HomeMy WebLinkAboutPermit Sidewalk 2009-11-19
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Status
Issued
Building/Combination Permit
PERMIT NO: COM2009-01675
ISSUED: 11/19/2009
APPLIED: 11/19/2009
EXPIRES: 05/19/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1950 E ST
ASSESSOR'S PARCEL NO.: 1703361212700
Springfield TYPE OF WORK: Sidewalk
TYPE OF USE: Repair
Residential
PROJECT DESCRIPTION: Sidewalk repair
Owner:
Address:
SIZEMORE GRANT W & LINDA S
1950 E ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
General
Contractor
ROGGE
License
Expiration Date Phone
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:
E~ergy 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:
n/a
I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Frontyard Setback: Overlay Dist:
Side I Setback: # Street Trees Rqd:
Side 2 Setback: Paved Drive Rqd:
Rearyard Setback: % of Lot Coverage:
Solar Setbacks, ATTENTION' 0
, _ . reonrt. '~1~1 ro,.. ,J".. _ ,
, N~;ift;a;~'~~:d~Pte1 by thellV<I&U6KiIf/iROVEMENTS',':
In..QAC 952 n er. hose ru,~.. ""HO>IIl:ilfh - . ~mv1II ~f-I~'k hrJr:'tRE IF THE W
StreetlmprovOOer's: -001-0010through OAR 952-001 ' -, OPIZErfi\l~ 111 't e. ORK
90. You may obtain cop' f h . ' ... - UI~ ER T ~ PERMIT IS NOT
Storm Sewer A\Qila"b':lhe center (Nol '.es 0 t e rules by "fJ!Ei\ICEr:PB'Pl'W~ ~I"
SpeciallnstrucliDmber for~~o footd1an~I's-'lltie telephone " i 80 DAY PERIOD uUNt:D FOR
'~. Vlt,UII utllty Notification ' .
Center IS 1 -800-332-2344)
No~s: - .
Total:
Handicapped:
Compact:
I Valuation Descriotion I
, ,
Description
Type of Construction
$ Per Sq: Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Page I of2
Status
Issued
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2009-01675
ISSUED: 11/19/2009
APPLIED: 11/1912009
EXPIRES: 05/19/2010
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Total Value of Project
Fees Paid I
Fee Description
+ 5% Technology Fee
Sidewalk Repair Permit
Amount Paid
Date Paid
Receipt Number
$1.55 . .
$31.00
11/19/09
11/19/09
1200900000000001271
1200900000000001271
Total Amount Paid
$32.55
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. will be made the following
work day.
I Reouired 1~
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 nil
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 hereiu, and
thai NO OCCUPANCY will be made of any structure without permission of the Community Services Division, Building Safety.
1 further certify that ouly contractors and employees who are in compliance with ORS 701.005 will be used on this project.
I further agree to ensure that all required inspections are requested at the proper time, that each address is readable from the
street, tbat 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 dUri~g=truC0ation.
(..----- ( {/v-.. .l.
Owner or Contractors Sf n\?ture
II-Iq- cJ1
Date
Page 2 of2
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
Job/Journal Number
COM2009-0 1675
COM2009-0 1675
Payments:
Type of Payment
Cash
cl{eccint)
RECEIPT #:
Description
Sidewalk Repair Permit
+ 5% Technology Fee
Paid By
TOM ROGGE
7-;:0.;.,,", '
J& '
,Co,' ,," _":.
-_. '--' ,., '. -. ~
City of Springfield Official Receipt
Development Services Department
Public Works Department
1200900000000001271
11:02:14AM
Date: 1l/19/2009
Item Total:
Check Number . Authorization
Received By Batch Number Number Uow Received
Amount Due
31.00
1.55
$32.55
Amount Paid
Ikw
$32.55
$32.55
In Person
Payment Total:
',t'
Page I of I
11119/2009
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:':\ :~'. DRIVEWAY/SIDEWALK' '.... :", PERMIT APPLICATION . :';,:!;/B~
225 FIFTH STREET
SPRINGFIELD, OREGON 97477
ENGINEERING OIV1SION
OFFICE TELEPHONE (503) 726.3753
APPLICATION ~A TE: III \ 'i I 01
, .
0'"1:=:;:)
~
PERMIT NUMBER (It/lIU-t'l'9- 0 IU75~
DATE ISSUED:
SITE INFORMATION:
APPUCANT
LOCA nON OF WORK, 1"1 '" (') j:: so\-
''1""", (I DJ'lA
117<; ,\..l:::'.~\ \....___
OTY L,o .(~\
PHONE
S'i 3, - lOt S-
ADDRESS:
S ,\-:----
TAX MAP:
STATE:
ZIP:
TAX LOT:
,
SUBDMSION":
ClYJNER:
ADDRESS:
PHONE:
CITY:
STATE:
ZIP:
REOUESTED PERMITS:
o SIDEWALK: .,....."....... .........,.......'..........
AMOUNT OF SIDEWAlK IN EXCESS OF 90FT.
~
o
SIDEWALK REPAIR: ......
........,............... '.,.............. $88.00 ..................'...... ~ $
@$O.oB SF. ~ $
..,............. . $15.50,....................,..... ~ $
CUR8 CUTjDRIVEWAY: NUMBER OF DRIVEWAYS
x.,.................
.. $88.00 151 Cui ~ $
o MULTIPLE PERMIT, DISCOUNT EA: .....,....(MAX 2) '... ,........,.....,...$30.00 2nd Cui -$_(-
(MUlTI PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION...Q..M.:t.
APPUES TO 2nd AND 3rd PERMITS ONLY. NOT SIDEWALK REPAI~ =$
o 5% Technology Fee $ TOTAL DUE \rVITH PERMIT $
o PROOF OF INSURANCE: $500,000 MINIMUM IF WORK IS DONE BY PROPERTYOWNER
CONTRACTOR INFORMATION:
1_
CONTRACTOR:
~ (2~\'\--,
ill~ 1~\~Q.,.)
15<.~~ ..
S'\-
PHON", 5'13-/07<:
ADDRESS:
CONTRACTOR REGISTRATION NO:
PROJECT SUPER\IISOR:
EXPIRATIONOATE:
PHONE:
INSPECTIONS:
AN INSPECTION REOUEST SHOULD BE MADE PRIOR TO POURING CONCRETE. AFTER THE PROPOSED WORK HAS SEEN FO RMED AND MADE READYTO
POUR. CURB CUT AND SIDEWALK INSPECTIONS CALL 726-3769 {RECORDER) STATE YOUR OESIGlNATED CI1Y JOB
NUMBER/PERM1T NUMBER, JOB ADDRESS. TYPE OF INSPECTJQ\I REQUESTED, M-lD \'\'HEN YOU WILL BE RE.A.Qy FOR INS PECTlON, CONfRACTOR'S OR
OWNER'S NAME AND PHONE NUMBER. REOUESTS RECENED BEFORE 7:00 AM. WIll BE MADE THE
SAME DAY, REOUESTS AFTER 7:00AM. Will BE MAOETHE NEXT WORKING DAY. INSPECTIONS ARE TO BE CAlLED IN
AFTER EXCAVATIONS ARE MADE AND FORM INORK IS IN PLACE SlIT PRIOR TO POURING CONCRETE.
D Single driveways serving single -family and duplex dwellings shall
be paved for the first 18 feet when abutting a curb and gutter. 4.2-2(3)
You are required to)1'1I utility notification center "one call number" 811 before digging
SIGNATURE: /'1.........
AMOUNT RECEIVED:
RECEIPT NO:
(Ii') -
DATE PAID:
RECEIVED BY:
By signature, I state and agee.. that I have careluDy examined lhe comp!eted application and do he repy certify that al M1famalion hE'f"ein is true
and correCl and IlurthE'f" certifY lIlat af!Y and all WOfk performed shaJ ~ dooe in accordance with the Ordinances of
the City of 5, pringlield, appflca6te City Standard speollcations and Dra'NinQs. and the laws of the Slate of Oregon pllftarning to lha 'NOrk described herein.l fur1her
ces1ity lhat only contradors end employees who are Ir1 compliance with GRS 701.055 WIll be used
on !his proJed. .
T1'e City may ins, pect,lhe work, site pascribe:d in lhls permil at ,~ny tim, e durir'!g a on, e year Period 10 nowing tl'!e receipt by the City 01 nollce of com~lellon 01" the
d.esCllbed work and spealy. allhe City s sole discretion any addiUonal restoratitrl work reqLnred 10 return the SIte 10 a staridard accep'!able to the Ci . The
pemllnee will be notified in WIlling of any wor1I required MId wilt have lhlrly Clays (30) Irem!he dale oIlhe notice to complete the work Work not com aled at the end
ollhe thirty days wiU be performed by llil! City and the costs win be billed to lhe permtlee. '
Ilurll1er agree \0 ensure that alllequired inspections are raquesled at the proper, time. lhat proj eel adaess is reada~e Iran the
street. and the approvec:t Sel 01 ptans will remain on the site at a1llime~ during construction. .
Signature
Oale