HomeMy WebLinkAboutPermit Sidewalk 2004-8-16
-~
Status
Issued
CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2004-01017
ISSUED: 08/16/2004
APPLIED: 08/16/2004
EXPIRES: 02/16/2005
VALUE:
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 1360 1ST ST
ASSESSOR'S PARCEL NO.:, 1703263300515
equir~~ OF USE:
PROJECT DESCRIPTION: sidewalk rwttm~NPfi)fi31i~Wifhr Oregon Utility
p..l dopted by 11 Ie J ttorth
(-\I""" rl lies a - r ,lac ::lre 5e
Owner: THOMAS KELLY L YNNN~titication ~~~~~1 ~I ~~;;Ugh OAR 95~-~Ub~
Address: 1360 N 1ST ST SPRINGF~9a~7~"f7 btain copies ot the ru e
ac,:n Vnll ma'l o'l~...l:': .ho tP\eoho~e
Ca\ . tile centel. \ !,.ly,:....~'Qtiticat'on
(JQtJNFul I ' ON
nu Center lS -
Contractor
MARK DORMAN
Springfield TYPE OF WORK: Sidewalk
Repair
Contractor Type
General
License
147257
Expiration Date
03/15/2005
Phone
541-501-5985
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 Ist Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
; Occupant Load:
n/a
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
I DEVELOPMENT INFORMATION'
. .00183d A\fO OB ~ AN\f
80~~~>>~~~~! 80 038N3~~08
ION SI~JalDili~lR.q~30Nn 03Z180HIn\f
)j80M ~dfjjojJ~D:lga:\;fHS Illt\l83dSIHI
:3:l110N
REQUIRED PARKING
,
!F
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS I
Street Improvements:
Storm Sewer Available:
Special Instruction:
Sidewalk Type:
Downspouts/Drains:
Notes:
I Valuation Description 1
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Pal!e 1 of 2
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fee Description
Sidewalk Repair Permit
Total Amount Paid
I Fees Paid I
Amount Paid
Date Paid
CITY OF SPRINGFIELD'
Building/Combination Permit
PERMIT NO: COM2004-01017
ISSUED: 08/16/2004
APPLIED: 08/1612004
EXPIRES: 02/16/2005
VALUE:
8/16/04
Receipt Number
3200400000000000211
$10.00
$10.00
I Plan Reviews 1
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 Reouired InsDections I
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 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 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, 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.
!~~
Owner or Contractors Signature
Pal!e 2 of 2
CCr-/fo-OC-f
Date
225 Fifth Street
Springfield, Oregon 97477
541-726-3759 Phone
.'
RECEIPT #:
Job/Journal Number Description
COM2004-0 1017 Sidewalk Repair Permit
Payments:
Type of Payment
Cash
8/16/2004
Paid By
KELLY THOMAS
3200400000000000211
Received By
vrJ
Check Number
Batch Number
,
Page 1 of 1
<\J.V of Springfield Official Receipt
?....,~elopment Services Department
Public Works Department
Date: 08/1612004
Item Total:
Authorization
Number How Received
In Person
Payment Total:
2:18:27PM
Amount Due
10.00
$10.00
Amount Paid
$10,00
$10.00