HomeMy WebLinkAboutPermit Sidewalk 2006-07-05,&prxifit{hF*ffif &
Status Issued
225 Filth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-37 69 I nspection Line
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Building/Combination Permit
PERMIT NO: COM2006-00830ISSUED: 0710512006APPLIED: 07/0512006
EXPIRES: 01/0512007
VALUE:
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SITE ADDRESS: 1490 5TH ST APT I
ASSESSOR'S PARCEL NO.: 1703263101100
PROJECT DESCRIPTION: 20ft of new sidewalk
Springfield TYPE OF WORK: Sidewalk
TYPE OF USE: Repair
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Owner:
Address:
Contractor Tvpe
General
MAINSTREAM HOUSING INC
433 W STH AVE APT OOI
EUGENE OR 9740I
Contractor
NANCY R BELL CONTRACTING INC
e telePhone
y Notification
License Expiration Date
129922 07t2512007
Phone
541-485-6828
CONTRACTOR INFORMAT
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
# 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/o of Lot Coverage:
Lot Size:
Sq Ft lst Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:nla
Sidewalk Type:
Downspouts/Drains:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Setback 5'
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
DEVELOPMENT INFORMATION
PUBLIC IMPROVEMENTS
Description Type of Construction
Paee I of2
Value Date Calculated
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,oon Utilit!
aie set forth
AR 952-001'
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Valuation Description I
Building/Combination Permit
Status Issued
225 Filth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-7 26-37 69 Inspection Line
PERMIT NO: COM2006-00830ISSUED: 0710512006APPLIED: 07/0512006EXPIRES: 01/0512007
VALUE:
Total Value of Project
Fee Description
Sidewalk Permit
Amount Paid
$80.00
$80.00
Date Paid
715106
Receipt Number
32006000000000003s2
Total Amount Paid
Fees Paid
Plan Reviews
To Request an inspection call the 24 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.
Sidewalk - Setback: Alter forms are erected but prior to placement of concrete.
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.
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Owner or Contractors Silnatu.e
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Date
Pase 2 of 2
Kequlreo llrslrceuolls l
225 Fifth Street
Springfield, Oregon 97 477
541-726-3759 Phone
6uty of Springfield Official Receipt
r,elopment Services Department
Public Works Department
RECEIPT #: 3200600000000000352 Date: 0710512006 ll:53:4lAM
Job/Journal Number
coM2006-00830
Description
Sidewalk Permit
Amount Due
80.00
Item Total:$80.00
Payments:
Type of Payment Paid By
- -- - -- ehEk Number
Received By Batch Number
Authorization
Number How Received Amount Paid
CreditCard NANCY BELL vrJ 047 570 047570 In Person
Payment Total:
s80.00
-$8o--o-d'
cReceint I Page I of I 71512006
a*Ertaa'lS.It
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
oFFtcE TELEPHONE (503) 726-3753
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SPRINGFIELD
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7
PERIUIT NUN/BER
DATE ISSUED:
SITE INFORMATION
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PHONET
STATE:
PHONE
J
STATE:ztP:I
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CITY:ZIP . _
CIW:
ADDRESS:
OWNER:
APPLICANT lr'/.r*t*
TAX MAP:
TAX LOT:
I
SUBDIVISION
LOCATION OF WORK:
ADDRESS: 3'/ y j
B MULTIPLE PERMIT DISCOUNT EA: .........(MAX 2) .....,................,....$ s0.00 .
(MULTI PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION ONI Y
APPLIES TO 2nd AND 3rd PERMITS ONLY. NOT SIDEWALK REPAIRI
TOTAL DUE WITH PERMIT $
E PROOF OF INSURANCE: $500,000 MINIMUM lF WORK lS DONE BY PROPERTYOWNER
REQUESTED PERIUITS
:$
:$_(-
:$
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$ 80.00............... : $tI CURB CUT/DRIVEWAY: NUMBEH OF DRIVEWAYS X
..........$ 80.00
@$0.08 sF.
..........$ 10.00
Q$E,ru*oLK: .....
A-UouNT oF sroewn.r ir.r ex;;;; ;; ;;r,
EI SIDEWALK REPAIR:
CONTRACTOR INFORN/ATION
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EXPIRATION DATE:U
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PHONE:2 -q)?(
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PHONE:<''*7/ -{"4(
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INSPECTIONS
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CONTRACTOR
ADDRESS:
CONTBACTOR REGISTRATION NO
PROJECT SUPERVISOR:
AN INSPECTION REOUEST SHOULD BE MADE PRIOR TO POURING CONCRETE, AFTER THE PROPOSED WORK HAS BEEN FO RMED AND MADE READY TO
POUR. CURB CUT AND STDEWALK TNSPECTTONS CALL 726-3769 (RECORDER) STATE YOUR DESTGTNATED C|TY JOB
NUMBER/PEHMIT NUMBER, JOB ADDRESS, ryPE OF INSPECTION BEQUESTED. AND WHEN YOU WLL BE READY FOR INS PECTION, CONTRACTOR'S OR
OWNER.S NAME AND PHONE NUMBEB. REOUESTS BECEIVED BEFORE 7:OO A,M. WILI BE MADE THE
SAME DAY, REQUESTS AFTER 7:OO A,M. WILL BE MADE THE NEXT WORKING DAY INSPECTIONS ARE TO BE CALLED IN
AFTER EXCAVATIONS ARE MADE AND FORM WORK IS IN PI.ACE BUT PRIOB TO POURING CONCRETE,
r H E LA N E u r r L r ir"E'd'8bU H'BiRr"Atr N o c o u N c r L' s.,ONE CALL NUIVBER" 1 -800.332.2344
48 HOUBS BEFORE DIGGING
SIGNATURE:
Bv sionature. I stale and aoree. lhat I have carelullv examined the comoleted aoolication and do he rebv cerlifu that all inlormation herein is true
and c6rre"ct, and l ,urlher certifu"thai anv and all work o6rformed shall be done in aicbrdance wilh the Ordin'ancesbf
the Citv of Sprinqfield, applicable Citv Standard specrlications and Drawinqs, and the laws of the State ol Oreqon perlaining to the work described herein. I further
certifu [hat ohly dontractbis and emp'loyees who Are in compliance with OHS 701 .055 will be used
on this prolecll
The Citu mav insoect the work sile described in this oermit at anv time durino a one vear oeriod fo llowino the receiot bv the Citv ol notice ot comoletion of the
described r.iork 5nd Soecifu. at lhe Citu's sole discretion.'anv additioial restoratiSn work i'eouired to return th"e site to a'staniCard ac'ceotable to the Citv. The
permittee will be notifibd in writinq ol ahv work required and will have thirty days (30) from th'e date ol the notice to complele the work.'Work not completed at the end
bt the thirty days will be performe'tJ by tlie City and the costs will be billed'to tlie permittee.
I further aqree to ensure thal all required inspections are requested at the proper time. that proj ect address is readable lrom the
street, and th6 approved set of plans viill remain on the site at all times during'cohstructioh.
DateSignature
RECEIVED BY:
DATE PAID:AMOUNT RECEIVED:
RECEIPT NO:
DRIVEWAY/S!DEWALK PERMIT APPLICATION
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