HomeMy WebLinkAboutPermit Building 1977-11-8
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APPLICANT'S NAME AND ADDRESc:~dtf l/lJ.L.,(b_.Pii_""~ - Sd'-:r.n....P
OWNER'S NAME AND ADDRESS t. if , -"'1'
CONTRACTOR'S NAME AND ADDRF~~ '.' II lv'
Mail permit to (1...,,)"Applicant ( ) Owner ( ) Contractor. ( ) Prefer to pick up, Call
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Acreage or Lot Si7P
Contractor's O.S, # _
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(owner, etc.) when ready'.
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STRUCTURES NOW ON THE PROPEHTY
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THIS PERMIT IS FORIie. /1 C!J7)" __5/;::;- /____} //..,1'1 # BEDROOMSi: " # PLUMBING CONNECTIONS
WATER SUPPLY //V /Jr-' \\f\ v SEWAGE DISPOSAL /1/~/ ,,' :'-~i'\f" S.1. #
THIS PROPERTY IS ~ITHIN ONE MILE OF TH'E CITY OF ;. /1~:"'q . PLUMBING1.~'y; ,V ~./1- -V-
I h~rebY certify that ;~he above statements a~e true and accurate, an/that I have the f~119,wing l~gaii1ter~st in the property: owner oL?~cord;
contract purcha~er; potential buyer; realtor or agent. .1 further certify th,a,tl(if no} th.e~ol!Yner) I am authorized to act for the owner of
record, arid tha, t ~i<Jowner is aware and C1pgroves of this action. I hereby agree to COIlilPlytwith",all a'pplihal51'e 'Codes relating to this permit.
Fee Paid $1 t;},,~. 0 (/J 0 o.~ .J ,Signature ~~&~e~;~~ . Date A,'"
( ) NEW ADDRESS ( ) FACILITY PE'RMIT TO TRANSPO'RTATION DEPT, ,'(. )'SPECIAL PMT. AREA. MIN.JLEVATION:
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Comments:
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BUI..LPI~G
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;. '.:-,. Type of Construction
I' . \" I Jse Classification
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".," ,: Com'ments:
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SANITATION
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Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
Group
Fire Zone
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._-E!,t~<J_,_." BY:C;~~. ~~ h9t,~ Date: /1-?-77
PLANNING.f3E9UIJ~J~MENTS SATISFIED. B~u..::r- iY Date: 11- /-77 (/ Date Issued: ~O" 8>/'11
ZONE: /// /1 SETBACKS: FRONT 1'" SIDE -FACING STREET (FROM CILl INT. SIDE YARD REAR (FROM P/U
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE.. EUGENE, ORE6oN 97401
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By:
PHONE: 687-4394
C55.13
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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SITE INSPECTION
ApPROVED /
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DISAPPROVED /
REMARKS
FOUNDATION INSPECTION
ApPROVED /
/ DISAPPROVED /
REMARKS
FRAMING INSPECTION
/ DATE
/ DATE
ApPROVED / / DISAPPROVED / / DATE
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REMARKSgA-,.,.../~,,_, -<l.f".../---~ .-0-., / ...4< W..
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LATH OR SHEETROCK INSPECTION
AP.PROVED /
/ DISAPPROVED /
REMARK S
FINAL INSPECTION,
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ApPROVED / ~/ DISAPPROVED /
REMARKS
CERTIFI~ATE.OF OCCUPANCY
READY TO ISSUE /
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NOT READY TO ISSUE
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REMARKS
/ DATE
INSPECTOR
INSPECTOR
INSPECTOR
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INSPECTOR
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DATE6 - ff.... 211 NSPECTOR
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DATE
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INSPECTOR