HomeMy WebLinkAboutPermit Sidewalk 2009-3-20
Status
Issued
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-00369
ISSUED: 03/20/2009
APPLIED: 03/20/2009
EXPIRES: 09/20/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 609 67TH PL
ASSESSOR'S PARCEL NO.: 1702341403200
Springfield TYPE OF WORK: Sidewalk
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Sidewalk Repair
Owne'r:
Address:
MILLER SHARON L
24434 10TH AVE S
DES MOINES WA 98198
I CONTRACTOR INFORMATION 1
Contractor Type
General
Contractor
TOM ROGGE- CITY CONTRACTOR
.B.UlLDING I~FORMATION.I
License
Expiration Date Phone
541-741-8134
#of Units:
Primary Occupancy Group:
Secondary Occupancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
# of Stories:
Height 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 Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
InEVELOPMENTINFO~TION .1
Frontyard Sethack:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
'Paved Drive Rqd:
% of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped: '
Compact:
, ,'PUBLIC IMPROVEM~'E:
Street Imp(eme~JTJPN: Orego~ law requires YOUlO THIS PERM!;Td~tlkl:r~IRE IF THE WORK
Tallow rUles adopteo by the Oregon Utility' AUTHORlzm "~'n~R1M'S PERMIT IS NOT
Storm Sewer,Wvailable:::enter. Those rules are set torth ,"Dol*liffi b'\ll r.~w~:
SpeciallnStruCtion:52-001-0010through OAR 952-001- COMMENCED OR I A AI~uuNED FOR
0090. You may obtain copies of the rules by ANY 180 DAY PERIOD.
Notes: calling the center. (Note: the telephone
number for the Oregon Utility Notification
veil Lei 1.;1 I -UVl.rvv~ -.c:;,v"'t-.
I Valuation Descrintion J
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Paee 1 of2
E_.._..
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
Amount Paid
Total Amount Paid
$0.00
Total Value of Project
J.<~e~ ~a\lU
Date Paid
[ Plan Reviews ~
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00369
ISSUED: 03/20/2009
APPLIED: 03/20/2009
EXPIRES: 09/20/2009
VALUE:
Receipt Number
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 Reouired Insnection~ 1
Sidewalk - Setback: After forms are erected hut 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.
~ Q~
Owner or Contractors Signature . UU
Pal?:e 2 of2
5~Jv~o'9
Date