HomeMy WebLinkAboutPermit Miscellaneous 2009-2-19
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Perin it
P~RMIT NO: COM2009-00232
I,SSUED: 02/18/2009
APPLIED: 02/18/2009
EXPTRES: 08/18/2009
VALUE:
225 Fifth Street, Sprillgfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspectioll Line
. SITE ADDRESS: 235111TH ST
ASSESSOR'S PARCEL NO.: 1703261105200
Springfield TYPE OF WORK: Curbcut
TYPE OF USE: Alteration
Public
PROJECT DESCRIPTION: Driveway
Owner: HAAG JOHN R & ORA J
Address: 2351 N 11 TH ST
SPRINGFIELD OR 97477
I CONTRACTO~ INFORMATION ~
Contractor Type
Contractor
License
Expiration Date Phone
r BUlL~ING INFO~MATlONi
# of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height of Stru'Cture
Type of Heat:
Water Type:
Rallge Type: .
. Energy Path:
Sprinkled Building:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
'Occupant Load:
n/a
I DEVELOPMENT INFO~MATlON I
Front yard Setback:.
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Halldicapped:
Compact:
'__... ,(nl\ to
taw ,-"_.... . .......,
:TTENTION: Oregodnb" thEII',U.BLIC-IJY!P,ROVEMENTS ,
A adopte, "'V _~. ,
Street Improvell;1e'iIts'; fule5center. Those rUle~I'R 952-001-
N0\i1ica\lon 010 through le5 by
Storm Sewer A~ailable:952-001-0 . conies 01 the rUh 'ne
'n VI'''' obtain ~ lep 0
Special !nstructioniJo 'Iou nlaY . (Nate'. the te '1' ,\ion .
UU '. the center. 'unity Notl lca .
callIng h oregon I 4)
Notes: number lor t e. 1_600.332-234 .
.center \5 .
I Valuation DescriDtion I
. :~~.., ......~ ...
. N,'1IJ.G/i:T e: .
Tflls PERMlreSHALL EXPIRE IF THE WORK
AB~~'1J~Y1'&lif~~'I!R THIS PERMIT IS NOT
COMMENCED OR IS ABANDONED FOR
ANY 180 DAY PERIOD.
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee I of 2 '
'>
_~".!~.!il~i
',1 :
',"
Status
Issued
225 Fifth Street, Springlield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 5% Technology Fee
Curbcut Permit
Total Amount Paid
Amount Paid
$4.40
$88.00
$92.40
Total Value of Project
Fees Pairl I
Date Paid
! Plan Reviews I
2/18/09
2/18/09
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-00232
ISSUED: 02/18/2009
APPLIED: 02/18/2009
EXPIRES: 08/18/2009
VALUE:
Receipt Number
2200900000000000181
2200900000000000181
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 Renuirerllnsnection,s'
Curbcut - Standard: After forms are erected but prior to placemellt of concrete.
By signatllre, 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 witb
the Ordinances of the City of Springfield and the Laws of the State of Oregon pertaining to the work described berein, 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. .
J:!:::.m,'f.. ~;-::::'ar
Paee 2 of2 .
c;<. - ;g- Vp
Date
'.
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. :~::, ~ __/ -. . .~'-;:". :,' . ;~: .<:,:-;"'~.~/-". ':":~ .~ ~~...,~ :. ..; :.;: <~.~ '.' ':"'~'~ ':.:-' > '. .~.'~ .~'r" .~:.;,' ",:: - ~l'..: ',.:~ . '- :', : " ~.:- ~;~::;;~~t.~
'i:;-'~i "'DRIVEWAY/SIDEWALK :::'\ ...:fiPERMITApPLlCATION ::\\71~
225 FIFTH S1REET
SPRINGFIELD. OREGON 97477
ENGINEERING DIVISION
OFFICE TELEPHONE (503) 726-3753
~~~
'PERMIT NUMBER
DATE ISSUED:
/i
Lo""<~ooq - co;)~:;; ,
APPLICATION DATE:
SITE INFORMATION:
LOCATION OF WORK: 2'3"5i //-6<.'
(APPUCANT~h/&..f J/./lll Go
(AllDRESS: .::l. -'::i .<:-/ // 7/t ..,:;r-:
'o1>6P47*P":L/).STATE r;,I7.
:;SUS6MSION:
(.OWNER ..5/1/};',6 A5' A&//'?"
5f
'. PHONE
55'/:-75/7- 6-/33
TAX MAP: 17-03-,:1&- II
TAX LOT: (!JS,;ztrt>
C~Z1P:
9'?~~~
.c PHONE:
( tDDRESS:
. CITY:
STATE:
. ZIP:
REOUESTED PERMITS:
c#'SIDEWALK: ................
AMOUNT OF SIDEWALK IN EXCESS OF 90FT.
o SIDEWALK REPAIR
$88.00
@$ODil SF.
$15.50 .....
.. ~$
~$
............... ~$
~-
"l;Zl CURB CUT/DRIVEWAY: NUMBER OF DRIVEWAYS--,- X
........... $88.00 1st Cut ~ $
g9.00
o MULTIPLE PERMIT DISCOUNT EA .... .....(MAX 2) .......$30.00
(MULTI PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION.Qt:{LY .
APPUES TO 2nd ANa 3,d PER"1ITS ONLY. NOT SIDEWALl< REPAI~ .
u;a/S% Technology Fee $ +. 4CJ TOTAL DUE Willi PERMIT $
o PROOF OF INSURANCE: $500,000 MINIMUM IF WORK IS DONE BY PROPERTY OWNER
2nd Cut ~U'
=$
Q;",40
CONTRACTOR INFORMATION:
&, 7t. V, L -u. I.L If..- L; hU',L.e. .{
MJORESS:Z9S,6!? CI'/1l.r1l /I/LL ,.fJJ>. E"dtFt!f/L/€ .6IP
.. ,
CONTRACTOR:
PHONE,3f/3.ffl'lJ
CONTRACTOR REGISTRATION NO:
PROJECT SUPERVISOR:
~PIRATlONOATE:
PHONE;
INSPECTIONS:
AN INSPECT10N REOUEST SHOULD BE MADE PRIOR TO POURING CONCRETE, AFTER THE PROPOSED WORK HAS BEEN FO RMED AND MADE READYTO
POUR. CURB CUT AND SIDEWALK INSPECTIONS CALL 72&3769 (RECORDER) STATE YOUR DESIGINATED CITY JOB
NUMBER/PEAMIT NUMBER, JOB ADDRESS, TYPE OF INSPECTION REOUESTED, AND WHEN YOU WILL BE READY FOR INS PECTION, CONTRACTOR'S OR
OWNER'S NAME AND PHONE NUMBER REOUESTS RECEIVED BEFORE 7:00 AM. WILL BE MADE THE
SAME DAY, REOUESTS AFTER 7:00 A.M. Vv'ILL BE MADE THE NEXT WOAKlNG DAY. INSPECT10NS ARE TO BE CAlLED ,IN
AFTER EXCAVATIONS ARE MADE AND FORM WORK IS IN PLACE BUT .PRlOR TO POURING CONCRETE,
YOU ARE REOUIRED TO CALL
THE lJ'INE UTILITIES COORDINATING COUNCIL'S
"ONE CALL NUMBER" 1-800-332-2344
4a HOURS BEFORE OIGGING
'SIGNATURE:
AMOUNT RECEIVED:
RECEIPT NO: .
DATE PAID:
RECEIVED BY:
By signalure, I slale and agee, lhatl have carefuRy examined !he comFi'eled appUcation and do he reby certify ltlat aB infamalion hE!"ein is true
and correct and I further certifY Ihal <ll"!Y and all work pertOtmed shall be dCW'1e in accordance with the Ordinances 01 .
the PlY 01 Springlield, applicable City Slandard speciIicalions and DrawinQs, and Ihe laws oI1he State 01 Oregon pertaining 10 lhe \'wOrk descnbed hwein, I further
certify IhBl,onfy contractors and employees who are in compliance Wllh OAS 701.055 wdl be used
on lhisp-oJeCl, .
T!1e City may inspect.the worl< si!e desaibed in this perrr./t al.1!ny lime durif1g a one year period 10 nowing Ihe receipt by lheCity at notice 01 ccm~e(ion cllhe
descnbed v.'Ctk and s~ly. atlhe City's sole discrelioo any additiotlal,resloratlCJ'l work leqUlred to return t/l,e site \0 a standard accep'!abIe \0 the CI . The
pemunee will be nOlified in writing 01 any work required .ind will have thIrty days (30) !rom !he date of lhe nOlrce 10 complete the work WOtk no! com eted af the end
of fhe Irymy days Will be performed by Ihe City and the cosls wiU be billed to tlie perrruUee. \
I further agree \0 ensure Ihat a1llequlred Iflspecllons nre requested at the proper lime thaI pl"oJ ect address Is reada~e from the
street and lhe appl"oved sel 01 plans ..wI remaIn on the Slle al all Umes dulll1g conslfucUon
s,g~a~;J~ ..f'. '-'7-P1f' D~' ;Z -/8 - t? Y
225 Fifth.Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00231
COM2009-00231
COM2009-00231
COM2009_0023I
COM2009-00232
COM2009.00232
Payments:
Type of Payment
CreditCard
cReceintl
RECEIPT #:
Description
Curbcut Pennit
Overwidth Application Fee
PW Disc - 2nd Pennit
+ 5% Technology Fee.
Curbcut Pennit
+ 5% Technology Fee
Paid By
JOHN HAAG
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000181
1:15:09PM
Date: 02/18/2009
,
Item Total:
Amount Due
88.00
40.00
(30.00)
4.90
88.00
4.40
$195.3U
Check Number Authorization
Received By Batch Number Number How Received
Amount Paid
Ikw
030691 In Person
Payment Total:
$195.30
$195.30
Page I of I
2/18/2009