lincoln county department of planning and …
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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
