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Home My WebLink AboutPermit Curb Cut 2001-11-14Job# 01-01200-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Tr!iltfi!-ii n,-lT--llllll ; i !a^rr Un I L- " i'auv i-+ r:-uu trJf r,f :1n - r: A 5-:, ra i.llll l\!-LU"L + U.J.J I tt rnrt! x i4n, l?rrr - -44 Lnu! liLi\ ' ULf Page 1 ol 2 SPR!NGFIELD h, t: t r n 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 260 00035th St Spr AssessorsMap#: 17023131 Lot: Block: Addition Job Number: 01-01200-01 Office: 726-3759 lnspection Line: 726-3769 Tax Lot#: 00300 Subdivision: ctrY oF SPRINGFIELq OREGOAT Owner: Ronald Neuharth Address: 6343 c street Scope Of Work: Curbcut Phone Number: City/State/Zip: New 541-747-3846 springfield, OR97477 Value: $O new curb cut, applicant also has an encroachment permit for sanitary and storm sewer Contractor Type Contractor - ROW Contractor Ron Neuharth 6343 C Street, Springfield, OR 97478 Registration # Expiration Date Phone 541-747-3846 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 callthe 24hour recording at726-3769. 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 Plum Storm Sewer Line -Prior to filling trench PqlllefryeAe--l CC-Standard -After forms are erected but prior to placement of concrete Area (Sq Main: # Of Stories: Height (feet): Current Units: Proposed Units Census Gode: Does not apply Accessory Total Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? f] Job# 01-01200-01 Page 2 of 2 Fee Paid On Receipt# Value/Quantity Fee Amount Minimum Plumbing Permit Fee State Surcharge - Plumbing Storm Sewer Footage Administrative Fee - Plumbing Total Plumbing 11t14t2001 1111412001 1111412001 1111412001 7258 7258 7258 7258 205 $.00 $5.11 $73.00 $5.84 $83.9s Public Works New Curbcut Total Public Works 1012912001 7116 1 $65.00 $6s.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 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. 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 project address is readable from the street, and the approved set of plans will remain on the site at all times $148.95 /-4-3-a:1 Date during coygtru$iglfl. H*W {-il,l Signature a,ID-I n D 225 FIFTH STREET SPRINGFIELD, OREGON 57477 ENGINEERING DlVISION OFFICE TELEPHONE (5031 726.3753 APPLICATTON DATE i i2t - ::1 ->( ,ERMIT NUMBER: O r -- l2-,s-5-Pi DATE ISSUED: EPFTN(lPIELD SITE INFORMATION: LOCATION OF WORK: 4am, 3a ,)/ 7t ? I Y ),P uX Lor: /_ P:,o/rc: C.*L zt fq /- J. TAX MAp: / ) ^ oA :)t _.J CITY: STA SUBDIVISION: ADDRESS OWNER: e^<< APPLICANT ADDRESS: crryt S|O////iF/L.U srerct (i0€- zr: REOUESTED PERMITS: d .r*, cur/DRrvEWAy: NUMBER oF DRTvEWAv s / * . {- E MULTIPLE PERMIT DISCOUNT EA: ....(MAX 21........... (MULTI PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION ONLY APPLIES TO 2nd AND 3rd PERMITS ONLY. NOT SIDEWALK REPAIRI TOTAL DUE WITH PERMIT $ E PROOF OF INSURANCE: $500,000 MINIMUM lF WORK ls DONE BY PROPERWOWNER @$0.06 sFAMOUNT OF SIDEWALK IN EXCESS OF gOFT E SIDEWALK ....... E $ ASqD $ 65.00......... - $ =$ CONTRACTOR INFORMATION: coNrRAcroR, P.tJEu*/Ar# C-ouctr T/C- flnnr /lru' |' PHaNEt1?)-*Y4, )? -37A TloN DATEr 06 - /7 - Q e ADDRESS CONTRACTOR REGISTRATION NO: PROJECT SUPERVISOR: INSPECTIONS: AN INSPECTION REOUEST SHOULD BE MADE PRIOR TO POURING CONCRETE, AFTER THE PROPOSED WORK HAS BEEN FORMED AND MADE READY TO POUR. CURB CUT AND SIDEWALK INSPECTIONS CALL 7?6"fl3tr (RECOBDERI STATE YOUB DESIGINATED C.Iry JOB NUMBER/PERMIT NUMBER, JOB ADDRESS, TYPE OF INSPECTION REOUESTED, AND WHEN YOU WLL BE READY FOR INSPECTION, CONTRACTOR' S OR OWNER'S N AME AND PHONE NUMBER. REOUESTS RECEIVED BEFOBE 7:OO A.M. WILL BE MADE THE SAME DAY, REOUESTS AFTER 7:OO A.M. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE CALLED lN AFTER EXCAVATIONS ARE MADE AND FORM WORK IS IN P{.ACE BUT PRIOR TO POURING CONCRETE, rHE LANE unur'lE'dE6BH=BilttriiNc couNctl' s" oNE CALL NUMBER" 1-800-332-2344 48 HOURS BEFORE DIGGING SIGNATURE: Bv siqnature, I state and aoree, that I have carefullv examined the comoleted aoolication and do herebv certifv that all information herein is true and cbrrett, and I further certify that any and all work irerformed shall be done in abbordance with the Ordinancei of the Citv of Sorinqfield, applicable Citv Stardard specifiiations and Drawinqs, and tho laws ol the State of Oreqon oertainino to the woik described herein.'l further dertifi thdt only contractors and employees who are in co-mpliance with ORS 701.055 will be'used on this proiect The Citv mav insoect the work site described in this oermh at anv time durino a one vear oeriod followino the receiot bv the Citv of notice of comoletion bf thb deicribed work ard specify, at the Citv's sole disiretion, anv 6dditionil reitoration work ftquired to'retJrn the site to a stmdard acceiptable,to the.Citn The permittee will be'notified in writing of. any work reqLired and will have thirty days (301 from the date of the notice to comalete the work. Work not completed at the erd of the thir-ty days will be performed bythe City and the costs will be billed to the permittee. I further aqree to ensure that all required inspections are requested at the Droper time, that proiect address is readable from thestreet, and thl approved set o, plans will remaih on the site at all times durin! cbnstruction. DATE PAID: RECEIVED BY: ftignature ,€)at6trU( e /C,, AMOUNT RECEIVED: RECEIPT NO: Citg of dprnsfield P RMIT APPLICATIDRIVEWAY/SIDEWALK 66G /-.?</r o .(7 I Job# 01-01200-01 RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Page 1 of 2 Job Number: 01-01200-01 Office:726-3759 lnspection Line: 726-3769 Tax Lot#: 00300 Subdivision: SPRINGFIELD h, 225 North Fifth Street Springfield, OR97477 Location Of Proposed Site: 260 00035th St Spr AssessorsMap#: 17023131 Lot: Block: Addition: ctTY oF SPRilVGFfiELq OREGOfi| Owner: Ronald Neuharth Address: 6343 c street Scope Of Work: Curbcut Phone Number: City/State/Zip: New 541-747-3846 springfield, OR97477 Value: $O new curb cut, applicant also has an encroachment permit for sanitary and storm sewer 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 a1726-3769. 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:Accessory: # Of Stories: Height (feet): Current Units: Proposed Units: Census Code: Does not apply Total: Fee Paid On Receipt# Value/Quantity Fee Amount Public Works New Curbcut Total Public Works $65.00 $6s.00 Grand Total 10t29t2001 7116 1 $6s.00 Job# 01-01200-01 Page2 ot 2 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 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. 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 project address is readable from the street, and the approved set of plans will remain on the site at all times duri /a'2?-2e'/ Signature Date I:-l :I>f.l:i: rn;r3 :r::I)'2: .--tE3;il:r) :r, -1 -rn L|f.. {* "{ r.; Lf:rJ (.-JvJ(}rn f.J -.{rfOtsE'(}H.. Pci'.