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HomeMy WebLinkAboutPermit Sidewalk 2001-8-7 . . I Job# 01-00843-01 I Page 1 of 2 CITY OF SPRINGFIELD, OREGON RESIDENTIAL PERMIT City Of Springfield Community Services Division Building Safety Job Number: 01-00843-01 225 North Fifth Street Springfield, OR 97477 Office: 726-3759 Inspection Line: 726-3769 Location Of Proposed Site: 452 Pioneer Parkway West blvd Spr Assessors Map#: 17033523 Lot: Block: Addition: Tax Lot #: 07900 Subdivision: Owner: Address: Orman Carter 2470 38th street Phone Number: 541-741-2818 City/State/Zip: Springfield, OR 97477 New Value: $0 Scope Of Work: Sidewalk Replacing approx. 25 ft of sidewalk. Quad Area: # Of Units: Constr. Type: Water Heater: Office Use Land Use: Zoning Code: Bedrooms: Range: # Of Buildings: Occupancy Group: Heat Source: Sq. Footage: 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 working day. SW-Setback Required Inspections I Public Works I -After forms are erected but prior to placement of concrete Construction Types: Occupancy Groups: # Of Buildings: # Of Bedrooms: Handicap Access? D iArea (Sq. Feet) I Main: Accessory: # Of Stories: Current Units: Census Code: Does not apply Height (feet): Proposed Units: Total: Fee Paid On Receipt# Public Works 08/07/2001 6367 Value/Quantity New Sidewalk Total Public Works Grand Total 25 Fee Amount $65.00 $65.00 $65.00 . . -- " I Job# 01-00843-01 I Page 2 of 2 By signature, I state and agree that I have carefully examined the completed application and do hereby certify that all information 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, applicable City Standard Specifications and Drawings, and the laws of the State of Oregon pertaining to the work described herein. I further certify that only contractors and employees who are in compliance with ORS 701.055 will be used on this project. I also understand the City may inspect the work described on this p~y time during a one year period following notice of completion, at the City's descresci)~~ ( ( Signature ohio ( Date D =<: ..... ..... <:::l;;o DD :::0 --t :z: rn n1 tD c-J.... :;::I: (""J t::J J>.. :J> ...co (0 f'.JUJl--L :c I 1-lC"J~oo rr1 ::c -J 0 :;0 :D 0-. -0 ..Zt.nNCi' OQ- OL..J O"-rt1ooo-.. f",J..O.........-J