HomeMy WebLinkAboutPermit Sidewalk 2005-6-30
CITY OF SPRINGFIELD'
,;. Building/Combination Permit
Status Pending
225 Fifth Street, Springfield, OR
541-726-3753 Phone ATTENTION: Oregon law requires you to
541-726-3676 Fax follow rules adopted by the Oregon Utility
541-726-3769 Inspection MBflfication Center. Those rules are set forth
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In UJ-\t'\ ~OL-UU I-UV I v LlII VU:::l I ,.. I :.JJ_ ~e .
omvou may amain (';UJ.1I~::> VI Lilt:: l.ul".:> L} .
: SITE ADDRESS: 1792 . f.h ~ (Note: the t~g~R~d TYPE OF WORK: Sidewalk
ASSESSOR'S PARCEL NOSa IproJ3~11'O~ [0'0 . , ..,
number for the regon Utility Notification TYPE OF USE: use initials
PROJECT DESCRIPTION: Side(;&lJlt~~Jiif-~Q~t1~s2344).
( PERMIT NO: COM2005-00834
ISSUED:
APPLIED:
EXPIRES:
VALUE:
06/30/2005
Owner: LIND ANNA M
Address: 1792 I ST
SPRINGFIELD OR 97477
I CONTRACTOR INFORMATION I
Contractor Type
Right of Way
Contractor
DAVID HYDE
License
Expiration Date Phone
BUILDING INFORMATION.
# 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 1st Floor:
Sq Ft 2nd Floor:
Sq Ft Basement:
Sq Ft Garage/Carport
Sq Ft Other:
Occupant Load:
n/a
I DEVELOPMENT INFORMATION I
Front yard Setback:
Side 1 Setback:
Side 2 Setback:
Rearyard Setback:
Solar Setbacks:
Overlay Dist:
# Street Trees Rqd:
, Paved Drive Rqd:
% of Lot Coverage:
REQUIRED P ARKINq
Total:
Handicapped:
Compact:
I PUBLIC IMPROVEMENTS'
Street Improvements:
, Storm Sewer Available:
Special Instruction:
Notes:
Sidewalk Type:
lN011~E:ER":.,M'I;r te,' ,UlA' I,L'L \'E....lp.\;R:E '\'F ;rHo 'rDo~nsp' puts/Drai~s:
ifik1\\~ If! ,", Ii :0n' I 'A',." :Ie" VI ,
AilJirHOHIZED ,l!l:N:DEiR iTHI'S PEiRM,IT.lS NOif,
CDMMENOED DB :IS ABANDONEO iFOH
ANY 18.0 DAY PERIOD.
I Valuation Description I
Description
. Type of Construction
$ Per Sq Ft
or multiplier
Square Footage
or Bid Amount
Value
Date Calculated
Pae:e 1 of2
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I'
Status Pending
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
Total Value of Project
Fees ~a~<lJ
Amount Paid
Date Paid
6/30/05
CITY OF SPRINGFIELD
Building/Combination Permit
PERMIT NO: COM2005-00834
ISSUED:
APPLIED: 06/30/2005
EXPIRES:
VALUE:
Receipt Number
3200500000000000402
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.
$10.00
$10.00
I Plan Reviews I
LReouired Insoections 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 durin~ construction.
C~ S~(~ r G~ ~O ~O~
Owner or Contractors Signature
Paee 2 of 2
Date
225 Fifth Street
Springfield, Oregon 97477
541-726::3759 Phone
. . ~ .
RECEIPT #:
Job/Journal Number Description
COM2005-00834 Sidewalk Repair Permit
Payments:
Type of Payment
Cash
Paid By
OREGON TRUCKING
..
It
"
"
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6/30/2005
~ity of Springfield Official Receipt
...>evelopment Services Department
Public Works Department
3200500000000000402
Date: 06/30/2005
Item Total:
Check Number Authorization
Received By Batch Number Number How Received
CAS In Person
Payment Total:
Page I of I
1:52:23PM
Amount Due
10,00
$10.00
Amount Paid
$10.00
$10.00