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HomeMy WebLinkAboutPermit Sidewalk 1994-04-14ll/ao JOts ADDRE99: ,ffif,q"{,r,ffit"" 3tD ENT r4L APPLICA Atc. IAL SPFr ,,VGF,ELE' !>, o N a-((" AgSEgSoRg l'1AP No.-o ts-a - 4."- TAX LOT No.L,(-)SLIBDIVISION: otUllER: Uta ,ADDRE99, F4.r'r9( t550 2 7r+1-CITY. 9IA IE:zlP, *(ci-lEcKED FoR DELINaJ=NcrEg ./'_ I 2276 #&\ RECEIFT NO; cA9l-{ cHEcK X rh SIGNED, 'JAl=1 +77 PHoNE No. ri.roFK DE9CRI PTlOl.{' CURs-CUT: REgtDEhiTlAL -- .o*=*,"*I_SECOND DRI\EIIJAY ( SEE TRAFFIC )EaUlREg AFFLICAT|OI.I fOR A *coND DRt\€uJAy(T_4.1a) FT,f"ffil:g. appr_ r cAr r oN roi-raZ rll ri r= rc,r r r ( c aa - z @ 3 ) DATE G APPLICATION grDEruALK {.cuRB glDE ..--9EIBACK OuJNER ?<CONTRACTOR*CH Rt ADDR=es 23 b ( tltt-Yftet> r''REGrgTR.atou *o.*:ExpiR=s, / i'fnA^)J <(-.€d {s P*ONE, 3 r-(4 r t PROCEDURE FOR IN9FECTION REaUEgTs 3ALL 12b+1ba (RECORDER ) 9TATE YOUR CITY D=9IGNAT=D io3 NL'|-13=,R, JOB ADDREgg,TYP= GINSP=CTiCN.t REAU=9iED AD TIJHEN Y,OU UILL B= R=ADY FO,R iNSP=CTtoti,CC.InNT,RACTOR9 OR OU.NERS NA}.1E ADPl.lc'|,.IE NI.JI'1tsER REAU=sT5 RECEI\G D BEFORE 1,,O@ /;1 UILL A= HABE Ti{= gAi-1E DAY, REAUESIS #lERitooIUILL BE I.1ADE THE NEXT IUORK|NG DAY EXl9TlM.: BUILDING FEBIIT NO. ( IF APPLICABLE ) *YOUR CITY DESICNA'TED JOB NO.,sf I 4C sc'AgEE BOOK gIDEIUALK / DRI\GUJAYrcR ALL CONCRETE PAViNG IUITHIN THE sTR=ET RIGI]T OF IIJAY, TO 3EIIADE A=TER ALL EXCAVATING 19 cotlPLETE Al',iD Fosl u/oR<AID 5UB-3A5= T1ATERIAL I9 IN PLACE CURB / APPROACI-.I APRON, AF,'ER FORI15 A, ERECTED tsUT PRIOR TO POURI){G L.C./NLKE iE- FEE9: glDEtlALKS CURts-CUT uJAL< x'tlO.OO + tO.tb/LF.( X ) oF UJALK_ t -_ _ -_?2z Ltr@ cb> = 5 ,1O.OO+sO.b/LF.(X) '7c> TOTA PEffllT FEE' COMI1ERICAL DRI\€ITJAYg SHALL.ze HAVE >'ro 6,FLAIR9 l3 - 3'- @, 5TA\eARD$ I i"la\€ CAR=FULLY EXAFIINED TrrE coi'IpLETED AppLtcATioN FoR pERilir, AND Do HER=Bv cERTtFy -IHAT ALLINFoBIATIoN tlER=oN l9 TR,IE AND coRREcT. AND I FURTHER CERTIFY 'ii-lAT A\Y A\D ALL ilr"R< PEE=OR-1EDSHALL BE DONE IN ACCORDANCE II]ITH TI{E ORDINANCE, G THE CITY OF 9PRINT.:FIELD, AND THE LAUS cF T{-,lE 51A1E CF OFEGON PER]A\N\NG ]O lHE UOR< DESCR\BED \-IEREIN. AND THAT NO OCCUPANCY UILL BE I1ADE OF ANY 5IRJCIUFE U\IHOJI PER1\55\CI.I CF 1\{E BU\LD\NG D\V\5\ON \ FURTI{ER CERT\FY lIi.IAT ONLY CONTR,ACTORg \!\TI{ OR3 1O\O>> \!ILL BE USED ON TH\5 PROJECT Ll ,4J.lD (( 9 U}]O Are N COI'IPLIANCE i,AIE .(c{"g{ _ / PEE-1IT tU. REOU IRED IN9PECTIOI.IS K