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HomeMy WebLinkAboutPermit Application 1998-1-12 ~' ' .. . DEVELOPMENT SERVICES DEPARTMENT Manufactured Home Placement Permit Application Placement Location: 5335 ~ J~ .5t, Sp' IS2.. Assessors Map Number:-.l7 t!; z.. j 3 s-o , . Lot: Block: "" ; Partition Number: SP.FIELD 225 FIFTH STREET SPRINGFIELD, OR 97477 (541) 726-3753 FAX (541) 726-3689 City Job Number: 5f y I :f~'ld ,~ Q1t.j 191 Tax Lot Number: 0/3 6f) Subdivision: Parcel Number: Has Partition Been Approved?: --OWNER-- Name:0C~"'Th ~'-liprDy)I@" M(SoYl PhoneNumb(~-~~ Mailing Address: 7~ ryg ITdiJrd/ I< City:lJeJl~State:-DC zip:~7< Installer:~Ve., 6ra~ Plumbing: Lar') nw/ev, 'Electrical: - UtrJ-tJftXubv General Contractor: --W~"i hwk V (if applicable) ..J , Mechanical Contractor: , (if applicable) Business Name: N6~ Mailing Address: City: --C~IjA~ORS-- CCB#:.f) 11dfO~ '. CCB#: Ita I CCB#: It d1 ~ { CCB#: (f OOJ{; I rro 'X # 'JJ5 CCB#: --LENDING INSTITUTE-- I-I ;.qq EXp:~~ Phone{1ITJ3) 1'1311 Exp: (...1 'r13lPrhone:(;f/ ,)131.' emf Exp: l-l~~Phone{9I;) 132-e1l# Exp: '~11' ')I;Wphone:(s4D737:'dI'3Ij Exp: Phone: Phone Number: 1/2. lG:> Attention: State: Zip: --PERMIT INFORMA TION-- Value of Footing/Foundation: Type of HeatA.cb:J'c. Heat Pump Installation?: A'lo Value of Home: Lfj 16/0 Sq Footage of Home: CJ37 Sq Footage of Garage/Carport: / / / I I Application Received By: Plan Check Fee: x Date: '--.1/2.. Receipt Number: c-j....-:-., .~