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Home My WebLink AboutPermit Sidewalk 2009-1-13 r. "I ~., ,.\- CITY OF SPRINGFIELD Building/CoqIbination Permit Status Issued PERMIT NO: COM2009-00053 ISSUED: 01/13/2009 APPLIED: 01/13/2009 EXPIRES: 07/1312009 VALUE: 225 Fifth Street, Springlield, OR 541-726:3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 463 39TH ST ASSESSOR'S PARCEL NO,: 1702311403000 Springfield TYPE OF WORK: Sidewalk TYPE OF USE: Repair Commercial PROJECT DESCRIPTION: Sidewalk repair for south side of building Owner: VICTORY TABERNACLE Address: PO BOX 946 SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION 1 Contractor Type Contractor License 'Expiration Date Phone . BUILDING INFORMA TlO!,! 1 # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construction Type Secondary Construction Type: # of Bedrooms: # of Stories: Heigh! of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1st Floor: Sq Ft 2nd Floor: ,Sq Ft Basement: Sq Ft GaragelCarport Sq Ft Other: Occupant Load: ilia I ,DEVELOPMENT IN~ORMATlON 1 REQUIRED PARKING Overlay Dist: ",;rrEOlVr/' Total: - # Street Trees Rqd: lVo~:'O"'1 rille 01V; Ore Handicapped: Paved Drive Rqd: in o~';,f!lion S EiC/op gOn If! Compact: % of Lot Covel'age:?90 I) 952_0 Center leCl by I~ requi c '. You 01-00' rho e Or res Yo n. Eill,'nr>" m''ll' _, 70,~ se rlIl--:. ego" ,U to I PUBLIC IMPROVEMENTS" fo~"','Zeni;;Ei'n co;~gh 0'4';;e set-;;'Iy t'e 'Ie 0,; (IVOI .'2$ Of 952_ rill ntESi.\!e}':aIk)JiYJt'~:lhe I the rUle 00,. -800 t'litv. ^ eletJh s by DownspoIi67.p.~insot'a one 0:144), CatiOf] Frontyard Setback: Side I Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: , Street Improvemenif:TlCE' "rl"" . Storm Sewer Ava,i1able::JERM SpeciallnstructiOlHTHORIZE IT SHALL EXp r..,OMME D UNDER T IRE IF THE W Notes: itVY 18 NeED OR IS A HIS PERMIT IS ORK o DAY peo/EX;, BANDnMr:~.t,;_ NOT " .. ' I Valuatio~ Descri9tion,I Description Tvoe of Construction $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Paee I of 2 . Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-00053 ISSUED: 01/13/2009 APPLIED: 01/13/2009 EXPIRES: 07)13/2009 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line Total Value of Project Fees Pai~ 1 $0,78 $15,50 Date ~aid 1/13/09 1/13/09 Receipt Number Fee Description . + 5% Technology Fee Sidewalk Repair Permit Amount Paid 3200900000000000022 3200900000000000022 Total Amount Paid. $16,28 I Plan Reviews I To Request an inspection call the 24 hour recording at 726-3769. 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 work day. I Relluired J nsne~ti~I1,S 1 Sidewalk -,Curbside: After 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 bereon is true and correct, and I further certify that any and all work performed shall be donein accordance with the Ordinances 'of the City of Springfield and the Laws of the State of Oregon pertaining to the w.ork 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 "cr:::~7M7 . 10 to - OC? Owner or Contractors Signature ~ Date Paee 2 of2 ., ,,,_.,' "". '. "..: '.F'., J_~-","IPJ . ,'., '" .:..' :;",',; ^..~., "-:,,~ ~ _.': " ,", . .~,..' 1,: '-..> LJfT.!/,OJ/tJpnnOjI'7," ,". ..' . _, . -' ;. '''. .' .'\.,';.....t:fjf; .::; >:.:: ~,'>>, :- ~.' I' "FF'>:{!:~" ~.~~.. :.:", ....."'. '?':" :~ .:' :~ <>~': ':',~. . ./ .:": ' ."'.: ;"i~:' :~\.' .> :.::.' ~ :.'~ ',~: ,< :.~':::~,,~;~~~~~ ,if ::'~~!DRIV.EWAY/SI[)EWAl..K' ; .:,'!' ;,'PERMIT1:\PPLlGAJION ;~:/;':;;lf 225 FIFfH STREET SPRINGFIELD, OREGON 97477 . ENGINEERING DIVISION' OFFICE TELEPHONE (503) 726.3753 .P~~ ~~ PERMIT NUMBER: DATE ISSUED: (ltTnC 7-nJ q - (}-()-O $- 3 1-,2,-07 APPLICATION DATE: /-/?r"'i I SITE INFORMATION: I LOCATIONOF>>'ORK: ~ () _'if/ J.f~/1.) /I/. ..;:!1/~ <r <' "~}A~ 1;:., /J - / (- 'A ,"'C')~Cc-.JNtJ r;~ q PHOrE .~<f-rl. . f ~(.. c... 1), C - 15 7 APPUCANT ADDRESS: TAX MAP: ow '(" ;/10<: J..:.tJ"'ATE: SUBDIVISION; r-- OWNER ADDRESS: (').~ ZIP: q 74 '76 TAX LOT: PHONE: CITY: STATE: ZIP: REOUESTED PERMITS: ,51' SIDEWALK: AlvIOUNT OF SIDEWAlK IN EXCESS OF 90fT.' tsl SIDEWALK REPAIR:... $88.00 ....,........... @$o.oir SF. ,$15.50 ........... ........ ~$ "$ ....... ~ $ 1<:', S-O o CURB CUT/DRIVEWAY: NUMBER OF DRIVEWAYS_ X ........$88.00 1stCul ~$ o MULTIPLE PERMIT DISCOUNT EA .....-. ..(MAX 2) ,.. ... ....,...,......$30.00 (MUL 11 PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION ..DM..Y )PPLlES TO 2nd ANO 3rd PERMITS ONLY, NOT SIDEWALK REPAJRl . (jJ"5% Technology Fee $ ().7'b . TOTAL OUE WITIJ PERMIT $ o PROOF OF INSURANCE: $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNEA 2nd Cut ~$j. \- =$ Ire. ,2,& II CONTRACTOR INFORMATION: CONTRACTOR: o (^ J;J {' /' ADDRESS: CONTRACTOR REGISTRATiON NO: PROJECT SUPERVISOR: PHONE: EXP1RApONOATE: PHONE: INSPECTIONS' 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 SIDEWAU\ INSPECTIONS CAll 726-3769 (RECORDER) STATE YOUR DESIGINATED CITY JOB NUMBER/PERMIT NUMBER, JOB ADDRESS, TYPE OF INSPECTION REOUESTED, AND WHEN YOU WILL BE AEADYFOR.lNS PECTJON. CONTRACTOR'S OR OWNER'S NAME AND PHONE NUMBER. REOUESTS RECENED BEFORE 7:00AM. WILL BE MADE THE SAME DAY, REQUESTS AFTER 7:00A.M. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE CALLED !N AFTER EXCAVATIONS ARE MADE AND FORM WORK IS IN PLACE-BUT PRIOR TO POURING CONCRETE. YOU ARE AEQUIREO TO CALL THE LANE UTILITIES COORDINATING COUNCIL'S "ONE CALL' NUMBER" 1-800-332.2344' <8 HOURS BEFORE DIGGING 'SIGNATURE: AMOUNT RECE~ED: RECEIPT NO: DATE PAID: RECEIVED BY: By signature, I state and agee\lhatl have carefulfy examined the compeled applicaliOll and de he reby cerlify that aH inlorma~on hwein is Hue and corfect and I further certifY tha al1Y and all work,gerlormed shall be done in accordance WIth the Ordinances of the Ptv of Splinglleld, .applicable City Standard spe~fica!lon~ and D(a>MnQs. and the laws of the Slale of Oregon perlaining to the work described herein. I funtier ceMy Ihal.only contraclors and employees who are In comphance 'Mth GAS 701.055 'Mil be used .' on Ihlsp-oleC!.' . The City may inspecrthe work sile described in this permi! at any time during a one year period f6 Rowing Ihe receipt by the City 01 rio/ice 01 com~lelion ollhe d.escnbed work and specify, at the City's sole discretiOl1 any additional restoration work required 10 relum the sile 10 a standard acceplable 10 the Ci . The permltlee Will be no@edin writing of any work required and WlII have lhlrty days (30) from the dale ollhe notice to compIele Ihe work. Workno/ camp eled at Ihe end 01 Ihe I~irty days will be pertormea by the Clly anc:llhe costs will be billed to tlie permlllee. .' ::..~ ,__'Signature Ilurther agr to en re Ihal ell required inspections are r lIeSlad at the proper time. that project address is readatle tram the streel, and the pproved sel of plans 'Mil remain on Ihe site al I time~ during conslfuclion. " \' I(J()~ ' ,') "".ull) I I ~ "/J Dale / - )3-()f '-' :- ~ 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-00053 COM2009-00053 Payments: Type of Payment Check cReceintl RECEIPT #: Description Sidewalk Repair Permit + 5% Technology Fee Paid By VICTORY TABERNACLE City of Springfield Official Receipt Development Services Department Public Works Department 3200900000000000022 Date: 01/13/2009 1l:56:28AM Item Total: Check Number Authorization Received By Batch Number Number How Received Amount Due 15.50 0.78 $16,2M Amount Paid Ikw $16.28 $16.2M , 679 In Person Payment Total: Page I of I 111312009