HomeMy WebLinkAboutPermit Building 2008-4-7
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City Job Number 10tM2CiCZ'-o C> iLl 9' 0
225 FIFTH STREET . SPRINGFIELD, OR 97477 . PH:(541)72~-3753 . FAJ(; (541)726-3689
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o Demolition
o Other
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1 & 2 Family Dwelling or Accessory
I'vlu Iti-Family
Commerciillll n'dustrial
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Ne'w Construction
Ad dition! AI teratio n/Rep I acem en t
Tenant Improvement
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Heat Source: Primary (", t'; L:.. . Secondary
Water Heater (<-,<, "" Range Energy Path I
Do you require-any of the following for this project? (
Over-width or Second Driveway 0 Yes I)5J No
Temporary Power iii Yes 0 No
Notice: All contr~ctors & subcontractors are required to be licensed with the Construction Contractors Board of the State of Oregon
under provisions of ORS 70 1 _~na may beTequired to be licensed in the jurisdiction where work- is being oerformed.
I.For Office Use.Onl" '..""."_. ".". ',..... ...:" ,:".,f. '-. '.;":; "...." ... . .,.,'.. . ...
I PLAN CHECK FEE I "? 7z--, I RCPT# I
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PERMIT
Job Address
Lot ;Mq
Block
Subdivision ~t"
Project Name
Description of Workllocation on premises/spec.ial conditions
o P':op';rty OWir~,: ,:;:::<-i, '-:'.L.;~:'-
Name /-J<v.;d~r. ~es
Mailing Address ;}4f.,f./ 5w 6/",c/"" 1'/.
City kcl"""""",A State oft. Zip "77S~
Phone 5Zf/-.l2q-",q~") Fax 14[ -a-S7?-
Owner Representative.
Phone
Fax
. 0 '4pplicant
Name 4vr.J"" /-hn->e:"c,-
Mailing Addr:ss 1'.0. ~y <?i<""i
City ~/~ (e,10< . State . Zip
Phone .szr!. 28Jf? -~q~..- Fax 74. f ' ~$ 7;1
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Name j!"'Jp,U'\ ~mLC: r M en n
Address . .
City
Contact Person
State
Zip
Phone
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.. .EJ. f-C()nti-a.ctor(s-)7S s-;';,+6'g~c;r,~,,;~;;' ..
Contractor's Name
General !f:.yd,n (*-".. .-
Plumbing fi~~ PI.;n-.A"() .
Mechanical ?ev, c,l- j'f,\- (n....~1-
Electrical. .. M 1 w,.. E(pclr,t: . ..
o :ComnIercial/Ilii[l1,st;r,-ial Pjojei;is'
Has site review application been submitted?
DYes 0 No 0 N/A
If so, Name of Planner
Journal Number
Fax
...
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BUILDING
Date
Bldg No.
M.....J"".!i Tax MaplTax Lot
Suite No.
):9:5 ?D30c::>
D7/0a
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!&:i2 {i:Linily Diuelliilg r.
SQFt
-fCfJI
4iSd.
i2f::J'i () YvCF
X $/SQ Ft
Value
New Dwelling Area
Garage/Carport Area
Other Structure Area
Total Value. /1' (,Ill
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~9c;iri'Ti,.~!'G~ii:Ll/j ('-dysiriiLl/1I1 ulti- Family... .
SQ Ft X $/SQ Ft Value
Existing Building Area
New Building Area
Total Value
'-
Existing
New
Occupancy Group(s).
Const Type(s)
Number of Stories
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CCB#
Expiration Dal~
Phone #
I DATE
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APPLICATION
I BY I
Shared-Drive(T:)IBuilding FormsIBuilding. Permit Application 10.02.doc
APAJ',
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BUILDING PERMIT CHECKLIST
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I Lot Size.
I Zoning
I Plim Designation
I Metro Plan Designation
Building Height
Solar Setback Approved
Percentage Lot Coverage
Willamette Greenway
Hillside Development
UF-IO
Historic
FloodPlain Zone
FloodPlain Panel
Floodway
Wetlands
.{.I]/:I r ~.,,_uc'~ r-_-j(r -,.
Tree Felling .1
Setbacks f JJ/6,)~,1
(house) .s 57"1 Ws I 2-:;-
. I Pave Driveway
I Number of Street Trees
Prior J O'urnal Numbers
Ca~?Z 6
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Comments
Setbacks
(garage)
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199
6328 SO. FT.
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