HomeMy WebLinkAboutPermit Sidewalk 2009-5-18
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Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-00679
ISSUED: 05/18/2009
APPLIED: 05/18/2009
EXPIRES: 11/18/2009
VALVE: .
225 Fifth Street, Springfield, OR
541-726-3753 Phone
54]-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 305 21ST ST
ASSESSOR'S PARCEL NO.: 1703361305500
Springlield TYPE OF WORK: Sidewalk
TYPE OF USE: Repair
PROJECT DESCRIPTION: Repair Sidewalk panel
Owner: WILLIAMS CONSTRUCTION COMPANY INC
Address: PO BOX 2158
JASPER OR 97438
1 CONTRACTOR INFORMATION I
Contractor Type
General
Contractor
WILLIAMS CONSTRUCTION CO INC
License
157195
Expiration Date
10/08/2009
Phone
541-937-4215
I. BUILDING INFORMATION I
# 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;
11/'
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Front yard Setback:
.Side I Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overl.y Dist;
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
Total:
Handicapped:
Compact:
. I PUBLIC IMPROVEMENTS I
ATTENT/nM. n .
Stre<;slmprovements:regon law requires you to Sidewalk Type:
'.'.C:" rUles adopted by the 0 . .
StotJ.~S~We'irAvliija.I?!~: Those r I regon Utility Downspouts/Dr.ins;
SIr. (jll' n ~^~ .- - u es are set forth '0' TI
pecla . nstrllctlOnl-0010 through OAR .\. GE:
0090. You may obtain. 952-001_ ")-'/S P
Notes,alling the center. (~~t~':et~~ft~~: r~~es bY~JTHO~~MIT SHALL EXPIRE IF THE WORK
number for the OreQon Uti!;'" ^,~"p__.~e ,.,,.,,,_ __. ED UNDER THIS PFRnAIT 1<< ""'T
'''''''''' IS 1-800-332-2344) -...-.. -~..",,~IV"CU UK I:) ABANDONED FO . --
. . I Valuation Descri~tiY'JYI180 DAY PERIOD. R
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I on
,
CITY OF SPRINGFIELD
Building/Combination Permit
,
Status
Issued
PERMIT NO: COM2009-00679
ISSUED: 05/18/2009
APPLIED: 05/18/2009
EXPIRES: 11/18/2009
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Lille
Total Value of Project
Fees Pai.d I
Fee Description
+ 5% Technology Fee
Sidewalk Repair Permit
Amount Paid
Date Paid
Receipt Number
$0.78
$15.50
5/18/09
5/18/09
3200900000000000370
3200900000000000370
Total Amount Paid
$16.28
Plan Reviews ,
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 follo.wing
work day.
I Relluired Insne~tio!l.~ I
Sidewalk - Setback: 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 hereon is true and correct, and I further certify that any and all work performed shall he done in accordance with
the Ordinances of the City of Springlield 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 th.t only contractors and employees who lire in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all equired inspections are requested at the proper time, that each address is readable from the
street, t.h.at th')-permi~a1'is I caled at the front of the property, and the approved set of plans will remain on the site at all
"~lT . 5/%01
Owner or Contractors Signature Date
Paee 2 of 2
22~ Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-00679
COM2009-00679
Payments:
Type'of Payment
Check
cReceinl1
RECEIPT #:
Description
Sidewalk Repair Pemlit
+ 5% Technology Fee
Paid By
WILLIAMS CONSTRUCTION
City of Spri~gfield Official Receipt
Development Services Department
Public Works Department
3200900000000000370
Date: 05/18/2009
Item Total:
Check Number Authorization
Received By Batch Number ' Number How Received
Ikw
In Person
Payment Total:
1531
Page 1 of 1
8:19:08AM
Amount Due
15.50
0.78
$16.28
Amount Paid
$16.28
$16.28
5/18/2009
,.
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~:' :\:~~'~:;:~f
:.:1:'.: .F:'; DRIVEWAY/SIDeWALK '.~:: ."~':.'E\ PERMIT APPLICATION >:,\,!}~
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
OFFICE TElEPHONE (503) 726.3753
PERMIT NUMBER:
DATE ISSUED:
~In"l
10'1'1
- O~l
APPLICATION DATE:
SITE INFORMATION:
LOCATION OF WORK'
APPLICANT tJtl/'ft<o.) i1.-y. ~
ADDRESS, 5. [) s :;1./ ~
C1Tv8P"",t/Y.. STATE, Of\...
SUBDiViSION:
OWNER:
ADDRESS:
c:....~
/IUL PHONE
TAX MAP:
71P: q)<f77 TAX LOT:
PHONE:
STATE: ZIP:
CITY:
REOUESTED PERMITS:
o SIDEWALK:
AMOUNT OF SIDEWAlK IN EXCESS OF 90FT,
~ SIDEWALK REPAIR:..
o CURB CUT/DRIVEWAY: NUMBERDF ORIVEWAYS----,- x.
$B8.00
@$0.08 SF.
. $15.50
................. ~$
~$
~$
.............. $88.00 1st Cut ~ $
o MULTIPLE PERMIT DISCOUNT EA: . .......(MAX 2). . ...... .. .........$30.00 2nd Cut ~$_(,
(MUL Tl PERMIT. DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION ..illlLY
APPLIES TO 2nd AND 3rd PERMITS ONLY. NOT SIDEWALK REPAIRl =$
o 5% Technology Fee $ TOTAL DUE WITI--l.PEAMIT $
o PROOF OF INSURANCE: $500.000 MINIMUM IF WORK IS DONE BY PROPERTY OWNER
CONTRACTOR INFORMATION:
1-
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 F=O' RMEO AND MADE READY TO
POUR CURB CUT AND SIOEwAU< INSPECTIONS CALL 726-3769 (RECORDER) STATE YOUR OESIGINATEO CITY JOB
NUMBER/PERMIT NUMBER. JOB ADDRESS, TYPE OF INSPECTION REQUESTED. PND V\'HEN YOU \lll[Ll BE READY FOR INS PECTfON, CONTRACTOR'S OR
OWNER'S NAME AND PHONE NUMBER. REQUESTS RECEIVED BEFORE 7:00 A.M. WILL BE MADE THE
SAME DAY, REQUESTS AFTER 7:00AM. WILL BE MADE THE NEXT WORKING DAY. INSPECTIONS ARE TO BE CALLED IN
AFTER EXCAVAllONS ARE MADE AND FORM WORK IS IN PLACE BUT PAIOR TO POURING CONCRETE.
YOU ARE REOUIRED TO CALL
THE LANE UTILITIES COORDINATING COUNCIL'S
"ONE CALL NUMBER" 1-800-332-2344
48 HOURS BEFORE DIGGING
-SIGNATURE:
AMOUNT RECENED:
RECEIPT NO:
DATE PAID:
RECBVED BY:
By signature, t slate and !Igee, that I have caretul1y examined the complet~d application 80d do he reb)' certify thai all informaUOll herein is true
and correct afld I, funher c~lJfV that any and all work QerJormed shall bl'1. done In accordance With lhe Ordinances of .. ..
the CIN 01 Spnngheld; applicable City Slandard speaficallons and DraWlnqs, and the laws allhe Slate 01 Oregon pertalnmg to Ihe work desOlbed hereU1, I further
certlly fhal ,only conlraClols and emplDy€es who are in compliance With OAS 701.055 WIll be used _
on lhlsprojec1.
The CHy may inspecllhe work sile described in this permil atany lime during a one year period 10 IIDWing the receipt by IheClty 01 no/ice of com~lelion of the
described work and,specify, at, the ory's sole discretion any additional, restoration work required to return the sile to a standard accep.table 10 the Ci . The
perrnlttee will be notilled in wrl.lll'\g of any work requirecl and WlII have lhlrly days (30) from the dale ollhe notice 10 complete the work Work not comp eleCl allhe end
o('lhe (~Ir1y days will be perlC/(mea by Ihe City and Ihe =sls will be billed 10 IIie perm/llee. \
Ilurlher agree \0 ensure lhal alllequired inspecliDrls are requested atlhe proper time, thaI proj eel address is readable tram Ihe
street, and Ihe 8pprO\fed set at plans will remain on Ille site al all time~ during construction. '.
Signature
Dale