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HomeMy WebLinkAboutPermit Building 1978-2-13 :S~.' ~''/ TRS Tl , j"''?/~l ':1 1. _~. '1 ::l.rJoo JOB LOCATION )6~d -:- r -m I~ ~ / . tJ../1'7 ,t:A") ~A- (/ '" , "'cf' '.... . .' ....-,. -:/ ~-?' ':/d -?' 10."'., \ ,'; c' ~. .. LANE COUNTY PERMIT Acreage Of~ot-:~SI7P /bD.X /(11) Partitioning,iF ,jl/A-~' '~ ,,) Completed SubdivisionflLt;/J1 /A "V/itA~~ . Contractor's O.S. # '/'f'i':Ir' ' IJ . " /J' '/J../J 'Lot '~ - Blb~rY:e',~~,)~, ; ,~, "'" ,,': APPLlCiNT'S NAME ;ND-ADDRESS.v'7.A~A--./1 J v--- YI1-rfiJ t:vViLf"J: Jra??LJotJ~ a )./tj).' ' ; Phonf; /~~,q-.59d';' OWNER'S NAME AND ADDRF~~ ()IffA/J.!;n-7P,p/fl'#)AlLe&~ ~""JCF:<:;., (.J~" - / / ~- . Phor;ip.ry-d'7-'~t:;.()-\~ CONTRACTOR'S NAME AND ADDRES~ ::t;';r,-<::.:- _/6~1P n,~ ..;r,-y.;,Lhl Y/t}/?? 19_ tL..t...'A.- C) 7 1.../0 C/- ' Phdhp' . " , Mailpft,rmitto ( ) Applicant ( ) Owne~~(r) C~ntractor. ('.c.-}'Pref~rtopickup. Callf!?;?:::c;S9?tI, . (o~ner;etc.)wh~n read:~'., ,,' C'i<:- 'S--fr.l) # BEDROOMS , . SEW'AGE:UISPOS;A.,.C",.,,:/l/A,'. ';"P '5'.T ~~". . PLU~EfING BY(]/; a.....o.-'na h~~_<::' ,- " - ",', I hereby certify that the above statements are true and accurate, and that I have the following legal interest in' the property:' ' 'owner of reco'rd; .' :.. ~ontract purchaser; potential buyer; realtor or agent. I furtper certify that (if not the oW,ner) I am authorized to act'for the ciwne'r of record, and ~t said owner is aware and approves of this action. I hereby agree'(to_comp\y with all ~EE.licable Codes relating to this permit ' " ,', Fee Paid $ 71.0 cf C5;.:J.t90..) Signature \~;I f::(v".:_ f- 1"'1/. Y: \lrV/l'1 Date cO-lo - 7g? ( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. () SPECIAL PMT. AR,EA. MIN. ELEVATION: STRUCTURES NOW ON THE PROPERTY' S'PD THIS PERMIT IS FORevh?YFM ./';' f-/A_/~~A NATER SUPPLY' IV A- :t:: .. 'j #P,~~M B I,~~, CO N~EC+ I'ONS',$:' ," :/ . 'i , THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF. 0<",," .~ : , Comments: , ' . ~. J. BUILDING, , "',, . ' ,/4{""'"A./: Type of Coostruc~io~' ,,'-I;. 'Group,_ ''':''?', :Fire Zone .~~:;;~Q~2r}'9",)~~..... ... ... .. ,_:~ "'. SANITATION .... , IVlinimum,Septic Tank Capacity, (Gallons) " pnilinfield Required,~ Lineal ,Feet .,' ' ,M,axirYllJrnQe'Pt/:1.,... ' """.-"4 By: _,----Eate,:,~~., BY:'~ ,~..; !r-14 UA Jbate: 2.- i ~ ~ ..., p , PLANNING':B;EQULREMENTS SATISFIED.'B~:-h/11'..I7'-; V DaterQ-/.E.....,ZR ",' ," Date Issued: ~-l.~ _on, ZOl'\fE: /}/~r SETBACKS: FRONT..,t..- SIDE FACING STREET (FROM C/U INT. SIDE YARD-REAR -('FROM P/L)>'.', . V' . \ ' ':: , ,LANE COUNTY DEBARTMENT OF ENVI RONMENTAL MANAGEMENT, 125 EAST ~THAVE., EUGENE, OREGON 97401 . POST THIS PERMIT ON MAIN BUILDING ATSITE C55,13 ,$LDG. PERIVU:r"': V:i'HITE; BUILplNG --~R'EE,N; PLUMBING - CANA.RY; SA~ITATION - G~~[;E:NROD; OFFICE, COP:V"'" WHITE \ _\..:~.. ,. :7:;,~_,~'~'~^.:a ._.r~,".:,~ .<..:'~ ,;,;:'~ ..'~ :';',: :.~':'.~,~;~~~~.f..:;".~~~_;~:_~' .>>~~', -:~_:~ _'~'.;:;,: ~;~:""-_ '.,~.~.: ~'t;.,J; ;::;:i:;t;<...~ < .: ~-~, ~ :;_'. :;:. _",,~:,,~,:_,<;:;i\:/_'~~... -,,-' ..:. ~,:,;:.'", ~~'":-:~'~'i~"'~;_ -,; ;;' "!:~';>~':;~1','75 Silver L~h~~')~"'\ Eugene,Oregoh'97494 .. (503) 688-9534 ',:41'-,,.,,, I', d ..",.. , ~' . ...." ,t.. ~71~!~~::~4;44t~,~;U..::~~~~~~,~~~~i~~:~J,~~ i:. ~:"';:". ::" ~..... ;~~"'. "j~'. ,j ;-.....:.L.., ~~;. "- ".~, "",- 'f . \, -w~, " .~" ''I'' . ," . ...; ~H '.. EMPLoVMENT AGREEMENT. " ...,.' AGREE~~~T'WITl1:" -M ~ ~ 'M(L?~~--R~JlDJ ~G. "., " ,,' 741.~~'~ - 3~~ -~CU ' . .~. ", . 1.... ~t , :;/DATE:~ I 'l,J 1,~ , ,I' . ~,f :" . , . ,,"" . y' :' . :~IPSON I & PATCH, INC,. ~e.f~ft!l.1...caJled t.~ Ciomp~y, prop~s to furnish, <!~~~all MATERIALS according ,to ~~~ following specifi- catlons.'~ or on ,he property at ~~_ ""lC~__,_,_I...t:l___p ~C , ,_ .. ", ' " " ,., .' ~F~~~D~L~~Of J(~_BRLe~S r/c-'LEb.\ACC:- f~)~T ~F~;~ D)-S)4W~H~ , ~.rajl.\ rcUL C ~c c.'\~1 c, ~~L {).!lftV--1-~ k'",(,1c. SE- ~r8L~~/IoJc;, ~1C.: tJ.f~ "'LL~ " 'r>~"&:~-f-r~~~~Jt1;~'J<<_;iAA_~_f-!! ~t ~;;""" ~ J:r12-~..Al OE.It, " '0: ~, .'_ ~,.. .1, (!:,'O~, ~1l.ltJ,I.J) L~,' ,(.,.~~,I1~I.s 'Uf~,f~,.,JN,tn",'~, 6u,6C.~~.f~~li,l,,',,~', "',~,:,"', ,',.:",', "E.~/li.v~'()iBK~0' /#J Kj(f/#,.;ft~8_).i4-~~ ,1,.3 ~~OER,Ai,~JJIi). , flwJ V;M LrbJ I(/tithAl &~ /fJ..zftP~f!!::J ' ~~MpU~,~/;U/~Jf~Ft., ,M - "3 ~DR~~ /~'1~.s C!flflJ '-'~~~/;jf~Mw,~ '':~;': d.{'~., ~Iu. ,J't~ l:,;/ U€*K: _~li,;'t'?~~F. ('jJl;vf~;. '::;~' . ~~~~.::~:. ~~ ~.ma7/.S/. ~v~jlJA~.')fA{( 3" -!~~C~b ~- ~tV~Lff{{ ~~~~~?R-~Ae~~~~.' /~,It!~~~:i' . ," " If't,hJdJ/L ~~ ~z.r/NJ/4-/t!d?-lAl_, ,; ",' ," , ','. ,; ,,',.,',: ~ ...' ' J -0fmrtd~ tJ'W Hk P~/INI:J ~aefl " ,'. " 'G/. : ,I '. . ,', , ,'. <J f, ' ~ : ., <, : CJb "<; ,'; ",,,. ,: :'" ,,?~:,:t~:;:~:'.l:,;:>~:: .', ,For services performed and materials provided, I/we agree to pay the su~'of!l; /~,2'oc '--:-'" "," :'.":;' "', --"...t!rrie, being , ~ , " .~ !'l~fl..'l~ ~~~~~Z;a~ ~(!?,UP-i? . ~.1o/=~l3i::1'J!;~/-~'~ :;&;~<t~LM' ~ ~ u( -f-~ / ~~~~~;-bt_'g/ - E:7? .";.u ,;' ..,' ~# 2..~:2 1( OS !3~~~ ': .',,:" jj,(5"~'~Arrr:::;~~~xJ~dU>:' ..........' _ a~~~~8E~;~dJ/77&~!dJ ~ . .~~ "~I ..... ".: ,'~!' '~" , ','~ -l' " '. 1 "'. ,.~ + "r 4' .......'".. ',,'n' , ' "0'\' .l"" "';<: .. :1. . "-'. . ",;. \'~ .~ ~ . , ~..-. .- \ " , ~:' .'.~ ;. \ "";. .~ '. ': .,i ;V':.'.. .~,- , -.' " , " ...:., ~b ;1." /::,' ; " .~, " .:, . 'This agreement ShaJi bedome binding~Pon the Company's 'written approval hereof ~s indicated ttii~ugh sign~tur~'iri'~ the'aPPropriate,"space', '.,~~",t." below, or upon' the Company's "conimencing performance. Upon such approval or commencement of performance this instrument shall cbnstitutethe ",' "; entire cOntract and be binding upon the parties hereto, there being no covenants, promises, warranties or agreements, written or oral, expressed or ':- ': implied" except .as'tiereiri'set forth" No repr~sent~tive of the qompany has 1!utl1ori!y to altEjr the .ler:,ms of thi!; agrElernentin ar;1Y p1!rticular"un/ess qone ' so in' writir;'Q and approv~' byth~ Somp~n}j,'AQ'-/ changes rpade"b},: tM custome/mustoe, i n,;Writi~g.and:aS;Cepte((tiy, i,hl:!. Corppany.:' ,'.;;;,', ,', ;;',..' ":."~ ;," , _10--.___'___ ...' . ..~'~'...",...... ::.~'_:....::.~;.,.......--2.: . ,- ~,.~,l.'__ I.,' ~,".~"...__=:.::.:::;~ .,~. .~-.'c..--'.-'.~....'--';.;"......_'.i'_'......,.,.._~:~.~':..~~.,.",..",f..'~'" ."~' ':' .. l11e, Company s~II flot be ,resP9I'lsible, for9~mClge o~delay d,ue to"strike, fireS, ?cciqents,o~, o~h,e~ ,~~~es~yond its control,Thecompany\ ,:;:-. '..>-: carries Woikrrian's Compensation and' PiJblic 'Uabilitylnsurance, 'but dOes nof assume risk fo'r liabilitY of any' character' undedhis' contract other ,than " ',' ~y~t~bysuchi~su{apce~" '",,', .. "', " .'..:. ' ';':'q:'.'" "; >.;~,; .::~':"i;::'~':,'~:.,""'::;"':' . : . ,", '..If thls'~ccOuntis in default and placed, in the hands of an attorney or agency forc:ollectiori, the undersigned cLJstomer'promises' t(jJP~y'i::oll:e<:tiOn, i ';': costs; }ricf,udingreasonable'att6rney's fees, 'even though no suit or action is filed hereon; if a suit or'action;is'filed, the amount of.::such'attorney:s fees..c ':" shallbe fixect by the court or courts in which the suit or action, includingaryy appeal therein, istried, heard or decided" ' " , "., 'THE:' COMPANY HEREBY EXPRESSLY DISCLAIMS ALL WARRANTIES, EITHER EXPRESS OR IMPLIED; INCLUDING ALL IMPLIED WAR- ~';'S!;i~'~'~: RANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE, AND THE,COMPANY NEITHER ASSUMES NOR-AUTHORIZES ',.'.' .' .,'. 'ANY OTHER PERSON TO ASSUME FOR IT ANY LIABILITY IN CONNECTION WITH THE,WORK PERFORMED UNDER THIS AGREEMENT OR ' THE MATERIALS PROVIDED UNDER THIS AGREEMENT, WITH THE SOLE EXCEPTION THiAT THE COMPANY GUARANTEES THAT THE LABOR I . PERFORMED UNDER THI$ AGREEMENT WILL BE PERFORMED IN A WORKMANSHIPLlKE MA,NNER ACCORDING TO THE CURRENT STAN. DARpS: INTHE'IND~STRY, ' ' "", .", r ':," ,-.., ; . , . . '~ ., .' , '. . .. . "', '. . .. .,.' ~;,1l1e ul)de~signect customer hereby acknowledges receipt from Gipson & Patch R~modeling ora copy of. this .COrltract., , . ,'~1" ~. "'-. ~:,' ',-" ..'~"/'.'( _' ".,,\ :" ~;' '.: '<. ." \ .~' . " . ;; '" ...., ::-:':-.:'::: ::, .:~~.>;'-~'" '.:; :'t ,~'. , . ", GIPSON & PATCH REMODELING:' 'CUSTOMER:: }, . fT,.'.:: c : >) I ,'., '" i, ,.' "~:JA>, . i!JJ~<<:, " I/~~~ :.t..>;"'>>" ;~ltl.~~,(~y}~,:,>,", <' /; :,' ., ,.' ',"., , ..' ",>"'" .</:.." :. 'r/~~":'" ';C. Ii':;;;",' .' 1'" ;..," < , ,..:-a'.;;"~.-i,~i !:"~"'itt.'':,t'.;~_:'$X-'''~,'D.~'' . t~ :~. .;,,: : '" ," . }" Job Location J()8~ ''fYltJ/J1./~) vdu.~ J /5/cCt::O~, () 0 , 3/11f TRS, TLl1~ b3'\:)1 3~ 0 Wri tten Directions :2000 1;- //11 tJ /J1 t! I ~ 'J ' INFORMATION SHEET " , ; '\.' ( vf B ui Idi ng Per m it -<< 'JV\l"d..o..lk~ ) Site F eas ib i lit y Study lor Septic Tan k. Number 01 sites . Acreage or Lot Size /bD -...,c.:.,/6)O Test holes will be ready 'Partitioning '# . ( ) Completed S~bdivision ~1) Mt'U Oc'\.)t ~ Lot 3', Block 3 APPllC~Nr$ NAMl'AND A~D~~~~a~~L,,-Q~+~L J~ j} ',yjp~r~): /75 .->!iJ. n L<MIa.9np'- Phone ~!?-949f1 OWNER S,.NAMEAND ADDRESS, If dlffererl't from apP,licant's ~ ~Jfi&ftZ~Jl'a-oh Ctd~yp."!!t:$-3'lq ~3: '\-'lBA.... Phone-2"'* 'T-3ta1Q' CONTRACTqR'S NAME AND ADDRESS )J-,JYK.Q (If' ~~.1f'CUY\.+: ' ">(1. ," ,', ,,' . , Phone II', , ':. Mai~ermitor results, Pf, ,site"feasibilitYostudy to ( ) APPli,cClnt~'r ,( .) OW,ner (J:Contractor",i " ' .' , (v-} Prefer~o pick up. Call ~rrLil'~~. (owner, etc.) when ready. "ContractOrs o. S<'# I '+:'7q~ , ;::~::~:~:;~:lSDp:r:;t~1;~C"~:=~..;~~';~:~"f2'E~- ... . ~:~ .~7-'-' WATER SUPPLY , n I;, ' d well', etc. If public, name of system) , rfh /' , () h a/) /J1Ila~ I " SEWAGE DISPOSAl (existing or proposed septic tank, etC.) S.I.:I: . 1" a, . j1' PLUMBING, BY , Address .~ .~. , ..' )',PROPERTY IS WITHIN.oNE MILE OFCITY (. ~ ",' *** ** ** ** ** ** ** ** ** ** ** *'* ~"':~ ** *'.j, ****** **** * 0 FF I CE USE ONLY BE LOW TH'IS :[1 N E * ** * ***;*'* * * **, **,* ~ *) **** * * * ';"":* * * "':"':** *" * "** *" ;;: ,- ~ ;.-. " ( ) New Address Necessar'y , , ZONE, , ( ) Facility Permit Necessary " ' ) Special Perr.nii Area. 'Minimum EI~vation: SET~ACKS: Front , Side Facing Street (FROM CENTERLINE OF ROAD) Interior Side' Yard ' . Rear IFROM PROPERTY 'LINES) g .; ~, .. ~ To: Planning/Building Inspector/Sanitarian/Surveyor. This applicant appears'tohavea problem wi'th ' ,Your assistance will be appreciated. C' ,t; ~' ~, " By Permit Processing Section , Response: C55,12 By DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue 687-4394 ' nivision : ! '. TRS, TI !J ,." :? <"', ''1 :; ''d; ;; .1=, 2- ~..f F' _ '.I. H V "~-I """",.",1"""\1 .~j' Ii j I,: _'" "~~ JOB LOCATION } 'A~ t' J /1 ?#,A/ !!. - . ~J/ ~'. II /J1I~' - '.i'." .......~ 1.1 I .#. ,,/i ,~ .tPf, . \ ',' t~r.(l,f' C:..._ II 1/ '" \, '- ~...:. ....... j --',;? <'j .,' f~~' "".;;(1"':.'; ~ r 0..:::.... ....'"'- ~ Of) ....) Ii ~" ~ "4, t,+7 .~~ '-=: - ,#' .. LANE COUNTY PERMIT Acreage or Lot Sizp ItJt] ,X !.f'r'! Partitioning, # //}P<-+ ) Completed Subdivision l'7Ir:.,/.:; /#1 ;:.);? f1l; .... Contractor's O.S. # /V-~;;Qq. Lot .;;e -- Block~~d\ q, II <':1 12 -I. f (j .;{)", /.~ II 0"[> ' ~~ APPLlCANT'SNAMEANDADDRFc:c:,if!U::::LZQ~ I~ Ii /';l, (iJA ~j!jr"' liit(--.I1'1 r,;A',~l--'f,A C Jr ",g",). Phonp,,~~~AZ!'::;?c;9<f-'.> OWNER'S NAME AND ADDRESS ! ,~<WA~::'!.r; ,q~;V:"'A<;"t~~.A ~7-. ~~ ~.c/~;d{ . . / ..-- ',~ Phon~r;}.(/';7-"4L:/'\"" CONTRACTOR'S NAME ANDADDR'ESS .~t);;-;c.:;'. '7' fih+.A:f~ 77.<"" ..;l; -/:',f j.t ,..::f/} if. 1;' ;~.J ~ C}7(/7(/ Phonp ~ ~. -.,-' Mail permit to ( ) Applicant ( ) Owner'~( ~;r) C~ntractor. (~)"Pref~'r to .pickup. CaIT??P';QS9'?/ . (owner; etc.) when ready:,. .--..... STRUCTURES NOW ON THE PROPERTY S,t::".fJ p_ /7 /} . / " TH IS PER M IT IS FO R fL,.ph, t1/,,{...Lk::. ./...41 r- ~:"LI JI'lA_ WATER SUPPLY Ii..) k S fr.{) # BEDROOMS # PLUMBING CONNECTIONC: '6 THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF, ~, SEWAGE DISPOSAl >,'1./.4 " . S.1. # , /l/~. .' . PLUMBING BY t, :fUX.d"J?Yl /# ,4 <:" ,- ., ,,, v I hereby certify that the above statements are true and accufC,lte, and that I have the following legal interest iA the property: owner of record; contract purchaser; potential buyer; realtor oil/agent. I further certify that (if not the owner) lam authorized to act for the owner of record, and that said owner is aware and approves of this action. ,I hereby agree,.to.cQ[llply with all applicable Codes relating to this permit. ct1'r""'f' 7", (l /' ?-: -; d'>.1"""'; ') , 'I "'''-, ~ I " ~ I,' ,"'"' t '\ 0"') ~ /.) rl ,/ Fee Paid $ l~, (,J ! '-"~); -# r'/"",:-.; ,Signature \-.J" ~~'1'11_,:, 1" I"l).. 'Jr, ...J",::~_ / Date 'v /\_" ~ ,,., ( ) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT, ( ) SPECIAL PMT. AREA, MIN. ELEVATION:, ~ : .f SANITATION Minimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth BUILDING . ~t/, Type of Construction ~Z- ,,.d- - ~ "'" ~ ,p -, " ~ I Jse Classifica.tion ~~"----7" ,"," " Comments: ~..J .J.~,+-:' r~' ' Group ~? Fire Zone Comments: .1.#1' ._ ,~~ 4' #~....-!'A!-4. ~4-~,. /' By: Date: ,,'_, By: V g,.".-;l.-d ,.-<I I~"'" U..f 1M/Date: :1 ~ I ~ = "1 7~ " ..- PLANNING REQUIREMENTS SATISFIED. BY~-./}A1.l;f-~ {J' Dated7..../,i?- 7r>t'i Da'te Issued~ :;t.-lb ~"~f?1 ZONE: /1/<< SETBACKS: FRONT JI...-' SIDE FACING STREET -~' (FROM C/U INT. SIDE YARD ~>>~, REAR -=('FROM P/L) L,ANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT,'125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394 POST THIS PERMIT ON MAIN BUILDING AT SITE C55,13 _ BLDG, PERMIT -WH'ITE;BUILDI'NG - G8EEN;:,F>LUMBING - CANARY; SANITAT'ION - GOLDENROD,; OFFICE COpy -, WHITE . .;' . . . . ":.; ~ ': . , .. / . <( '\ 1:.I .....-.. ~, SITE INSPECT ION, ApPROVE~ I ,/ DISAPPROVED 1 1 D"H' REMARKS 1/. ,(i ( . ~ o. i ' I 1 I' 1 FOUNDATION ,INSPECTION ApPROVED // DISAPPROVED 1 REMARKS " 11 ; // , ,/ DATE ,., l :1 I 1 I FRAMING INSPECHQN ApPROVED I 1 DISAPPROVED 1 1 DArE, REMARKS~ /dn-e~ J,- ~I;r ~~J I I' I LATH OR SHEETROCK INSPECTION --- ...- Ap,PROVED 1 ,/1, DISAPPROVED / INSPECTOR '- INSPECTOR' 'I J INSPECTOR J -/'7- 757 9~ 1 DATE y-c 2 - 78' ,I NSPECTOR C}w--t::..? ,~"'- z- 78 INSPECTOR Q~ y ,_"" c/- ~~.-??' ~ O..d_ REMARKS FINAL INSPECTION :~ ApPROVED I'? I D~SAPPROVED 1 1 'D~ TE REMARKS..aJ' " f'H,,,,:-"-_:, ,I../.~ ,;) , -/_./~r:> __, 1-' Y" ' I I I ,1.' ~? , , CERTIFICATE OF OCCUPANCY READY TO ISSUE 1 1 NOT RE'ADY TO I S5UE ,I I, DATE REt:1A~K S INSPECTOR i~ , ''(j'' -f-~' . TRS, TI . r, ;;; '~~l ~,) :;P d J :::1; ~....,...r;-':'. _ ~# ,/", r. J .. .. J -"')~..:,-\^A, .;:"~' ..' ir ~ 'i(~.~.l JOB LOCATION i ,...... ,,f;' .... : . ;~.-<:~~ v 1." J'r I ('.;.:,"',' I .. ~ ..tol..y C-:b ./ .J'" LANE COUNTY PERMIT '. ~ . /f /', r'_ "-, ' Acreage or Lot Si7P /~ ,~:.X I;.:?{--:' Partitioning #' if ,/~ ) Completed SUbdiViSiClJf!~t/~'~:::~ r Contractor's O.S. # , <pJ-'fq' lS.ot _4; , . r, tf),w r ' . 1'-)7"!..' / ;; ',(~:,:,), L' II:~ ~.,h,. " ," ~ ' , ""7" ~ oi, ' _ ./-.~~t;.~' .'"'..J,W"1t::... ,~ .. APPLICANT'S NAME AND ADD R ESS. ~ll-t....,l.l t-:~."),~...'l . 1ft- 1"-:'1,,# /''(i ill (l.~ii tr:~ I; a/;,};}. '''',r~O /7')"1)(-':-1 ~i'.&'('/") ~ Phonp "' -.'V' ~, "...::. ;';;.j ~~ OWNER'S NAME AND ADDRESS I ,1;1./;,<1, ~:i'<1~.' /-....~~/(./;-f/ r'. , P~"':;'F _'-:. e.,r";~f . '.JJ J,,;'; Phon'p';"{;I"7"~';<:>':/5"-: i CONTRACTOR'S NAME AND ADDRESS ,.J':'_~r: <;;;, ,,~ If'ifr c",'J,( /7..."",. "--.' ,':l:".Lt l' ".I;"~l,;r] c, tZ! \'ic' "f,,,t]Y"', (./r.'-, <-/ Phon~' ~ J Mail permit to ( ) Applicant ( ) Owner' (r ) Contractor. (t.-'}"P~efer to pick up. Call~:~y?'?'.:?'<~9,;i.?/1'{;:'t-'('C;wnerJ' etc.) when ready. .' - '::;~"~ ;...:,;- J.J ' I _" '. , ,'" :1'..... ,:;~F l-' /- ,,~~<,)j-/ .' ~ ,_ ch '.'11'1.: ~, , ,L.,' ''c'''';:- , !~'l ., ,,/iT " J -I.....tt t1jpJ/v4 .....,,;,;. r j ./I 1,# BEDR:D0:MS /1 -:~:! ! Ii< " ) >,A').I '~:":Ji}.' SEWAGEDTSPOSArr;~;/{i1::;"7r """'5.1#' , I:'::" ."'" o~ !/{::~ i~ ; , THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF --- .-' . P;~6MBINt' '@f:Y'h/'_~F', ddV':~ ;'YI' /#,M'I' ~~ I herebY certify that the above statements are true and accurate, andthatl have t'~e followiqg legal i~t~~e}t in the p:ope'rt~:' " v owner of record; , contract purchaser; potential buyer; realtor or agent. I further certify that (if~n6t the05V'1,ne,r) I am authorized to act for the owner of , record, and th~tsaid oWl}er is.aware and approves of this actio.n. I hereby agree,to,co[l1ply with al~,lica~le1S~des rel~ti.?g to this permit. . cf'I,:r<.(1 /L: -'1r~' '\ '-" ~ f .,jl--~),\.j)l'~t../" ',',ij "-'-" Fee Paid $:. tt"'" C' - ,J" ,..... , "',. -'...,/ Signature. ( ~, \\. 'ff ",., , ; 't l ],,11',; .....,..., Dat~ ... ( ) NJ::W A~D'R'ESS"( )'F:A.~L1TY PERMIT TO TRANSPORTATION DEPT. r:~rECI~\_ P~~T,. ARE~ MIN. ELEVATION: ,SANITATION B~D;NG ",'~1" ,/ J))./JIL-7" J! Minimum Septic Tank'Capaclty'(Gali6ns)' -~ Aj , Type of Constructioh/.tr::. t:Group ':f "F.ire Zone., . D . f' Id R' . F fi';' 0' ;.,// . :.. ,,, " ram Ie ' . eqUlred - Lineal, eet e;:::;~~-, J.-:.~::"-:! ~ ~,.-:; '19se CI;~s~~9alion' , I ' Maximum Depth' 'c' .'~Ji{l'~ ' w ~h1 ,",,;;$,. ',-.I' , .,.4' omments: ~"," "";';q~.'W';""4'~'I-: ~~"'" ~",,~..,~. '''q q'f'it . ,~c ~ ;.:s <>' jv' ,(J '() ';'1 /;/ {J' ~ -- hi'. J. .\.- (j i;' in U; .-,. t' ~~.~ j...'~f-' .,.J"j. \.. 4.. II<". ".. By: Date: B ( ;./ p;"l I::''''' "-(lJ.{ J.. ,./0' "."...~ (f' y: ...'!~. f....;l"'7~,,<f....r }:,ltf;1,d ",'.4 ~.,"'~ ate. I ~6' / ,7'. '" PLANNING REQUIREMENTS SATISFIED. By,.....,Jj~,#lI)tj' ;,' DatecQ-/J8- 7/i:f1f, Date Issued: ;l"'8~...-r8 ZONE: /],1f4-' SETBACKS: FRONTJ." S:IDE FACING STREET ".-" (FRo.MpC/U INT. SIDE YARD .- REAR ,__(FROM Pill LANE COUNTY DEPARTMENTOF ENVIRONMENTA't>MAI\rAGEMENT, 125 EAST 8TH AV~!., EUGENE, OREGON 97401 P~6NE: 687-4394 . .' 1. POST THIS PERMIT ON MAIN BUILDING ATSITE ' I,!", Block " ,::r:,~ . J,!.'" t"~"~!?_L, ;yft.-......r;:. " ":;~~I .{ STRUCTUR~S,NOW ON THE PROPERTY "l; . _' ; :~ i' TH IS PERMIT IS FOR 6 ~"''li ,"j ~.l:-,f .(:', '0)' .!.I j l'l.~ VVATERSUPPtY ,/{,.,~'. ~ # PLUMBING CONNECTIONS ,.':} / I ...- " ; - ,:~ f j. t;' ~ f .," " J Comments: , ~ ~-~- . C55-13 . ' . . . . -- ',,'. . '. - . . BLDG. PERMIT -WHlTE;BUILDING- 9RE::.7~;PLUMBI~,~- C:ANARY; SAN:,,"AT.ION iG'~,LD~,~ROD; OFFICE COpy ~ WHITE , "", ',: ';' "', , ' ... ,'" ,,':\..',",.;.' , ,,' 'Y . ", ,.:\",'" ~ 5 LAB FLOOR PLUMBING GROUNo..JORK ApPROVED I / DISAPPROVED I / DATE INSPECTOR REM'ARK S I 1 I , 1 GAS PIPING GRbUNDNORK ApPROVED I / DISAPPROVED I / DATE INSPECTOR . , REMARKS ! i I ROUGH PLUMBING ApPROVED / //1- DISAPPROVED / I DATE d ..-c:J.6 74':SPECTOR RA-. ,\ REMARKS ROUGH GAS PIPING ApPROVED I / DISAPPROVED I / DATE INSPECTOR REMARK S' 1 I 1 I FINAL PLUMBING /to~~ I~ ~,-,.~ ~A-D~11">~:,~ ,,1"7 '~7~. ApPROVED / I 01 SAPPROVED 'D~ , INSPECTOR : I. ' Ry,1J,,~R~KS ~~ . t;-:~I~~~~"~ . -(~ -<-, lA'./'. :-. ---:,. \. ~~" ~ ' ' , A /l I' .' . II (./ I FINAL GAS PIPING ~9S4r-~/'''-Y3 ApPROVED I I DISAPPROVED I I. DATIE INSPECTOR REMARKS CERTIFICATE OF OCCUPANCY READY TO ISSUE / I NOT R~ADY TO ISSUE /' I D~TE INSPECTOR REMARKS ,I J