The URL can be used to link to this page

Home My WebLink AboutPermit Sidewalk 2001-4-12 ,. . Page 1 of 2 . I Job# 01-00364-01 I SPRINGPIELD ~ CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00364-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 6935 main St Spr Assessors Map#: 17023533 Lot: Block: Addition: Tax Lot #: 06100 Subdivision: Owner: Artie Mae Harlow 1919 22nd Street Phone Number: 541-746-4060 City/State/Zip: Springfield, OR 97477 New Value: $0 Address: Scope Of Work: Curbcut standard curbcut Quad Area: # Of Units: Constr. Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: 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 working day. Curbcut Required Inspections ,------~--.-I I Public Works -After forms are ereceted but prior to placement of concrete. Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D [Area (Sq. Feet) Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Fee Paid On Receipt# Public Works 04/12/2001 4924 Value/Quantity New Curbcut Total Public Works Grand Total 1 * , Fee Amount $65.00 $65.00 $65.00 I Job# 01-00364-011 Page 2 of 2 By signature, I state and agree, that I have carefully examined the completed application and do hereby certify that all information herein is true and corect, and I further certify that any and all work performed shall be done in accordance with the Ordinances of the City of Springfield, applicable City Standard Specifications and Drawings, and the laws of the State of Oregon pertaining to the work described herein. I further certify that only contraotors and employees who are in compliance with ORS 701.055 will be used on this project. The City may inspect the work site described in this permit at any time during a one year period following the receipt by the City of Springfield notice of completion of the described work and specify, at the City's sole descression, any additional restoration work required to return the site to a standard acceptable to the City. The permittee will be notified in writing of any work required and will have thirty (30) days from the date of the notice to complete the work. Work not completed at the end of the thirty days will be performed by the City and the costs will be billed to the permittee. I further agree to ensure that all required inspections are requested at the proper time, that the projeot address is re able from the street, and the approved set of plans will remain on the site at all times during const uction. . . -" L Signature Ie/( 'U. (mDI f r -/Z Date -or 690:~3IHS\!::J : 39N\!H::J OO'g9 $ 6:a::J3~ lW\! 1:006 61: ~d\!:31\!a ?66?000-1:0:#SN\!~1 j 15: 17; PAGE 2/3 225 FIFTH STREET ...j:......:u- ~ SPRINGFIELD, OREGON 97477 ENGINEERING DIVISION OFFICE TELEPHONE (5031 726.3753 ~ .. APPLICATION DATE:~ Q...'2.4l51 P.ERMIT NUMBER: 61- C:l)3k.4. - () I ~ATE ISSUED: ~ \1.., L15n 1 SITE INFORMATION: LOCATION OF WORK: l.'13 ~- lng, l n - Lo T o.I:._'PL.1tful4-d :JoL1..... :5"pd,u.Hrno< APPLICANT Gr!!.h-r~ te. ~.r'tnA../IIJ"'-h';"~'j:f!:!lHONE 7'f:Je...:...th:)/:."!_____ ADDRESS: .:t4~~ N1ar'l"~ 1(4.. ; TAXMAP:.J!.!?~.~~ CITY-*U.~~fie tJ STATE'tO,..~A:'" ZIP; q"7l.J. 77 .TAX LOT: .,IDD SUBDIVISION: rl).?-~ Y\ 5...h:t tJl~_.__ : OWNER, G~{)<"~ g.HtUltN "a~tJ-e., Ma~.fh::rl(lW PHONE 7f.)C::,-</-ofr> 9 ADORESS, ...~-k'? YUal"u-tA. R.d CITY' Snfl"t:i'~-e lei STATE [)kG .ZIP, 9.1...1/-71 Uf' f ); J REQUESTED PERMITS: "DRIVEWAY/CURB-CUT/5IDEWAlK: .......... ....................;.. ..... ..... ......... ....... $ 65,00 AMMOUNT OF SIDEWALK IN EXCESS OF 90FT. @!$0.06 SF. $ Q SIDEWALK REPAIR:.......,............................................;.................$ 10.00.......... Q ADDITIONAL DRIVEWAY: .....................................;.................$ 35.00......... : 1:1 PROOF OF INSURANCE' $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER TqTAL DUE WITH PERMIT $ ~..s oP ....... CONTRACTOR INFORMATION: CONTRACTOR, 4~ -t.e.'dPC1~~~___.+____......_______._______._...--_._. .... ....... ..'." ADDRESS: ./f-/ () '~ Qtf;.'17..!l.Q..':L__...._._._..__....."'.....PHONE, t. f(1H "3.,6 CONTRACTOR REGISTRATION NO: lJ 5"771{. 'f " EXPIRATION DATE, '7 -h-O"L PROJECT SUPERVISOR: <.."'."" "'1 l<.u-... (!" 6./../,., 1:;.."I-o'2.fs PHONE, t, 1i'.R- '37 Ie. INSPECTIONS: AN INSPECTION REQUEST SHOULD BE MADE PRIOR TO POURING CONCRETE, AFTER THE PROPOSED WORK HAS BEEN FORMED AND MADE READV TO POUR. . CURB CUT AND SIDEWALK INSPECTIONS CALL 726.3769 (RECORDERl STATE YOUR DESIGINATED CITY JOB NUMBER/PERMIT NUMBER, JOB ADDRESS, TYPE OF INSPECTION' REQUESTED, AND WHEN YOU WILL BE READY FOR INSPECTION, CONTRACTOR' S ; OR OWNER'S NAME AND PHONE NUMBER. REQUESTS RECEIVED BEFORE 7,00 A.M. WILL BE MADE THE SAME DAY, REQUESTS AFTER 7:00 A.M. WILL BE MADE THE NExt WORKING DAY. INSPECTIONS ARE TO 8E CALLED IN AFTER EXCAVATIONS ARE MADE AND FORM WORK IS IN PLACE SUT PRIOR TO POURING CONCRETE. YOU ARE REQU!!!ED TO CALL THE LANE UTILITIES COORDINA liNG COUNCIL' S " ONE CALL NUMBER" 1-800-332-2344 f) 48 HOURS BEFORE DIGGING SIGNATURE: 4~U/ j(' d~-8j ?I ~7lA.w ~._LO AMOUNT RECEIVED, RCCCIPT NO, DATE PAlO: RCC[lVED BY' BV signature. I state and aarec, that I have carofuly examined the completed Bpplicstion and do here~ certify that all information horein is true and congert. ard I further c8ItifY that any and all work perlormed shall be dona in ill:c()(dance with the Ordinances of 'the City of Springfield. applicable City Standard specifications Dnd Drt'wings. pnd In" lawl' of the Slate of Orogon penainilg to the work described herei~. I further certify that only contr8ctors end employees whO Bfe In compl!anctl with ORS 701.055 will be used on thiS prOJect. I'ho City m8Y InspOClltlO work sile Clescribad in thilS permit lit tiny tima duting a onB year patiOd IOIlOWlng tne teceipt by the CitY 01 notice of complatiOI 0' tho dosctibed work and spacify, at the City' 8 BolB daaCrBGsion, any additio:nal rQ'toration work t9Quirod to rBlurn tho sito to 8 st3ndard acceptable t(, tho City_ The permittee will be notified in writing 01 any work reQuired and will hava thirty days 130) ftom the dete of tho notice to complete the work. Work not completed at the end of the thirty day.s will be performed by : tho City and the costs will be billed to lhe permittee. . I hlthor agree to ensure that ell required. inspec.tion, are r~queflt9d ~t tho pro~9r timo, t~l proIect addross Is readable from the ~:"~~.Z"""'~;:::'::~,_.+"~I SENT BY: SPRINGFIELD PWj . 541 7361021j APR..1.15:17j PAGE 3/3 V'(;'N'J. NO SC s~ 00 , ~!z <It! f1i~ "w w "'>- ;:...~ -' x>= W~ --~ LOT EX 14' STORM SEWER EASE. -;,<;,' \1-0'1. <;,9 >!I~'?" \..0\ \~I' 69TH PLACE ; ---- ---- ~o:--: --------------. ~.. 'C ..~~':;. ."'.2~': ,'''.'. ,.:;, ,.;;::. 'iJS,t::;;;~~~Z .;",',,;"";". ,;...-,...' :.:i;.;..;.:..:.~,..:":' .",., .,..::..rf.. .:." .:.0~ ,:. .-.:....:::~::.:.:.:.".;-:'i:... ::...;.. .''' .'.I.;;.......:....~...--.. --_.__.__.._.. ....____.._ :;;::;..... I ...----...-..-....- I , I , . I ----- -- ":,'''-;';' \1-0'1.~ 0'1.0\ >!Ip..'?" \..0 ,ro.l' aE BY lEES LIST OWf'.ER & QEV.ELQPI;R : GEORGE R. 6. A!lTlE:: MAE HARLOW 2433 MARCOLA i ROAD SPRINGFIELD. ORi 97477 (5411 746-4069' l.::... "~oS: 12-31-2002 WILL 'is AT LAST REVI$ED: 12/19/2000 POAGE ENGINEERING & SUn P.O. Box 2527 &.gene, C. "'':l'"'' I 97402