Loading...
HomeMy WebLinkAboutPermit Miscellaneous 2007-1-1 .,: ,. CITY OF S~ lNGFIELD, OREGON () SP~ ~ .',,- 225 FIFTH STREET. SPRINGFIELD, OR 97477 . PH:(541)726-3753 . FAX: (541)726-3689 City Job Number 1:.ovVt e..c>c>7 -Of f::%Z Date o 1 & 2 Family Dwelling or Accessory 0 New Construction o Multi-Family 0 Addition/AlterationlReplacement %- CommerciallIndustrial I2K. Tenant Improvement Job Address '3" (" IF /"7tft-/o/ f f- Lot Block Subdivision Project Name 7 - i:[ I... if.......) Description ofWorkllocation on premises/special conditions o o Demolition Other Bldg No, Tax MaplTax Lot Suite No, r 70:5 5bJZ 0"])0/ , . nb/~ {LAM (/ o I Pronertu Owner Name 7- c/~,,<:.J Mailing Address 1'3 9 t. City S,rIN~r<clj Phone I 1 & .2 Familu Dwellina SQ Ft X $/SQ Ft Value L: State /'?,.,.,,,J 5 r (!);< Zip 9 7'1 77 New Dwelling Area Garage/Carport Area Other Structure Area Total Value L Commercial/Industrial/Multi-Familu SQ Ft X $/SQ Ft Value, Owner Representative Phone Fax /(V/lo/ t/ /~i,e /1 Fax o I Anvlicant Name p".~ ,'r:.", )2.,'''''' Mailing Address 10 /.( 2 'f City ?c=..-f-kwvd Phone <;;'D3 319 :Jet? .J;;Jlcr /lfh2 S ~t:: Ci..e.frv Bfu.<.,~ Dr? State e>/Z Zip 977-/C, Fax Existing Building Area New Building Area Total Value -r/'o ?S""D~ o l ArchitectlpesigneriEngineer Name Address '. Existing New City Contact Person Phone State Zip Occupancy Group(s) Const. Type(s) Number of Stories Fax o I Conlractor(s) Contractor's Name ?,,/.o ,=,.,. 12.",", J:;vIe. i dT{ 5 CCB# 1'i6S-1{, Expiration Date Phone # 5()] 'OJ 8.,,'7 I 0 I Residential Projects Heat Source: Primary .Water Heater Range Do you require any oflbe following for Ibis project? Over-widlb or Second Driveway 0 Yes 0 No Temporary Power 0 Yes 0 No Notice: All contractors & subco!!.tra~tors are required to be licensed with Ibe Construction Contractors Board oflbe State of Oregon under provisions of ORS 70 l' and,maY'"e requireil'to-be li~ensed in Ib~ iurisdiction where work is being performed, ~ Qffice Use Onhf~ ) .& :t- CHECK F?E't 7 Z 06 __/_.1 ~GPT# I. 1 DATE 'Fe#' B &LL.D-I-N'G PER M IT General Plumbing Mechanical Electrical rM+Commercial/lndustrial Projects Has site review application been submitted? DYes 0 No 0 N/A If so. Name of Planner Joumal Number . Secondary Energy Path I BY I AP PLICA TION Shared Drive(T:)lBuilding FormsIBuilding Permit Application IO..o2.doc