HomeMy WebLinkAboutPermit Building 2002-4-8
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o 225 nmiSTREET . SrRINGnELD, OR 97477 . rH:(541)726-3753 . fAX: (541)~:-~6~9
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ll~ Description ofWorkllocation on premises/special conditions
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M ,Mailing Address 8791 ~A1u,<rf725>./ Jf'
f(\, Citv r; /'r'c/) _ State",:--J'(" Zip
~ Phone 71"7-8'19 ( Fa>'
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o Applicant
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= Notice: All contractors & subcontractors are required to be
licensed with the Construction Contractors Board of the
State of Oregon under provisions of ORS 70 I and may be Requires LDAP Yes 0
~ required to be licensed in the jurisdiction where work is
beinq oerformed.
II PLAN CHECK FEF ...4;~ .0-'1 ' RCPTfi
CITY OF 81- .tliNGFIELD, OREGON \j
City Job Number 0;)- tJ 0 39"l- 0 I~ ~'!, '
8 I & 2 Family Dwelling or Accessory New Constructio~
Multi- Family Addition! Alteration/Replacement
o CommerciallIndustrial Tenant Improvement
Job AddrjS_' G 7 f ~ ~ LN.?:' " 'Bldg Nn
LOL ~ '. Block ~ubdivision ~/ LAn).l#t!i Z~ MaplTax Lot-.4!1)9,
Project Name
TRANS#:01~0008547
r-DATE:APR-08 2002 ,
-AMT RECD: 2 $ 688.09 r.
. CHANGE: c
CASHIER:032
o Demolition
o Other
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SQFtX $/SQFt = VALUE
NewDwellingArea ~~ 1#>8/3-
Garage/Carport Area ~ ~ i~7G
Other Structure Are~ ):>..-(1/
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Total Value
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1 & 2 Familv Dwelli"p
Owner Representative
Phone
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CommerciaVIlldustriaVMulti-Familv
SQ Ft. X $/SQ. Ft
VALUE
Mailing Address
<;:ity
Phonp
Statp
Zip
Existing Bldg. Area
New Bldg. Area
Total Value
Exist.
New
State
Zi:-
Occupancy Group(s)
Const. TypeCs)
Number of Stories
Phone
I 0 Colltractor(s)'
Contractor's Name
General 'VE~,/f/./J ~~J'<-
Plumbing 7~b.>V &U-.J/(
Mechanical .J-/o .--.. ~ 0.c. _ . ,ro~-r-
Electrical C:"T,,{EL/F #,A t./c..,A(
I,OCominercia1l!ndustr.ialP;lJ;ects
Has site review application been submitted?
o Yes ONo 0 NIA
Fav
CCB#
t 2-.(. S-- z..
Expiratioll Date
/ z. - 20 -0 ~
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Pholle #' ____
;; '7'7 -,B't"ls
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o Residential Projects
Journal Number
Heat Source: Primary Secondary
Water Heater D<;I'lgp J;nergy Path
Do you require any of the following for this project?
Overwidth or Second Driveway 0 Yes 0 No
Do you need temporary power? OYes ONo
If so, Name of Planner
No 0 Applied for? Yes ONo 0 1.
Date:
'I
BY C?}J. J
Planne"
nATE 4- ~ -0'2-
Shamt Drive(T:YBuilding FormslBuilding Pennit Applicationl-02.doc