HomeMy WebLinkAboutPermit Mechanical 1983-1-25
CONSTRl :TION/PLACEMENT
PERM IT \1 \1\
COMPLETE THIS BLOCK. PLEASE USE BLACK INK ANd PRINT.
TOiVNSHIl/7 RANGE.3 I S~3,.3. t/ _ T~/e80UT Of'
SUB I\7ISJ:N/PART~ ~ap~/--: ks LOT/PARCEL BLOCK
~~r:; ~DDRESS I (!r:;:E:~ f) St. ~cP, Cq1<-17'fP
STRl'CTURES CURRENTLY ON P'ROPERTY- (J ~ V
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~~MROP~? WORK 'fV(1[) / ~fLAJ /IV-- ./'/ ~ I $ VALUE
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certify that any and all work performed shall be done in accordance with the Ordillu:1CC.S of Lane County and thc; La.\'o's of the SUlt:e of Clr(~q:-)Il J.1)rLaiIJilq
to the work described herein, and that NO OCCUPANCY will be made of any struct1Jr~ without the PQrmi~,sion of the Building DLvision. I furt.h0r cTrt.i fy
that. registration with the Builder's Board is in full force and effect as requirGd by ORS 701.055, that if exempt the basis for exemptioIl is notr.:d
hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this projGct. I HAVE READ AND ClIEC:r:'E'D THIS
APPLICATION THOROUGHLY.
AtzD,qffJi p<infJL-Lfd()~ \d~~
o PLANNING/ZONING: Zone ~/4-- Partition # Parcel # Parcel Sizeo/ fi
cbacyff ~ / C -
~ ::;:;:O:J&i/~/;kZ:"e~ _~~~~
/'~~//#{ \,,/ r;~ate:/-/?-%3
7D FLOODPLAIN: In flood hazard area? 0 No 0 Yes. see attached sheet.
o RURAL ADDRESSING: GRID COORDINATE N E
o S]\J~~ITATION: S. 1. # B. P. # Installation Eecord Issued? 0 Yes 0 No
~
Installation
Specifications:
Lineal Feet
of Drainfield
Gallon
Tank
Comments:
FOR OFFICE USE ONLY
APPlicati~/1_ y 3
Permlt #g L/' 0 '
DTwo Copies of Plans
D Two Copies of Plo,t Plans
DMechanical Checklist
D Plumbing Cl1ed:list
[JPlan Check Info Sheet
PPUPOSED us~ OF Pr.:.OPEHTY
1Ir
o Residential
Dlndustrial
o Commercial
Dpublic
~"eI
-:4-.,
1-)7 ~3
o Contract.cr:..'
DATi::
[J Agent
Date:
~
D
D
Date:
Maximum Depth
of Trenches
Date, D
rV PLANS EXAMINATION: Type_I5AJ Group ~ Use 0ll2O~
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'o~'eo"'~ /)J ~ t!/J~1d?.. /'J/I,7If~h.JL/1?f~
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-FUJA1 &N.,~ ~I&L, ~ Jbo# ' Date: /-21)"-'33 ~
CONSTRUCTION AUTHORIZED BY THIS PERMIT
~~2; Eu
~v~y
Floodplain Fee
Subsurface Fees
Building Fee
Sewer/Storm Drain/Water
Plumbing Fixtures
Mechanical
Plans Check Fee
State Surcharge
$
$
$
$
$
$
$
$
. / }d~
/&~
//~
'/- /_/
,_/ (0 ..,..
c7(O, 6 c(
TOTAL FEE $
FEESe~VCa'h
Jate, / :I /-/l-f3
PERMIT APPROVED BY BUILDING OFFICI-'lL/DESIGNEE (;'er..-~7:~ /~k1:r:;~?
Sq. Ft.
Fixed Fee/
Unit Cost
TOTAL VALUATION
$
LANE COUNTY DEPARTMENT OF PLANNING & cor'lHUNITY DEVELOP~lENT / 125 EAST EIGHTH lNENUE. EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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SETBACKS AND,OTHER;,CQNDTTIONS OF APPROVAL MUST BE STRICTLY OBSERVED> VIOLATION CAN RESULT IN REVOCATION OF THIS PERMIT, - '
C ITATION U~D~R;,~~OVI;$IPNS:.. OF ~~NE, C,OUNTY' S INFRACTION, ORDINANCE, AND/OR OTHER REMEDIES AL~OHED ,Br ,.LAW. ' ' '.
WHEN READY' FOR I'NSP'E:CTION 'CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE'FOR' INSPECTION REQUEST MUST BE:' "..":,"';
GIVEN. Have the. f,oJ,lQl'!ing i!lfonnatiori'ready: Permit number; job address, typeof,ins'pectioil, :wh'en: i(wili be'r'eaay, ", ,,-::
your name and ,p,~,oti~.~Ufn~e::; and g,ny special di~ec,tion~'.t~,site. \\ . _, *> \. '.
..
BUILDING DIVISIOK: ,
;,REQUIRED IrISPECTIONS ,~,':,:: <. 'r'j;,\, '.' . ," . ~"'>' ..,
1) FOUNDATION. INSPECTION:: To be made after trenches are excavated and forms erected and when 'all materials for the foundat'ion
are delivE!r:ed onthe.job. Where ,concrete fro~a central,mixlngplant'(common'ly termed i'trarisit.mixed") is to be,us~a,c.'''.:', ,
materia1s-h,eed"not be on, the-job. " " t-.
, ; ,. , , '.._,
, 2) CONCRETE SLAB OR: UNDER-FLOOR INSPECTION: To be made after all in-slab Qr,under-floor building.service,equiRm~rt, .!
conduit, pipi,i1g :accessor,ies and other ancillary equipment items are in place but before any .concr:ete'is'; poured '
or floor sheathing instaned, including' the subfloor, "-'~'r'" .- ,.' ,'.', . ,-', J':," .
" ~ :.:.. ... _ ~ '. .. . 1'\;,.Ii '-.. . ~':~ ~ .'
3) FRAMING:...& INSULATION,'INSPECTIONS: To. be made, after the roof, al.l'framing, fire' blocking and bracing a're ;'h-pi~ce 'ana
an piReS;"fireplaces and chimneis~ a'nd',vents',are' complete and'al;l,-rough electrical ,and'p'lu.!TI~'i~g ,?re ~pproved._",An
. win insula{ion aiid va"porbarrier, a're in place:: " -.' . "
~ . ' . .., . ,;-.. \'J ~ . . . .. " . . .,. \. . . . ,
4) :lATH ,AND!O'R GYP'SUM BOARD"lNSPECTION':' To 'be made 'after an .lathing and gyps!Jm board,- fnterior;a~d ex~eri6r,. fs in' pla'ce'
bl!t befdre'any I?lastering' is applied or before ,gypsum board joints and fasteners are' taped ~nd finished. '
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5) FINAL INSPECT'ION:"To'be \llaqe'after the building is complete and beforeoteupancy.,:" .'" -';", ". ,
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A,.PPROVAl'_REQUIR,ED'.,No.:work shal:l,be done_,on any par;t'~of'the',bu,Hdiiig"or' structure'beyond',the 'point indicated ,in~eaph' : ",
successive i~specti,onwit~out first obtaining the approva,l,of tlie bu.ilding offic,ial. Such.approval shall be given orrly \
afte~,an. i ns.pe.ct~on . shal}, h~ve 'been~~de of each suc.ces~i ve HIi'!P ,in the cO)1st'ruc;ti o.n, as ,fndi Cii-teq by eac;h of the' i nspec:ti ons. '
-requlred.':'" ,"." -';' " " .. '" , "" \ -,' '.'..,,"" \". '" " j",
NOTE: All buildin,g"'permi{s require inspections. for the wo'(k authoriz;d~. such as but not'limited to: :. ..~.~.
. ~ ','
A; 'BLq~K WAL~: l'O'be made after reinfor:c)ng' is, in place, but 'before any grout is poured. This'inspection is,,'
J'\equ~l':',e~ for.'each b,ond beam pour.' T,here will be no approval'untiJ thep)umbing and el~ctrical inspe'ctions
have, been made a,nd armroved. ' " ", ' , ,
B. ~OOD ,STOVE: To be made after completion of masonrv(if applica~leJand,when'instana:tion is'c.omolete,
Ins ta 11 ation sha;11 be ; n accordance wi tho an approved nat; onar11y recogni zed testl ng agency and the manu- ....
,fac~~t~r,'_s fn,?t'a'll ati on, instructi ons. _.,,' ',,:' ',. 4" _' ~ ~,', :,' ~.." , ',.' , :: . .., ,'.,", \'\ ,','0:
c.'J40iHLE HO~E::' Ai1,insp~ction i,s required aft~rth~ mobilehQ[Tle is,~onnected ,to, an approv.ed sewer 'or ~ep1;ic
.", system for:'; setback-requireme'nts, block,ing,' footin'g connection', tiedowns,:'skirting, ii-rid'plumbing , .. '
" 'connections.",.' .' "" "" ,\,;;','" ,"
..........~....... .~.,~,.."....-. .' -''\'">(._. ".
, '. (1 f Footings',and piers to comply with State foundation requirements for mobile homes 'or as recommended
""...-::.Ey',theriianufacturer. ',', < " _,.,,', '.'..
, " '(~.l~obil e' hOl1)e, [Tli n5mym fi.)1i sn:fldor: el eva'tion sh'a 11 be, certiJi,ed whe.n ,J:eq,ui red by' a fl oodpla in
;.".',<~ma:na'geme:rit,"lefte"r'..~, ~~_'. ...... _ ""~"'<' . .,' ,,). .'<'.. ...... h . ',:. ,...' "
::>(3J.,J~obH!=!-home tiedowns, when'required, and skirting shall be. installed and ready for inspecti.o!l "-
'-:',: ,wi,thin,at"least 30 days after occupancy.. Tiedowns'and sk.irtingshall be installed perenc]dsur.e...' ':,';' '.J
. ..'-,
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.~. +,
..:... '..
D. SWIMMING pooL:
isil1st~JJe<j., .. _
APPROVED PLANS MUST~EQN' THE'J'OB SITE AT ALL TIMESDURING WORKING,'HOURS. 'THIS, PERMIT WI.LL E,XPIRE IF ~JORK DOES NO,TBEGIN'
WITHIN 180 D)l.YSOR IF:'WORK r's SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS. ,SUSPENS(ON OR REVOCATION MAY..OCCUR IF THIS
PER~1IT WAS ISSUED Off THE ',BAS IS~ OF INCGr1PLETE OR' ERRONEOUS INFORMATION.
. .. -" -- ...... .
..... .', ,.' .' " ,
Below grade ~hen steel is in plac~'and before ~oncrete,is poured.
. .... ' ."
~bove grade when 'p~dl
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ANYONEPRO(iEDiNG'PASrTHE~,POINT OF REQUIRED INSP'ECTIONSHILL DO SOAT.HIS OWN RISK
:' "00, . SUBSURFACE' AND ALTERNATIVE SEWAGE DISPOSAL' SYSTEMS "
, ' ,
(1)' Permits"sha)r be,~'ffective for cine year from tn~ date of issuance,"
(2) Upon, compl eti~g th~ ,<;:on~t~uctiont.:Qr whi ch a permit, has been' ,i ssued,.t,he penfd t lioTder shall 'noti fy the ~,
Department by sutimitfHlg the 'i [lst,all atiori recorc!fo'r,m. ,The 'Depadme~t-,.sha'" inspect'..the' construction to - /.
, .~ d~termi ne:d ( ft cO!TIpii e:~' wi th,..tlie .rul es cont~in~p ,i n,J.h~_s A~ vi si on . ,If ,the ~onstruct~iQ.n do~scomply vii th ,,'\
" '"sLi'Oh'\rulegi; the.'Departmentshal1 lssuea certlflqate of,sat~sfactoryc,ompl~t!on" to'~.t.he"perlT\,lt,.hol,der. If the ,
'construction'does not'complY wi:thsLich rufes;.,the Department~sha.l,l( notifFthe- permit"tlOlder a'n~ shall rE!quire' ..
sat.i.s'faf:tcirY:',;c.:ornpl'~J.~OI);l>e'f(rr.e 'i s~~i,iig {he '~e-rt,.tfica,t'e.., '. fCi.i 1 ~f'ic,:t?,!I\~.et' the,,'requ] rern~.rrt;s , fat sa!i's,fac):?!:'-Y5 " ~"':;~:;"~
compl,e~iolJ. w:ith,in' a ,reasonable time constitute~,.a_.viola_tiqn of OR~ 454..605, to ,454,.~,45 a!1~ thJs_!,yle." ",,~ ," ~>:'
.._. '. "I"-..:~",,;~: _..:... .. .. ~:,'''<... ~'.}._;.:....':,.,,~~,_~.\'\o:~:"/;':\'" ':~"...~:"~\~ ~' . ".:~~)...~.~.;:':'~;l.,~:~.....l,~,"..".l.t,~.":'\\":' "I "':~';> ..,;..
',Setbacks - Subsurface, Sewaqe Disposal " , , " " ' .. "
Septic Tank: <,Dr~infiel~
10' ..,.10'
10' ,,"";: '10'
5' :;J 0"
50' 100'
From:
Interior property lines
,Eage of road right-of-way
Buildingfoundahon..
, Wells, ;o:t.tJer water sources'
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APPLICANT AL.LEN,
TL~ 1703233402100
NEW BL.DG TYPE
mJNEF;: NME I
CODE APPL NO' ACTION DESCRIPTION
,0~:BP
HP
3P
,BP
BP
LANE COUNTY DEPT ENV MGT RECEIPT
RANDOL.PH ADDR 357 CAMBRIDGE,
SUBDIV
USE R BDRMS 3 UNITS 001 STORIES
A DIm
SQ FT UNIT COST VALUATION
~~ ~)E)K~ DATE ~)11-?fq L .
SPRINGFIELD, OREGON
LOT ElL.1<
OBLDGS 001 PHONE 747 4008
FEE
D(.l Y ~
'-
PL NO.
MECH'
Slm
PCI<
MECH LC
:=-CI<
FIXTUF~ES :
NO.
CONNECTor.;:S : '
MECH~NICAL FEE
STATE SURCHAJ=~GE
PLAN CHECI< FEE
1 ~5. 00 E(:"1 C 1,,1 -.,
t I'.j
4%
I.> ~:> ;~
~)083 WS
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4.00
0.;64
I. I: ~ SUR
CATG: APP
SEQU: 0
r.AI<EN BY RLH'
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FP ,
SDS SI
PCI<
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ISS
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E:S"r A
COMPL.ETION DATE
.
TOTAL. FEE**' , 20.64 CK
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~lANNING & COMMUNITY DEVELOPMENT
ACTl vITY INFORMATION SHEET"
"klnecbunty . ,
",
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
{6. LLGtiUlS' - , "
" PERSON ,MAKING REQUEST
351 (AvvJy~[l~ ,Sf-,
MAILING ADDRE.5S
5:;, I-it 6~! r7 '--[77
CfT)Q STATE ZIP CODE
5rA---vv~
K~cf;;ZY~{)f~
MArLrNGADDRESS \j
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, ' CITY: "
STATE
ZIP CODE,
'74:7 - 'lfCl 0 8'
BUSINESS TELEPHONE #
7t./7-G:73L
HOME TELEPHONE #
:BUSINESS TELEPHONE #
HOME TELEPHONE #
2, PROPERTY ADDRESS 5<<f./V\~'"
, (IF DIFFERENT FROM MAI1INGADDRES~)
3 MAP & PARCEL NUMBER
(REQUIRED INFORr~ATION) ,
(from tax maps in Department of Assessment and Taxation
or from tax statement) , "
/7 :) c:23~.3{Y,' d I tJO
TOWNSHiP RANGE SECTiON TAX lOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE 'SECTION
TAX LOT(S) OR PARCEL # . ZONING'
'TOWNSHIP RANGE SECTION
.
TAX LOT(5) OR PARCEL i ZONiNG
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
14 SUBDIVISION (ifapplicable) '~~',~ lOT,
15 REQU~ST (stateexactlywhat you PIano-to do) , '.~ q,.lfV.-.~
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, 6 ,DIRECTIONS 'TO SITE: 6N--* 5"-t4-- ~ '0:~_~/d, !~, ~&.IV\ ,~~ ~12- ,iD '
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.' 'ACRES
BLOCK
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ZONE/LAND USE:
BY:' DATE:
DATE,
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TIME IN:
, OUT:
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