HomeMy WebLinkAboutPermit Building 2008-3-24
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225 FIFTH.8TREET . SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ~~ ~ ~
<:!!I Job Number C0w1Z00 g-- 60::5 ? ! Date ;h-'{~ f
..-0 I & 2 Family Dwelling or Accessory 0 New Constructinn tJ Demolition
o Multi-Family 0 AdditionlAlterationlRej>lacement 0 Other
o Commercialllndustrial 0 Tenant Improvement
Job Address 8':36 .s 3/ Sf- P L Bldg No, Suite No,
Lot ,7 Block Subdivision 10.-T'tYwIt f'L.'1,t~Map/TaxLot /Boz Of,z.1 O??OO
Project Name
Descripti~n ofWorkllocation on premises/special conditions 5'-<J /~ M,.,,,~, rZE.s. d.~.N'c.tf.
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Name DAiAl E
Mailing Address
City
Phone
t!!'l S?:i'Fanulu'DWellina,r r
B (A.-tl.e/
State
Zip
New Dwelling Area
Garage/Carport Area
Other Structure Area
Total Value 172. 7?J
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SQ Ft X $/SQ Ft = Value
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520
X $/SQ Ft
Value
Fax
Owner Representative . D tPLE t:iA Jt'
Phone 5l7~Ssso Fax 687-?6Je
Existing Building Area
New Building Area
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Name bJ''S :r,^,U<<.~l'lM-ti.A-( LLc..
Mailing Address 2f:l bO t'l,V'l-ft{\-.!:"-" AV R
City O-w~e State 0(2- Zip 'i7'ro'i;..
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Phone S-C7-~ Fax 68Z-'263'E
Total Value
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Name A-$Oc..');l.~ 'be<;'!AJ
Address
1
Existing
New
, City
Contact Person
Phone '1tl- 2D 8 2- Fax
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State
Zip
Occupancy Group( s)
Cons!. Type(s)
Number of Stories
o
1
Contractor's Name
General D:-S,S )'u<J\l<Z.IT~A1\
Plumbing -:;"'9 ::r 1'\ ?>L-~~L-..^.~
'Mechanical WLA-J _"""",
Electrical {36(}, 1--:-,4..<--
o f\ CoiitmerCitil!IndiiStriiil PriJieCtst 1 0 rResiileittiiilPi-OieCtifCc
Has site review application been submitted? Heat Source: Primary G A- 5
DYes 0 No 0 NIA' Water Heater GAS Range G,4.<;.
If so, Name of Planner. Do you require any of the following for this project?
Journal Number Over-width or Second Driveway ::J Yes 0 No
Temporary Power ~Yes 0 No
Air Conditioning ~ 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 70 I and be to be licensed in the where work is performed,
CCB#
Expiration Date
Phone #
LLC
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Secondary
Energy Path
, I PLAN CHECK FEE I c- 7U 7Z I RCPT# I
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BUILDING 'PERMIT
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APPLICATION
Shared Drive(T:)lBuilding FonnsIBuilding Permit Application 3"'{)8.doc
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BUILDING PERMIT CHECKLIST
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I Lot Size
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I Solar Setback Approved
I Percentage Lot Coverage
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I Hillside Developrp.ent
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j FloodPlain Zone
I FloodPlain Panel
1 Floodway
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Prior Journal Numbers
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DeTAIL
(NTS)
-::>69626
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DETAIL
(NTS)
~005-00057 '