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Home My WebLink AboutApplication APPLICANT 6/8/2010 > . . ~ PERMIT NUMBER . . . _.dr APPLICATION AND PERMIT TO OCCUPY OR 1.1"1. M J;'~ "~.i .~ i1, I\:; \,"-r I! :! ;;.." ~;<: if '... ,;' PERFORM OPERATIONS UPON A STATE HIGHWAY . _. . '0 See Oregon Administrative Rulel Chspter 734, Division 65 CLASS: . I KEY' I GENERAL lOCATION PURPOSE OF APPLICATION ITO CONSTRUCT/OPERATE/MAINTAIN) HIGHWAY NAME AND ROUTE NUMBER D POLE TYPE (-~-- . I MIN. VERT. CLEARANCe SPRINGFIELD HWY (pIONEER PARKWAY) LINE N/A I ~~~___ HIGHWAY NUMBER I~OUNTY I dURIED TYPE 228 20 '" LANE CABLE N/A BETWEEN OR NEAR LANDMARKS D PIPE TYPE FST & CENTENNIAL BLVD. LINE N/A HWY. REFERENCE MAP I DESIGNATED FREEWAY T:N U.S. FOREST I ~EE AMOUNT 88-28-2 DYES IZl NO DYES IZl NO D ~1b~COMMERCIAl $0.00 APPLICANT NAME AND ADDRESS IZl MISCEllANEOUS O?ERAnoNS AND/OR FACILITIES AS PAULA or JOHN PARI(ER OESCRIBED BELOW FOR 0001 USE 0 LY 1000 3rd PLACE BOND REQUIRED REFERENCE: AMOUNT OF BOND SPRINGAELD, OR 97477 DYES IZI NO OAR 734-66 $0.00 035(2) INSURANCE REQUIRED REFERENCE: SPECIFIED COMPo DATE 541-741-1298 IZl YES D NO g::':.34.66 3/8/2011 DETAIL LOCATION OF FACIUTY(For more space attach additional sheets) MILE MILE ENGINEERS ENGINEERS SIDE OF HWY OR DISTANCE FROM BURIED CABLE OR PIPE SPAN POINT TO POINT STATION TO STATION ANGLE OfCRQSSING CENTER OF PVM RJW LINE DEPTHNERT. SIZE AND KIND LENGTH 0.83 33+16 LEFT 25' 5' XXX xxx xxx - -. - --- DE6CffiPTION AND lOCATION OF NON-COMMERCIAL SIGNS OR MISCELLANEOUS OPERATIONS FACILITIES INSTALL 3" DRAIN PIPE INTO CURB. SPECIAL PROVISIONS (FOR MORE SPACE ATTACH ADDITIONAL SHEETS) TRAFFIC CONTROL REQUIRED - OPEN CUTTING OF PAVED OR SURFACED AREAS ALLOWED? .. IZI YES [OAR 734-55-025(6)) D NO .. D YES [OAR 734-55.100[21 IZl NO (OAR 734-55~100(1). .. AT LEAST 48 HoURS 8EFORE BEGINNING WORK, THE APPLICANT OR HIS CONTRACTOR SHALL NOTIFY THE DISTRICT REPRESENTATIVE AT TELEPHONE NUMBER; 541-686-7626 OR FAX A COpy OF THIS PAGE TO THE DISTRlcnlFFlCE-i\T; N/A SPECIFY TIME AND DATE IN THE SPACE 8ELOW. . A COPY OF THIS PERMIT AND All ATTACHMENTS SHALL BE AVAILABLE AT THE WORK AREA DURING CONSTRUCTION. .. ATTENTION: Oregon Law requlres you 10 follow rules adopted by the Oregon Utility NotIfication Center. Those rules are set forth In OAR 952-O01~0010 through OAR 952-001-0090. Yeu may obtain copies of the rules by calling the center at (503) 232-1987. CALL BEFORE YOU DIG l-BOfJ.332.2344 COMMENTS, OOOT USE ONLY PERMIT AND PERMISSION TO INSTALL DRAIN PIPE WITHIN ODOT RIGHT OF WAY. WORI< TO INCLUDE A HOLE BORED INTO ANDTHROUGH CURB, ATTACH AND INSTALL 3" DIAMETER DRAIN PIPE. PLEASE SEE ATTACHED DISTRICT 5 LANE RESTRICTION GUIDELINES. SEE ADDITIONAL PAGES OF THIS PERMIT FOR GENERAL & SPECIAL PROVISIONS IF THE PROPOSED APPLICATION WILL AFFECT THE LOCAL GOVERNMENT. THE APPLICANT SHALL ACQUIRE THE LOCAL GOVERNMENT OFFICIAL'S SIGNATURE BEFORE ACQUIRING THE DISTRICT MANAGER'S SIGNATURE. LOCAL GOVERNMENT OFFICIAL SIGNATURE TITLE DATE TITLE '0 Ot.</.frl e-r- lhl Ijgnil6PPrOYCd bV thGC/lpartmcmt, tho applic:Dnt ill eel .=pt...nd..pp..._ DISTmCTMANAGE P cnna and pl'omIQMoonb!lil'led and llttaclled: and t"I01m, of Oregan Admfnil:tJIlINe Rulp. Chap~r 734, Olvlslon 55, wllk:h Is: by this reh!:renc:e mllde II part ~f lbb pem11t. ' TELEPHONE NO. 51-/ 0{~8 APPROVAL DATE -v-A' . 734-3457(7.0'> PAGE-LOF.l Date Received: LP - "z5 - I D Planner: SH '. . Status Issued CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01491 ISSUED: 04/09/2009 APPLIED: 10/09/2009 EXPIRES: 08/1712010 VALUE: 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line SITE ADDRESS: 1000 3RD PL ASSESSOR'S PARCEL NO.: PARKER 3RD PLACE P Springfield TYPE OF WORK: MisceUaneous TYPE OF USE: New Residential PROJECT DESCRIPTION: 200 AMP meter change and water line Owner: JOHN PARKER Address: 1000 3RD PLACE SPRINGFIELD OR 97477 Phone Number: 541-741-1298 I CONTRACTOR INFORMATION ~ Contractor Type General Electrical Plumhing Contractor SNAPPER CONSTRUCTION BURRELL BROS ENTERPRISES INC OWl';>:R License 84836 136446 Expiration Date 0712112011 0812012011 Phone 541-342-5426 541-747-2724 BIDLDING INFORMATION I # of Units: Primary Occupancy Group: Secondary Occupancy Group: Primary Construcnon Type Secondary Construction Type: # of Bedrooms: #of Stories: Heigbt of Structnre 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: . Occnpant Load: nla I DEVELOPMENT INFORMATION I Fl'Ontyard Setback: Side 1 Setback: Side 2 Setback: Rearyard Setback: Solar Setbacks: Overlay Vist: # Street Trees Rqd: Paved Drive Rqd: 0/0 of Lot Coverage: REQUIRED PARKING Total: . Handicapped: Compact: Notes: "''"'T'CE' ,":U 1.-. iHIS PERMIT SHALL EXPIRE IFTHE WORK .UTHORIZED UNDER THIS PERMIT IS NOT . Ci !'J]i,jlENC ED OR IS ABANDONED FOR !tiN i 80 DAY PERIOD, I PUBLIC IMPROVEME~~INTION: CfSQ,O'<:'I1!,,", "" , !,,;t:iily. . rules adojJ,t:;,j '.Jj ."" . ~ ,. '.~ ~~h h , l' ''''':lo'''i\-,s,:,ri.;; ~el,o,l Notificatiorl>IlleWlilk Ype:~' 'h"O' A''''R' 8~o001- , _ 01-001Othroug' ,.~~- In OAR 952rPo]\'''SDy:~tll/;lrl'l..,,:of the rules by 0090, You m"y O\J " I" 1- h . ' the center. (Note: the'te ,:P one caltlbng I r the Oreoon Utility Notification num er 0 ~ 344) '. ' . Center is 1-800-332-2 ' Street Improvements: Storm Sewer A vailabl,e: . Special Instruction: Date Received:0 '-'n'\[) Planner: SH Paee I 00 '. . Status Issued 225 Fifth Street, Springfield, OR 541-726-3753 Phone 541-726-3676 Fax 541-726-3769 Inspection Line CITY OF SPRINGFIELD Building/Combination Permit PERMIT NO: COM2009-01491 ISSUED: 04/09/2009 APPLIED: 10/09/2009 EXPIRES: 08/17/2010 VALUE: I Valuation Descrintion i Description Tvpe of Construction . $ Per Sq Ft or multiplier Square Footage or Bid Amount Value Date Calculated Total Valne of Project ~ Fee Descriplion + 12% Stale Surcharge + 5% Techuology Fee Perm ServlFdr 200 amps or less + 12% State Surcharge + 5% Technology Fee Water LIne - 1st 100' Water Line - Each AddtJ 100' + 5% Technology Fee Curbcul Permit Amount Paid Date Paid Receipt Number $19.44 $8.10 $162.00 $11.40 $4.75 $76.00 $19.00 $4.40 $88.00 10/9/09 10/9/09 10/9/09 10/13/09 10/13/09 10113/09 10/13/09 3/4/10 3/4/10 3200900000000000700 3200900000000000700 3200900000000000700 2200900000000001176 2200900000000001176 2200900000000001176 2200900000000001176 2201000000000000194 2201000000000000194 Total Amount Paid $393.09 I Plan Reviews ~ 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. IJe(JllirecUn~np.p.tions ~ Electric Service: Approval required prior to utility company energiziug service. Water Line: Prior to filling trench and including required testing. Curbcut - Standard: After forms are erected but prior to placement of concrele. DateReceived: Co 0-'iS r I Plimner: SH Paee 2 of3