HomeMy WebLinkAboutPermit Building 1979-9-11 (2)
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POST THIS PERMIT ON MAIN BUILDING AT SITE
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JOB ADDRESS: 1460 Del Rose, Springfield, Oregon
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TRS, TL: 17-03-24.3.3 (j 5200
CONSTRUCTION PERMIT #
LC-2648-79
Subdivision: na
This permit for the referenced property is hereby approved. Setbacks and other conditions of approval must be strictly observed. Violation can
result in revocation of this permit, citation under provisions of Lane County's Infraction Ordinance, and/or other remedies allowed by law.
Applicant/Address:
Owner/Address:
Contractor/Address:
Contractor's OS #
Al Taylor, P.O. BOX 994, Lorane, Oregon 97451
Ronald Burk, job address
same as applicant
19892 Total Construction Value: $15,000.00
Telephone:
Telephone:
Telephone:
942-5759****
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.,nstruction approved by this permit:
Water Supply: na
PLANNING DIVISION
WATER POLLUTION
CONTROL DIVISION
2nd level addition @ 572 sq ft;
Structures now on property: house
# Bedrooms:
na #Plumbing Fixtures: 3 _
na
# Employees:
Zoning: R-l Partitioning # na Parcel #
Minimum required structural setbacks, from: centerline of road, front:
side exterior: na ; interior property lines: na ;rear property line:
Special Instructions: na
na
na
na
Parcel Size:
; centerline of road,
na
For information call 687-4394, Donnalee Meilts
Site Inspection # na Installation specifications:
na lineal feet of drainfield required; max. depth of trenches:
Special Instructions: na
Setbacks Septic Tank
.xerior property lines ' 10'
ge of road right-of-way 10'
Building foundation 5'
Wells, other water sources 50'
CONSTRUCTION
PE RM ITS/INSPECTION
DIVISION
Directions to Site:
Date Issued:
09-11-79
na
na
gal. min. septic tank capacity;
Drainfield
10'
10'
10'
100'
For information call na
between 8:00 - 9:00 a.m., na
Type of Construction: 5-N Group: R-3 Fire Zone: 3 Use Classification:
Instructions: See reverse side of permit for required inspections.
SFD/ADD
For plans information call 687-3767 between 8:00 a.m. and 9:00 a.m., Jim Lamb
For inspections (see back of this permit) call 687-4065 between 8:00 a.m. and 5:00 p.m.
out no. 19th
Springfield, Oregon to Yolanda, left to Del Rose
By: Roger
6ne county
ca
L. McGuckin/ly
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE I PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE. OREGON 97401
Job ,Address 1'4 (,,0 DI"l-:, P..,<;e
.'E11'P9j1W?ifij!,1,4l!}Ytr!ll,~ 17-0 B -24 .~ ~
Appl ication for /?"'Mlll>...~ T? I? "" ~ f
Structures now on the property p~( <-. 'N ()lI ;.I0/)';P
!!IrnR\j11111:j)"jjtq;fEpmli:iE~$i' tX I!lliI'j9jji!~jJj t/ ~9!OO!~J%J'Jl
/l.L /)'\l(1-0~
tln!!~~!nphlntl
If this application is for an agricultural building it will be used for purposes allowed by the State Building Code and
Lane County Code Chapter 10 (zoning) and for no other purpose. I have the following legal interest in the property:
owner of record; contract purchaser; lessee; holder of an exclusive option to purchase;
duly authorized to act or he owner, who is knowledgeable of this ap~'ication.
Signature/Address I~ ~r3><' q~.;C / a/5.Qu r- t5 R <2
Te phone or Date
When permit is ready notify: ~ Applicant I~/ Owner ~ Contractor ~: ~I mail
Owner -I:QAdt.!d2.. R oR r Jo~ 1I.,;,f:>p<:s (zio)
Contractor 7'A"'L/)1? L:'",...,,,,'1- <!(A.-MP ./1.< ~"'I-"",,;hiO)
Contractor's OSR# 10,9:9 Z Plumbing by '1"1 {,(JJ-J-e,e
r2. '^ <I ,,..,
.EPARTlIENT OF ENVIRONI~ENTAL I1ANAGEMENT
PSB, 125 EAST 8TH AVENUE
EUGENE, OREGON 97401
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, hereby certify that this information is true and accurate.
Affidavit:
I,
7i!1 phone
Phone
II
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!~~~~i~
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(zioL974f -S /'
Phone 14:z. ~ -5"7 S7
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DO NOT WRIT[ BELUW THIS LINE
# of employees 111ll[IM'~'[:xisting, BP #
/~/ Proposed, SI #
~:s~::::::~~l~Il~I~~
SI test holes ready
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Fee
( \~m~
$
$
\~ ( 0 ~) $
$
~...........~
---
g !~ill
Received by ,,')V \f\....
Total Valuation: $
illl_lifTtlittlli'ii1 at $
!.,tlil:~fJ~~ri81Ij at $
Subtotal
4% State surcharge
Plans check. fee
Change of Occupancy
Water Supply
Proposed Existing _
Year Installed
TOTAL
=
PERMIT PROCESSING
Zon'e~ - \ Part. #
1\.. front
p~ t:'J~--; L.
1., side
ml-i
~ into ; rear __
l~ ril\
Parcel #
Parcel Size
Minimum setbacks:
COlTlTlents
To be typed on permit
CP&I Type ~)
To be typed on permit
J2..~
Fire Zone ~
Group
For plans information call (area inspector)
Directions to site, ~~ ~. Obr
...<...~ ~ I <",r~"
PI ans to: CP&I t' ::;;et( s)
WPC _____ set(s)
By LlL<f~~) Date
1 fJ-IYIA Phone
No 19ft. 5'!i.II'1(';r>{j-, t/r, O",/,I}k.flA.
I~I CP&1
CI WPC
CI Planning
~I Public Works
/~I Elevation CI nla
CI Address
C/ Facil ity Permit
CI Environmental Health
Date
~?~
Date
Completed
Hold Sl ip
to PCC
o SIFO
$
each $
each $
$
$
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$ " l() ,
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Da te to
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FOR INFOR~~TION about progress of your application call:
C74-171
Permit Control Center
687-HELP (687-4357)
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~ 2b4C19 DATE 082279
~'?4, LOi';ANI:::, Of.:Ec.ON '17/15; :'i
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riD I.W~T~' 001 f~O SHmn:: NO l:.i...llG~' 00'1 ·
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1"1 NO. FIXTURES:
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2Nll LEVEL liDD
NO. CONilECTORS:
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S"ft-iTE: SUf.:CH.:iRGE
rU,N CHECI\ :=EE
5.00
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