HomeMy WebLinkAboutPermit Building 1980-05-13r(
, POST THIS PERMIT ON MAIN BUILDING AT SITE
JOB ADDRESS: 10 Scr..rd Ave., Spfd, OregoE CONSTRUCTTON PEBMIT# LC-77{-AO
TBS. TL: L7-03-22.4.1
'
3N subdivision: Bueda vr.st., Lot 3, BlocL 2
This permit for the relerenced property is hsreby CAIICELI.EDD. .. .Getbacks and othor conditions of approval must be strictly observed. Violation can
result in revocation of thi6 permit, citation under provisions of Lane County's lnfraction Ordinance, and/or olher remedies allowed by law.
Applicant/Address:Luclen E. Vlll-eneuve, Jr., L042 South 70th, Spfd, Oregon
Owner/Address: Dr. Robert A. Mofflte
Contractor/AddresstslL1 Sklltem
contractor's os + 001655 Total construction Value: 92002100
Construction approved by this permit:Dry rot repaLr.
97477*r,Telephone
Telephone
Telephone
7 47-4822
I
Water Suppl v na + Bedrooms:na +Plumbing Fixtures: n6 + Employees:
PLANNING DIVISION Zoning: RA Partitioning + na Parcel + na Parcel Size: 99 x t-30
Minimum required structural setbacks, from: centerline of road, front: {5r ; centerline of road,
side exterior: na ; interior property lines: 5t ;rear property line: 6r pUE
Special lnstructions not going beyond exlstlng foundation.
For information call 687-4394, Candi
WATER POLLUTION
CONTROL DIVISION
Site lnspection + naq lnstallation specifications: na
na lineal feet of drainfield required; max. depth of trenches;6
I nstructions:
Septic Tank
10'
10'
5',
50'
gal. min. septic tank capacity;
AT APPLICANT
Setbacks
I n teil-o r p roperty I i n es
Edge of road right-of-way
Building foundation
Wells, other water sources
Drainfield--lo-
10'
10'
100'
6*a
For information call NA between 8:00 - 9:00 a.m., NA
CONSTRUCTION
PE RM ITS/INSPECTION
DIVISION
Type of Construction: lU\ Group: NA - Fire Zone:g4
lnstructions. PERMIT CANCELLED AT APPLICANT'S REQUEST...;
Use Classification NA
For plans information call NA between 8:00 a.m. and 9:00 a.m.gA
For inspections (see back of this permit) call 687-4065 between 8:00 a.m. and 5:00 p.m.
lane countyDirections to Site: NA
Date tssued. 05113/_Bo 6l!'.t-
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE / PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401c55-1 3
By: R.L. McGuckln/1ky
t
/c
Permit * *i' ?O
Name (please print)
Address
Appl i cant 0wner ( )
Reason for can 1 ing pe rmi t
CANCELLATI FUND
tractor
ZATION
DateSi gnature
Fees paid for waste disposal systems (site inspections and/or applications to install the
septic tank and drainfield) are ordinarily nonrefundable. Some refund may be made on the
building and plumb'ing portions according to the amount of the permit processed.
CONSTRUCTION PERMITS & INSPECTIONS
Authorization for possible refund:ol
lo
o/
lo
/o
ol
lo
Building permit fee
Mobile home fee
Plumbing permit fee
Plan check fee
State surcharge fee
*-a$
$
$
$
$
$
-c)-
Si gnature
WATER PO LUTION CONTROL
Authorization for possible refund:
TOTAL AMOUNT
Date
Septic disposal system $
Site inspection fee $
TOTAL AMOUNT $
Date
O-
ol
/o
S'ignature
TO: DEPARTMENT OF FINANCE
Bujlding permit refund $
Septi c d'i sp. sys t. refund $
Site inspection refund $
TOTAL TO BE REFUNDED $
PLEASE MAKE CHECK PAYABLE TO:
24-08-24/Acct 46960/Prog 021
24-08-25lAcct 42.l33/Prog 0ll
24-08-25/ Acct 42134/Prog 01 2
Receipt #
Recei pt #
Receipt #
Name
Address
S'i gnature Date
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE/PUBLIC SERVICE BUILDING
I25 EAST 8TH AVENUE, EUGENE, OREGON 9740I
c74-tl9
*f,i'DEPARTIIENT OF ENVIRONI4ENTAL I,IANAGEI'4ENT
PSB, I25 EAST 8TH AVENUE
EUGENE, OREGON 9740I
Job Address
Appl ication for
Structures now on the
Affidavit: I
If this application is for an agr
Lane County Code Chapter 10 (zonj
owner of record
:Sfi:0n:lt:.
t 's. ,titii z-]l*#t{ti#ittilt.t'iit /-/ iffiilii}#iii
hereby certify that this information is true and accurate.
tural building it will be used for purposes allowed by the State Building Code and
and for no other purpose. I have the following 1ega1 interest in the property:
contrac t purchaser;lessee;holder of an exclusive o ption to purchase;
cu
ns)
--Y-duly authori toa
Si gna ture/Addres s
r, who is nOl/appl icat ion.ru,0
,
Tel
,ti fy:
e or Date
/-/_,Ovner /-7 Contractor !X mail
z'l
X, Pnone
Phone
enon"@
[,Jhen t is
If Corunercial
Residential:
# of employees _t#,lifl.,ti1ww"ii
t&#..*lii /:/ Existing, BP #
17 Proposed, SI #
'li t
Owner
Contrac tor
Contractor's 0SR# 6lL<{Plumbing by
SI test holes ready
Sceiliiil:ii. *frrir.l
:st*iiirtXii rr .* i
l#:,:]ti.#lits:lit#ili::: i[ffii Fee
Total Va.'l uati on $$
$
$
at
at
each $
each $
/_/
Rece i ved
l,later Supply
Proposed
Su btota'l
TOTAL
$
4% State surcharge
Plans check fee
Change of Occupancy
$
$Existing _
Year Instal led $
PERMIT PROCESSING Zone
Minimum setbacks:t, f"on
Cornment
To be typed on
t, si
Parcel #Parcel Sizfi nt.; rear
Da te
CP&I Type_ Group_ Fire Zone Use C
To be typed on r"" r,
lassification )
#
-\---7-----T--'7
DateBy
For plans i
ons to
/-/ IIFO,/ Plans to:
rf,1L4e&I
/-l iPc
! Planning
/-/ Public Works
/J Elevation /-/ n/a
, Address
/-/ Facil i ty Permi t
/ / Environmental Health
( area s pec tor
FOR INFORI'IATI0N about progress of your application call
c74-L7L
Hold Slip
to PCC
Da te
Compl eted
CP& I
l,JPC
set( s )
set( s )
Da te
Requ i red
Date to
PCC
permit Controt Center 687-HELp $87-4357)
DO NOT !.JRITE BELOW THIS LINE
Valuation
By
I
2
3
4
5
6
t0
12
I4
t
t6
u
20
22
24
26
28
.T
32
34
36
38
40
!2_
44
45
48
50
57
54
56
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HOLID SLIP
APPLICATION #
il!r'-7
Name
Address
pco
The above lication is being held for the follow'ing reasons:
r_1
.f------f
W'*tw*
Ipqfiffir"
(?tilrw {LtT *(a
try{aw ft
Date
;*A,
?l ti
Division
S'ignature
Te1 ephone
This app lication will be held until If the information required
above has not been furnished by tha t date your application w ill be cancelled.
Building fees paid for permits cancelled under these circumstances will be prorated
according to the work that has taken p'lace as of the date of cancellation.
ENVIRONMENTAL MANAGEMENT DEPARTM,"fA
125 EAST 8TH AVENUE / EUGENE. OREGON 9r*7form C74-139
lane countyHOLD SLIP
APPLICATION #
il!t-.-
fr
Name
Addres s
Zip Code
The above applicat'ion is being held for the following reasons:
I lie
Division
Si gnature Date
Te1 ephone
This application will be held until If the 'information re
above has not been furnished by that date your application w ill be cancel
uired
ed.
q
I
Building fees paid for permits cancelled under these circumstances will be prorated
according to the work that has taken place as of the date of cancellation.
ENVIRONMENTAL MANAGEMENT DEPASTMEN
125 EAST 8TH AVENUE / EUGENE, OREGON
,{a
form C74-139
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