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HomeMy WebLinkAboutPermit Sidewalk 2009-11-25 Status Issued CITY OF ~rK.H\iL.FIELD Building/Combination Permit PERMIT NO: cOM2009-01699 ISSUED: , 11/25/2009 APPLIED: 11/25/2009 EXPIRES: OS/25/2010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 54,1-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1282E ST ASSESSOR'S PARCEL NO.: 1703351404600 Springfield TYPE OF WORK: Sidewalk PROJECT DESCRIPTION;: Repair 01'25' of setback'sidewalk TYPE OF USE: New Residential Owner: Address: JANE WISTAR STARUB REVOCABLE TRUST 1282 E ST " SPRINGFIELD OR 97477 I CONTRACTOR INFORMATION I Contractor Type General cflntractor THOMAS MARC ROGGE License 11 0976 Expiration Date .Phone 05/1112011 541-741-8134 BUILDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Gro~p: Primary Constrnction Typ~ Secondary COllstruciion Type: # of Bedrooms: # of Stories: Height of Structure Type of Heat: Water Type: Range Type: Energy Path: Sprinkled Building: Lot Size: Sq Ft 1 st Floor: Sq Ft 2nd Floor: Sq Ft Basement: Sq Ft Garage/Carport Sq Ft Other: Occupant Load: n/a I DEVELOPMEN,T INFORMATION I REQUIRED PARKING Front yard Setback: Overlay Dist: Side I Setback: . # Street Trees RqdN Side 2 Setback: I Paved D,'ive Rqd: T o TtCE' Rearyard Setback:' . % of Lot Covera~eii~S PER' Solar Setbacks ATTENTION: Oregon.la~ re9.U1re~ .Y~~.~. :1}!.'HOR/7~~r.~HALL lOlIn, . N~~tfi~a;~~C~~t:r:vTh~~~';~I~itiR'j.~tiiiilkoVEMEri:fS:I,NCED ~R~~R THts'1~;:HE WORK' Street 1m roJ~a,952-001-00,19 through \_"-\" ".......... ,- . -, DA~Siail\>'lk;W~~iDON IT IS NOT .. p 0090. You may obtam caples of the rules by . "vD. ED FOR Storm Sewer A'llIilftl1!J~he center. (Note:.~he telephone ' Downspoutsmrains: Special Instructiumber for the Oregon Utility Nollltcatlon Center is 1-600-332-2344). Total: .', Handicapped: Compact: , N9tcs: ~ I Valuation D~scriDtion I Description Tvpe of Construction $ Per Sq Ft or mnltiplier Square Footage or Bid Amount Value Date Calculated ,:,c': Paee I of 2 Status Issued 225 Fifth Slreet, Springfield, OR 541-726-3753 Phone ' 541-726-3676 Fax 541-726-3769 Inspection Line " Fee Description +'5% Technology Fee Sidewalk Repair Permit Total Amount p'aid 11 Amount Paid $2.33 $46:50 $48.83 Total Value of Project Fees P~id I Date Paid Plan Reviews I CITY OF SPRINGFIELD Building/C~mbination Permit PERMIT NO: cOM2009-01699 ISSUED: 11/25/2009 APPLIED: 11/25/2009 EXPIRES: OS/25/2010 VALUE: Receipt Number 11125/09 11/25/09 3200900000000000772 3200900000000000772 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 workday. I ~efl'~ir,~d I~sl'ectioos I Sidewalk - Setback: After forms are erected but prior to placement of concrete. By signatnre, 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 contractors and employees who arein compliance with ORS 701.005 will be used on this project. I I'urther agree to ensure that all required inspections are requested at the propcr 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 sile at all times d'uring construction. j . Owner or Contractors Signiature Paee 2 01'2 Date 225 Fifth Street Springfield, Oregon 97477 541-726-3759 Phone Job/Journal Number COM2009-0 1699 COM2009-01699 Payments: Type of Payment CreditCard ,.. cRcceintl RECEIPT #: Descript;ion Sidew~lk Repair Permit + 5% Technology Fee Paid By THOMAS ROGGE City of Springfield Official Receipt Development Services Department Public Works Department 3200900000000000772 Date: 11/25/2009 Item Total: Check Number Authorization Received By Batch Number Number How Received njm 035260 In Person Payment Total: Page I of I 8:21:57AM Amount Due 46.50 2.33 $48.83 Amount Paid $48.83 $48.83 ] ] /25/2009 . .' . ": .," .'. .,. "'" t. . ':' ':nb"O.f,~- ,...Ji"'d '?,::. '. .~. . ~ '." ,', ',.".r. c ',' 1 . _. . _ ,_ _. ..lJI~ 9.~nl'<<lI(,!lt ;.'.." ., ". . .; _"."", ,-C' ._~.: " ,:~ ~. / <:::~ " :", . ::,-' ;. :.:,; ,.:~ .\' , . ~'~'.~ :";'" ,.:;~~,rC?,J. . '.' . ~ . .: ::~: ".; . '~)'~: "i.;':/ . ~ it ,:~ '~ :'. ~ -~:;.:~. ..~~.: t;~~t~j >~".;" PRIVeWAv/SIlJEWALK .:: '.', ';~; ::"'PERMIT APPLICATION':: ;:),;i~ 225 FIFTH STREET SPRINGFIELD,OREGON97477 ENGINEERING DIVISION OFFICE TELEPHONE 1503) 726.3753 , ~~ , 1-;)5 -err Cr:; ~()/~ CI c.1' PERMIT NUMBER: ~ I . DATE ISSUED / /:;:;5/09 APPLICATION DATE: SITE INFORMATION: LOCATION OF ~ORK: \ A. ~ 2 ~ APPUCANT ': Ir::.>-/V\ 1'l7'~ OTY S~e-U .. SU8DMSION: OWNER: -\ t:tJV l:: Sl- ADDRESS' \2.x . IL~t<>- PHONE ""-15-10" TAX MAP: STATE: L'i-L. ZIP; TAX lOT: ~c.~~ PHONE: ADDRESS: CITY: STATE: ZIP: REOUESTED PERMITS: o SIDEWALK: ..,............ .... .............. AMOUNT OF SIDEWAlK IN EXCESS OF 90FT. IjiI SIDEWALK REPAIR:.... .....................d-5:.~:t.. $88.00 ... @$0.08 SF. .. $15.50 .... .. = $ =$ ......... =$ o CURB CUT/DRIVEWAY: NUMBER OF DRIVEWAYS_ X ......... $8B.00 1st Cut = $ o MULTIPLE PERMIT. DISCOUNT EA: ....... ..(MAX 2) . .... ....$30.00 2nd Cut =U' (MULTI PERMIT DISCOUNT GOOD FOR ONE SITE AND ONE SITE INSPECTION..ow . APPLIES TO 2nd AND 3rd PERMITS ONLY. NOT SIDEWALK REPAIR! =$ o 5% Technology Fee $ TOTAL DUE WITH PERMIT $ o PROOF OF INSURANCE: $500,000 MINIMUM IF WORK is DONE BY PROPERlYOWNER CONTRACTOR INFORMATION: CO~CTOR ~ . ~2~y-- . t2'Jci<- ADDRESS \l7~ 1-\w.;\WL q j:l1~~ I'K' ((M."-.j",,, U..,(, PHDNE, 51 ~- JOt '<;: CONTRACTOR REGISTRATION NO: PROJECT SUPERyISOA: rt'(1.., EXPIRATION DATE: PHONE: INSPECTiONS: AN INSPECnON REOUEST SHOULD BE MADE PRIOR TO POURING CONCRETE AFTER THE PROPOSED WORK HAS BEEN FO AMEO AND MADE READY TO POUR. CURB CUT AND SIDEWALK INSPECTIONS CAlL 726-3769 (RECORDER) STATE YOUA DESIGINATED em' JOB NUMBER/PERMIT NUMBER, JOB ADDRESS, TiPE OF INSPECTION,REOUESTEO, AND lM-lEN YOU WILL BE READY FDA INS PECTlON, CONTRACTOR'S OR OWNER'S NAME AND PHONE NUMBER. REOUESTS RECEIVED BEFORE 7:00 A.M. WILL BE MADE THE SAME DAY, REQUESTS AFTER 7:00A.M. VvlLl BE MADE THE NEXTWDAKING DAY. INSPECTIONS AAE TO BE CALLED IN AFTER EXCAVATlON~ ARE M4.0E AND FORM WORK IS IN PLACE BUT PRIOR TO POUAIN~ CONCRETE. c::::J 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) YDU are required_to call utility notification center "one call number" 811 before digging SIGNATURE: CI "'" {i-yJo, AMDUNT RECEOIf.il/ 0 0 }).'1 /I j'd-y/07 RECEIPT NO: DATE PAID: RECEIVED BY: ---1' rt/Yl (~i/'l . I . i By signalurell state an.d agee, lhatl have carefully exa. mined !he c.ompleled application and do he reqy cerliry thaI all information herein is true and correct and further certifY Ihal an-y and all work Qedormed shall be done In accordance with the OrditiGJJces 0( the City of S. pringfield, applicable City Standard speClficallans and Dfawinq5, and the laws of the Slate of OregCitfpertainlng to the v.ork described herein. I furltier certify fhat only contractors and employees who are in compliance with GRS 701.055 will be used OIlthlspl"Olea. ' . The Cltymay inspecl_the work sHe described in this permit at any time during a lYIe year period fo ncrwing Ihe receipt by the City 01 notice of com~leHOIl cllhe descnbed work and,spool)'. Bllne ory's sole discretion any addilionalrestoration work required to return the slle to B standard accep.table to the a . The permnee will be notified in wilting of any work required and will have Ihll1y days (30) from lhe date of the notice to complele the work. Work not camp eted allhe end ollhe lhirly days Will be pertormed by the City and (he costs will be biiled to Ilie permittee. - , I further agree to ensure thai all reqUired Inspections are reouesled al the proper time that Prol ect address IS readable tram the street, and the approved sel oj plans WIll remain on Ihe 511e at aJllimes during construction ct::Y'\. f2r~^ - Dale (!- JS' ~ dO Slgnatura