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HomeMy WebLinkAboutPermit Sidewalk 1994-1-27 II~O ~5IDENT1[~;AL:-1 c~~iC_'~L _' _. AFf'L[CAT[ON I PERM[T ' 225 NORT~ F[FT~ STREET SPRiNGfiELD, OREGON 91411 ENGINEERING DIVISION OFFICE NO. 126-3153 INSPECT[ON L[NE, 126-3169 . SPRINGFIELD J06 ADDRE88. /(,,;,)3 IfA-R..EoR... DRIVE ASSESSORS MAP NO.*" /~'-D3- 02.32 TAX LOT NO: *" 2100 RECEIPT NO, 0 II 4-'6.0 CASl-I SUBD[VIS[ON, C~ECK OIU-lER, .suzAN/Je: I3RouJN ADDRESS, ito<;3 J+AP-13OR DP-IVtE STATE,,oRE; ZIP, q 7+77 WORK DE5CRIPTION. ~ CITY, Sf/<./AJU"fELD P~ONE NO. 4S 5"- 71'::3 *" C~ECI<ED FOR DELlNa'JENCIES _ SIDEUlALK, CU!'19 S[DE CURB-CUT, -X- RES[DENTIAL ~ SECOND DR[vEWAY (SEE TRAFF[C ) REQU[RES AFf'LICAT[ON FOR A SECOND DR[vEWAY('T.4.1a) OR A COUNrr ,l.,PPL[CAT[ON FOR FAC[L[TY PERMIT (C 9/;-2(3) [F IN T~E U.Cio.9. S:TBACK CO:1MER[CAL _ S[GNED, DATE, DATE OF AFf'L1CAT[ON 1/2-7/14- -l3~ ~ 1/27/"14- UJOIO:K TO BE PE~D 6.,.., OliNER X CONTRACTOR CONTRACTOR*" McmL CLAD BUILDeRS IIJL;!<EG[STRAT[ON NO.*" '1#7"1 ADDRESS ,/?-:!.''G~-:': c.4 Sf4- AId), S"TH 51: 5/i/2//Vc:;,ct'G"(L) r-~:...,JRE FOR IN5Ff:CTION REQUEST, Cl2E:5cuecc / O/<, cr 74-2.r.;" CALL 126-3169 (RECORDER) STATE YOUR CITY DES[C,NATED JOB NUMBER. JOB ADDRESS,TYPE OF [NSPECTlON REQUESTED A'lD UJ;.1EN YOU W[LL BE RE,l.,DY FOR [NSPECTION, CONTRACTORS OR OliNERS Nh'"1E "''lD , PJ..lONE NUMBER. REQUESTS RECE[vED BEFORE 1,0" "-'"1 WILL B: MAD: Ti-!: SA'"1E DAY, REQU:STS AFTER 1,00 AM W[LL BE MADE T~: NEXT ~[NG DAY *" SEE BOOK EXIST[NG BU[LDINC, PERM[T NO. ( IF APPL[CABLE ) YOUR C[rr DES[GNATED JOB NO. [Sf EXP[RES, i '/b/~4. PHONE, 'ii'9S'- 27&'b c.r3/ '377 ~ --..-r~ / -/ .1- ~ - l;..) \0 D ~ CURB I ,l.,PPROAC~ APRON, AFTER FORMS ARE ERECTED BUT PRIOR TO POURING CONCRETE. REQUIRED INSPECTIONS S[DEWALK I DR[vEWAY FOR ALL CONCRETE PAV[NC, WIT~[N T~E STREET R[C,~T OF WAY, TO BE MADE AFTER ALL EXCAVAT[NC, [5 ca1PLETE ""'lD FORM WORK A'ID SUB-Bt.5: MATER[AL [5 IN PLACE FEES, ~U?)X/06r, .10.012)', ~.I:;/LF.( X )jj,!)D SIDEWALKS .i0.00 , ~0.1:;/LF. ( X ) OF WALK TOTAL PEI'MIT FEE, ~ /1,5'0 COMMERICAL DR[vEWAYS S~ALL i-!AvE &' TO e' FLA[RS 3'- 0" STA'IDARD WALK X' / "\ l X' J " [ HAvE CAREFULLY EXA'"1INED THE COMPLET:D AFf'L1CAT[ON FOR PERM[T, "''lD DO HEREBY CERT[FY T~,l., TALL INFO~ATION J.4EREON IS iRL.!E A"'-lD CORRECT, A"JD I FURTr4ER CERTIFY i~AT .:.,~.,... A~D ALL lJ..iOR<, PE~O~ED S~ALL BE DONE [N ACCORDANCE W[TH THE ORDIN"''lC:S OF T~E CITY OF SPRINc..F[ELD. AND T~E LAWS OF T~E STATE OF OREGON P:RTA[N[NC, TO THE WORK DESCRIB:D i-!:RE[N. "''lD T"AT NO OCCUPA'lCY W[LL BE MADE OF ANY STRUCTURE WITHOJT P:RMISS[ON OF T~E BUILDING DiViSION. I FURTHER CERTIFY THAT ONLY CONTRACTORS AND-EMPbO ES UJ;.10 ARE [N COMPLIA'ICE WIT~ ORS 1"1.D!'>& WILL BE US:D ON T~IS PROJECT. /' ~2A~/J/ ' /-~7-7r/ S/ ~;/' DATE