PERMIT# ___________ _ REC. ______ _

Date

Plan#

Application is made to:

Owner1 Ed and Joan Tanabe

LINCOLN COUNTY DEPARTMENT OF PLANNING AND DEVELOPMENT APPLICATION FOR BUILDING PERMIT

Valuation

Permit Fee Plan Ck

F.LS.St. SrchgZoningOnSite

Total

□ ErectA D Repair

□ Alter

o RelocateD Change of

Occupancy

□ DWELLING8 □ BUILDING

Approved

Disapproved

Date

By

OCCUPANCY GROUP

D STRUCTURE

a:: Owner2 Richard and Sally Grant

Address1 4825 Lincoln Ave., Depoe Bay Address2 4815 Lincoln Ave., Depoe Bay Address3 4805 Lincoln Ave., Depoe Bay Address4 4755 Lincoln Ave., Depoe Bay

Phone ______ _ O Owner3 Shari Kain � Owner4 Teny DeSyMa ;: 6rchitect/ Builder PLI System s, Inc. 1-

Address 304 5 SE 61st CT. Hilfsbo ro OR 97123 Phone 50 3 -649 -8 1 11

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Applicant ___ --'-P=Ll-"SC<.ys=te=m=s""-, =ln�c . ____ Address __ 3_04_5 _S_E_6_1_ st_C_T_ .,_H_ill _ sb_o_ ro_, O_R_97_1_23 ____ Phone __ 50_3 _ -6_49_ -8_1_1 _1 __

CCB License # __ �15=8�Z5�1 ____________ E=m=ail: -=pe=te=r=@=p=lis�ys=te=m=s=.c=om�--------------

Site Address: 4825, 4815, 4805 & 4 755 Lincoln Ave., Depoe Bay, OR

Directions to Job §_ite: ____________________________________ _

Lincoln County Assessor's Map/Tax Lot#

Setbacks from property lines: Front ___ _ Rear ___ _

Is proposed structure replacing an existing structure?

Is property served by PUBLIC sewer system?

Side ___ _

No

No

·11[·. l- .. .J

Side _ _ _ Height __ _

Describe work to be done. INCLUDE NUMBER OF BEDROOMS EXISTING OR PROPOSED WHERE APPLICABLE.

(Only work described herein will be approved by this permit).

C on st ruct a seaw all spanning the ab o ve 4 properties to mitigate severe ero sion

NOTE 1: SEPARATE PUBLIC SEWER AND WATER PERMITS MUST BE OBTAINED FROM LOCAL DISTRICT.

NOTE 2: SEPARATE PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT MUST BE OBTAINED.

I AGREE TO BUILD TO THE ABOVE DESCRIPTIONS, PLANS AND SPECIFICATION AND WITHIN THE REQUIREMENTS OF BUILDING CODE OF THE COUNTY OF LINCOLN.

Signature /J� �ar::

OFFICE USE ONLY:

Planning Qivision _____________________________________ _

On-Site Waste Management

SEE REVERSE SIDE FOR INSPECTION INFORMATION

0 8 1 1 2 1 C D 15100, 15000, 14900 &14800