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HomeMy WebLinkAboutPermit Sidewalk 1992-07-20I=E,i7ll-/E,l\ I IAL - t'-.1)l-ll- lE,l=L-lAL CsrpeualR)cuRtscur - AFFL ICAT|C'I\I / PER.IIT SPRINGFIELO 225 NORTH FIFTI{ gTREET 9FRIh!3FIELD, ORE60l.l 9'14"1'1 El.l6tNEERll.{6 D lvl I I OhlffitcENo. 126-)1b3 IN9PECTIOI{ L lNE,'126 -3169 JoBADDRE99: 75t //oRTt+ AeeEeeoRs rlAF No.* /7 -O 3-5S-, z TAX LOT NO.2ooo 9tlEDtVt9lot{; our{ER w tLt\A A sT€fil€N 9 ADDre.eg. ?5'l NaPTH A7H crry: SPel ft4t€CD STAIE;OB-€, ztP: 17 +71 PL{oi.l= No. STDBIIALK: x CURs gtDE _ 9ETEACK _)<_ CI,JRB.CUT: RESIDEI{TIAL \<. CO'|.1I.1ERICAL - 9ECOhID DRI\EIIJAY ( sEE TRAFFIC ) REA'J!R=9 AFFLlCATlol.{ FoR A SECot{D DRI\€IIJAY(T- 4.lr ) OR A COTJNTY APPLICATIOhI FOR FACILITY P=FMIT (C A8.2O3) IF IN THE U.G^8. q1>JULY LO, IDATE G APPLICATIOI.I RECEIPTNo: iGtZ CA*1 CHECK < * CI]ECKED FOR DEL NAJENCIEg SIGNED: DATE' tuu >- IIJORK TO tsE FEFFOFIIED EY: oirl{=R X ca.lrRAcroR coxrn+croe* l/caN S|ftgcn oN REGrerRAror.,r No.*5ocg8 EXptREe: f€8, ?3 ADDRES9 o 702 EUG€NG A/?4,Pi{ohrE: 7+7-o3OL- PROGEDURE FoR lNgFECTlctl REaUE9T: CAJI12b.31b9 (re,c,Orc-ER ) gTA]E YOUR CITY DE9ICNATED JOB NUI-l3ER, JOts ADDRE99,TYPE OF IN9PECTIOT.I REAUESTED AID II*{EN YOU TUILL BE READY FOR INSPECTIOi.I, CONTRACIOre OR OIIhIER9 NA1= AID Pl-lchlE NutrlBER REotlEgTg RECEI\ED EEFoRE 1,oo lfi u,lLL BE I'1ADE Tl-.lE gAllE DAY, REATJE9T9 IF]ER lzoo Ai'1 u,lLL BE t'lADE THE l'l=xT tlJot<<tNc DAY EX|9Tri.lc tsutLDtNc PEBIIT NO. ( IF APPLICABLE ,) *YOUR CITY Jo3 No. ter ?20?? oSEE EOOK grog6EPz DRt\EurAy FOR ALL CONCRETE FAVING IUITI]IN THE gTREET RIGI]T OF IUAY, TO tsE I.,IADE AFTER AL EXCAVATNG 15 CO|.IPLETE AID FORI1 IUORKAID gUB.BAgE I'IATERIAL 19 IN PLACE CU@ / APPROACI{ APROI.I, AFTER rcFfi5 ARE ER=CTED BUT FRIOR TO POURING C,oNCR=TE. x FEE9: + OF UALK TOTA FER!'1IT FEE:1 t7, os cuRB-CUT *O.\>/LF.( X)41 / rio.oo + to.t)/LF.(X)U,JALK X' CO|.1}.1ERI CAL DRI\GIUAYS gI-.IALL AA..6 >'TO 9'FLAIRS3'. O" gTADARD I HA\G CAREFULLY EXA1INED TI.IE COHPLETED APPLICATIOI.I FOR PEB1 IT, AID DO I]EREBY CERTIFY T}.]AT ALLlNrcE.1ATIOt.I I{EREON 19 TR.JE A\D CORR=CT, A.ID IFURTH=R C=RTIFY Ti.{AT ANY AND ALL IIORK PERFOBIEDS|]ALL BE DONE IN ACCO@ ANCE u,JlTt-.| THE ORDINA\CE5 OF Tr.,I= CITY 4 9PRING'FIELD, AID TUE LAu.6 G Ti-IEgTA;E OF OREGON PERTAINING 'iO T{.{E luoFa< DESCR|S=D li=,R=IN, AND T}IAT NO OCCUPA\CY IIILL BE HAD=G ANY STR,JCTURE UJIT|-]OJT PE Rir55rott oF Tt{E BU|LD|NG DlVIglol.l I FURTIiER CERTIFY TI{AT ONLY CONTR.ACTORS TI]19 PROJECT. 5 ARE IN IANCE IUITI.{ OR3 1O1O>> UJILL BE U9ED ON DA RE@UIRED INSPECTIChIS