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HomeMy WebLinkAboutPermit Building 1979-9-28 . r.~\ '1-/ r , Job Address " II qi1 \/~-k:-Le~ Ave..-', C1ty sl'1fk/ 'TOWllt~ip, Range, 's!iC~J~~, Tax Lot j !Y' 1l7'>0(, ':Nr:_ '3~, . SubdMs;on "'"" yn- -IrLi"'~' , Lo. -~ MaCk ~ Appl1cat1on for - '!/~'1D .... C>ect.P ",-rldJ-h.OIll I Structures now on the proper'l'y - ~bl,. ~_ mt-l Propased US" of, property,' ~ ReSld~~tlal CI COlll1lercial CI lrnluttri'lt Cll'ubliii' Affldavlt I. ~/-e.., Q ~R~'{H::.: , hereby certlfy that thlS lnformatlon 15 true and accurate Il.pl~.s~ print If thlS appllcatlon 15 for an agrlcultural bUlldlng It wlll be used for purposes allowed by the State BUlldlng Code and Lane County Code Chapter 10 (zonlng) and for no other pmpose I have the followlng legal lnterest In the property J<: owner of record, contract purchaser, lessee, holder of an excluslve optlon to purchase, duly authorlzed to act for the owner, who 1S vnowledgeable of thlS appllcatlon ~ Slgnature/Address ~--'~~~J I/tf/O f<-'" ~iv!;v ./'fJ-v-e----------,lP) 97'Cz7 Tele~e - I or Date J' When permlt 1S ready notlfy /~/ Appllcant /~ Owner /~/ ~ontrac or Qy ~/ mall I~/ phone Owner _:R~ YJ1t:1W/?-&f~--=- fL/a)1:.-~u 'i ~6-TZlO) 1717 7 Phone ?979'/f?/ Contractor f),..~/3r f.p""e;;-!. / (ZlO) ~ 7 Y177 Phone ?'t 1 7'/'i'1 Contractor's OSR# l'irvlf3 Plumb1ng by DEPAPT~IENT OF ENV I RDNI~EN fAL 11ftNAGEhENT PSB 12:, FAST 8TH AVEdUE EUGE~E, OREGON 97'01 / \- r rl~(.\~~~ A'$i~fi.~ Numb~rs ....-- --- If Commerclal Resldentlal Y DO NOT WRITe BELOW THIS LINE I # 'Of storle'S.~ # of employees If 1>1 Qn~ts ~ c:...~e..~ 1/ af bedl'OOlllll SIlS: LI EX1St'" BP # ~," ~ SI test holes ready CI Propose .~I,-\,. "- Cd) (0)) ()u::::::, c~\ ~, tee COd~ llescrioilon ~ ~ ~ / . -.,-,. v r, r>, f- f'~ \ ~ '-PI:;-~W \.....\.C'J.~,:.,'~ -, id.. . 'Y:::::'c:.. 't-,'^-- - ( . - t; c.~--\'J '\O~ I~~~ # ... RecelVed bv '\. ')'f\r\Jo.-.... Sq. n. 01' II of Sjt~s Valuatlon Fee . lnt $ LX:.:)C) $ $ $ $ each $ each $ $ $ $ $ $ \ ()~ ~ r~~':-~~~) \... J '--= - ) / f \ ( Total~aluatlon $ N, l>t_ing htU1'll$ at $ , Sewer/wat <;onn. at $ Subtotal - 4% State surcharge Plans check fee Change of Occupancy '\~ Water Supply Proposed Year Installed EXlstlng TOTAL " PERMIT PROCESSING Mlnlmum setbacks 20nO('..,. Y' - ;;-a'*"-it - 1\.. front- ~ '~--f\' 5 slde Parcel # Comments To be typed on permlt CP&I Type&::: -N. To be typed on permlt Group ~- .~ \ By ,-U'\ '\ Y "\... Date ~ - \'\. '7., Use Class1f1cat1on~..o, <\; Ap,.~~ /'2Rt:) ~..::b ~ -'./1 1~~ --J - -11/ M Flre Zone '9 By i~ 11. / \..t; '7- Oate Q-ZY//7- For plans lnforma~lo~~ll (area lnspector) _ ~~~. Phone ~":;'/~.~ DlrectlOns to Slt...~"" J._ c\. _ I\. \l '\0. , '" - ~ \'-.r,-, ~ "'~.' ~ ~~ \ 0 _"'-.,r. ~'Y~ ~~ \ 'So. 4- '-> \ <3"\'0. ~:, '\. ~+ %1 S 0 Plans to CP&! setls) Date Hold Sllp D.te ~ O.te to - WPC set Is) Requ 1 red to PCC Comp 1 eted PCC I~C~ Iftc - /~I Pl aom n9 CI Pub7 Works I]if ElevatlOn CI Address () FaCl1lty Perm1t /~I Envlronmental Health q/~ I' ~ ~/a 9~~~ ~/,oy1 ~ n1 FOR C74-171 INFOR~~TION about progress of your appllcatlon call Permlt Control Center 687-HELP (687,4357) . PLOT 'PI--IJ-i! Vle,,"j.(Y t11Clf W\1.1J <;'1 CS,aftcl !' .' ~ ~ ~ " ,JMJ:l.v..... R. I) l~~ ~ ~ . j l' , .... "- J - , /7; -0 2 '0(, - Y;o ( N ~ <!IF- 123"- r- ~(.U FreLS> --=I .16 Jt' jJ t= - -=: __ r 2:c -- --- --------=:- ---- "'tlT j"'-.3?J:\ J:::ecJ<:' ...J ?tZO.POSCj) (rfJRA6E , ,/ ;,/ / ,I ";, / ,- ;' // I /:eXI5iIN~ // ' , I . I r/7).m G: " ,',/71 / /~ / / / . ' ,/ / ' ~ > / , , ., / / " , ~/ / ~ - ~ 2,0' , ~ ,,/ K, N '\ Z. L-e. Y A-ve" ~ I' 3 , , " ~~~:i~~ r }~ -:'1':'. " " - -- ~--? 111m C()lJN IY jJ['I'l LNV til, I I~I ('I II' I ~: '><)43'/9 IlAH ()9i '(Yi M.I:'I fU\Nl l)f I'mi' (,[lrl::TmIC fl ON CO "ON, i i 41) 1\ r N r IU')' <;:1' h fNl,[' ~I U' ,lkl::"tlN j U~ i aO:'(,'.');"04,1~ 0 i SIII,I) J Ii [ Dl 11Ll< NI:W nl Ill, ; {f'I' GAl, 1),\'1 h: I'll f'JII.'ri,\' 00 NO Ur; [1 \ (,Oi Nll .\'101: 11':.;' NO [l!.D(;S 0111 C(IO\. ,'iI'I'[NO ACIIONIH.'nnfTHlN ,';(lff UNllr;OSTW1I,lI,HION I'fr Dr'iYc 131, NI' hi l;til~r,Lf Hl ) (, ()'; ',' "63 l:W DI CI( 4()(, ',!.' 0 i (',; =, I-I' I' '! HtlTH PI" ~o I I Tf 11F' ~r' j,l[' 1-1 '1[: ['II ,;UF< I 'CK 1 2 .1. . 2- ..!, .!;. 1D 12 l' 16 '"II t', ~ 1!. !! ~ lD !! !! !!. " 10 '1, t ,L I C ;'<J 43 I(i N['111i PO. I [X I I I f"f.,,' !! S 110 ('I'I I AItf.N \'Y 1'l,i "II r: '!. 18 o ~ " :-L ,6 " - , ---' ,0 ! ! 4 J10~ PU',N . '-OIHH:I' 1f)1~:; tilCflANJCM IlL Sf 11 I 1- :: IJlWHI1F:(,f 1-'1 (,N I'I-if l K n f I , EV ()))DI, FF' CtIr,F'U TI]) HY " ~;.'. IJf) q;.. I)(\/:, d2-l,~{ U,CII . [,I'. II I (11 III 1 U . !' " "fl. (,(\ ...~O... {'If) J) -") ._ ~ I ,,'\ ,00 i Oil. 7;' LK i ~h .H " o (' () o (' ,0 I I ()j , . . . < 3 , ~ .[2 ~ v ~ 11 < 10 ~ \ ~ ~t;;, o' ~' Ii ; 5.i . 0 , , ~