HomeMy WebLinkAboutPermit Curb Cut 2009-6-3
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Status
Issued
225 Fifth Strect, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769Inspcction Line
SITE ADDRESS: 300 FAIRVIEW DR
ASSESSOR'S PARCEL NO.: 1703274100101
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00774
ISSUED: 06/03/2009
APPLIED: . 06/03/2009
EXPIRES: 12/03/2009
VALUE:
Springfield TYPE OF WORK: Curbcut
PROJECT DESCRIPTION: repair cxisting drivcway entrance
TYPE OF USE:
Owner: HEAD START OF LANE COUNTY'
Address: 221 B ST
SPRINGFIELD OR 97477
Owner: RENEWAL AGENCY OF LANE CO
Address: 177 DAY ISLAND RD
EUGENE OR 97401
Owner: HOUSING AUTHORITY & URBAN
Address: 177 DA Y ISLAND RD
EUGENE OR 97401
Contractor Type
Contractor
# of Units:
Primary Occupancy Group:
Secondary Occnpancy Group:
Primary Construction Type
Secondary Construction Type:
# of Bedrooms:
I. CONTRACTOR INFORMATION I
-License
BUILDING INFORMATION I
# of Stories: (
Height of Structure
Type of Heat:
Water Type:
Range Type:
Energy Path:
Sprinklcd Building:
n/a
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
% of Lot Coverage:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Notes:
Expiration Date Phone
Lot Size:
Sq Ft I st Floor:
Sq Ft 2nd Floor:
Sq Ft Bascment:
Sq Ft Garage/Carport
Sq Ft Othcr:
Occupant Load:
REQUIRED PARKING
Total:
Handicappcd:
Compact:
Sidewalk Type:
Downspouts/Drains:
Paee I of 2
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00774
ISSUED: 06/03/2009
APPLIED: 06/03/2009
EXPIRES: 12/03/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541_726,3676 Fax
541-726-3769 Inspection Line
, Valuation DescriDtion I
Description
Tvpe of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Fees Pai~ I
Fee Description
Amount Paid
Date Paid
Receipt Number
Total Amount Paid
$0.00
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. wij( be made the following
work day.
I, Relluired Insnections I .
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 cedify that any and all work performed shall be done in 'accordance with
the Ordinances of the City of Springfield and the Laws ofthe State of Oregon pertaining to the work described herein, and
that NO OCCUPANCY lYill..!!,e made of any structure without permission of the Community Services Division, Building Safety.
I further certify that only cont); ctors and employees wbo are in compliance with ORS 701.005 will be used on this project.
[ further ~ensure that al required inspections are requested at the proper time, that each address is readable from the
s~reetn'dth l the pe, mit ~ard is loc ted at the front of the property, and the approved'set of plans will remain on the site at all
times A 109 constru?n. r-- .
;1 (' 6 ~ 09
ow~o~~r Contractors Signature Date I
Page 2 01'2
225 Fifth Street
Springfiel.d, Oregon 97477
541'-726-3759 Phone
Job/Journal Number
COM2009,00774
COM2009-00774
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
Curbcut Pennit
+ 5% Technology.Fee
Paid By
SNAPPER CONSTRUCTION
City of Springfield Official Receipt
Development Services Department
Public Works Department
2200900000000000599
Date: '06/03/2009
9:07:34AM
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Amount Due
88.00
4.40
$92.40
Amount Paid
bank
$92.40
$92.40
8140
In Person
Payment Total:
Page I of I
6/312009
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;',';;,~"';"~~DRIVEWAY/SIDEWALK" .;:~;,' ::,~ "PERMIr'APPLicATIPN .;, :){~~:\
, '
225 FIFTH STREET .P~.NQFlE1.D
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
OFFICE TELEPHONE (503) 726.3)53 . ~ ~I
APPLICATION DATE 'J 'r.,! c:> '1 .
/ 1 '
PERMIT NUMBER: C/;!'1bO
DATE ISSLlED:
;x 007 '()0771"
SITE INFORMATION:
LOCA liON OF WORK, 5....() (' ) v--) <2." ".
APPLICANT ';\ C- \,1;. ~ cp v-<--.. _"'- \j "
ADDRESS Va . ~~, y ~ ,"t ,.,
.l~Ad (')
<", .
~)
PHONE
~WI
'5'l~ l.q' 6 \
TAX MAP:
CITY: <; v--Z STATE: (oj. r ZIP: 0\,< lot c L\ TAX lOT:
SUBDIVISION: '1A1,/l C-';>1At L-; QJJ
OWNER ~\ "" C.S', PHONE:
ADDRESS: \'CC" CITf; <;,,~v,--<c SlATE: d') ,/ ZlP: "11477
rill'. u~"-" /'
REOUESTED PERMITS:
o SIDEWALK,..
AMOUNT OF SIDEWAlK IN EXCESS,OF 90FT,
............... $BB.OO
@$O.OS' SF.
. $15.50
.. = $
=$
....:.... =$
o SIDEWALK REPAIR:.. ......................
/
12] CURB CUT/DRIVEWAY: NUMBER OF DRIVEWAYS
t
x ......... $B8.00 1 5t Cut = $
lA[)<t1-
o MULTIPLE PERMIT DISCOUNT EA .. .......(MAX 2) ..............$30.00 2nd Cut =$J
(MULTI PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPEC1l0N..ill:ll.X
APPLIES TO 2nd AND 3rd PERMITS ONLY. NOT SIDEWALK REPAI~ =$
o 5% Technology Fee $ TOTALDUfWITI-lPERMlT $
o PROOF OF INSURANCE, $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER
. I CONTRACTOR INFORMATION:
CONTRACTOR:
ADDRESS.
CONTRACTOR REGISTRATION NO:
PROJECT SUPERVISOR;
PHONE:
EXPIRATION DATE:
PHONE;
INSPECTIONS:
AN INSPECTION REQuEST SHOULD BE MADE PRIOR TO POURING CONCRETE, AFTER THE PROPOSED WORK HAS BEEN FO RMED AND MADE READy TO
POUR. CURB CUT AND SIDEWALK iNSPECTIONS CALL 72&3769 (RECORDER) STATE YOUR OESIGINATED CITY JOB
NUMBER/PERMIT NUMBER. JOB ADDRESS,"TYPE OF INSPECTION REQUESTED, AND \tVHEN YOU YVlLL BE READY FOR INS PECTION, CONTRACTOR'S OR
OWNER'S NAME AND PHONE NUMBER. REQUESTS RECEIVED BEFORE 7:00 A.M. YVlLL BE MADE THE
SAME DAY, REQUESTS AFTER 7:00 A,M. WILL BE MADE THE NEXTWOAKING DAY. INSPECTIONS ARE TO BE CALLED .IN
AFTER EXCAVATIONS ARE MADE AND FORM WORK IS IN PLACE BUT PRIOR TO POURING CONCRETE.
YOU ARE REOUIRED TO CALL.
( ()LANE IES COO.RDINATING COUNCil'S
A "ONE CALL: UMBER" 1-800-332-2344' .
Ii <:..... ~ 48 OURS BEFORE DIGGING ..
SIGNATURE: Ii I ?---
Y \ '1'1 a...0
AAlOUNT RECEIVED' : p(.. 7 .
RECEIPT NO, ;<{,l,Odl(,cx;,.o~1 '5'1'(
DATE PAID:
.G-3 -;J.oCJ9
C .,.I'I
RECEIVED BY:
and ~~~a1:/i~'1 !,~~:, ~;I~~I~al ~~~v:U ~~kull~a;a~~~h~F b~o:r~~l~da~~~~~~ :l~ d~~b~~~ag~~~~Qlhal all informa~on ha"ein is !rue
the City 01 Springfield, applicaole City ~andard speCl~calions and Ora".,.;nQs, and Ihe I~ ol/he Slate 01 Oregon parlaiMg 10 the Y\lQrk described herein.! furlnel
caMy lhal ,only conlraclQ(S and employees who are in compliance v.ilh ORS 701.055 .,.,,11 be used
on Ihlsprolecl, .
The City may inspecllhe work sile described in this permit al any lime during a one year period 10 lIowing the reCeipt by the City of notice 01 com~lelion of the
desCTlbed wex-k and spool)', ai, the City's sole dIscretion any addiUonal, restoration work required 10 return tile sile 10 a standard accep,lable 10 the Cl . The
p.ermlttee will be notified in writing of any work required and will hilve_lhlny days-(30llrom the dale 01 the notice 10 complete Ihework. Work ne{ competed althe efld
of Ihe (~Irty days will be performed by tne City and the costs wi~ be billed \0 Hie permlUee. ,
Ilurther agree to ensure thai all required inspeclio/lS are requested al the prOper time, that proj ect address is readable from Ihe
streel, and the approved set 01 plans will remain on the sile at all times dwing construction, ..
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1. ~ (9../ ..:;^...
Date
Sign':lture
C.a; .~.
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