HomeMy WebLinkAboutPermit Sidewalk 2010-09-09ffi CITY OF SPRINGFIELD
Building / Residential Permit
PERMIT NO: 811-SDC2010-00265
IVR Numbe r: 21017 0387 943
ISSUED:9/9/10
APPLIED: 9/9/10
22s Fifth st
Springfield,OR 57477
Phone: 541-726-3753
lnspection Phone: 541 -7 26-37 69
Fax: 541 -726-3676
permitcenter@ci.springf ield.or.uswww.ci.springfield.or.us
PROJECT STATUS: lssued EXPIRES: 31712011
VALUE: $0.00
SITE ADDRESS: 94228TH
ASSESOR'S PARCEL NO:
Springfield
1 703361 1 09600
SCOPE
WORK INVOLVED:
TYPE OF STRUCTURE:
PROJECTDESCRIPTION: Sidewalkreplacement
DEVELOPMENT INFORMATION
REQUIRED PARKING
Frontyard Setback:
lnterior Setback:
Sideyard Setback:
Rearyard Setback:
Solar Setback:
Overlay Dist:
# Street Trees Reqd:
Paved Drive Reqd:
% of Lot Coverage:
Highest point on structure to
north property line:
Total:
Handicapped:
Compact:
PUBLIC IMPROVEMENTS
Street lmprovements:
Storm Sewer:
Storm Sewer Available
Special lnstructon:
Subdivision Accepted:
Notes:
Description
Sidewalk Type:
DownspouUDrains:
: -:;r l-: :r, :, i "l
Valuation Description
Tyoe of Construction Unit Amount Unit Tvpe Unit Cost Value
Description
Sidewalk up though 90 Feet
Amount Paid
$88.00
Date Paid
09t0912010
Receipt #
374271
Technology fee (5% of permit total)$4.40 09/09/201 0 374271
Total Amount Paid $92.40
Springfield Building Permit 91912010 12:21:33PM Page 2 of 3
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225 FIFTH STREET
SPRINGFIELD, OFEGON 97477
ENGINEERING DIVISION
oFFrcE TELEPTJONE (s03) 7 ?6-37 53
APPLICATION DATE:
HIry
srATE _2P.._-
tL
PHONE
STATE:'/,'/77
PHONE:
AOOBESS crfi:
SITE INFORMATION:
LOCATION OF
TAX MAP:
TAX LOT:
lToaaat/-
bfGe a
APPLICAtIT
AODFIESS:
REOUESTED PERMITS
EcUnBCUT/DRlVEWAY:NUMBEBoFDRlVEWAYsX,',.............,.....$88'001stCut=s-
Q MULTIPLE PEFIMIT OISCOUNT EA: .........(MAx 2) ...........................$30.00
(MUL]I PERMIT DISCOUNT GOOD FOF ONE SrrE ANO ONE SIIE INSPECTION.ONLY
APPLIES TO 2nd AND 3rd PEFMITS ONLY. NOT STDEWALK REPAIfr
g/s"kT.r},nology Fee S *. VD rorAl DUE wrH pEFtMtr $
El PBOOF OF INSURANCE: $500,000 MINIMUM lF WORK lS DONE BY PROPERTYOWNEB
g/sroewnx,
q
AMOUNT OF SIOEWALK IN EXCESS OF gOFT @$0 08 sF =s
2nd Cut:$_(- )_
CONTRACTOR INFORMATION :
"ro*r, fil fi71
EXPIHA'NON OA'TE:
7h
PHONE;
ADOFESS:
CONTRACTOH REGISTFATION NO:
PROJECT SUPERVISOR:
INSPECTIONS:
AN INSPECTION BEOUEST SHOULD BE MAOE PRIOH TO POUHING CONCBETE, AFTER IHE PROPOSEO WOBK I.IAS BEEN FO RMED ANO MADE READY TO
POUR. CUFB CUT ANO SIDEWALK INSPEC]IONS CALL 72A3769 (RECOBDEB) SIATE YOUB OESIGINATED CITYJOB
NUMBEfuPEBMIT NUMBEE, JOB AOORESS, TYPE OF INSPECTION BEOUESTEO, AND WHEN YOU WLL BE REAOY FO8 INS PECTION. CONT.RACTOB'S OR
OWNER'S NAME AND PHONE NUMBER. EEOUESTS FECEMED BEFORE 7:00 A.M. $LL 8E MADE THE
SAME OAY, BEOUESTS AFTEB 7:m AM. WLL BE MAOE THE NErf WORKING DAY. INSPECTIONS AFiE TO BE CALLEo lN
AFTEB EXCAVATIONS ABE MADE AND FORM WOBK IS IN PLACE BLII PRIOF TO POURING CONCREIE.
YOU AHE REOUIRED TO CALL
THE LANE UTILITIES COORDINATING COUNCIL'S.,ONE CALL NUIVBEF" 1 -BOO-332-2344
48 HOURS BEFOBE OIGGING
SIGNATURE
AMOUNT FECEIVED:
BECEIPT NO:
DATE PAIO:
RECEIVEO BY,
that proj ecl add(ess is readat e hm the
Bv sionalure. I slale and aoree. lhat lhave carefullv Mmined the cornoleted aoolication and c,o he rebv cerliltv lhal allinformauon herein is lrue
md csre-ct. and I furths cerlifilhat anv and allrcrk oirrlrymed shall be done in aiiordtre with lhe Ordrnances-ol
tfri:-Ciry ol3pnngi'elO, "pptica6E
eiti Stan&ro i'peoTcatrcjniint diJrnoql, and i q laws of Ihe . State ol Oregm pataining to Ihe rIk dssibed hse's]. I lullhgr
cedify fhal ohly dcnlracliis and enlployees wno ere in cornpliance wilh OHS 701.o55 will be used
on lhrs goled.
The Citv mav inso€cl the work site dessibed in this oermh at anv lrme durino a me vear o€dod lo 0oflino lhe receipt W lhe City ol nolice ol coqlpl4on ol lhe
dsoibedvi,orkindiomfv.arlneGN'ssoledrscretim'mvaddrtrohalresloratiSn$Drkieouired loreturnlhEsileloaSlilidadaci-plablelolheCrty. lhe
p'ermifle will be nolilibd in?riUno ol ahv wdk rmuired end 'will have thrrlv days (30) km lhe date ol lhe nolice lo cmdete the wsk. Work no( moeteo al lne sO
bl lhe thirty days will be periorme? by llie City and lhe @srs will be bilredio ttie dermillee.
llurtherstret, md plans on
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PERMIT NUMBER:-
DATE ISSUED:
CONTFACTOF: