HomeMy WebLinkAboutPermit Building 1900-1-1
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COMM ERCIALlI NDUSTRIAL
PERMIT APPLICATION
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225 Fifth Street, Springfield, Oregon 97477
LOCATION OF PROPOSED WORK: ~ ({.~) t::Jc. ,y.J1-?, ,?/<
ASSESSORS MAP: J? "'C-:? . "?'--- ~
OWNER: :\,\j!A LL- ,i2A",SPOl2-, eQL-I,plV\(:.-J, C'-'.
ADDRESS:
~0DI
o L -/ Wl Pic.. "5',
CITY'
"S?:7_IIo..J./:"'~t~Ln
STAT~' OrL-
DESCRIPTION OF WORI<" CDN57 'D,".Oc.'2- PA-12 II '[JON
NEW
REMODEL '>(
DEMOLISH
ADDITION
ARCHITECT'
NAME
lJ IA
ADDRESS
CONTRACTOR'S NAME, ~~5 ADDRESS _
'2~.3: 1.)0/001 ~ 1.~P<'iFc..;;;>.
GENERAL:_A.IJ,..-\-DlI-,-II... NlU.6..7i?C'O/o.lSl. IIJI. 'f'1h17
PLUMBING: to! / A
MECHANICAl' N I A-
ELECTRICAl' N '; A
PLlIMAING
I
II
I I
I I
NO
FEE
r:H4RnF'
Single Fixture
Relocated Bldg,
Inaw fix, addtl\
Water Service
Sanitary Sewer
It,
It.
Storm Sewer
It.
Backflow Oevlce
TOTAL PERMIT
.
JOB NUMBER 9'? /"":) .,:> '7
INSPECTION LINE: 726.3769
OFFICE: 726.3759
TAX LOT:
02/~
PHON~'
'7'2(., - 06.:2.?-
ZIP' <174'1€;'
OTHER
VALUE: -GJ.r,flll"!!
PHONE
CONST,
CONTRACTOR'
Q'18A'2...
EXPIRES
PHONE
(\ . 'l\ - ~6 '7210' 71.l.l37
ME'r.HANIr.Al
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"1:IAaGi
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$10,00 )
I
Furnace/ burner & vent
< 100,000 BTUs
Furnace/burner & vent
> 100.000 BTUs
Floor furnace and vent
Suspended wall or floor
mounted unit heater'
Appliance Vent
separate
Stationary evap.
cooler
Vent Fan/Stngle
duct
Vent System aparl
from AC or htg.
Mechanical exhaust
hood and duct
I ""~
TOTAL PERMtT
Permit Issuance
l'
"\' '.
,II:
.\",
'I"
\\j;
- OFFICE USE -
QUAD AREA'
. OF BLDGS'
OCCY GROUP'
LAND USF'
. OF UNITF'
CONSTR, TYP~'
. OF STORIES'
HEAT SOURCE:
SQ, FT.
$/SQ, FT,
SQ, FTG MAIN
X
SQ, FTG ACCES~
SQ, FTG OTHER
X
X
PLAN CHECK FE" 2?"::4> =? RCPT'
DAT~
I BUILDING PERMIT I '38. '5"c:::>
15% Stata 147 I ' '9- ~
Surcharae T? / . I ~ -
I MECHANICAL
15% Slate
Surcharae
I PAVING
PLUMBING
5% Stale
Surcharqe
I FENCE
VALUE $
I SIDEWALK
I CURBCUT
FT,
FT,
HANDICAP ACCESS:
FLOOD PLAIN'
ZONING:
LIGHTING POWER BUDGET:
WATER HEATER'
VALUE
TOTAL VALUE OF PROJECT
BY
DEMOLITION
SUBTOTAL
PERMITS
SYSTEMS
DEVELOPMENT
Y./. 5'8
TOTAL PERMIT FEES I
EXCLUDING ELECTRICA'
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