HomeMy WebLinkAboutPermit Curb Cut 2004-1-23
..
.f CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00082
ISSUED: 01/2312004
APPLIED: 01/21/2004
EXPIRES: 07/23/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4350 Mt Vernon Rd
ASSESSOR'S PARCEL NO.: 1802052108400
Springfield TYPE OF WORK: Curbcut
TYPE OF USE: use initials Commercial
PROJECT DESCRIPTION: SIDEWALK PERMIT FORA PATHWAY CUTDOWN WITH ADA RAMPS.
Owner: WILLAMALANE PARK & REC DlST
Address: 200 S MILL ST SPRINGFIELD OR 97477
, CONTRACTOR INFORMATION'
Contractor Type
General
Contractor
BROWN CONTRACTING INC
License
114260
Expiration Date
05/30/2005
Phone
541-338-9345
BUILDING INFORMATION'
# 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:
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Impervious Surface Area:
,
I DEVELOPMENT INFORMATION'
SETB&CKS REQUIRED PARKING
Frontyard Selb~~c. Overlay nist: Total:
Side I se~b ~o/$ A ~. # Street Trees Rqd: Handicapped:
Side 2 Se ~" (C'-9;16 Paved Drive Rqd: Compact:
.4.;'.41. "'-9/.>-.q, 01) \0
Rearya,u~ll)~ <!'b 05'~-4. % of Lot Coverage: I)I,eS ~ u\\\\\~
Solar Setba~/)~!'b Ul1;b}(!'..o.. I' \9-'JoI te~O,/!p';OI\ \ \e(l
, I'lA r/\ -~"J' _,,0 \~'" -~ 1'>6 .J:,
, P!,;/;,I$-if. 1-;;$ ;!' If:' ~l PUBLIC IMPROVEMENTS~...;\O~";~\ed O~S0 t\)\0~;~ g'3~\Q; \
Vo ~46 (C'J> 'ITP 0 \fd!l e; af ~~ \)g~ ~6 tl)
Street Improvements: . VOA:1~1' <- ~" I" \\O'Jol 'fU -Sl1~IK R<P~,tO . as 0\ ~ ,,~ol\a
'''!'o I.r "'-9.... \0 ~\\Ol\ "l'\\.QO . CO~I 0\6\0... \\01'
Storm Sewer Available: I'a 11;0 '. ~o\\\iC gc;,Q.ownsP8!lt~aI8~" \~ ~O\\\IC~
Special Instruction: ~ 'I' \'\ Op...~ ~OIJ ~0.'i el\\et. ~~ I' U\\\iti ?I'A'"
uort/'}"\\I\9, \~e ~~e Ot6~~I\_?-?-~''l
Notes: c0.\ at \Op . \e \.'"
1'\\\<;1\'0 ,..,...,..,ltft'
I Valuation Descriotion I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Paee 1 of2
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. CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2004-00082
ISSUED: 01123/2004
APPLIED: 01121/2004
EXPIRES: 07/23/2004
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
L.Ff'f'S P3id I
Fee Deserilltion
Sidewalk Permit
Amount Paid
Date Paid
Receipt Number
$75.00
1/23/04
1200400000000000095
Total Amount Paid
$75.00
I Plan Reviews I
To Request an inspection call the 24 hour recording at 726-3769. All inspection 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 ReolJirf'1lnsredions I
1 Sidewalk - Curbside, After forms are erected but prior to placement of concrete.
By signature, I state and agree, tbat 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 descrihed herein, and
that NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safcty.
I further certify that only contractors and employees who arc in compliance with ORS 701.005 will be used on this projcct.
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.
,
Date
/ ) J3 JlJcJ
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[$1ner ~~ntraet~rs Sign-ature c:0
~
Paee 2 of2
225'Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2004-00082
Payments:
Type of Payment
Check
Description
Sidewalk Permit
Paid By
BROWN CONTRACTING INC
.r
ih;~j
~*.
Receipt #: 1200400000000000095
Received By
swb
Check Number
Batch Number Authorization Number
15712
City of Springfield Ofiicial Receipt.
Development Services Department
Public Works Department ~
Date: 01123/2004 8:24:56AM
Amount Paid
Item Total:
75.00
$75.00
How Received
In Person
Payment Total:
Amount Paid
$75.00
$75.00
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12/15/03
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MON 13:53 FAX 54~3689
CITY OF SPRINGFIELD
1~t:lz..O'SU o84/fl) .
225 FIFTH STREET
SPRINGFIELO, OREGON 97477
ENGINEERING DIVISION
OFFICE :TELEPHONE (503) nlh1153
APPLICATION DATE: rz. -'2.., ~ 0 ~ .
~~
PERMIT NUMBER: C. OM
DATE ISSUED:
)...00 l/ -cJOO,?Z'
sITe INFORMATION:
4~Su MI'. i/iZR
,
LOCATION OF WORK: '-B..l S+. S"pr:I(':f:' Inl
APPLICANT t<r /lwl"". CcI'ltr6-Ch",-'I I.r'\L
ADDRESS: 'i'ild IfIrk....,j" <: f-. -J ~ us"u'<'.
. i ,;
STATE: . ~fl
A/Ol./
rR
I~ D..
'q7i1?-~
CITY: ...G::-~ L-
SVBDIVtS10N:
. OWN~~ 1,.,);\I"'''^..I,."....~.r,\. ~~ a.<<:~t;.........:
ADDRESS: CITY:
PHONE "5s ,,- 'I ':. 'tc;;'"
012 9 )9'0'2 . TAA MAPS. I~ 02...0~"Z. I
f71./()7:... TAX LOT: ~i/(IT)
ZIP
PHONE:
STATE:
ZIP:
REQUESTED PERMITS:
~. SIDewALK; ..................... .................... ........... ............. ........$ 75.00.......:.. .' $ =f S:-aO
AMOUNT OF SIDEWA~K IN EXCESS 0' eOLF. : '@$O.07 SF, . $
o SIDewALK REPAIR:........... ..,....:............:.. ................. ..... ......,......$10.00 $'
o CURB CUTlDRIVEWAY: NUMBI!R OF DRIVEWAYS: X...............$75.00 ........... $
o MULTIPLE! PERMIT DISCOUNT EA: .... (MAX 2) .......................... ..... $30.00 ........... . = $ (_ .1_
(MULTI PERMIT DISCOUNT GOOD FOR ONE 61TE AND ONE SITE INSPECTION ONLY
APPUES TO 2nd AND 3rd PERMITS ONLY. NOT StDEWA~K REPAIR) . -* '7 scrO
TOTAL DU.E WITHPERMrT $' T
o PRQOF OF INSURANCE: $500,000 MINIMUM IF WORK IS DONE BY PROPERTY OWNER
CONTRACTOR INFORMATION:
CONTRACTOR: . P.."''''.J^' . Lo<\-\.n.c..t'.~~ :I:.Ac....
)
ADDReSS: '1'b(J ('(\.,.'K."t\e.\" e..,\- _ <"'~'N\,L- ~R-
CONTRACTOR REGISTRATION NO:
PROJECT SUPERVISOR: . "'J.Ie '1>'" <>+c..-I~
INSPECTIONS:
'.
. PHONE: G't'iO,-
EXPIRATION DATE:
PHONE: ~_n4.,
AN INSPECTION REQUEST SHOULD BE MADE PRIOR TO POURING CONCRETE AFTeR TIlE PROPOSl;D WORK HAS BEEN 'ORMEO ANO.MADE
READY TO POUR. CURB CUT AND SIDEWALK INSPECTIONS CALL ne-~719 (RECORDERl STATE YOUR DESIGINATeD CITY JOB
NUMBER/PERMIT NUMBER JOB ADDRESS rfPE OF INSPECTION REQUl;STeO AND WHeN YOU W1~~ BE REACY FOR tNSPECTION.
CONTRACTOR'S OR OWNER'S N AME AND PHONE NUMBER. REOUESTS RESEIVED BEFORE 7:00 A.M. W1~L BE MADE THE
SAME DAY REQUESTS AFTER 7:00 A.M. WILL BE MADE THE NEXT WORKtNG DAY. INSPECTIONS ARE TO BE CALLED IN
AFTER EXCAVATIONS ARE MADE ANI) FORM WORK IS IN PLACE BUT PRiOR TO POURING CONCRETE.
YOU ARE ReQUIRED TO CALL
!g~EL~~tLU~\T~T~~i,POORD~~toTd~~3~3~~~.1 L' S
48 HOURS BEFORE DIGGING
SIGNATURE;
AMOUNT RECEIVED:
'RECElPT NO: .
DATE PAID;
RECEIVED BY; .
By aignature,l fl1ale Pl'ld = Uun', have CBrefultv examIned the complelecl appDcatlon end do herebY certifll that elllnfonnatlOl1 hereIn
. ls true and corraCI, .~d I certify tNrlsnv and aU work Derlormed ahlD be dtlt1ftlr. III"'.r.nMA"Nlo ~th tk;'-i'\rrflnltr\"ollll ",
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12/15/03 MON 13:34 FAX 341
,,~.... '
'. . CITY OF SPRINGFIELD
. ~004
PlAN REVIEW COMMENTS I PECIAL INSTRUCTIONS: .
RESTORATION WORK SHALL BE IN CONFORMANCE WITH EXISTING CITY CODES ANI) IN COMPUANCE WITH CURRENT
STANDARD 8PECIRCATlONS. EXC!PT AS NOTI!D Ilfl.OW. . .' .
. C1 0 018 Mlnunnm4' I"" ,".. atanypai'nt.IIIWk'tv-.wr(.
. 001 1lo.1dIlI wi'" tI m_ ..011.' D ~O Oon:r'lD mlnmm 4' "pU, 3.0000sL'
D 002 CO_....lY 18' "",..doJ>lh. J c.11' 1'tolIclIIO bo'T- CUL' .
D 003 Roqu... DO ., .... with...... roll". . J 022 .,.'" 6110\.1 Ccu\1y ponnt.
8 004 A.C. tg match 1h~ graattror ub~ dap1f1 or 4-, J 023 NIl ,brml'vn:I1J11d uU;l'a1i'Qa In &iduwalk or handkl.p rornpa.'
005 All..... sulod Itlf ftnollnapec\lln, D .024 . Dloniond.... A.CJCooctOlD vo'" 110...10 CIl.d...
OOS Tempor.,., pdah may,t. unci .t thl .Dd af 1M dlY. 0 Q28 . Frech 011 dOni I Gnldod.
o 007 lIIg.....& and ~ PNII..1on to comply w~. MlITCO 0 025 Cal:nP1y _ _.nl wlth DOoebt1l1n Aal.
[] OOB CUt canarlll' cntr an mD1II Un" or cold, lolnll. , 0 027. eu.:.nt..tab&, 71h... aurlng tlrml. '4600ps!. .
J 009 61ll'~11I'n<l drNowoVS min. 3,000pol. 0 028 """,,"II 01"" roqul"jDInt ",'m.-l
. 010 C\Irbll1llmln3,600polIN.poll:hVl""'...._:r. 0 on. oriv.wOV.~_I"v",,18'.
; 011 Moot mIn. roqulrcm.nto .n curb cuto. Spl'cf. coda. D 03C Submh _ ""11'01 pion prior .\. ....v.lIan.
01 Z ,,",to'" pl_ ...... Bpllf. """" 209.3.06 C1 031 NotlIy rr.tt!Il OMslon borOl1l ....vlllon.
o 013 Bp"'.lIPBo"IJ..l.'NOA.~."'... D. __ c...cirm...nUn.._to..2~mln.a"d..
o 014 Mlon.nloal_a "",...01. .
O 016 No "_.-~ D _~ 0 033 MUllcamplywllh1lutprovi.Ion..10RS 7111.'41",
__._.1 '_. 751.571.'
o 015. Lo...oJ aJllI to _ conlnll donalty I\IL [J ~ . e' _ ho~c)'V...
o 0'7 Cull to be pOIym"lz;d 0_ ...h,d 10. flnal.,.peo1ion, D
o 015 MOoInum 2' _bod ""'" lI'mlnul.
Comments:
YOU ARE REQUIRED To CA~L .
THE LANE UTILITIES COORDINATING COUNCIL'S
., ONE CALL NUMBER" 1-800-332-2344
48 HOURS BEfoRE DII3~13
INSPECTIONS:
o CURB CUT AND SIDewAll{ INSPI!C'TlONS CAll 726-3769 {RECORDER! STATE YOUR DESIGINATED CITY JOB
NUMBERiPERMIT NUMBER. JOB ADDRESS. TYPE OF INSPEC'TlON REQUESTED, AND WHEN YOU WILL BE READY FOR
INSPEC'TlON; CONmACTOR' S OR OWNER'S NAME AND PHONE NUMIilI!R. REQUESTS RECEIVED BEFORE 7:00 A.M. Will BE
'MADE Tlie SAMe DAY. REQUESTS AFTER 7:00 A.III. WIL~ BE MADE THE NEXT WORKING OAY.INSPecTIQNS ARE TO BE
CALLED IN AFTER EXCAVATlONli ARE MADE AND FORM WORK IS IN PlACE Bl1T PRIOR TO POURING CONCRET~
D SANITARY SEWER. STORM SIlWER. ENCROACHMENT PERMIT AND OTliER INSPECTIONS CALL CITY MAINTENANCE AT
726-3781.
SIGNATURE:
AMOUNT RECEIVED:
RECEIPT NO:
DATE PAlp:
RECEIVED BY:
!lY "9I1I1tUrc. I ~... and agroa thai'l hava ~alully examined tha J:Qmpleted 'PPr.f.~tlon II1d do hera~ O'Ortify that al1lnformatlon .
h~.relii Ie tN. ~n corre~t. lod 1 fuither cotti that anv 8/ld. an work , .', ;..." 'ad ell 1 be done ill 8OCO BIlCS With the -Oldlnaneea of the
ell\' Qt Sprtng d ""pllcabl8 City 5W1dal'd oaciflcatrona and Draw'"1/B an tIla OWB 01 tho Stlrle 0 O....gon partalnnv to the WQr~
dos.crtbed horn n. (IUrther cantty that only contrBCtllr8 and employees who are in compllonca With ORS 7Dl.055 wlllll6 ueod on thlll
proJect.' . ..... .
Th. City may In.s~ecl: th~Work .ite d.eoribed in tf"~e ermlt 81 any ~me duril'lg a ona vaar pericd following the ..aelpt by tho City of
notlca ~ complauon of 9 dascrtb8lj wcrl< and '0 . at thWiCIl\' . Bolo d.scre88l0n.JnY addltion.1 rostoredon wen. I' 9Qulred to
rlltulT1t . e/tll 1q a stan Ki acc~le to tha CItY. a PQI1Jl ca will bB notlfled In wnung of cny won. r\lllulred end w II have ltJlrty
dn1l13 'thfrom 111. dm t1Je mti.. to comDlala Iha wor~. ork not oompl.tad at lI1a enil 01 tha thirty day. wlll bB per1'ormBd bV the
City an a COGtC wlJl be ,UIed to lt1. parmlll..... .
I rUJtlIor agree \0 ansurr tlIBt an J:!Illulr.~ inspections are reQUasted .t;t,e pro"", tIm.. that pro/eot ~dre.s i. readable from tho S1J801,
on" the .pprcwed set ~~:a1e III remam on the '~ at ell tm~durng corulitruct~n.. .
SIgnature 7/ . ~--- ~ -'- --. . _' . . . Dato / - Z 0- 6,/
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VALlDATION:'-
o TRAFAC REYICWEO BY:
o ENGINEERING. REVIeweD BY:
DATE:
OATE:
It MAINT"NAN"""
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. D PERMIT ISSUED BY:__
.......
FOR'SJDEWALKAND CURB i:rJr PBlMITS PlACE A COPY (COMPLETED/IN PE1lN1IT'DRAWER.
D1t
J
.
INSPEC110N:
INSPECTION'
WORK IN PROGRESS
AT TIME OF COMPl.ETION:
ELEVENTH MONtH:
DATE:
DArE:
DAH:
DATE:
DATE:
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