HomeMy WebLinkAboutPermit Building 1985-08-27.. RESI \TIAL... APPLICATTTIN/PERIIIIT
225 North 5th Street
SprLngfteld, 1regon 97477
Building Diuision
7 26-37 53
Job Loeaticn:
Assessore Map # /?cr Int
Stbdittision:
eddtess: f /.'/ tt P1@ne:
L uy.)
{Desa+be l,lork:
Additicn
RenoCel
SPFINGFTELD
Z f
INSULATION/VAPOR BARRIER IIISPEC?TON :
To be maCe after aLL 'Lnsulaticn qrd
requ:-red oapor burie?s @e in place
but before ory l.a.th, Wpsum baatC or
tnLL eooering i.s applied, cnd before
ay irnulation i,s concealed.
DRWALL TNSPECTTON: Tc be made
aftet, aLL fuyuall ie in p'la.ce,
but pr"tor to any taping.
I,\AS1UBY: Steel Location, bond
ffijg?outi.ng or oerticals i.n
aceordotee ttth U.B.C. Seetion
2475.
WOODSTOI|E:
@r,pT;m.
After installation is
CURB & APP804CH APP,QN: After fontsd.; erectAEtnffi to bouri.ng
cone?ete.
SIDEWALK & DRf'"WAY: For all con-
aret; pa,r@Gffi street rtght-
of-tn!, to be made after aLL e.rca-
uattng snnplete & forn tsoz'k & sub-
base materlal in Place.
Receiot I
ci
r9
1
aB Date
Date of Applicati
GeneraL
ELeetricaL
tlecharieaL
Constmellon_Leile? . =
It ie the tespansibilitg of thl penrit holda to aee that alt iaapectiotts ee nade at tlte Elroper tine, that eaeh addrees is te,tCab''i-e
fron tlv street, and tlat the pemit card is Located at the frcnt of the ptopetty.*9uilding D.iuicion appro"*ed plan slnll remain on tle Building Site at aLL tines.
PROCEDUPE FOR INSPEC?I9\|_3!AL[ES!:CALL726-3769 (recotdet,) state gour City Cesi-grnted job ltwnber,, job aCiress, type of inspecticn
eadyfolit,epection,Contraetors"ias,.,s-,,*,eLndp7niemlnber'.Requestsrecei"^bdbefcre?:00a1
a'tLL be nade the sane dag, ?eEtests made after ?:00 qn vtLL be nade the nert aorking day.
You" CitA Desigr,ated Job Nwnber fs:650?rl'/
SITE INSPEC?ION,
ez;alratl;;; but
To be nade after
pr.ior tc set up of
-\7l paormG & F)UNDATTIN: lo be nade
"
r\) M-tren Es a". e"cattated ard
forns ate erected, but ptior to
pourLng ccncret€.
a uwtnptooR pLutErNG & MECHANTcAL:tof
floor insulation or decking.
A posr AND BEAM: To be made prtot to
) ffi;;td;;of floor insui)tion or
deckirq.
_-1 ROUGH PLUDIIIG. ELECTRICAL & MECH-
I
-
util these inspectioris lmte been
mod.e and aoorotsed.
1 rtpzpuczi pn on to placirq facing
-)
matetials and. befone froning inepee-
tion.
Vl pafi.ltwc: ltust be teqaested aften
D "pprot"L of nough pl,bOr:ng, e-Lectni-
- cal & neclnnical. ALt roofing
bracing & chintneys, etc. mtst be
. eonpleted. Ilo uork ie to be eon-
. eealed until this inspectton lae'been nwde anC approtsed.
l
lI
fonne.
aN0ERSLAB PLUW4tq qLECIRTC4L &
WCI{r'-IIICAL: ?o be made before angwtk is eotlet,ed,
FTUAL PLUABING
PTNAL MECHANICAL
?IIIAL ELECTRICAL
hthen conplete -- PvooiCe
or motsable seet'Lons thz'ough
toTo
?ENCE:
gates
F
ALL project eonditions, such as the i.nstallation of street trees, co:pleii.on_of the
,"qrr:"nd Landseepirg, etc., mtst be satisfied before the BUfLDLNG FII\AL can be requested.
B, FrNAL BUTLDING: The Final Buildittg Inspeetion mtst be requested aftet' the Final Plunbi.ng
LV Electrieal, otC Meehanical rnspections hape been made atd apptotseC.
P.A
DEI.IOLITIO!,] OR :,:OW) BU
Sardtary se-ter ecpped at propetty Lite
Septic totk y"arVed and. filled urtth gratel
Final - hhen abcue itene are eanpleted
and uhen Cq.tclition is cornplete o! st?uc-
ture motseC otd prer,rLses cleaneC up.
Mobile Hcmes
Blocking otd Set-up
Plmbing connecti.oze -- aate? otd. uatet
Eleetrtcal Ccmnection - Blockittg, eet-ug
and plwnbing connections nr;st be apprcted
before requeeting elee!r[ca'|, inspectiotr
Accessory Bui.lding
Pinal - After pctches, skitting, deeks,
etc. @e canrpleted.
Page 1 of 2*ALL \4ANHCLES AND CLEANOUTS LTUST BE ACCESSTBLE, ADJUSTIIENT T0 BE UADE /.T ll0 ccsT T0 cr?y
f
Lisc. #7 Adiress Phone
JOB NO
Zone:
Total
SOLARACC S REQ.-Yq
d BeCroone
Date Paid:'- z3-?
L-co c
-€-=>-eu
9-2 7-t5
r EAw CAREFULLy ExAlnrNED the eompleted application for pernit, atd dolpreby cettify that aLL infonratibn hereon'is trae aid. eZrreet-, tnc rf"otker -certify that any ard aLL uork perforned sLnLL be done in acco?-dance tvLth the ozdinanees of the city of bpringfield, and. the La,,s of the* state ol oygeon pertaining to the uook ce"lonlbla t niLl.i, ori- tt-t No occa-PANcr trill be nade of an-a stzacture uithout permission -o7 tt " BuiT,ding N-tsisio,n. r further certify that only eontraciors azd etplcgees uho aie ineatpliance dith ORS Z01.0SS uil,L be-used on thie p,oject
Lot Sq. rQ.
% cf Lct Caserage
# of Stor[es
?otal Eeight
Iopography
/3zo LCT TWE
X Interior
Lot Faces -5ou?ees,22
/4'.€nO.2%
Se lIeat
DT House Aceess
Corne?
Panhand.Le
CUL-de-sac
ruEM FTC x Value
&
Building Volue & Permit
This pennrt is granted on the erpress eondition tlat the said constractionslnlL, in all nespects, confonn to the 0rdirnnce adopted y:y the City ofSpryngfield, ineluding the 2oning Cydinance, regulating thZ ccnstruZtibn
otd.use of buildings, and may be suspend.ed or rbtsokeC at cry time upon uic-Lation of atlA prcoisions of said Ordirnnces.
?OTAL VALUE
S.D.C. 1..5 z
Buitding PermLt -a0
State
?otal Clnrges Receipt #t 0 lt
Signed:
N0.FEE CHARGE
?ictures Plumbing P rn it
Resil.entia.L (1 bath)Ng petson slwll _consttact, insiall, altet or e|wnge anA neu cr existing
el*\lrrS or drainage systan in uhole or in pott, inless such person is- tlelegal -possessor of a ualid plutnbet,s Licensb, edcept tlnt a pZtson nag doplunbing aork to p?ope"tA uhich is otned, Leased on operatei ty tne ,ippti-caflt.
Seuer
Plunbing Penrtt
State
Electricol Permit
wlez'e state Lan requires tllat the electrLeal uoz,k be done by an EleetrLealcontraetor, the eleetrteal portion of this pernit slsll not- be oali.c untilthe Label has been signed by the Electrtcal- Contractor.
Iotal 0
NC CIIARCE
*
Mechqnicol Permit
/0.ao
ll a,t / Eot enl. C ir cui t s
Sentice
blunst HooC
llcodstote
Vent Fdt
Petmit fssuq.ce
Meclnnical Per,nrtt
Sec"u-tty Dzposit
Stotaae
Itlaintqn4nce
Pentrtt
Cvtbeut
Sida,:alk
?ense
Eleetricat La,bel F OQ 1K ,ZO
Mobile Home ,r-?o*v,?ay t w tJQ-'*
TOTAL /I],!OUN? DI]E:*q4,+r
'= t2"i!-4+ BbenT
Date
F!E
h,onace E?U I S
-
Rcceict c
SPFTINGFIEL.D
, " RESIDI rTlAL"
APPLICATI"t/PERllI?
225 North ith Street
Springfield, Oregon 97477
Butlding Ditsision
726-37 5s
Job Locaticn:'{
Svbdioiaion:
Addtess:
ci
Tas Iot #
Phone:
Desct+be h'otk:
VdLue
{,/'oLZ-
fk*
Addition
RenoCel
!!obi
Date of App Lieaticn
GeneraL
QN-r.q.'e-?
4 Date:
EiONC
L
Construetion Lender
ii is the. resaonsibilitg the permit hoI-der to see that aLL inspections ate r,ad.e at the ptoper tin., thdt ecch adltess is psa)a/'-z
t?om the atreet, anl tlat the penilt
!d*..E il.oiciot ao.pro"^ed plan shc
eatd is Located at the
Buildrng Sttcfront of tl,e prope?tyat aLL tines-LL renain on the
];!c::!"'?g Fon Iits-e:cTl1il p!e!.)EsT :CALL 7 26-37 69 ( recondez, ) state uour City Cesigrnred job ntaber,:2oues;ea dia Dzen lou uL LL OE ready for inspcction, Contraeic?s c"Asne:s nane cni u-none nwlbet.';LLL be na<ie the sane dcy,?equests nade cfter 7:00 on mLLL be naCe tite nex,t
iemti.na,4 Ycu? CitA Desigrated Job Number Is
job atiitess, t'gie
P,equesrs receixeC
of irsoee=icn
bejcte ?:9C c-
I irlE J:tS?i:::J:l: To be nwcie after
_) ffic", 'r"x prian to ser up oi
rorme.
cooered.
'.TNG Io be rmCe
tyenciTes a"e e.ccatsated and
fonns ote erected, but ptior to
pourLfig ccncreta.
FTilAL PLUINIilC
FIIIAL I,TECHAIIICAL
FINAL ELEMRICAL
|\|SL'LATI)N/vttPOR BARRTER ITSPEC?rC:] :
?o be made after aLL insuZaticn ed
required oapor b*rie?a are in p'La.ce
but befoz,e oty la.th, Wpswt bouC ot,
tnLL covering is applied, otd. beforeoty ttlsulation is concealed.
(t
DRYWALL IllSPlClI)N: ?c be madeafter aLL dryuall is in place,
but prior to any taying.
MASONRI: Steel Location, bond
beans, grouting or Derticdls in
accotdotee vrth a.B.C. Section
241 5.
V)2DST)',.E: After instal|ation is
cctnpLeted.
Sotitarg seset eapped ct propetfii Lir:e
Septic totk yt-:ce<i e"d. filled rsith graiel
linal - h1ten abcoe it.ens ate eaoletei
and uhen Cetttcl'ttior: is conclete bo "t.u"-tuye notted ad. pranises cleaned up.
I cnyTo
- ut:pxRcpourp ?LUt4prNc, sswp. ,I.ATER.)Lirq crenehes.
1 unomrtooR pLtJt:BrNc & I.IECIIANrzAL:
-J
To be natie prior to installation of
floor insulation or decking.
1 Posr mo etm: To be nade ptiot to
) i;frL;Elcn o; floor insu-caxion or
d.ecking.
_I ROI.'Cil PLA!BI'!:G. ELECTPICA,L A IIECH-
I
- urtil these inspeetiors itaoe been
nad,e and. apoyoued..
1 r*wucti wLor to plceirn fccino),rc@panrl before'froninlg in"p.-.-tio{
-.fu: ttust be requested after
4 dppr"oo"L of rough plwrbing, e'Lectni-a.L & neclnnieal. Al! roofing
bractng E ehimeye, ete. tust be
. completed. llo uctk is to be eon-. cecled until thia inspection lr,s' . 'been nad,e anC apprcrted.
CURB & APPRCACH APP)N: After fornsee ereeteC but prio? to pourLng
conc?ete.
SIDEHALK & DR|ITWAY: For aLL con-
crete paoitlg uithin street right-of-teq, to be na.de after all etca-
oating cattplete & forn uotk & sub-
base nnterial in plaae.
iD^taD.
aateB
Men conplete -- Protsid.e
or motsable seet'Lans through
E
ALL pro.iect conditions, such ae tle i.nstallation of atr.eet trees, con-oletion o;'tie
Landsccpirq, etc., nuat be eatisfied before the BU|LDING FIIIAL can be tequested.
FINAL BUfLDINC: The Final Buildtng In*pection rruat be requesteC dlter the Final Plunbing
Electrieal, otd. I,lechar:ical fnspectiona itquc been nad.e ati aoprooeC.
P.U
l
lf
I
Blocking otd Set-ttp
Plutnbing connectioas -- aate? al. ucJet
Eleetrical Ccmnection - Bloeking, set-u.
and plunbing connections n.st be qprcxei
before requesting eleeirical inspecliot
Accessory BuilCirq
Pinal - After pcrehes, skitting, decl<s,
etc. are cornpleled.
Page 1 of 2'ALL |IANECLES AND CLEAil)UTS ttUST BE AC1ESSIBLE, ADJAST!!?:]! r0 BE tt4DE l!.T ll0 CCST TO CM
Aaaesaors Map #
soLAR ACCESS REQ.-L-CO c+
lcne:Occuoancu Groun 6e1roN,s:pt Sq. Pxg.
i cf Lct Ccterage
i of Stortes
iotal Height
?opography
LCT TWE
_ Interior
_ Cornen
_ Panhard,Le
CUL-de-sac
Int Faces -
teat
Wa
LACe
-- Fees --
Df /,ccessHouse
No?th
Eas t
Sot;th tou-e
I./est
I
:!r:.t
Building Volue & Permir
rhis--pennLt,is granted on the etp?ess condition trnt the said eonstntctions_hal.L, in all respects, confonn -to the ondinance adoptec b,y the city ofspringfieT.d, |ncluding the zonina crdinance, regulcting thle ecnsttacticnotd .use o-f buildings, otd. m_ay b.e- suspend.ed or reookeC at cty tine upon uic_Lation of any prclisions of iaid Oydinances.
TOTAL VALUE
:.D.C. 7.5 c
x VaLuc
\\,tr
2 L.Lto
Buili't-ng Pennit
Totcl Clunges
Fee:
LAXq Pold:
Receipt #
Sigted
:esienti.al (i batil)
Serser
P|unbtrg Peyrit
StaXe Si&ci:a?oe
Plumbing Pernrit
No person shall eonsttaet, instali, alter or cizange any ned cr e:istircylwr,2irO cr <irainage systen in uhole or in part, -urlesL
"r";, t"r"o|-ii'tnnLe?aL.possessor of a ualid plwnber"s License, ereeDx tt"a.t c D'e?son mav dcolunbing uork to p?opepty uhich is ounei, Leased ot operaxia'oy-lin ip"li-cant.
I
I
I
l
I
5 -.{o
;s/Z=teri Circuits
L Perni'"
Electricol permit
i.inere Stste La) ?eouiz,es tiu.x tne eiectrical uotk be <ione bv cn Zleetyieeicontraeicr, tne elee=ricel aorrior; of thia p";i; ,r.=t'i'iol'irZ u*ai.ii ut:::-ithe Label itas been signei by the Eleextical Conr"ccror.
IVlechonicql Permita
:i':.ant HooC
tod.sto;te
Pet rtt issuqttee
Meci,a.nical Pernr:-t
1n
latt
ieualk
bile Hste
-- Ei;cRCACililElt? --
Total Cnarocs
I HAW CAR9FULLY EXLAI-\E\ the completed aoplication for pernit, cnd dchereby eertif.y that aLL info:mati'on hereon' is tnue ""a "L"ii.Ji .ra tfutthet' .eettify that any ai- aLL uork perfozmed. sru\.L be do:re- ';.n ,n"or-tiance vitlt the Ordinancb: of the City -of SpningfieZd.,
"rra t*, Ldi;s of thcs-tate ol olegcn pertaininc to the uork ces'eribla n""Llr, ""a- *it i,rc occ!-
!!yc.v Dillb^e nyde of anli st?uetu"a uithout pernissiot'o1 ti"-srtuinc Di-ulslon. I !u"the" certifii that only cont?aeto,s a:.;d cnplcyee" il".r-iZ i"conpliance uith CRS Z1j..7bS uiLL be used. on this pnojec't
?^tr-F€
?AL NIOIJ\I? DUE:'bl-Signed Date
JOB NO.
-
Caraoc
lttt
ll
,Llo
2C)5
?cee:-ut .
SPRI,VGFIEL.D
.. RESID JTIAL..
APPLf CATt-tl/PERIII?
225 North |th Street
SprtngfieZd, 2regon 97477
Building Diuision
/zo-6/b,t
Job Loeaticn:
Aasesso"s ltdD #
Svbdiuisi.on:
A,nter:
Addtess:
Ne,)
T-ft
?az. Iat #
Phone:
zip:
I,loyk:
Additicn
RenoCel *t.-1.tr d- s",il
/0
Date of Ato o Val.ue
Aact,ess
General
PLunbi
ELeetrieaL
l!ech.ar.ie.zL
Constr-rction Leruier
!) is +-he responsibility of tie permit hoZ.d.et to see that aLL tnsoectiol.s ate nade at the;ro7 the at?eet, anC tltat the penmit card is Located at the ftont of t|.,e orooeyty.tZuiliiq Dtuicio- acproxeci cl'an shcll yenein on ti,E Build.rng Sttc b= aLL' tines.-
a:tc::r';?9 Fon. ii:sP:crr)n .E_?.JE9?..CALL 726-3769 (reeoydet,) stdte your citg designe-ced job
.2oucsiea a:i u,i':en i;ou uiLL be reatiy for insccetion, Cant?dcxc?s cr A,jners nane cni ;-rone:!iL be nacie the sane d.cy, ?eauests ncrie cfter 7:00 G11 trtll be naie the ncst.soy,kit:t c.er.
Icur City Design".ated Job Nunber fs
p"op?t tin., thdt e24h -iAtsss is v2aia'^'-;
: nl.nbe?, iob ai&ess, t'pe of ir.spee=i.cn
ni,it;tber. P.equesrs receixed beicte 7:99 ci
fso I //
aomti nai Trena-+i avol
I
l
escataxicn, cut prLar to sei up of
forme.
U\ID!.SSLAZ PLL':.BIIIC. !!!C:PIC,',L A
/..auE.)-n1L^u: ,o oe naae oeJo?e cnyffiffiorscred.,.-:
FiC!.f:;G , !CU:|D,1TICI:: ldbe rm.Ce
;f1;;; cr"";;"" ae .tcauated and
form;t ar.e enected,, but prior to
pow.lng ccnereta.
- ultDtRcpou:tD pLu:.rzn;c. sshE?. n,.1TER.
) DPA|IIAC:: fo be raie prior xo fil-Lirq trenehes.
e,-n 7rt^--^-?1ir. t^ ipt-- r-tJ:'.J__J-;r /U Ce mAAe after : : ; s L' L :.: I C :t / V /'.Pn.? F i.?.?rii L"'S ? ! 3 ! I C I i :
lo be naie after aLL insulaticn e.d
requlred uapor bawiers @e in plaee
bat before ory Lath, Wpsun boarC or
tnLL eooetino is cttlied, and. before
o",y insulation is : '.:ealed.
.F '- -DRYII;LL fiISPICTI.]j: -c be nade;ita-an6;t f-is in place,
but prior to cny taping.
tlASOItt?I: Steel Zoeation, bond
beons, grouting or De?ticcLs in
aceorri.otce uLth U.B.C. Section
WOODST1I,.E: Aftet, installation i.s
ccrnplexed.
)!;:iL;::c ;; : ? ;:3tiaa E -'rLD:::is
.a
Scnitaty seser ccpced. ct progert-u Lire
Septic tork plryed and. fnlled vith graiel
ltnaL - h1ten cbcue itens ote ccr,pletei
axd uhen iqncll.tion is con:>Lete o? s'.:-;3-
xuye naued. ari premLses e\'eanei up.
l
Xl
l
l
o
AilDERFLOCR PLUI.EING & I.ISCIIANICALrobenari@of
floor insulciion or cieckina,
1 posr nt:o atnt: To be nade prior toj T;sa;-"-";"rcn of floor insul,axion or
deckittg,
_1 ROI.IGI! PLUIBI::C, ELEC!!?ICA,L'T, ITECH-
I
- ur.tiL these inspeetiors iuve beer
made and. aoorouei-
1 ftpwuctir' pz-tor to olceirtt faeino) ^aifrG Qrul before'fronini in"pnl-tion. I
1 fnl:tnc: ttust be nequested after
) @ou"t of rough plwr,bing, electri-
eal & nechtnical. ALL roofing
braeing I chinmeys, ete. rrust be
. eonpleted. llo ucrk is to be con-. cecled until this inspection las- 'been nad.e anC apptoued.
CURB & APPROACII APPON: After formsue ereeteC but prio? to pottrLrq
conerete.
SIDEHALK & DRI\EI,IAI: Fot aLL con-c"eteiffi rrltd" street right-
ofaxA, to be made after aLL esca-
oatinq canplete & fotn uotk & sub-
base rcterial in place.
A!!L: hhen conplete -- tuotsiCe
gates or mottable seetions through
P.U.E.
ALL projeet cottditions, such ae the i.nstallation of atreet ttees, conolction of tie
required Landsccpir.g, ctc., tmlst be satisficd before the BUILDI\|G FfilAL ean be requested..
PINAL BUfLDLNC: The Einal Buildittg Inepeetion trust be requested cfter the Pinal Plwnbing
Electrical, otC l,leeiuricel Inspections hq,Ja beet nad.e arui caproved.
FTilAL PLUI|BITIG
FITIAL I,IECHAIIICAL
FINAL ELENRICAL
l:cbt)
Bloeking otd Set-:tp
Plutnbin4 connections -- sare? al. ucter
Electrical Ccnnection - Blockin-o, aet-u=
and plwnbing conneetions nrl,st be cpprcx:ec
beforc requesting eT.eetrtcal inspec:iot
Aeeessot-; BuilCing
Pinal - After pcrches, skitting, decl+s,
etc. ate eotnpleled.
Page 1 of 2.ALL I4ANHCLES AND CLEANOUTS HUST BE ACCESSTBLE, ADJUS?IIZIIT IO BE I,'4DE I.? IlO C1ST TO CIIY
d,r-
7o7te:
soLAR ACCFSS REQ.-L-CO G+
Gm=-Eearo@,s:Iot Sq. Ftg.
i cf Lct Cotetage
t of Stories
iotal Height
lopogrcphy
LCT TWE \J
_ Interior
_ Corrre?
_ Panhandle
CUL-de-sac
[,ot Faces -
!1eai
Rangc
LACC
-- Fees --
P. L.House Caf,aoe Access
llo?ti1
East
South tove
West
:f
:?E;.t
'.lain
lcees
Building Volue & Permir
This -permit -is granted on the e*press eondition ttut the said. eonsttttctions_lnll, i.n-all ."es_pe_e.ts, eonfcrn'to the Ordinanee ed.opted. by the City ofsprt-ngfielrl, ineluding the zoning crdinance, negulaii*g thZ ccnstracticn
drl.d. .use of buildi,gs, otd m-ay b.e_ suspended or yevokeC -at
"*y t:.me upon uic_l.ation of any prcoisions of -aaid
Ord.inances.
? n . 1 < - lucLue
TOTAL VALUE
Euilciing PermLt
State
?otcl Chatges
PLan
D-+^ D-.').
Reeeipt #:
Si-gned
x VaLuc
FEE
:esiiential (i bath)
Seaer
yLu-1"-r3 Perr:Lt
Styei:.qyae
Plumbing Permit
No person shazl eonstntct, instalr, alter or eizange any ne' cr e:istircpluntbing or drainage systen in uhole o, in pott, unlesi "r"a ,nriJ-n-ii'tl"nLegaL possessor of a ualici plwnber's license, ereeDt tl"a.t c D'e?scn na> ccplw:,bing aork to p?operty uhiciz is ounei, LeLsLa-Z; "i*"r)d';r-;;""';r?l;_cant.
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a;/Zzterd. Circuits
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Electricol permit
Itrne?e state La) ?eoui?es tizax tne eiectrical uoyk be done bu ar: J-t ectyiecicontracxcr, tne elecn..cal portion cf this "nili "r-11-i""'rZ iaii ut:=iithe Label ias been sigtea by the Elecxtical' Conrz.ccrcy.
IViechqnicql Permit
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Penrit issuqnce
l.teciunicel perqrtt
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r HAw cAR$aLLy lxAnr-rlED the coroleted aopl.teation fo-n permit, cnd <ichereby certify that aLL it:fo:nation hereon' Ls tpue ana eorrecz, cttc rfut'ther certifs- that any arl aLL uork pe,forned. shalt be do:te ';.n n".on-<ianee rrittt the otdinancae.s of the city -'of bp*ingyieid, ;"d-li'; L,c;s of thas_tat-9 o{ o19gcn pertaininc to the uork ceserib"cd herzin, cnd- tlit iJo occu-PAilCy diLl b3 ,yCe of any st?uetu?e uithout permissiot Zy tt " m;Zd.tno p;-vLslon. r tu?the? cet'tt-f1; that,,otly contraeto?s a;id enpTcyees uho ar,e ineonpliance uith 1RS ?01.055 uiLL be used. on this ptoject
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74a -fA'IAL A|l)Ult? DIIE:.ls,po Date
JOB NO.
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