HomeMy WebLinkAboutPermit Electrical 2008-3-7
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225 FIFTH STREET . SPRIN~FIELD, OR ~7 . PH:(541)726-3753 . FAX: (541)726-3689 ,
City Job Number r / q; .." 2J? )J Date G 3, Ci 7 0 8
D 1 & 2 Family Dwelling-;;r Accessory tJ New Construction D Demolition
D Multi-Family l.P~qD A ~ AdditionlAlterationlReplacement ~ Other
D CommerciallIndustrial ("1 rh _ :0 Tenant Improvement
Job Address ~C) C ~ J
Lot Block Subdivision
Project Name 1-. 7q [) ,1-\ ~ 'T 0 u (J LF "-
, .
DescriptIOn of Work/location on premises/special conditions
(, 4JA1r~) T/ t:..{ c?N/)
D Residential Projects
Heat Source Pnmary
Water Heater Range
Do you requITe any of the followmg for this project?
Over-width or Second Driveway DYes D No
Temporary Power DYes D No
Air Conditioning D Yes 0 No
Notice: All contractors & subcontractors are required to be licensed with the Construction Contractors Board of the State of Oregon
under provisions of ORS 701 and may be requlfed to be lIcensed m the jurisdictIon where work is being performed
For Office Use Only
PLAN k)CK FEE I I RCPT# I
~UILDING PERMIT
~ ~~ t0~.\).
[] Property Owner
Name /Y/ ;01(\(\ e I ,,"", \ ..;ll e... \/oSS:.
Mailmg Address ;(::;0 b B 7'-. .s I
City sf State ~ ZipC()l.{78
Phone SL/ /. 7 iy 7 Jj''-( (13 Fax ..2iJ. 7"'C7 gl{/7
Owner Representative -S /1rY"'I c..
Phone Fax
~ Applicant ,
Name )~ I chQ e.\ n- J..; t \ 0<.... Vos>S
MaIling Address ;..50 f. 23 r h S I
City 5 f State 0 (.l Zip ~ 7'17 B
Phone tL/7 ~ CZ'i' 8 Fax 7 '17 - 8Y, 7
<9/ b - 2-/'7 0 (c:.J
D ArchitectJDesigner/Engineer
Name 'fhv f\ t'^' h, v ~e. ~::, 1?J T)'S
Address (J-S3 0 S I'
City S P State o~ Zip q") '-II 7
~'N
Phone ','1 b -- J ( ,') 7
ontractor(s)
\ \ Contractor's Name
I ~ t:J W~E:.1l.
9;:' ~~g .!t/;:g. UJ~
r.J~ ~cal -J..it(!.~ ~'1
'1 ..,~e(~al ;(UAUerL .~_
3-;- ~om~ercial/Industrial Projects
, Has site revIew applIcatIon been submitted?
DYes D No D N/A
(If so, Name of Planner
Journal Number
~
Contact Person
Fax
Bldg No. Suite NO~,\ - I. ,J J~
Tax Map/Tax Lot J f) @(.r'ft. lA.(J{J.::::>LJ
J. & 2 Family DweUing
SQ Ft X $/SQ Ft
New Dwellmg Area ,~ l.{, S-o
Garage/Carport Area 7 b B
Other Structure Area
Total Value
Cc".,,,..ercialJIndustrialfMulti-Family
SQ Ft X $/SQ Ft
Value
Value
EXisting BUIlding Area
New BUlldmg Area
Total Value
EXisting
New
Occupancy Group(s)
Const Type( s)
Number of Stories
CCB#
ExpiratIon Date
Phone #
-?'~...,{)~S
Secondary
Energy Path
I DATE I
I BY I
APPLICATION
Shared Dnve(T )lBwldmg FonnsIBwldmg Penlllt Apphcabon 3-08 doc