HomeMy WebLinkAboutPermit Sidewalk 1992-4-7
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~ JOB ADOREe&. 44- 7' C/- ZV{,-J
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A55ES5ORS MAP NO, /13-0:' -oE: -'"2. {
5UBDIYISION, Ll./cE-eA.J6 .:# 78
ou.NER. Ro F3 ( /J, ST AJJ. D A R::> ~ D
ADDRE55, 44-74 :r u ~ CITT, '5 PFLD
5TATE, 0 g.... ZIP, '7714-78 PI-lONE NO, 74--7-'/~
22S NORTH FIFTH STREET
SPRINGFIELD. ~GION !l'<ll'
~INEERING DIYISION
OFi'ICE NO, '26-~'S~
1N5PECTION LINE, '26-~'6!l
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SIDEWALK I CURBCUT
APPLICATIoN I PE~IT
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SPRINOFIELD
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TAX LOT NO, *7600
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CHECK .:i:::
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RECEIPT NO,
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CI-lECKED FOR DEL INQ'JENCIE5*" :zS...
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~ DE&c~PTION.
SIDEUJALI<,"-- CURB SIDE _
CURB-CUT, RESIDENTIAL _
SECOND DRIvEWAY (&EE TRAFrIC )
REGlUlRE5 APPLICATION FOR A SECOND DRlvEWAn.,.-4.1a)
OR A COUNTT t.PPLICATION FOR FACILITT PE~IT (C !l6-2~~)
IF IN THE U.G..B,
DATE OF APPLICATION .=1:/7../92-
&ETBACK _
COMMERICAL _
51c.NED,
DATE,
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4:17 (<=h _
WORK TO BE F'E1O!f'v.... Il::D BY'. OUNER
CONTRACTO!O! *" J?c, BC=JZ... 'I 110 PPtE.~
ADDRE5& 93900 'ST<:b/nl='. l.v
X CONT!O!ACTOR
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REGISTRATION NO, 3760
'- t,,uC''T" to-V G~rCP
EXPIRE5, if ;1;5/9 <?
PI-lONE, 998-8379
........""""'JRE FOR INeFECTION REGlUEST.
CALt. '26-~'6'll (RECORDER) STATE YOUR CITT DESIGNATED JOB NlJ:'1BER. JOB ADDRE&S,TTPE OF
IN5PECTION REGlUE&TED AND u.\-IEN YOU WILL BE READY FOR IN&PECTION, CONTRACTO!O!5 OR ou.NER& NA'1E A"D
P!-IONE NUMBER. REQUE&T5 RECEIvED B"r~r= 1,00 AI"! WILL B: MADE TH: &AI'1E DAY, REQUE&T& AFTER 1,00
AI"! WILL BE MADE THE NEXT lllORl<lNG DAY
* SEE BOOK
EXISTING BUILDING PE~IT NO, ( IF APPLICABLE)
YOUR CITT DESIGNATED JOB NO, 15f r:::? 7j"')C:; .d... ~
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REQUIRED INS~CTIONS
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&IDEWALK I DRIvEWAY
FOR ALL CONCRETE PAYINc;, WITHIN
THE STREET RIc;,HT OF WAY, TO BE
MADE AFTER ALL EXCAYATING
1& COMPLETE AND FORM lllORl<
AloID 5UB-BA&E MATERIAL 15
IN PLACE
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CURB I AF'Pl'10ACH APRON, . 'I
AFTER FO~& ARE ERECTED
BUT PRIOR TO pOIJRING
CONCRETE,
FEES: SIDEWALKS CURB-CUT WALK x'
.10,00 . .0.1S/LF. ( X ) .10-"'0 . ~.15/LF. ( X ) / ""
Of WALK
COMM:RICAL DRlvEWAY5 SHALL l I.
I 50 HAVE S' TO &' FLAI1<5 X'
~ ~'- 0' ST ,1.NDA!O!D " 'I
TOTAL OC1"<l liT FEE. / -
I HAvE CAREFULLY EXA'1INED THE COMPLETED APPLICATION FOR PE~IT, "'''D DO HEREBY C:RTIFY THAT ALL
IN:"-o~ATION HEREON IS TRUE A"lD CORR!:CT, A"lD I FURTH:R CERTIFY THAT AN.,. A"lD ALL WORK PE!'l=O!<MED
5HALL BE DONE IN ACCO!O!DANCE WITH THE O!O!DIN"''JCES OF THE CITT OF SPRINGtFIELD. AND THE LAUJ& OF THE
5TAiE OF OREGra-J PERTAINING. TO T~E llJORK DE&cRrSED ~EREr~, '!"~D i;..lAT NO OCCUPA~C",( UJILL 9E Mt..DE
OF "'''Y STR'JC.TI!~ WITHOJT PE!<MISSION OF THE BUILDING DiViSION. I FURTHER CERTIFY THAT ONLY CONTRACTOR5
,'-ND EMPLOYEE& WHO ARE IN COMPLlA'JCE WITH 01<5 '01.<:>55 WILL BE U5ED ON T,"15 PROJECT,
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