HomeMy WebLinkAboutPermit Miscellaneous 1983-7-13
Lane County Authorization
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. TOWNSHIP RANGE' SECTION'J ~ LOT OOUT' OF
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a(j~~o;:;O"D ;hm0"Rtr\tLC~ ) ),,0r I ()~ ~ 1 X1LU'\ DECLAREO $ VAWE
. OF, ff''"'''' (:9OF ,"',," , DE E~Y~ i::!', TER SUPP~Y :J Proposed
1f\~ ~ (I) V cJLL7fl--cn ~Existing
'~;'~ER'S ~c5Yna<7? L43 ~~r~ 3P q1A~"7'~ ~:Pr::E(Z;~-
CbN CTOR'S~":: AND O~....... ~'6J[ I -::.! I' ,(fft< ~"fi,mONE~BER '2r
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~ ~VE CAREFULLY EXAMIN~HE COMPLET:D APPLICATION FOR~IT' and do hereby certify that all information hereon is true and correct, and that I '
have the following legal interest in the property: Downer of record; 0 contract purchaser; Dauthorized agent with evidence of authority attached.
'I f~rther certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the Laws of the State of Oregon
:pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I fur-
,ther certify that registrat10n with the Builder's Board lS in full force and effect as required by ORS 701.055, that if exempt the basis for exemptlon,
11S noted h eon, and that only subcontractors and employees who are In[m iance with ORS 701.055 will be used on thlS proJect. I HAVE READ AND
CHECKED T IS PPLICATION THOROUGHLY.
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-.-- READ THIS SEC;;O'~ WEFULLY.' YOUR AUTHORIZATION HAS BEEN BASED~ THE FOLLOWING CONDITIONS ~
o PLANNING/ZONING: Zone t-J A Partition # Parcel #
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7(15'
for:
FOR OFFICE USE ONLY
Appl~ca tio,p,'..,A, I ~ ~<-::>
Perm1t # ~ ~--{)~
o Two Copies of p-lans -
o Three Copies of Plot Plans
DMech/Plumbing Checklist
DLegal Interest Document
o Plan Check Info Sheet
ZIP
PROPOSED USE OF PROPERTY
~side~ntial D Industrial
Parcel Size
Minimum Setbacks: CL, front CL, side interior
'Pl~ (X)nctf~~~B~~~
rear .
o FLOODPLAIN:
In flood hazard area? D No DYes, SEE ATTACHED SHEET.
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Date:DtLl_~ (~-t~~
Date: U n
~NITATION:
S. 1. #
B. P. #
Installation Record Issued? DYes D No
Maximum Depth
of Trenches
Installation Gallon Lineal Feet
Specifications: Tank of Drainfie1d
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Date:
o PLANS EXAMINATION: Type
Group
Use
COMMENTS:
Date:
n
TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
Description
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-.,f@-L(' () .I
Sq. Ft.
Fixed Fee'! Floodplain Fee $
Unit Cost Subsurface Fees $
Building J;ee $
~12ch/p 1mbg Fee $
Plans Check Fee $
S ta te Surcharge $
DEQ Surcharge $
TOTAL FEE $$
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~ -- PERMIT APPR~~~B~ING OFFICIALiDESJrGNEE (per ORS 456.805(1)) DATE
LANE COUNTY D~RTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISICN, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
?SEE REV~RSE FOR INSPECTION INFO~TION
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,,-..;~ SETBACK"S .AND' ,OTHER CONDITIONS OF. APPROVAL '.MUST BE ST:B.ICTLY OBSERVED. VIOLATION 'CAN (RESULT IN' "RE'VO-
CATION OF THI'S PERMIT" CIrATION UNpER; PROVISIPNS' OF LAN,E COUNTY 1 S INFRACTlO~: ORPINANCE;, AND/OR '6T~ER
~EMEI~~ES~L,LOW~~,BtLAW::~'; ..""..'...' ',.'. _",'",. '_'._' "'.', ",..., '.,'
WHEN ,READY FOR. INSPECTION', :CALL '68 7 ~'4 O~ 5,. ,A MINiMUM, 'oP"'A:'T 'LEAST'~'24 HOUR'S"""ADVANCE' NOTicE FOR:: "IN'sPEG-;;. ,-,
,TI()N REQUESTS MUST BE, GIVEN, Have ,the 'followirig i'nformatlon -ready:. "permit 'number', ,job address,:,t'ype
of inspection, when' 'i t will be ready, your 'na)TIe ari~ .phone 'number', and..any. ?pecia}" d~~,~c~J:ton,s::to 'iiite,.
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BUiLDING DIVr'SION: .. ,'.;0; ,"~ if
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REQUIRED 'INSPECTIONS: '~
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1, F.ounda tion, Inspection: To be made after trE)nches ar,e :excava ~ed,a~d forms erected. ~and when all
materials for the foundation are delivered on, ,the job: Where concrete .from, a cel).traJ.:' ,mixing
plan,t (c6iTImonIy, t~rmed ,,'transit mixed") is to~j:)etised,~materia.fs need 'not. be on t?e'" job, '. '
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2:'. 'Cb~crete S:l~J:S oi:-' ,Under.-Fl'oor ~'Inspect'ion':; Tolb~ made. kfter: aU, ih-:-~lab_or 'under-fibor building
service equipment', conduit, piping' acces,poriesl,-.'and, other: ancillary equipment, i te)lls are in,
place but be,fore any concret,e~s p~ure9 or ,~~~?r,Sheathingi}::s~a:l:~ed,_ ~~S:,Iuding: tl:~ S~bfl.oor:__
'3, Framing ~ Insulation Inspecti'ons: To, be. made after,the r9of" ail framing, f ire' bio~k~ng ,"a~d ,..:'
. brfic:ing .ar~ :j.n ,place 'arid a'll, pipes", ti !"ep.1gce 5 I. ch.!mneys,'ap,d vents are. cO]llplet:e ana a~l,'x~,ug~
",' el'ectrical and plumbing are approved , ,:A'llwall insul,M:ioh an~ vapor, barr,~er are,. in place,' .\
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4, ,La tl')<;ind/orGypsum Board' rnspectlon:,J: 'T0 be made" -afte1C:a'll lathi~g 'and gypsum board, ,interior ;
"and',ex,terior., ,is, iIi:, place "b.u't before, any" plas:ter'irig: :is 'appl,ied 'arid 'before gypsum 'board joints
.. an&.lfasteners' are . taped' and 'fiMshed, ' .j; : ., I~ " .: \, ! '; ': '1", ' . j'.
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5o.,\...Fin'al Inspection :', To':..l?e' .made after .the building ,is c?mp,~ete .,and I)e,fore ",occupancy,
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API}RO.vA~ [REQUIRED.', No work shall 'be done on any part of ,the, buir~ding or str'ucture'l?eyond ,tr:e .po~nt (',
'indfca'ted;:,in i each successive 'inspection w~ thout' fir,s,t ),qbtairiing the approval', of the ,builaing officj,ah
'Suchappr,oval.' shal:l: :be' given only"after- 'an inspection:shall'.'have ,been' made, of each ,successive 'step'
in the, cO,nstruction ,as: ,indicated' by., each,o,f, the, inspec.tions, required. I'. "
NOTE: AILbuildi~gperrriit~ require~in~~ecti.ons"for<~he ;'ork'autho~ii'e~, such as but not limited to:
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A. Block :Wall: 'To be .made. after ,reinforcing i? in piace" but,befo,re. any 'grout:,is poured., 'This
inspection is'required for each, bond beam pour. There'will be no approval.until the 'plumbing
and electri:cali inspections have,ibeen made and approved. '" " "",,'
B'. W90d Stove: To'b~ made after comp~etion of masonry (if 'applicable) and ~hen installation' is
_complete. Installation shall be, .in "accordance with an' approved, nationally recogni zed tes ting
,,_~gEO!n.cY and th,e .manqfac'turex; 's ;l.nstall?- tio,n in~sr).lchons.', j ." j ,
:,C.. 'Mobile Home: An inspe~ti~n,.is,requi-red after, the mobile home is conne~ted. to, an approved
sewer :~~ ,~~ptic sys't:em tor "setb'i,ck . '~eq\1Jremeii ts,' 6IocK~ng, 'footing c'orinect1'on; tie,downs,
skirting! arid pllimbing' 'connections', ' , . '," ,. I,,,,,,, .' "
1. Footings and piers to cq'l)1ply with, State foundation, requireme'n',tsAfor ,mobile homes 'or, as
"recommended"by the manufacturer.... ' ' . , '. ..' -, ,.. '
2. 'Mobile nome" minimum .finish'floor elevation sha-il'be certified wherirequired "b:{a' flood-
plaiD;\mar;ag,~m,ent~e;tt~,r. r ,.' '(. . "',~,:i,,.,>'., .
, 3: 'Mofsi'ie~hoine'tied'ow~!s'/ 'when" required', 'and -skirting shall be:'in'~tal~ed' a~'a ready' for inspec-,
tionwi thin at least 3'0 days after occup\ancy~,' i Tie9-pwn's an9- s'kirtrng sharl "pe' i!1stalled,
,', - p'er'enclosure. ' '- - - ", ' ,-, "7 '
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+ 1\'0,' Swinim:i:ng;Pohl~:,_'Below'gr'ade when steel is in place and before ,concFeteis poured., Above grade
./ when pool i~,installed,
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APPROVED PLANS MUST BE,ON THE JOB SI.TE AT ALL TIMES 'DURfNGWORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK' IS ,SUSPENDED OR ABANDONED FOR ,MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFO,RMATION. "
ANYONE PROCE,~DINGrp~ST THE POINT Of ,REQUIRED', INSPECTIONS WILL'DO SO AT ,THEIR OWN RISK.
SUBS,URFACE AND, ALTERNATIVE SEWAGE DISPOSAL SYSTEMS: "'. :) '. ...- "'" ," ,
,"t. . p~f~'i t-{' "S'ha 1,", 1 be--Mie'cirV8' for Jo~'~ 'y'~at, from:"'the ~ da t~" of, i"'Slsua~,c.,~-:' . I., ,-"'...."
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2. Upon, completing" the ,construction for which, a" 'p~r,mi t has,'b~en ":'i~~ue'd, ..the...p~rmi t hc:>,rae'i' shall,
no.t:ify, the .Lane:';County Department of Planning al').d Community Development bY."submitting the ,
i,nst:aB,at:Lo'ri record"form, 'The Department shall inspect the constr,uction to determine if it
comp'lies with the rules contained in this division, If ,the construction does comply wi th suC;h",
rules, the,Department shall issue, a certificate of 'satisfactory completion to the permitiholder-:.
Tf .the construction does not comply .with such rules, the Department 'shall notify the, permit
,..holder and shall'require satisfactory completiqri, before issuing *he certi~icate, Failure to
meet th~ requirements for satisfactory completion within a reasonable time constitutes,a vio-
: ,lation, of ORS,454.605 to, 454.745 and .this rule".
..
,Setbacks - Subsurface Sewage Disposal
,Tank..
, Drainfield:
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Septic
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100'
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From':
Interior property l,ines ,;. ,';
Edge of road right-of-way
, Building f9unda.t.ion "
Wells, other water sourc~s,
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LANE COUNTY DEPT ENV MGT RECEIPT' . 201283 DATE 0713E
APPLICANT MOGENSON,' DON' ADDR '1142 WILLAGILLESfIE :1::7, EUGENE, 01:;:.
TUI: 1703233409000 SUBDIV FIRST ADD TO ROYAL DEL.LE ' , . L.OT j 9 BLK 3
NEW BLDG TYPE USE R BDRMS B UNITS,001 STORIES 1 OBLDGS 001 ,PHON~ 484 981~
OWNER NME THOMAS, JOH~ ADDR 443 BLACKSTONE, SPFD., ,OREGON
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DAYSJ'
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PL NO. FIXTURES: ,
MECH
SUf~
PCK
SDS LC 201283 SDAN
SUR
NO. CONNECTORS:
'MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
15.00 EACH =
4i;
6~5%
50.00
5.00 ,) I
CATG :' APP f~A
SEQU : ~ 0
l ~, TAKEN BY CAD
FP SDS SI PCK
1 .
EST. COMPLETION DATE
OTH ISS
2
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TOTAL FEE**
55.00 CK
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16 DIRECTIONS TO SITE:/Vorfl- 6J- ~i No-\~ F-/~orn lV4-Vc10h j)nclqe WA-V' ;
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** FOR STAFF USE ONLY ** NUMBER
..
1!":J'.:J
Idne county
j PLANNING & COMMUNITY DEVELOPMENT
AC~TVITY INFORf\1i\TIOr. T
c:.l-lf-"T='T
'-"'.L.1~A-...4.A.
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
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J),,, . vnrfs&t'M~Kl~EQUEST
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~1A Il!I'NG ADb~ESS .J
CUG' ~ IJt (OPr P?~c:J/
CITY STATE' ZIP CODE
J6J/7 / ~O/7?A-)
, PROPERTY OWNER
L/"~3 g4K,S'~AJ~
MAILING ADDRESS
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r CITY t STATE
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BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE #
"I" 2 PROPERTY ,ADDRESS 4- 1-- 3 B lAc f:::" S ,l-v n E' S"' V+'fd
(IF DIFFERENT FROM MNILING ADDRESS) I
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ZI P ~DE
,Zj/7 / c; d-~'5
HOME TELEPHONE #
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(from tax maps in Department of Assessment and Taxation'l'
or from tax statement) i
I 7 (!) 3 ,;(3 3- Y 9 co 0<.) I
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING I
I
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MAP &. r::ARCfEL NUMBER
(REQUIRED fNFORMATION)
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL #
ZONING
TOWNSHIP RANGE SECTION
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TAX LOT(S) OR PARCEL ~
ZONING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
SUBDIVISION (i f appl icabl 0) / ",'/Id/:fr'.) l ~/ U4LDTj__Q
REQUEST (state exactly what you plan to do) 5EP77C ....'5' V> / r~
/
/N5"~FC'T70,J' ~ok A6f2.,Qli-G€ ~OkA) REVIEw,
ACRES ,
BLOCK 3
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en
ZONE/LAND USE:
BY: DATE:
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DATE
TIf'1E IN:
OUT:
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