HomeMy WebLinkAboutPermit Sidewalk 2004-9-17 (2)
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. CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2004-01138
ISSUED: 09/17/2004
APPLIED: 09/14/2004
EXPIRES: 03/17/2005
VALUE:
~.
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
5411-726-3676 Fax
541-726-3769 Inspection Line
SITE ADDRESS: 4856 DAISY ST
ASSESSOR'S PARCEL NO.: 1702324404000
Springfield TYPE OF WORK: Sidewalk
ATTENTION: Oregon law requires you to
follow ruiT:Yl~E((j)Ft:U:SE: the CRrepa'iln Utility Residential
PROJECT DESCRIPTION: REPAIR SIDEWALK FOR CIT)f~lNIIlENA"lJ~iID!.N(jlFJIDErules are set forth
in OAR 952-001-0010 through OAR 952-001-
0090. You may obtain copies or me rUles oy
calling the center. (Note: the telephone
number for the Oregon Utility Notification
Center is 1-800-33~-~;j44),
I CONTRACTOR INFORMATION I
Owner: WENETTA PAUL F
Address: 4856 DAISY ST SPRINGFIELD OR 97478
Contractor Type
General
Contractor
THOMAS ROGGE CONSTRUCTION
License
110976
Expiration Date
05/11/2005
Phone
741-8134
I 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:
n/a
Lot Size:
Sq Ft 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
. I DEVELOPMENT INFORMATION I
REQUIRED PARKING
Overlay Dist: Total:
# Street Trees Rgd: Handicapped:
Paved bj-TvllRq~( L EXPIRE IF THE ~0JIrn4ct:
% ofLqt,-~Bv:eEagMIT SHAL S PERMIT IS NOT
. AUTHORIZED UNDER lHI
_..~~'"' M"I \(' hQHlnnNED FOR
.. .
I 111\/11\1'''-''-1' 'L.,.I.I V" .-
I PUBLIC IMP~py.f\::M~N!~ IIERI,OD.
Sidewalk Type:
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Street Improvements:
Storm Sewer Available:
Special Instruction:
Downspouts/Drains:
Notes:
I Valuation Description I
Description
Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Total Value of Project
Paee 1 of 2
_~~_~~~~II~I' .
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.
. CITY OF SPRINGFIELD.
Building/Combination Permit
PERMIT NO: COM2004-01138
ISSUED: 09/17/2004
APPLIED: 09/14/2004
EXPIRES: 03/17/2005
VALUE:
Status
Issued
225 Fifth Street, Springfield, OR
541-726-3753 Phone
541-726-3676 Fax
541-726-3769 Inspection Line
Fees paidJ
Fee Description
Amount Paid
Date Paid
Receipt Number
Total Amount Paid
$0.00
I Plan Reviews I
Public Works Review
09/1412004
09/14/2004
APP SB
SIDEWALK REPAIR FOR CITY
MAINTENANCE. NO FEE.
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 Re~ Inspections 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 ofany 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.
~
q-/7- 8~
Owner or Contract
Date
Paee 2 of2