HomeMy WebLinkAboutPermit Application 2008-11-18
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225...... n STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 ' .. -. I
CitYJObNumber~~- 014<1'1 Date 11-)6 --- 0
o 1 & 2 Family Dwelling or Accessory 0 New C . . .. . 0
~ Multi-Family 0 Addition/Af... /Replacement 0
CommerciallIndustrial D Tenant Improvement
Job Address ~ 'ill L <..-t Bldg No. Suite No.
Lot Block Subdivision , Tax Mapffax Lot ll(./~S ~
Project Name ~~r - (',00J'J1f 0+ (.t.<..--P.
Description ofWorkllocation on premiseslspeci~1 ~~rrfiitions
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Name _I I,,,('o\n (\O?-bLy-' _, I
Mailing Address
City
Pbone
CITY OF SPRINGFIELD, OREGON
Demolition
Otber
L,<%~F&!!!~!YDw.'l.l!iJ.tg -
SQ Ft X $/SQ Ft
17. /Jl) D
.
Value
State
Zip
New Dwelling Area
Garage/Carport Area
Other S__,__._ Area
Fax
Owner R........._.)_.......:..
Pbone
Fax
Total Value
lcQmnteJ:Ci<tlilnd.!IS.tti<tlillf!LI!i...Etlmf4J
SQ Ft X $/SQ Ft
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~am~~ nil ~ C~~s:
Mailing Address ~ ~r .--
City State ~ Zip 97'11 y
Phone ~ 7 ~ Fax 3+?-, -4- <R7 Total Value
r-:-CZL...:...z...<63- I I
o LA!:'!'.1I.itectl.~~erJ~.,.gineer
Name ~b ~~ ~~
Address ~ \)a R, _.H.. '/Uccupancy Group(s)
City eu.a..V\I' S Zip "i'74DJ Const. Type(s)
Contact peMn I-<;p n-'\ (.le- (' Number of Stories
Phone :it..i-7 - (n'SJ I Fax:\-I'+-'8' _~
~-[r LGqnh;octQ!:(il -- - ,
CL.....,"'r's Name -J. CCB#
General E-':,<< X GevY>J-aP (bn'lfru.r:r1f)V)
Plumbing
Mechanical
Electrical
o I CQmmercial~InaUS'i'rial~ects.J 0 t::R'i.S.rd.~!Z<>j!!:.t.!
Has site review application been submitted? Heat Source: Primary
DYes 0 No 0 N/A Water Heater Range
Ifso, Name of Planner Do you. _,_:._ any of the following for this project?
Journal Number Over-width or Second Driveway 0 Yes 0 No
T.mr_...;Power DYes ONo
Air Conditioning 0 Yes 0 No
Notice: All contractors & sub._..__._... are required to be licensed with the Construction LL.........,. Board of the State of Oregon
under rovisions ofORS 701 and ma be r uired to be licensed in the 'urisdiction where work is bein erfonned.
, FQr 0 ce Use Old
PLAN "nc,,'" FEE
= Value
Existing Building Area
New Building Area
Existing
New
Expiration Date
Phone #
-
Secondary
Energy Path
BUILDING
PERMIT
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APPLICATION/
Shared Drivc(T;}lBuilding FonnsIBuilding Permit Application 3~8.doc
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