HomeMy WebLinkAboutPermit Sidewalk 1994-12-8
l;/~O
~IDENT~'~;AL:-' c;~~ERCIAL
. . - AFf'L1CATION I PER"!IT .
225 NORT;.I FIFT;.I STREET
SPRINC>FIELD, OREGON 'il1411
ENGINEERING DIVISION
ClFfICE NO. 1'& -3153
INSPECTION LINE, 1'''',31&'il
Joe ADDRE58. :2 /3
ASSES501'1& MAP NO.*
+0,"1'(/1 e.uJ
1'7 e." '1.."1 ~I
SUBDIVISION,
ou.NER,
H ALS A
ADDRESS, .::(.Q.n LV
STATE, O~ E iroN
. ~ DESCRIPTION.
Jair-V/El-<.'
ZIP, q7477
SIDEUJALK,
CUR9 SIDE _
DATE or AFf'LICATION
IJ-!t!qrj
ll.IORK TO BE PE~D BY.
CONTRACTO~* STAToAJ Cold. Tl'1c..
ADDRESS ;).,(3(N -J? Ai "por'LBd._
r-~....c;DURE FOR: IN5Fl:CTION REQUEST.
SPRINGFIELD
~~
.*
TAX LOT NO. ~f3t!)(j
RECEIPT NO, 15'''')>
CASH
C;.IECK
v'
CIT1\~ol-i" f~
P~ONE' NO.:! '
/
CHECKED FOR DELINOJENCIES* /
SETBACK
COMM"RICAL _
SI6NED,
DArEl
OUNER
)(.
CONTRACiOR
"(/Lb'!J ~.
,7/P.. jqt/
l I
EXPIRES,.? /J./ hs-
'. .
PhONE, ~/ -OO~
CALL 1,&-31&'il IR::CORDER ) STATE TOUR CITT DESIGNATED JOB NWl9ER J09 ADDR::SS,TTPE or
INSPECTION REOJESTED "''Ii:> UI.-IEN TOU WILL eE R::ADT FOR INSPECTION, CONTRACTOI'1& OR ou.NEl'1& NAME "''iD
PHONE NUM9ER R::QUESTS R::CEIVED eEFOR:: 1,0<?> "-'1 WILL 9E MADE THE SA'1E DAT, R::QUESTS AFTER 1,0<?>
AM WILL ElE MADE THE NEXT llJOR<lNG DAT
CUR9-CUT, ~ RESIDENTIAL_
SECOND DRIVEWAT I SEE TRAFFIC)
REQUIRES AFf'LICATION FOR A SECOND DRIVEWAT('T,4.1.)
OR A COJNIT AFf'LICATlON FOR FACILlTT PER"!IT IC 'ile-,"3)
IF IN TI-IE U.G.s.
REGISTRATION
*
NO. 0337/
'i7LfO;).
* SEE BOOK
EXISTING ElUILDING PER"!IT NO. I IF'AFf'LICAElLE )
TOUR CITT DE51C;NATED J09 NO.ISf- 9L1ll?13j
SIDEWALK I DRIVEWAY
FOR ALL CONCRETE PAVINC; WITHIN
THE STREET RIC;HT or WAY, TO 9E
M.<.DE AFTER ALL EXCAVATING
IS COMPLETE A"D FOR"! UJOR'<
AND sue.9ASE MATERIAL IS
IN PLACE
REQUIRED INSPECTIONS
D
FEES.
SIDEWALKS
110.012' . 10.15/LF. ( X )
Of WALK
TOTAL PERMIT FEE.
s /2.c.j{)
E"'(eJ1ej O/€.r
CUR9 I APPROACH APRON,
AFTER FOR"!5 ARE ERECTED
ElUT PRIOR TO POURING
=NCRETE,
WALK x'
/
I.
",
""
X' J.
~
CURe. CUT
110""0 . 10.15/LF. ( X ) / ~
COMMERICAL DRIVEWAYS 5HALL
HAVE S' TO e' FLAIRS
3'. O. STt..~OARD
I ;..lAVE CARERJLL Y EX":''1NED T;.IE COMPLETED AFf'LICATION FOR PER"!IT, "'''D DO ;..IEREBY CERTIFY THt.T ALL
!NFOR"!ATION HEREON IS TR:JE t.>o:D CORR::CT, A'iD I RJRTH"R CERTIFY T;.It.T "'''Y "-ND ALL UiOR'< PERl'OR"!ED
S;..IALL BE DONE IN ACCORDANCE WITH THE ORDIN":'''CES or THE CIIT or SPRIN6f'IELD, AND THE LAUl5 or THE
5TATE or OR::C;ON PERTAININC; TO THE UJOR'< DE5CRI9ED HEREIN, "-ND T;..IAT NO OCCUP"-,",CY WILL 9E M"-DE
or ANY STRUCTURE WITHOJT PER"!IS5ION or THE ElUILDINC; DIVI51~ I FURTHER CERTIFY THAT ONLY CONTRACTORS
"'''D EMPLOYEES WHO ARE IN COMPLIANCE WITH ORS 101.055 WILL BE USED ON THIS PROJECT.
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