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HomeMy WebLinkAboutPermit Sidewalk 1994-12-08RFsIDENTIAL -CCI1]-1EF.CIAL 9IDEI,,UALK / CURBCUT APPL ICATIOI.I / PEE-1IT SPRINGFIELO 2?5 NORTH FIFTI..I 9TREETgPRll.lcF |ELD, oREGOr.l 91 4'r 1sl6 tNEERll.r6 D tvt I tot'{ffitcE No. 12b-)1>3 INSFECTION LINE,'126 -3'169 JOB ADDRES9, *A95=990R9 tlAP No.' SUBDIVI9ION: TAX LOT NO. * orJ.h€R:A ACs ADDRESS:CiTY: srArEr o(, E Gotts ZrP: ql4 7 7 Pi{or.{= No. IIORK DE9CRIFTIOhI: 9IDEIIjALK: CUR3.CUT: OR A COTINTY IF IN TH= U65, cuRS 9rDE _ =grD=t^iTtAL _ 1=ta A-? coi-?,-1=RlcA.l_ _ g=COND DRI\GUAY ( gEE TRAFFIC ) EAJIR=5 APPLICA;ION FOR A g=coND DRt\€r.lJAy(T-4.ta,r Afr.IC,11ION FOR FACILITY P=Ri1IT (C O.8.2O3) i pat= G Ap,ELrcATtoN II.OR( TO tsE FERfuS{ED BY:ottl{ER \C coNTRAc;c)R RECEIPT NO, t5bct5 cAgf.l CHECK ! * CHECKED FOR DELINOJENCIES Z SIGNED: DATE: freoS A * =5GISTRATION NO,=xPtR=5, ADDE,95 PHONEr PROCEDURE FOR tNgPECTlCt l REA.jE9T' CALL l?b-ilbZ (re,C@=R ) STATE YOUR CITY DESIGNAT=D JO3 N'Jt.i==R, JO3 ADDE9S,TYPE cFlNgPEcTlohl R=aU=9ED A\D ul-i=N YoU UILL 3= REA?Y FoR lNgp=CTtcrlt, ioNTRAi-, o=s oR ot:,.lERg NAtl= avDPiloNE NtJi'13=R R=au=gTS R=CEI\.€D 3=FOR= 1,OO /:1 rult-L 3= tlAt= i|i= 9A-1= DA.r, R=auEsTS /f.nE?, lzooA}1 IUILL 3E MADE TI{= NEXT IIJOR<ING DAY EXl9Tl\lc 3UILDING P=R-ilT I{o ( 17 /^?aLtcAaL7 ) J:YOUR CITY SIGN:;ED JO3 NO. I5T ?+/604 * 5=E rcd- SIDEUALK / DRI\E,A/^YrcR A]-L CONCRE'i= PAVING t]JITi-.IIN TH= sTR=ET RIG']T OF I,UAY, iO 3= I'1AD= AFTER ALL EXCAVATING r9 coi'lPLETE A'.lD FOE-I rjD3< AND 5U9-3A5= tlATERtAt_ t5 IN PLACE cU@ / APFROACH APROl.{: AFTER FOR-19 AR= ERECTED BUT PRIOR TO POURING CONCRETE. FEE9: SIDEIUALKg t-11=r=._t-lta UAL< X TOTAL FER!.IIT FEE, tlo.oo , to.1>/LF.( X )tr UALK (0 tlo.oo + ro.l>/L.F. ( X ) /(O CO:1}-1E RICAL DRI\GIIJAYg 5i{ALL AAYE.5'TO A'FLAIRS 3.. O'gTA\DARD I i-.IA\E CA=PJLLY EXAYI\ED TP= CO|.,IPLETED APPLICATION FOR PEE-1iT, AND DO .IER=9Y CERTIFY ;HAT ALLiNTBIATIOhI I-]ER=ON 19 TRJE A\D CORR=CT, A\D I FURT|;=R C=RTIFY 'iH.r.T ,J.\Y A\D :LL '.l,oR< FERFOR-1=DgXALL 5E DONE lN ACCORDANCE uJlTl'l Tl-{E ORDINA\CEg G Tr.i= CITY OF gPRlNrs=t=LD,:ND 'l';-tE LAU5 oF TxE9TATE ff OR=GON PERTAINING TO THE I!OR< DE9CRIS=D HER=IN, J.\D TII,'.T NO OCCUFANCY U]ILL BE },1-D=d ANY gTRJCTURE I1JITilOJT PEFA-1ISSIC|N 6 TI-{E BUILDING DIVISIO\I. I FUF?;iER CERTIFY TI-.IAT ONLY CONTR.ACTOR9$ID =I.1PLOYEEg ITHO AR= IN COi-IPLIANCE IJJITI{ OR' 1OIO5> IUII.L tsE Ug=D c)N Ti-]Ig PROJECT. DATE / REAUIRED INSFECTION9