HomeMy WebLinkAboutPermit Septic Tank 1983-1-13rail + .4 I'OR Gi'FIl'D USE OE1.Y
CONSTRUCTION/PLACE ENT PERMIT9b � ,. Aer, ' 'c'�
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Two Cozies of Plans
•COMPLETE THIS BLOCK. PLEASE USE BLACK INK AND PRINT. . . ETwo Copies of Plot Plans •
TOWNSHIP RANGE BCCTT ON' TA3 OUT Or )echanical a1 -st '
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Plumbing Checklist
SUBDIVISION/PARTITION (if applicable) LOT/PARCEL BL CK —
Plan Check info Sheet
•
STION Al RE 5 'ye / r CITY • Zip PROPOSED USE OF PROPERTY
/ -//_-_ ..i AC/; _ ' ❑ Residential"' DIndus*_rial
�
,�'"/a j ON PROPERTY
'2: ,- I' / 0 Commercial: J Public
. • OFD a � / "-/
• 01 B "OOhS �Or ST E S Or Eh1P / F' WATER SUPPLY /l � P�ro/posed
. I ��.�q/ i/.. 1b.,sting
OI • S NAME - • -6 TELEPHONY NUMBER
/CA'
i._// . / i-2.•tage. //�/J �' TELCP190::ENUMBER
//M %i� / ./L.e/l//�i l f / / / /i..��_ . Lam. � //, �/. ...r —
ONTPvlC1'OR S O �/ �/ ,tea- / ,/ �/ / �� / '
I HAVE CAREFULLY E2U1 i0 TIIF. COMPLETED APPLICATION FOR PERMIT, and do hereby crrl_i 11 that. all in fermo Lion hereon in true and correct and I fur rner
certify that any and al work performed shall he done in accordance with the Ordinances of Lane Coui,t.y.'and the Laws of the: State n. t , 1,I La in in?
e
to the work described herein, and that NO OCCUPANCY will be made of any structure without the permission of the Building Divisi . I further c• -tity
that-registration with the Builder's Board is in full force and effect as required by ORS 701.055, Lhal 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 COIECLED THIS
APPLICATION THOROUGHLY.
1/: r E ./...e!! A asisrAi / li11 ./ 74. //04/ __.'
Nn' (please print) EI' nTHRE D.'+f' -
/r / 51 /
' 0 PLANNING/ZONING: • Zone /96. 7— Partition a Parcel Parcel Size/Ui xU /(/
Minimum Setbacks: CL,•front CL, side ®�/ icte ••r real" /
de Comments. __II i i/�i/i���/�L�� — ���.i✓�i .
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✓�/L _mow. .._i �� Gate: '��S —' �--
0 FLOODPLi N: In flood hazard area? 0 No O Yes, see attached sheet. • Date: _
. �0I RURAL ADDRESSING: • GRID COORDINATE N E ' �• Date: . _
IXI SANITATION: S: 1. __ _ B. P. # ns tallation Record Issued? 0 yes Q No
1�C
'Installation . Gallon • /5j0 Lineal Feet ' �/ e Maximum Depth '
Specifications: Tank C/ of Drain£ield Y) /h 9ff Trencher.
• Comments: ' 1 te i 53 a i 0 Ir " .$ ;,$ -to in i _
• / t
L- if / / _, • - of r Al I aCL -1 b ,n . -ice<i. 0 e O _
Date: / /3a
❑ PLANS EXAMINATION: • Type - • • : Group L use .
•
• Comments: .
. Date: I
CONSTRUCTION AUTHORIZED BY THIS PERMIT
• Fixed Fee/ Floodplain Fee •.• $ °/�{�-�F
D- cription Sq. Ft. Unit Cost Subsurface Fees $-CJ�
/' / `/ / - " Building Fee $
/��fl� - Sewer/Storm Drain/Water $
•4/ / i /i / . ..
Plumbing Fixtures $
Mechanical $
si/�j �y� Plans Check Fee - $
-.01/ • State Surcharge $�'r •
�j//./77///� `�, �� _ - TOTAL FEE $ Q��j
•�� - FEES PAID BY: a .- I.
TOTAL V'" ATION $ /
• _ BY /` %sea // •
Dte• T r- 62--en
. . fi , i, , -, A
' PERMIT APP•! E• - BUILDING OFFTCLAL/D•SIGP11 (1er'OIIS 456.005(1)) E
LANE COUNTY DEPARTMENT OF PLANNING & COMMUNITY DEVELOPMENT / 125 EAST EIGHTH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
•
SETBACKS.AND•OTHER.CONDI•T,IONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION'CAN RESULT IN REVOCATION OF THIS PERMIT,- ' '
CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOWED BY LAW.
•
WHEN READY FOR• INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST•24'HOUR ADVANCE ,NOTICE FOR INSPECTION REQUEST MUST BE • '
•
GIVEN. Have the following information ready: -.Permit number, job address, type bf inspection, when it will be ready,"
your name and phone number, and any special directions_ to•site. - - '
- .1' . .,. '-_.r ''-•, . . -
BUILDING DIVISION: - '
REQUIRED INSPECTIONS -`_, _ . . _ .
•1) FOUNDATION INSPECTION: To be made after trenches are excavated arid• forms erected and When all materials for the- foundation
are delivered on the job. Where concrete from7a centrallmizing plantt' (conimonly_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 service' equipmen-K ', ., .
conduit, piping accessories and other ancillary:.equipment items are,jn place but before any'concrete is poured • ,
',t or floor sheathing.installed,..including the subfloor.• s _ - .. `• (. , .•
3) FRAMING & INSULATION INSPECTIONS: To b'e made after the roof, all„franiing, fire blocking and bracing are ie- place and
all pipes,',fireplaces and chimneys and vents are complete and all rough electrical and,plumbing'are approved. . All
wall insulation and vapor barrier 'ire.in place.' -. - .
4) LATH AND/OR GYPSUM BOARD INSPECTION: To•be made,after all-lathing'and' gypsum'board;-interior and exterior is in place. 1
-
•c - but before any plastering is 'applied'-or before•gypsum board joints and fasteners are .taped and finished. '
5) ' FINAL INSPECTION: To be'made after the building is'complete,and before'occupancy.'.. ' ' - ' '-' ' ' ` ' '
APPROVAL-REQUIRED.) No. work,shall;'be done'on any.part of the building or strieture_beyond the point indicated in'each ". N
successive inspection without first obtaining the approval of the building official. . Such'approval shall be 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 authorised, such as but not limited to: )N;'
•
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.mason 'rv':(if applicable) and when installation. is complete.
Installation shall be in'accordance"with an bpproved'nationally recognized testing agency and the manu- .
•_facturer's installation instructions.,.
•- ) •v,.,- ,;,�• ,` - v \'` 'a _
•• 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) _Mobilehome minimum finish floorelevation.shall be certified when required by a floodplain
-management letter. — �, -. . ♦ ,� )`')'_.-ti T•:,. _
.--t' `')' (3) Mobile home tiedowns, when required, and skirting shall be installed and ready for inspection
• • 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. , - .
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 MORE.THAN 180 DAYS.. SUSPENSION OR REVOCATION MAY 'OCCUR IF THIS •
PERMIT WAS ISSUED ON THE BASIS,OF INCOMPLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING"PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT,HIS OWN RISK
• AY,-r.; ' .:..'1, -14, ..1., w; ' '\".: ,.-, n+\y ; .{ '^ '' b.'A .
' SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS ' '
\: 4 \I... 1,1 ^—.'t.. e ..,S,_ C.S ..�, t : 1) ) .1 .1..)� a..^..)1 1 ---1st J <L-: 44 : \'1kJ. � . .4 .. _
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;(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 ' .
Department 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 notifythe 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 violation of ORS 454.605 to 454.745 and this rule.
. Setbacks - Subsurface .Sewage.Disposal' - •
- - Septic Tank Drainfield " - - '
From: Interior property lines 10' ' '10'
. Edge of road right-of-way - ' 10' 10' - •
Building foundation 5' 10' •
Wells, other water sources 50' 100' - •
.
_
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r �ANNING & COMMUNITY DEVELOPMENT lane county
ACTIVITY INFORMATION SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
1 aw, aia- Ex Atr. F _1 boys ( �C3�uUu (U
Bite A c
PERSON MAKING REQUEST
PROPERTY OWNER
20Go BO
Ot s r ,
MAILING ADDRESS MAILING ADDRESS
orz 9 )4c>
CITY STATE ZIP CODE CITY STATE ZIP CODE
Ce®q-0757
BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE #
2:. PROPERTY ADDRESS 34- 21 BA Lp1 V 1 ew L ,
( IF DIFFERENT FROM MAILING ADDRESS)
3 MAP S PARCEL NUMBER (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORMATION) or from tax statement)
(1 o 23 Soo
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: ( s ACRES
4 SUBDIVISION ( if applicable) LOT BLOCK
5 REQUEST (state exactly what you plan ,to do) raepc.a,c.E ExrtriNS
cp rte f os-t tac szt 0 0-Art w •f-a-,4 ie
I Q Ps , C
6 DIRECTIONS TO SITE: Coos 1 _ Tp_ (p_
R A-L t- K O(e.) 40,
** FOR STAFF USE ONLY ** NUMBER- A
ZONE/LAND USE: DATE IA
BY: DATE: TIME IN: OUT:
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• LANE COUNTY DEPT ENV MGT RECEIPT e 2883 DATE 01108•
APPLICANT .EMERALD, EXCAVATING ADDR 2060 BROADVIEW, EUGENE, OREGON
TLw 1703230000300 SUBDIV LOT BLK
• NEW BLDG TYPE USE R BDRMS 2 UNITS 001 STORIES vBLDGS 001 PHONE 689 0757 •
OWNER NME ADDR .
CODE: APPL NO ACTION DESCRIPTION • SQ FT UNIT COST VALUATION FEE DAYS•
WBP .
BP - '
„BP•kF' •
. , . BP
•L NO. FIXTURES : •
NO. CONNECTORS : 15.00 EACH = •
MECH ' • . MECHANICAL FEE '
• SUR STATE SURCHARGE 4%▪ 'CK - PLAN CHECK FEE 65% ' •
SDS LC 2883 SDSC ' 50.00 JJ
•SUR 5.00 •
•CATG : APP • RA FP SDS - SI PCK 0TH ISS •
. , ESEQU : 0 • 1 2 9.
•TAKEN BY RL.H EST. COMPLETION DATE TOTAL FEE** 55.00 CK •
IP ID
lane county
PLANNING & COMMUNITY DEVELOPMENT
ACTIVITY INFORMATION SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
1 - \ 1 a / U I�
PERSON MAKING REQUEST PROPERTY OWNER
MAILING ADDRESS MAILING ADDRESS
CITY STATE ZIP CODE CITY STATE ZIP CODE
BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE #
2:. PROPERTY ADDRESS
( IF DIFFERENT FROM MAILING ADDRESS)
3 MAP 6 PARCEL NUMBER (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORMATION) or from tax statement)
�� T T(TO NS IP R SECTION TAX LO OR PARCEL # ZONI
TOWNSHIP RANGE SECT ON TAX (S) OR PARCEL # . ZONING
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: . //5/, . ACRES
4 SUBDIVISION (if applicable) LOT BLOCK
5 REQUEST (state exactly what you plan to ) c a A /+"j ' e
ill • . • -? 6
6 DIRECTIONS TO SITE:
** FOR STAFF USE ONLY ** NUMBER A
ZONE/LAND USE: DATE r
BY: DATE: TIME IN: OUT:
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�- ' LANE COUNTY ,INSPECTION RECORD
OWNER'S NAME
PHONE NUMBER
-/YS nil!/ _a J / 1Anrtei. )
CON TORS NAME
PHONE NUMBER
§ET BACK REQUIREMENTS #PLUMBING FIXTURES
CL, FRONT CL, SIDE INTERIOR REAR
WORK AUTHORIZED BY PERMI+T
DIRECTIONS TO SITE x---I
X44 15 '/ r4. /,)///./) , /,Ati : , d.�4J //q-X -22
SITE ADDRESS " ;j `., / - / ° PERMIT-NUMBER
FOOTING / FOUNDATION INSPECTION OR MOBILE HOME SET UP INSPECTION
Approved Correction Disapproved Date Inspector
CONCRETE SLAB / UNDER-FLOOR INSPECTION
Approved Correction Disapproved Date Ynspector _
UNDER SLAB / PLUMBING GROUNDWORK INSPECTION
Approved Correction Disapproved Date Inspector
ROUGH PLUMBING INSPECTION
Approved Correction Disapproved Date Inspector
FRAMING INSPECTION
Approved Correction Disapproved Date Inspector
INSULATION / VAPOR BARRIER INSPECTION
Approved Correction Disapproved Date Inspector
LATH / GYPSUM BOARD INSPECTION ' .
Approved Correction Disapproved Date Inspector
FINAL PLUMBING INSPECTION
Approved Correction Disapproved Date Inspector
FINAL WASTE DISPOSAL SYSTEM INSPECTION
Approved Correction nDisapp�rovedd Date Inspector
FINAL ONSPEC ON BUILDING r / MOBIL��LE HOME �y)
Approved Correction Disapproved Date — �yIns ector 7.cT—cam
5-/4-g2 azt oK , - - e _az,
CERTIFICATE OF OCCUPANCY TEMPORARY CERTIFICATE OF OCCUPANCY__ ___
Approved Correction Disapproved Date Inspector _
Form C74-197
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