEST SHOULD BE MADE PRIOR TO POURING CONCRETE AFTER THE PROPOSED WORK HAS BEEN FORMED AND.MADE
READY TO POUR. CURB CUT AND SIDEWALK INSPECT|oNS CALL 726-3769 (RECoRDER) STATE yOUR DESTGTNATED CtTy J0B
NUMBER/PERMIT NUMBER JOB ADDRESS TYPE OF INSPECTION REQUESTED AND WHEN YOU WILL BE READY FOR INSPECTION,
CONTRACTOR' S OR OWNER'S N AME AND PHONE NUMBER. REOUESTS RE6EIVED BEFORE 7:00 A.M. WILL BE MADE THE
SAME DAY REQUESTS AFTER 7:OO A.M. WILL BE MADE THE NEXT WORKING DAY. INSPECTIoNS ARE To BE cALLEo INAFTER ExcAVATloNs ARE MADE AND FoRM woRK rs rN pLAcE BUT pRtoR To pounino -couonete.
THE LANE UTILITIES COORDINATING COUNCIL' S"oNE CALL NUMBER" 1-900-332-2344
YOU ARE REQUIRED TO CALL
48 HOURS BEFORE DIGGING
SIGNATURE:
Cits of dprinsfield
ICATIONIVEWAY/SIDE WALK
?
P RMIT AP
A[r.\t tlitT otrntrnrtrn.4 'n*-NATE DAIN.rr /2, /o,z
RECEIPT NO:Zrf RECEIVED BY:(:lcL
that project address is readable from the street,
Date Z(0e
Bv sionature. I state and aoree. that I have carefullv examined the completed applicalion and do hereby certify that all information herein
is'tru6 and correct, and I fulthei certify that any and allwork performed'shall be'done in accordance wifh the Ordinances of
the Citv of Sorinofield. aoolicable Citv Standard soecifications and Drawinqs, and the laws of the State of Oreqon pertaining to the work
descri6ed hdreinl I fuithei certify thaf only contractors and employees who-are in compliance with ORS 701.055 will be used
on this project.
the Citv of notice
return the site to
(30) from the
the
the to
the City and the
I further
and the
to
work
at
that all
plans
,, 4
not