HomeMy WebLinkAboutPermit Building 1983-6-1
I' Qc.;\~
flb's cr ' sf l\)
Lane C.' OU~lty Authorization for:
APP1~catiOp1/.~ ~.__~~
'. .' - (permlt # ~~. ~
.OIt1fY\, (1Yt aJ'kJ,,~,- ., .l:2.tr54~l1fVltaOaL-L" DTWO Copies of Plans
h-~{. ~ DTl1ree Copies of Plot plans
ToWNSHIP 1'7AANGE03' S~~~.L.:I. T?i)\cyOUT OF B::::~p~~::~::tC::::~~::
: Sl!.Q~tQ:6rN (If appm,c~t~ ()('}rlitrmj LOT/izL ~r 0 Plan. Check Info Sheet
~ATIO Dj-FfSS ~~ET . ~ 'cq'~' ZIP PROP.r:D USE OF PROPERTY
; , &') (?\E[)u ,Yl 0. ". ~..J [1jReside_~tial , D Indust~ial
'o~~~~t~t, ~~~-fii~c;o"~al ~
,r ~ -- '--.. ./
I.~. 61ru LJ( ~ ~ -0. lnJ~ n(~_On I 6n l~lA- ~~eL __
u:prXm~f1oWORKCh~ECIF~ addib~' ~".1~ 'm '~() ~,CLARED $ VALUE
~ OF BEDROOMS # OF' STORIES Z1' # OF EM~EES ~E~, S 11 '" (( ::J~po~ed
.~ ,LJY\Q,/ (f) Cf>(J B'Exist1ng
O;Cll~NDGLrmcLrvv ZrS2 f?)WcU0~;0 ."0ft77 M::m7.4
~~~:rCem()b . -"~ McuWvtt.., ~~ g ~7'T .'e ~r'mII
""'\~~co ro '*544\,,'. Ak1 t U -to: YeafuJ ~~~~J ~ON' a~
I fmVE CAREFULLy'EXAMINED THE COMPLETED APPLICATION ~R PERMIT, and do hereby certify that.~ lnformat~o~ hereon~true a rr (~~~~~ I :
have the follow~ng legal lnterest in the property: []owner of record; []contract purcQaser;~uthorlzed agent with ~v~dence of auth9rJty attached.
I f~rther certlfy that any and all work performed shall be done in accordance wlth the Ordlnances of Lane County and the Laws of the Sta of Oregon
lpertaining to the work described_herein, and, that NO OCCUPANCY will be made of any structure without the pe~iss~on of the Building Division. I fur-
:ther certify that registration with'the Bui~der's :Board. is 'in full force and effect as r~quired by OR~ '701.055, that If exempt. the basis for e~emption,
~is noted hereon, and that only subcontractors and employees who are in compliance. with. ORS 701.055 will be use? on t,his project. I HAVE READ AND
:CHECKED THIS APPLICATION THOROUGHLY. ' , , ' ,
~Zl~u:EJ~ .
~ , . - SIGNATURE ,
~
FOR OFFICE USE ONLY
, .
~ r"l\.jo.J I ~ \/. DO\^' ~ E'?
NAME (pl~ase print) .
5A-/J3'-3
DATE
... 0 PLANNING/ZONING:
.......
\
READ THIS SECTION CAREFULLY. YOUR
.zone_f\-I
Minimum Setbacks: CL, front
AUTHORIZATION HAS BEEN BASED ON' THE FOLLOWING CONDITIO.NS ~
Parti tion # .
Parcel # .
Parcel .Size
CL, side
interior
~ .1 '
rear
cmU'IENTS:
k FLOO~PLm,
· '--~'/~:NITATION:
In flood'ha~a~d area? ~o DYes, SEE ATTACHED' SHEET.
, -
::::,~J L~
<LID
n
Installation Record J:SS~~d? D Yes 0 No
l1aximum Depth
of Trenches
Pft4'~1 k1~
., Date: s-/o-h./ ,~.
EXAMI~ATION: Type ~-II Group .R---1,. ,. ~se~~.r~~1( ~~~
cmmENTs:fJJJfIlS /lJ'I~IetJV~.D li'l A"Nr .(O~. ;fL5~6~J t (21 rGfS ~IJ1{J.JRGO 1'-1
IJ(JP;fOYiZ.b ,it If, M:A/JL. &-" q.JPM")/ dPI'ko/I)/&. ,~~)4 P"ILDI/tI~.&P<PJIr:.
/1..&.JJt j1~I'1T Jj ~s4HJJeGJJ "RIO~ 7l; T71$:.~fJ~ tbAu~. C' -/ -~~
S. 1. #
B. P. #
Installation
Specifications:
.cmmENTS: .. 1~J.tCJ.
--I ./,
Ga1io~
.Tank
Lineal Feet
of Drainfield
'I'11',h" I
~.'....
.' "
/.A
, - - - -
r .
10+
L.... A..... . ~ .
--~ ~
/'
~ANS
~'
TOTAL VALUATION
$
CONSTRUCT.ION
Description.
Sq. Ft.
AUTHORIZED BY THIS P~.s,;.,r(),F)J,JJJJr '/O..E"
Fixed Fee/ Floodplain 'Fee $
Unit Cost '
Subsurface F~es $
BuilaingEee $
Mach/Pl~bg Fee $
~laris Check ~ee '$~.~~
State Surcharge, $
",
",40r~
11., '. ,
"=t1m I~Qdd..
. '.. . - -#;,. a)
/ .A~ 'f)p ~ "~LJ.
140
DEQ Surcharge
$
TOTAL FEE $$
~eu/"."
PERMIT APPROVED BY, BUILDING OFFICIAL/DESIGNEE (per ORS 456.805(1))
..~ --/-8:5
DATE
LANE COUNTY DEPARTMENT Of PL~ING & COMMUNITY DEVELOPMENT / 125 EAST EIGHTH AVENUE, EUGENE,OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
f
J
J,~ ; . v... ,. ,~
\ >'" '
,r
"
"
.~',
~,
"
.'
~ ~ 't
.'
",
Ij
,1~ ..d'
~J}J ~:.
,,,',
,;
, ,
, ..
,J ,
../- I
'SETBACKS AND OTHER COND,ITICJNS OF' APPROVAL" MUST"BE STRICTLY dBSERVED. VIOLATION CAN RESULT IN R'EVO-
CATION OF THIS PERMIT, CITATION UNDER PROVISIONS! OF LANE COUNTY"S.INFR~CTION ORDINANCE, AND/OR OTHER'
REMEDIES ALLOWED: BY LAW. . . ' . '.". 1.. ! : ~ .. _ '1_1.. . . . ," ' . \ .
,
f', . #'.. ' < .' cf' '.
,i'mEN READY FOR INSPECTION, CALL 687-4065." x.MiNiMUM: OFAT,'LEAST'24 H'buRS' ADVANCE- NOTICE .'FOR INSPEC~
TION REQUESTS MUST BE GIVEN. 'Haye thE! foHowirlg ''inf'sr~atipn r~'ady; 'permit. 'number, 'j'o):> address,' typ~
,of, inspect'ion, when it will be rea'dy" y'o~r. name. and!phorie hU;mber, land any sp~cial, direct~ons ,to' si te.
1 . . ,;. ~" '.., .,~' r. _: ~. " ' . i } . .
,.;
"
BUILDING DIVISION:
. ~. " i
, , f ~ ~ _' . ! "__
REQUl~ED INSPECT:(ON$:'
.. . _ . '<0.\0 f . , " ~,i:. j . ',. ,l'; ,.' '.~ ~ . .' ..t
.1" 'Founda tion Inspection':.i_T,o be ;made a'ftec trenches. are' excava.ted and forms. erected and ~ when 'all
materials.lfor the found<;ttion are delivered oD the jpb... Where co~cre.te from'a ceBtial miX'i'ng
plant (con\monly 't:ermed ,l',trarisi t, mixed") is; to ,be used, .ma ter iafs: need, not, be'. ontne job.,'
. . . ~~. ~ --....: ~ ~... ~ . .. - . ': i '. ., ", . _ . ..'. ....... t." .' .
:2:' Concrete Slab or. Under.,.Flo.or Inspec::~ion: .To be made 'a'fter all'in-slab or under-floor building
service equipment, .conduiti.,pip.ing,acs:e~sories",and otperancillary equipment items are in .
place but ,before any cqncr;'!te is poured/or floor sheathing installeq" including the subflooi:-
'.3.:- :F'r~mir{~ "~. Tns~lati~'~' inSP'e(~~i~n~1; TOI'be ~ad~' after ~he~oof, all' ~ramin<J~ 'i:r~ bflbt~in(:(, a:~d'
"" ',{braci~9'. are in pl<;is.e, and a'll. pipes, fireplace.s,. qhillineys, and vents ~are.. SOI1)p'lete and all. rough
, \"-'. electr,ic<;11 and pl~r\1bi'ng~Cl.rr"app'roved. ' ,All Y.Ja.n 'ins~lation and .vaporl"bap;,i,e;r a're in plifce. .. ,
1.,. ....,.... i"~ ~ ' .1 '": .1 ~ - '#... "", ~ ~, --0' ,. .'.' .,.- . , .' '.. . .. . . t"" ,. -" . - - - ~~
., 4, "', I;a'th cJnd/ 6rGypstiw Board 'Inspectipn:, t:To ):Je' madeaf.tera 11 la tohing and g:yp.s urn :,board, in 1:er ior
; i>':,,: 7 _ ifnd ,ex1:e,ricir., f ts ;il}, p,l~.Fe/'but, b~f.or.~' I.ny "p'~ast'eril1g is.'~PP~Jed .?cnd ~efore, gypsum boa;d JoiJlts
_\' :i;lnd .fasten~rs. are taped and flnlshed. .'..
5. Fina-l~ Inspection: To. be made after- the building is comple~e and before occupancy.
"; .
t l
\,
,..
..... t ,,~
.:1
d 'J
- !.
.'
. ,
II .,
APPROVAL REQUIRED. No work shqll be done bn any part of the. building, or st~ucturebeyond the point
indicated in ,each successive inspection without first obtaining the approval of thE! build~ng official.
Such approval shaIl-b~'given only afte~ an inspection shall 6ave been made of each successive step .
in the construction as indicated by each of the inspectioris req~ired~
NOTE:, - ~:Ll-' buildi~5I permt ts .:requ~re in:pce.?ti'<;n7 for, ,t~:, w~'rk authorized, such::a~ J;m t J;1qt .;imi,trdt t:'?5
A. Block Wall: . To. be made after reinforcing is in place, but before any gro.ut is poured. This ,-
inspection is, required .for each Dond beam, pour. There will be no; approval until the p'lumbirig
and electrical inspections have been made and. approved.
B~ Wood Stove: To be made after completion of masonry (if applicable)' and when instaliation is
complete, Installation shall"be in accordance with an approved" 'nationally recognized testing'
a'gency and the manufacturer I s installation ins.tructions.
C. Mobile Ho~e': An inspection is required after the mobile home is .connected to an approved
sewer or septic system for setback requirements, blocking, footing connection, tiedowns,
skirting, and' plumbing connections. .
1. Footings and piers to comply with State foundation requirements for mobile homes or as
.' ;r:ecomme?ded ?y :the manufacturer.
'2. ~oblle ho~e-minim~m finish floor elevation shall be ce:rt~fied when required by a flood-'
plain management let.ter~
3; Mobile home tiedowns, when required, and skirting shall be installed and'ready for inspec~
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per, .enclosure.
D. Swimming Pool: Below grade when steel is in place and before concrete is poured. Above grade
when pool is installed.
, I
~l":
APPROV.ED PLANS MUST,'BE' ON ~HE JOB SITE AT ALL T'IMES DURING WORKING HOURS. THIS PERMIT' WILL EXPIRE
IF WORK,'!'50E'SNO,T'.BEGIN-WITHIN.180,DAYS, OR IFWORk:IS SUSPENDED OR ABANDONED_FOR M()RE"THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED 0N THE BASIS OF .INCOMPLETE OR ERRONEOUS
INFORMATION.
. I
:'.ANYONE PROCEEDING PAStcTHE POI~T or REQUIRED ,INSPECTIONS WILL DO SO AT THEIR OWN RISK.
,.
"',...,...
..... ..
SUI?SURFACE AND J\:LTERNAT-IVJ:']"SEWAGE DISPOSAL SYSTEM'S,i~" " "
___..o....:c_ , . ~""" ,_ .~_ . _ . .....
t:, :re~irtits},?t\l,~~~;: ,:~,f{ec:t,i,v.;~~,:~,:o,n~, \~~,~,\.,;,;tl).;:~e .d~tr '~,f/.,N:fu,!:n,~,e.,.,;,~.;, ..:.\...,<<\.,.. . ',.:,'",\\;
2. Upon completing' the construction for whicp. a permit 'has Deen i'ssued', the permi t 'holder shall,.
noti fy.: J:~e,\,pgn1';.C01:!l'\ty. ,....~,eP.a.:t;. ~en,t; $>~~' :~1,~fl.!1,;L.n~;\<;i~?\,Gr';l\!1lu'~~~,~'Y,,:\'D~:YEi';,1.0.pr,nel},~.;~,Y.v~Zu~m.~.t t~.~~g;.~R~, '.\.\ \
installat:lon record form. The Department shal'i lnspect the constructlonto determlne If It:
compli:::es. wi th" the~ . rul~;$}t'~C;I1,t,i'\,i;9~& \:i;p' "i~~l:!~~~,..:~f.v(i,~j;?n:':,;, IJ ';j:ti~f;~on.;;'!:~l1f,tj;q'r;:::'~p.e~. ',s:om.p:~,y.''Wtt,}1 ~'SB.C~,\
. rul'es, the Department sha'i:l lssue a certlflcate of satlsfactdry completlon. to the perml tf holder.
If the construction does not comply with such rules., the Department shall notify the permit .
':,..;>,holder a,nd shall requir~....satisfactory completion before. iss,uing the cert;lficate.. Failure, to
-':_:;l\le~t...the:o\~;e:q:u':&:rem€nt;~',..(6'f~r's:a_tisfactorY completion wi thi.n a reasonable time constitutes a vio-
lation of ORS 454,605" to' 454.745 and this rule.
,;
.,
, ,
. ,
., ,
. i
\
,
Setbacks' ~ Subsurface .Sewage
From:
Interior property lines
Edge 9f road right-of-way'
Buildi'ng foundation
Wells, other' water sources
Disposal
Septic
" 10 ~
., _.. 10 I.
5 I.
,~ 50'
Tank
Drainfield
.
,
"
1 ;,
0, j'
10 I.. " _ '
10'
100' .
., --l'
,~. .
" ,
. .(
.".... ..~.". ,,,.~~~..x>
;,-
--,
'h... '- . ,~ti..~...
<t.....;:'>; ..\.'~.. -~.
.. .~~,c\....
..-'!"
"".~.u..__ .......
~..~: ~~~:t,~:~~ .. w\,
C 14-25
, .
~-.~-'"\. ..' '!'
.....:.-~ ,l~ '.. l.......:...:\.-
, '"
"
.'1........
""-.r :":'
---
.,;
~...-.~~;i.: ~
.... -. :..... ..
.. '
. II 1,;./
'~
~' . I " I
, '1 ,l' I .
, 0 .
u
.J'
f' ~ "
,.
. 1 I
II..!: .2 L.tINE COUNT\' DFF'T EI",IV' rfiGT, F::ECEIF'T :il: (,::::,~::;B3 'D(.~'ITE ()::;O.<':IG~
(.IPF'L I Cr::ll'-i'r l,JES'rO\lEF:: CCiN::,;:T., (IDDF:4\?)34 j"'j(.:l I j\! ST"" SF'P I NG F I ELl)
TL.:n: '.j 703::'::.44., 03(j19 .SUBDIV 'I S'T ('I))D TO C(.~li".!TEBU!:::Y L.C)T' 'j 2.. -BlJ<~'j
~EW BLDG TYPE USE ~ BDRMS 0 UNITS 001 STORIES 1 tBLDGS 001 PHONE 7479971
OWNER NME GILMAN, .ALLEN ADDR 2782 BURLINGTON, SPPINGFIELD OREGON
CODE APPL NO ACTION D~SC~IPTION SQ FT UNIT COST VALUATION FEE DAYS
T3F' . (.:1))D TO DkIEL.I.:.ING 140 47" 7'() 667B
rip
BP
{{F'
BF'
PCK LC 665B3 RPPV,
OL NO. FIXTURES:
i'1ECH
.- ISl.lIF:
'::. C: I<
SD,~';:
t':~(i "j' G : tlF' F'
SE!)I...! : ()
T f::i 1< E i".1 BY' c:: tl Ii
S'I~:EF
F;:('~ .
.'
j\!Ci. C:DNNECTDI~:S:
HECH(INICf::-lL. FEE
S! J f~:l T E s: 1....1 F~~ C~ ,..J ,;"i F: c.;. [
F'L.r::IN CHEC!< FEE
FP
S'D:S.' S'I
PCI<
[S'T ,.
'j
COi"IPLE'fION D(.~IT[
'j ~:; ,. 00 [('ICH ::::
61:') "lt5
"V"-II
t~') ::::: :~;:
OTH
IS'S'
\..'
TOT r:~'IL. FEE .)(,,)1:
r fll
.4 (.) ... {:):])
fi II
::.:.~ ()
. 4 ,) " 6 :,::; c:: 1<
.'i., "
,A
-"'LANNING & COMMUNITY DEVELOPMENT
ACT! vlITY INFORMATIOI\ SHEET
lane county
;;
..
-
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
.,~~
1
wrf'~jI9'';f2:-_- ~~-r; .
PERSON MAKING REQUEST
...~__..~,.._._._____________~. ........._.~...__~~_. ,..__,~" ~__. .~ ..~.." .. .....= ....____"-".L....,.~. .... ,._"
.AL-LE:N c~, LlVlA 1'-1 .
PROPERTY OWNER
40 '.74 MAl K-I 7T,
MAILING ADDRESS
2782.~uj2.U ~l GTD~
MAILING ADDRESS
ry"'PRJ }...16,. F1 \z'Lf") 0 J2.-
CITY STATE
CJ7lf 7 7
ZIP CODE
....5PR.l ~G.Fl ELl)
CITY
012-.
STATE
I
. q747 1 ~ .
ZIP CODE I
!
7Lf 7- QCfl'
BUSINESS TELEPHONE #
. HOME TELEPHONE #
BUSINESS TELEPHONE #
71+ h - if.8 7lf:
HOME TELEPHONE #
2c,PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP &. PARCEL NUMBER
(REQUIRED INFORr~ATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
17:/ 0W ~L)
TOWNSHIP RANGE SECTION
TAX,LOT(S) OR PARCEL #
ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL #
ZONING
TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
TAX LOT(S) OR PARCEL #
ZONING
4 SUBDIVISION (if applicable) <-:'~IUTF:I2-"1"--'L.Jg.y Al2--:.1 ADD
LOT ) 2-
ACRES
BLOCK
I
1
j5 REQUEST (state exactly what you plan to dO~,,t\P17ITIOl--l
; . 'OF EYJ-7T lJ.-Jr:;' 12-E.5/D E.f-l-GE. l/.n - \)~
IU FAM) LY
cl;
J2-M,
6 DIRECTIONS TO SITE: :1:-/05 'IV MO~AW~ ~x,r, }-!o/Z-,.;-l O~ 1"1-t:b. ?1. , E:A-e>' Ot-l Y"OLAI-lDA,
klOeT\-) L) i--' ~7-d?T:
.L...,,,.,.,.......,.................,,.,.....................,.... .......,....."",.."..
"TO ~Uj2.U 1'-\ ~TDi'-I ~PE~Ty 01'--> LE-Fr -:?l D€- OF
(HOZ-/H 1
~";;)T~EEJ
~...._..,.. ...".",."~.,,........,._,1
** FOR STAFF USE ONLY **
NUMBER
DATE
-l
;0
(./)
ZONE/LAND USE:
~Y: . DATE:
..
-l
r-:
TIME IN: .
OUT: