HomeMy WebLinkAboutPermit Sidewalk 2009-8-25
Status
Iss u ed
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2009-01246
ISSUED: 08/25/2009
APPLIED: 08/25/2009
EXPIRES: 02/25/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 195 B ST APT I
ASSESSOR'S PARCEL NO.: 1703353200600
Springfield TYPE OF WORK: Sidewalk
TYPE OF USE: Rep'air
Residential
PROJECT DESCRIPTION: Sidewalk Repair
O.wner: MCALLISTER V T & LOLA A
Address: PO BOX 2478
EUGENE OR;197402
I CONTRACTOR INFORMATION I
Contractor Type
General
Contractor
TUFFY'S
License
Expiration Date Phone
729-6206
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 Fl Basement:
Sq Fl GaragelCarport
Sq Ft Other:
Occupant Load:
nla
I DEVELOPMENT INFORMATION I
Frontyard Setback:
Side I Sethack:
Side 2 Sethack:
Rearyard Sethack:
Solar Sethacks:
Overlay Dist:
# Street Trees Rqd:
Paved Drive Rqd:
0/0 of Lot Coverage:
REQUIRED PARKING
Total:
Handicapped:
Compact:
Street ImproveJ!lents:
Storm rSejV~rOO~ilable:
Special'Instruction:
AUTi/ enlvllT SHALL EXPIRE IF THE WORK
NotesCOMrvOR/ZED UNDER THIS PERMIT IS NOT
. ..., 7ENCED OR IS ARA~lnmlr::n m....
,.", I au UAY PERIOD,
nl lel'IIIUN' Or ,
I PUBLIC IMPROVEMENTS I follow rules . d egon aw requires you to
. Notif ',' ,,^_ ~ a ?pted by the Oregon Utility
, SJdewalkbType: Those rules are set f rth
In OAR 952'001-(ln1 0 thr 0
0090 DownspoutslDrains:ough OAR 952-001-
caliin'g~th'e'~Y UtU'd!fl copies of the rules by
cen ef. (Note: the telephone
numbercfor the. Oregon Utility Notification
enter /s 1-800-332-2344).
I V aluation D~scriDtion I
Description
Type of Construction
$'Per Sq Ft
or multiplier
Square Foolage
or Bid Amount
Value
Date Calculated
Pa!!e I of 2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone "
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
+ 5% Technology Fee
Sidewalk Repair Permit
Amount Paid
$1.55
$31.00
Total Amount Paid
$32.55
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01246
ISSUED: 08/25/2009
APPLIED: 08/25/2009
EXPIRES: 02/25/2010
VALUE:
Total Value of Project
Fees Pair! I
Plan Reviews I
Date Paid
Receipt Number
8/25109
8/25/09
3200900000000000603
3200900000000000603
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 Reollirer! Tnsnections I
Sidewalk - Setback: After forms are erected but prior to placement of concrete.
jl
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 ~ontractors and employees who are in compliance with ORS 701.005 will be used on this project.
1 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 sei of plans will remain on the site at all
times during construction,
~#~
Ow"" J'""."" ..."""
Pal!e 2 01'2
~O<!S J 00'/
Date pt" ,
225 Fifth Street
Springfield, .Oregon 97477
541~726-3759 Pliime' 'n__
Job/Journal Number
COM2009-0 I 246
COM2009-0 1246
Payments:
Type of Payment
Check
cReceintl
RECEIPT #:
Description
Sidewalk Repair Penn it
+ 5% Technology Fee
Paid By
LOLA MCALLISTER
j1:a::'4i
ilL
City of Springfield Official Receipt
Development Services Department
Public Works Department
3200900000000000603
Date: 08/25/2009
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
Ikw
1691
In Person
Payment Total:
Page I of I
II :06: 13AM
Amount Due
31.00
1.55
$32,55
Amount Paid
$32,55
$32,55
8/25/2009
, " ".'. ,: Ci!!Jofopringflc!d ,..... ",,' " , ,',:
:,:-, ,':- '.',-: :~: :);:' ,:.;::~,,:.., ' '...':.,., :.,...: ,:'::".~" ",,';" ":- ,,:,.<,{.~S;?
,;'~,! ,;,DRIVEWAY/SIDEWAlK;',;; ~,,:,i PERMIT APPLICATION :, '..:\dj-"
225 FIFTH STREET "
SPRINGFIELD, OREGON 97477
ENGINEERING DIVISION
OFFICE TELEPHONE'(503) 726"3753
.~=D ~
~~I
l1o-nl...~ ",
PERMIT NUMBER:
DATE ISSUED:
OieN/to
APPLICATION DATE:
SITE INFORMATION:
lOCA lION OF "YORK:
I qc:,- P, s...w.v>-r
VY\t'.. d. II ; sl,e rc:....
(I, A<..f!" "j'" _ '-t"",",
STATE, OiL--
PHONE
In9-.Q-$'311
,APPLICANT ' L () J 0-
ADDRESS: Il?"~
OW &<g~
SUBDIVISION:,
TAX MA.P:
liP:
q7L/b U
TAX lOT:
O\NNEA:
ADDRESS:
PHONE:
CITY,
STATE:
ZIP:
REQUESTED PERMITS:
o SIDEWALK: ................'......., ...........,......,
AMOUNT OF SIDEWAlK IN EXCESS OF 90FT
c;(SIDEWALK REPAIR:...."....,..,......",..,
I
.................... $88,00
@$O,08 SF,
.. $15,50
....... = $
=$
". = $
o CURB CUT/ORlVEWAY: NUMBER OF DRIVEWAYS_ X
.........., $88.00 1st Cut = $
o MULTIPLE PERMIT DISCOUNT EA: ..... ..,(MAX 2) .... ....$30,00 2nd Cut =U'
(MUl11 PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE S!TE INSPECTION..Q!AY
APPLIES TO 2nd AND 3rd PERMITS ONLY. NOT SIDEWALK REPAIR! =1
o 5% Technology Fee $ TOTAL DUE WITH PERMIT $
o PROOF OF INSURANCE: $500,000 MINIMUM IF WORK IS DONE BY PROPER1YOWNER
CONTRACTORiNFORMA TION:
V CONTRACTOR
1vJ.h...1~
I
Cc t\. e.>ul.e.
ADDRESS:
CONTRACTOR R~GISTRATION NO:
PROJECT SUPEFMSOR;
PHONE:
EXPJRA nON OA TE:
PHONE:
INSPECTIONS:
AN INSPECnON REQUEST SHOULD BE MADE PRIOR TO POURING CONCRETE, AFTER THE PROPOSED WORK HAS BEEN Fa RMED AND MADE READY TO
POUR. CURB CUT AND SIDEWALK INSPECTIONS CALL 72&3769 (RECORDER) 51 ATE YOUR OE51GJNA TED CITY JOB
NUMBEA/PERMIT NUMBER, JOB ADDRESS, TYPE OF JNSPECTION REQUESTED, mD V'lHEN YOU WILL BE READY FOR INS PECTION, CONTRACTOR'S OR
OWNER'S NAME AND PHONE NUMBER. REQUESTS RECEIVED BEFORE 7:00 A,M, WILL BE MADE THE '
SAME DAY, REOUESTS AFTER 7:00A.M, WIll BE MADE-THE NEXT WORKING DAY. INSPECTIONS ARE TO BE CAlLED ,IN
AFTER EXCAVATION~ ARE MADE AND FOAM WORK IS IN PLACE BUT PRIOR TO POUAINqi CONCRETE,
YOU ARE REOUIRED TO CALL
THE LANE UTILITIES COORDINATING COUNCIL'S
"ONE CALL NUMBER" 1-800-332-2344
-48 HOURS BEFORE DIGGING
SIGNATURE:
,A.t.AOUNT RECEIVED;
RECEIPT NO:
DATE PAID:
RECEIVED BY:
By signaJure. I s181'e and agee\lh811 have carelutly examined the compleled application and do he ret:ly cerlity thai an jnforma~on ~E!l'ein is Irue
and correcl and llurthef certifY the en,}' and aJl work ,Qedormed shall bf'l dale in accordance with lhe Ordinances of
lhe Gitv of Springfield. applicable City Standard speaficaJions and Dfe~nQ$, and the lam of the Slate 01 Oregon pertaining 10 Ihe work desaibed herein. 1 furltier
cenity lhal.ally conlraClors and employees who are In compliance 'Mlh ORS 701.055 WIn be used ,
onlhJsp-OjeCl., .
The City may inspect the work s~e described in lhis permil at.any lime during a ale yeSl Period 10 nOY.-Vlg the receipt by lheCity of notice 01 ~~e1iOO ot the
desCflbed vt01k and,spedty. 81,ltle QIy's sole discretion, any addllional restoralion work reqUIred 10 lelutn me site 10 a standard eccep'!able to fhe Ci ,The
permnee Will be notllied in Willing of any wor1<: required and WIll halle lt1lny days (30) from the dale 01 lhe noJlce 10 complete the work. Work not com eted at the end
of Ihe 1J:1lrty days will be perlormeCl by the City and Ihe COSls will be billed 10 Ine permillee" \
i lurther agree \0 ensure lhat ell required inspections are reQuesled at the proper time, that p-oj ect address is reac1ab:e tun the
slIeel, and lhe approvea sel 01 plans WIll remain on the slle al aJlllmes duling COl1Slruclion., '
Signature
Date