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HomeMy WebLinkAboutPermit Building 1997-3-10 . '~ CllP9 . COMMERCIAL/INDUSTRIAL PERMIT APPLICATION SPRINOPIELO ~ ~tJ "fi!D. JOB NUMBER ~7"??~ 225 Fifth Street, Springfield, Oregon 97477 INSPECTION LINE: 726.3769 OFFICE: 726.3759 P?et~ flt'~ rrfn- ASSESSORS MAP: /-;r-O-z. ~ ~ TAX LOT: '2--~Dt7 OWNER: LIPfdl-"fY -bAJ1/- - krrJ.~DfZ.A c;eM~NE:'?44 'c:Azi ADDRESS:~ c:fl ~ CITY: hl~t'#- STATE: ~ 011- ZIP: LOCATION OF PROPOSED WORK: ~ ~ DESCRIPTION OF WORK: Fet'??lI'I:L- OP Fl>~ l-113~ ('j NEW REMODEL ~ ADDITION ~Al7&LJD1L- O!,!%&S trOr;./tAi- BAril< DEMOLISH . OTHER CONTRACTOR'S NAME GENERAL:~PA ADDRESS 1$1 T. - (J!~ BAqE . ADD~EtS ~~<< CONST, CONTRACTOR' " lL4 '2.?g t~ -I--/!!:eg'O?8''JH.tS . VALUE~..0 ,hl , PHONE . I JPg~9;9CL ARCHITECT: ~ NAME tbu-- EXPIRES PHONE Mr~ '144'5 PLUMBING' MECHANICA" ELECTRICAL: ~ t:l..U-1lUv- JlWF 4tl:l:fI.Il3&I?~&JZ- ,AJI_,h~" ~ PLUMBING I MEr.HANIr.AI. NO. I FEE I r.HARGF I!l-i E.EF f'HARG.E-1 Single Fixture I furnace/burner & vent < 100.000 BTUs Relocated Bldg. I, Furnacefburner & vent {new fix, addlil > 100,000 BTUs Water Service I Floor furnace and vent It. Sanitary Sewer I Suspended wall or floor It. mounted unit healer Storm Sewer I Appllance Vent ft. separate I Statlonaryevap.. Backflow Device cooler I Vent FanfSlngle duel I Vent System apart Irom AC or htg. I Mechanical exhaust hood and duct I I Permit Issuance $10,00 TOTAL PERMIT I TOTAL PERMIT - OFFICE USE - HANDICAP ACCESS: OUAD AREA' . OF BLDG~' LAND USE: . OF UNITS' FLOOD PLAIN: ZONING' OCCY GROUP: . OF STORIE!'" CONSTR. TYPF' HEAT SOURCE: LIGHTING POWER BUOGET: WATER HEATER' SO. FT, $/50, FT, VALUE SO. FTG MAIN SO. FTG ACCESS SO, FTG OTHER X X X TOTAL VALUE OF PROJECT PLAN CHECK FEE ';5/~<<) RCPY' ~ '/ DATE ::?-/~ BY :~&?" -~ -: I BUILDING PERMIT 15% State Surcharae I MECHANICAL , 15% State Surcharoe I PAVING . PLUMBING I DEMOLITION 5% State Surcharae I FENCE VAlliE ~ I SIOE\".,A,i-K I CURBCUT FT, FT. I I " SUBTOTAL PERMITS I SYSTEMS DEVELOPMENT TOTAL PERMIT FEES I EXCLUDING ELECTRICAl