HomeMy WebLinkAboutPermit Sidewalk 1992-09-16I\EEZftTI=l\t I IEE-: (-,.;9rII-rEl<E;T4{L-_--
gIDEIIJAK / CURBCUT
APPL ICATIOhI / PEFA-IIT
SPFlINGFIELO
229 NORT}.I FIFTI-{ gTREET
gFRlhl3FlELD. ORECOI I 91411
E!.lG lNEERli{G D lvl 5 lol.l
ffilcENo. 126-11b9
lNgPECTlOhl LINE: 126'3163
JoB ADDREee: 4-@ tw, 24ft{ fl,
AeeEesoRs t'1Ap No.* t7 -O3- 36- l+ TAX Lor xo.x ggoo
SUBDlVl9lo,|.1,
ou^rER ,l/Ai/e? ? Aru LAfutuI)
ADDRE9e, 44a No, z4T* 9r 9R//'JGF/a.DCITY:
9TATE'ea,ata-?7 4-7 7 PHohrE No. 14-l -31 5B
RECEIPT NO: G
"-O
3
cA9*l
*
CHECi<ED FOR DEL NAJENCIEg
9IGNED;
DATE;
M-
TIJOFK DESCRIPTICI I:
9IDzuALt<X cuRB srDE X sETBACK
CURB-CLT: X RE9IDENTIAL- col'I,'ERlcAL
9=COhID DRI\EUJAY ( gEE TRAfiIC )
REAUIRE9 AFPLlCATlol.l FOR A *CoND DRI\GLUAY(T-4.1a)
oR A couNTY APPI-lcATlol.{ FoR FACILITY FERi'IIT (C aO-2@3)
IF IN THE UG.3.
DATE OF APPLICATIOhI 7
[IloFK TO tsE FEFFOFI'IED EY: ouNER X canrRAcroR
cof.rrRAcroR* ? \funrN€/ttlu€R bNtT4uc@&u,"r*orohr No.*67 411
za7 € ril*o lsoAt ap€, ?7pg PF{ohtE; Q87-o*S
PFOCEDUFE FOR IN9FECTIA{ RE@UE9T;
CALL ]'2b-1'163 (RECORDER ) STATE YOUR CITY DE9IGNATED JO3 Nt]'i'1gER, JOg ADDFES9,TYPE OF
IN9FECTIOh{ RE@IJE9TED AhID IIJi.IEN YOU IIJILL B= READY FOR INSPECTIAN, COhITRACTOR9 OR OU.hIER9 NAIE lJ.lD
FHOhIE NiJMSER. REAUEgTS RECEI\€D BErcRE 1@@ Nl IUILL 3E FIAD= TH= 9AI1E DAY, FEGUJE9TS /s1--.R 1,@@
AI"1 IJJILL BE F1ADE TH= NEXT UJORKING DAY
EXr9Ttr.lc tsLJILDING PER|IIT NO. ( IF APPLICABLE )
*YOLIR CITY IGNATED JO3 NO. Igf ?z t2-98gEE Wd.
SIDEu]ALK / DRI\GIIJAY
FOR ALL CONCRETE PAVING I,IJITHIN
THE STREET RIG}]T OF IIJAY, TO BE
I1ADE AFIER AL EXCAVATING
15 COi-IPLETE AID FORI1 IJORK
AID 5Uts-BA5E I,IATERIAL 19
IN FLACE
CU@ / APPROACH AT'ROhI,
AFTER rcRrl$ ARE ERECTED
BUT FRIOR TO FOURING
C,oNCRETE.
FEE9: SIDEIUALK9 cuRB-cuT IUALK X,
IIO.@O + rO.lb/LF.( X )
OFUALK , iIAO
t4',x.s 7rd
jlO.OO+eO.l>/LF.(X)G
tlD
COXIIERI CAL DRI\€I.!AYg 5I..IALL
HA\€ 5'TO A'FLAIRS
3,. @U STAIDARD
.lo
,@ x'
bToTAL PEffllT FEE'o
I i{A\€ CAREFULLY EX.+1INED TH= COHPLETED APPLICATION FOR FER-1IT ', Af.lD DO i-.lEREtsY CERTIFY THAT ALLNTSIATIOhI I.{EREON 15 TRJE AND CORRECT,, A\D IFURTI-.,IER CERTIFY T1.1AT ANY A\D ALL I.l'OR< PERFOR-1ED5'JALL BE DONE IN ACCORDANCE IUITI.I T}.{E OPINA\CE9 oF Ti-.lE C|TY G SpRNr-rFlELD , AlD THE LAUJS G TIiESTATE G OREGON PERTAINING TO TI]E IIJORK DESCR|SED HER=IN, AND *i-.{AT NO OCCUPA\CY UILL BE I1ADEG ANY gTRJCTURE I,UIT|{OJT PEBIIS9ION G THE tsUILDINC DIVI9ION. I FURTHER CERTIFY TI.]AT ONLY CONTRACTORSJND EHPLOYEES tiji]O ARE THIS PROJECT.
.g- (\--1
rN coi.lpLtANcE rutTH oRj5 1a10>> uJlt_L B= ugED ON
5llE
EXF'rRE3, z/t/q>
REAUIRED INSPECTIOT{g