HomeMy WebLinkAboutPermit Mechanical 1985-9-20
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L~ CO~lCY A~horization
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FOR OFFICE USE ONLY
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SJBDIVISION/PARTITION (if applicable)
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LOT/PARCEL BLOCK
PROPOSED USE OF PROPERTY
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. ilE~C PTION OF )'j<OPOSED WO - 5AE~ .7 ~~,; - 7~~e----/ ,,/ DECLARED $ VALUE
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= F BED;..O~..r: # OF 1;TOR~Y , # r~~EES \'iATER SUPPLY ~ / 0 Proposed
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I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERMIT, and ao hc.re1JY cert.Lfy that. all information hereon is true and correct, and that I
have the following legal interest in the propetty :..~w~er of record; 0 contract. p1lrchaser; o authorized agent. .. . .
I f:.:rther certify that any and all work performed shall be done in accordanc" wi thO the Ordinances of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and th~.t NO OCCUPANCY wili be made of any st.rl.lctUl'e without t~e permission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if 'exempt the basis for exemption
is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701,055 will be used on this project. I HAVE READ AND '
'/3?;;:~';:OO~4CZ/?' ACY;L~) 9f; ~
NAME (please print) I SIGNATURE DATE
READ THIS SECTION CAREFULLY. YOUR A~HORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS!
o PLANNING/ZONING: Zone &/ #- Partition # Parcel # Parcel Size
C ' / C, ' '
Minimum Setbacks: L, front; L, srde '- J,nter~or ,
CO~\IENTS: ~ ~~A'?~4 &~~}~~~~~
- ~ - ' - ~ p, -, Date:
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Installation
Specifications:
Gallon
Tank
Lineal Feet
of Drain field
Installation Record Issued? 0 Yes 0 No
Maximum Depth
of Trenches
o SANITATION: S. I. #
B. P. #
COMHENTS:
JYPLANS EXAMINATION:
COMHENTS:...cA 1 L
Date:
n
Type -
Group
useW _ ~ _
J LJ 5PJ:C-Tlo~ S..
J::~ R
7?SQUIIe E"D
Date:
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rplkS 9- 20 -~ c::-
PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (oer ORS 456.805(1)) DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION C 14-25 RB4-
"
SETBi,CKS A~D OT!lER CO:WITIO:.S OF APPROVAL ~IUST BE STRIC';'LY OBSERVED. VIOLATIO~ CAli RESULT IN REVO-
Crt';' lOll OF T!lIS PERHIT. CITATIO:. UNDER PROVISIOllS OF LANE COUNTY':; INFRACTION ORDI:.A:-ICE. ;,:-ID/OR OTHER
RE,IEDIES ALLOWED BY LAW.
!;HEN RE,~DY FOR I:-ISPECTION, CAL:' 687-4065. A ~lINHIU:l OF AT LEAST 24 HOURS ADv.weE NOTICE FOR INSPEC-
1'IO:-.J' REQL:ESTS :'l~ST DE GIVE~. Have the following info~~a t ion ready: permi t number, job address, type
of inspection, when it will be ready, your name and phor.c number, and any special directions to site.
BUILDING DIVISION:
REQUIRED I:-ISPECTIONS:
1. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
materials for the foundation are delivered on the job. Nhere concrete from a central mixing
plant (commonly termed "transit mixed") is to be used, materials need not be on the job.
2. Concrete Slab or Under-Floor Inspection: To be made after all in-slab or under-floor building
5ervi~e equipment, conduit, piping accessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framinq & Insulation Inspections: To be made after the roof, all framing, fire blocking, and
brac~ng are in ?lace a~d all pipes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
4. La th and/eE- GVl?sum Board Inseection: To be made. af ter all 1a thing and gypsum board, '.nter ior
ana-exter~or, ~s ~n place-SUt bet ore any plaster1ng is applied and before gypsum board joints
and fasteners are taped and finished.
5. Final Insoection: To be made after the building is complete and before occupancy.
APPROVAL REQUIRED. ~o work shall be done on any part of the building or structure beyond the point
indicated in each successive inspection without first obtaining the approval of the building official.
Such approval shall b& given only after an inspection shall have been made of each successive step
in the construction as indicated by each of the inspections required.
NOTE: All building permits require inspections for the work authorized, such as but not limited to:
A. Block Wall: TO be made after reinforcing is in place, but before any grout is poured. This
InSPection is required for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
B. wood Stove: To be made after completion of masonry (if applicable) and when installation is
complete. Installation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturer's installation instructions.
c. Mobile Home: 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
recommended by the manufacturer.
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-
plain management letter.
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 qrade
when pool-rs-installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR HORE THAN 180 DAYS.
SUSPENSION OR REVOCATION !1AY OCCUR IF THIS PEfu~IT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POINT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
1. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installation record form. The Department shall inspect the construction to determine if it
complies with the rules contained in this division. If the construction does comply with such
rules, the Department shall issue a certificate of satisfactory completion to the permit; holder.
If the construction does not comply with such rules, the Department shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. Failure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
lation of ORS 454.605 to 454.745 anu this rule.
Setbacks - Subsurface Sewage Disposal
From: Interior property lines
Edge of road rlqht-of-way
Buildinq foundation
Wells, other water sources
Septic Tank
10 '
10'
5'
50'
Drainfield
10'
10'
10 .
100'
idne county !,.
,
ACTI ~TY INFORMATION.\sHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
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, P~ON MAKING REQUEST
#&0 P/C..tJ2t1kL1/?J-~ tZr
MAILING ADDRESS
S"o!fl /V6hE..t~ Oe
CITY STATE
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BUSINESS TELEPHONE #
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ZI P CODE
~o/ LL 1$ AA-<<€ L/J-
PROPERTY OWNER
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MAl LI NG ADDRESS
:5;"e I/YG;//E L-.d iJe. 97y'77
CITY STATE ZIP CODE
~)L~c 793 1~1-~ 7-b
BUSINESS TELEPHONE # HOME TELEPHONE #
0011......
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,
/7L/-1-S7 76
HOME TELEPHONE #
'2 PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS) ,
~ 3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation~
or from tax statement)
17 0.3 <?::z ~ ~ o c:t '2-00
TOWNSHIP RANGE SECTION TAX LOT(S),OR PARCEL # ZONING
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
.
, .
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: ACRES
4 SUBDIVISION (if applicable) LOT BLOCK
ZONE/LAND USE:
BY: DATE:
DATE
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TIME IN:
OUT:
LAND MANAGEMENT DIVISION / 125 E. 8th ^VE., EUGENE, OR 97401 /687-4061
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