HomeMy WebLinkAboutPermit Miscellaneous 2008-1-1
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CITY OF ~;RINGFlELD, OREGON '-...J
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225 FIITH STREET . SPRINGFIELD, OR 97477 . PH:(54I)726-3753 . FAX: (541)726-3689
City Job Number Q}b - \1.0 CO
q 1 & 2 Family DweUing or Accessory ~ New Construction
~ Multi-Family Il1 AdditionlAlteratio~~placement
o CommerciallIndustrial 0 Tenant Improvement u.fJ.-r~
Job Address g 44 MILl- <;'t .Bltlg No, I - (., Suite No,
Lot Block Subdivision Tax Mapffax Lot
Project Name fo'l\iKoili.V ,P/JrrJu-- 1YVr, 5-mt12- ru,"'LkC€'~r
Description of Work/location on premises/special conditions I'ZBI1<.M/l11.t,l!VT eN' e-1"~t"n. S't7h/l.~
I 0 I Residential Projects
Heat Source: Primary
Water Heater Range
Do you require any of the following for'this project?
Over-width or Second'Driveway 0 Yes 21 No
Temporary Power 0 Yes Zl No
Air Conditioning 0 Yes zr No
Notice: All contractors & suhcontractors are required to be licensed with the Construction Contractors Board of the State of Oregon
under orovisionsof ORS 70 I and may be reQuired to be licensed in the iurisdiction where. work is being oerfonned.
I For Qfflce Use Onlu
I PLAN CHECK FEE I
o I Propertu Owner
Name cQ-to H A-Hol/.- L. L C
Mailing Address ;;I.'i?o a. n'~ k-te..
City 5lAb1Z<<E- State CtL Zip Q,4c1
Phone ?4-1- 34'4'~ I <"1 Fax
Owner Representative IJ 'EiUL <;) Ck.\t,F 6ii (2.y
Phone 541-'34J..A~I'l Fax r;~"- '3;7.3
o I Applicant
Name (b IN' N n)
"-
Mailing Address
City State
Phone 044--- 4 [q Fax
Zip
(0 'i?~- )S-1'~
o I Architect/..Designer/.Engineer
Name 6-11.ct I\-A-u- kaclk1:rl"...cr<;
Address II (P lfw of 'i'l N. S-re.. [00
City @A.lt.m.m State Df!!. zipQ140'Z-
Contact Person _)?W ittM~
Phone n4-H;iZ~-!i5<j oi- Fax C,M- t, 8lt-Oc:.:;O
o I 'Contractor(s)
Contractor's Name
General (OW t.' l::--rt-".
Plumbing /.; ill.-
Mechanical IJ 16.
Electrical "J I..
,-
o , Commercial/Industrial Projects
Has site review application been submitted?
o Yes ~ No 0 N/A
If so, Name of Planner
Journal Number
I RCPT# I
BUILDING
~L~
Date
o
o
Demolition
Other
11 & 2 Familu'Dwellina
SQ Ft X $/SQ Ft
= Value
New Dwelling Area
Garage/Carport Area
Other Structure Area
Total Value
I Conimercial/lndustrial/Multi-Familu
SQ Ft X $/SQ Ft
= Value
Existing Building Area
New Building Area
Total Value
~O,,'ro
Occupancy Group(s)
Const. Tvoe( s)
Number of Stories
Existing
.9--1...--
rblJ
1-
New
(2.-'2..
'iL - N.
'Z.
CCB#
Expiration Date
Phone #
Secondary
Energy Path
I DATE I
I BY I
PERMIT
APPLICATION
Shared Drive(T;)lBuilding Forms/Building Pennit Application 3-08.doc