HomeMy WebLinkAboutPermit Mechanical 1982-11-9 (2)
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CONSTRl -:TION/PLACEMENT
PERMIT (()J~1
FOR OFPles USE ONLY
1'1 03
SUBDIVISION/PARTITImj (if applicable)
LOT/PARCEL
BLOCK
Application/Q 3 I <:l.-
Permi t # I I') L - 0 L..
o Two Copic",. of Plans
DTwo Copies of Plot Plans
[]Mechanical Checklist
o Plumbins Checl:list
[JPlan Check lnfo Sheet
TOi'/NSHIP
RANGE
SECTION
Z.~.3,3
I
I
INK AND PRINT.
TAX LOT DOUT OF
2~OO'
COMPLETE THIS BLOCK.
PLEASE USE BLACK
LOCATION 2,DDRESS n STREET' . CITY. ZIP
27OX0/iotfl ' 1>\-111 .i'). ~_. k"7
'TF';Jt~o;.oo~~mt~ ofamuJ1# ~~ ;,~~
DESCR~TlON OF PROPO:f/.J ~ORK 0 b ' . -J <: $ VALUE
" ~fJ.:1;/)j)) . o'YY!ir!Cl ~/:;$ ,'(fIi~L.' ' 0 Propoced
,~ .(7) rJ\Lj~a _ 72/p- 51t..j.tPJo Existing
O\'P1h;'t~A(ti)LJ'IJlJI :)'7Q(O ~ Pnd ~97q-'iJ)7:;()r-I2zq,
~t10:ZN"~' AO"fctr i3<kJ(r;.J.IJ56..~.9 '.f"1C5Vi.(]r~7 _1f47~N/fXi7J -...
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WI Dfu f-lc , 0U-ctQeJ ~)f-, fZ.,M.t I (~'n f'"-f4:<Jf11 '
- II~ CAREFULLY EXAMINED TIL COMPLETED APPLICATION FOR PEiJ.T. and do hen.'bl '".'rl:i fy !h'lJ,:Jlu infDmatioll hC'r0')n ic; trllc and correct. and I furl.11"r
certify that any and all work performed shall be done In accordance wlth the Or.dlna;lccs of Lane County and the La",.;s of thf~ Stcll.C of 01"0'q-:)11 1.'~rl.)jIJill'J
to the work described herein, and that NO OCCUPANCY. will be made of any structuPJ wi.thout: the permission of the Building Division. .T [url"ll';r cct"t.i fy
that. registration with the Builder's Board is in full force and ~ffect as required by ORS 701.055, that if exempt the basis for exemption is notl"d
hereon, and ~at only subcontractors and employees who are in compliance with ORS 701.05 "II be used on thjs project. I HAVE READ AND CIlECY:'ED THIS
APPLICATIO THOROUGHLY.
PEOPOSED US!.: OF P"OPERTY
~idential []rndustrial
D Commercial
DPublic
'~r;t~ ~
t/lli: (l~~rint!/
~
((
o O'^'""r
D ContrCle,-",'
D_~TL
[J Agent
o PLANNING/ZONING:
zone-M-
Partition ff
Parcel "l'
Parcel Size....&! , A--,--
~lirlimum Setbacks:
C
L, front
eL, sid[-'
interior
rear
. CO_",~,A€ J%uur;7/:;n D0- 0 f'hdn) !;t. ~ UU.d. dt.ce/ lurru
{fldhf)} Tl(j- ~bIiJ ). ~JGn L ~ rlf.Y. t1.dt;i&i If)/hl;Z/iS"6 Ob
FLOODPLAIN: In flood hazard area? D yVsee attafrted sheet. Date: D
o RURAL ADDRESSING: GRID COORDINATE N E Date: D
o SP~NITATION:
S. 1.
B. P. #
Insta1lat.ion Record Issued? DYes D No
Installation
Specifications:
Gallon
Tank
Lineal Feet
of Drainfield
Maximum Depth
of 'Trenches
Comments:
.,~ANS EXAMINATION: Type~ Group..J!<'3_
/f7 --d~-
(~~ lLi2K
Jh 0"'", 0
Use ~jrrh~rc....
,
Comments:
.~7:2I.9/J Et:.17o /1/
, - ,
Date:
//44?z
~
CONSTRUCTION AUTHORIZED BY THIS PERMIT
~ Description
LA )(JI9t17l11JUf J
Sq. Ft.
Fixed Fee/
Unit Cost
Floodplain Fee
Subsurface Fees
Building Fee
Sewer/Storm Drain/Water
Plumbing Fixtures
Mechanical
Plans Check Fee
State Surcharge
TOTAL FEE
$
$
$
$
$
$_liJ.(jn
$ ~.:J5
$ "1(L)
$ {JW
TOTAL VALUATION $
FEES PAID BY: ~heck D Cash
By: (JLLf{jf /
PERMIT APPROVED BY BUILDING
Date:
- .1
~u/
4'5'b.8051)) ,
ff)/87 ) (121
, I
/1-9'-;l!L
LANE COUNTY DEPARTMENT OF PLANNING & CmmUNITY DEVEU0PHENT / 125 EAST EIGHT1 AVENUE, EUGENE '. OREGON
SEE REVERSE FOR INSPECTION INFORMATION
97401
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATION OF THIS fERMIT,
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 of inspection, when it will be ready,
your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED INSPECTIONS
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. Where concrete from a central mixing plant (commonly termed "transit mixed") is to b'eused,
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 equipment,
conduit, piping accessories and other ancillary equipment item$ are in place but before any concrete is' poured
or floor Sheathing installed, including the subfloor.
3) FRAMING & INSULATION INSPECTIONS: To be made after the'roof, all frami~g, fire blocking and bracing are in place and
all pipes, fireplac~s and chimneys and vents are complete and all rough electrical and plumbing are approved. All
,wall insula~ion and vapor barrier are in place.
4) LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place
bu.t before any plastering is applied or before gypsum board joints and fasteners. are taped and finished,.
5) FINAL )NSPECTION: 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 structure beyond the point indicated in each
successive inspection without first obtaining t~e 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 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 masonrv (if applicable) and when installation is comolete.
Installation shall be in accordance with an approved nationally recognized testlng agency and the manu-
facturer'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 )
(2)
: (3)
Footings and piers to comply with State foundation requirements for mobile homes or as recommended
by the manufacturer.
Mobile home .minimum finish floor elevation shall be certified when required by a floodplain
management letter. ' . ,
Mobile home tiedowns, when required, and skirting shall be installed and ready'for inspectiqn
within at least 30 days after occupancy. Tiedown~ 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 ins ta 11 ed.
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
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
(1)
(2)
Permits shall be effective for one year from the date of issuance.
Upon completing the construction for which a permit has been issued the permit holder shall notify the
Departm~nt'.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 ~Iith
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 violation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewaoe Disposal
From: Interior property lines
Edge of road right-of-way
Building foundation
Wells, other water sources
Septic Tank
10'
10'
5'
50'
Drainfield
10'
10'
10'
100'
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PLANNING & COMMUNITY DEVELOPMEf.
ACTIVITY INFORMATION SHEET
!CJr1(:::' county
. ,..
COMPLETE TH}S SECTION. INCOMPLETE FORMS WILL BE REJECTED!
.. . -~. . __A. ... - ",\.~t-- ... .....,-. -.
1 fit-v 7 ~v4r ~6er1 Ivd..r
/ PERSON MAKING/REQUEST - ~ PROPERTY OWNER
~, - '"~'l~ ~)r .13 '1 () 'c r ..cf- <2. 71 b LaAi le -Dy.
-... MAIUNGADDRESS MAILING ADDRESS
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2'. PROPERTY ADDRESS ~
(IF DIFFERENT FROM MAILING ADDRESS)
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CJ~ 91'117 ti
STATE ZIP CODE i
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'?V7-2.;(S'O ~
HOMt TELEPHONE # .~
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(from tax maps in Department of Assessment anp Taxationl
or from tax statement) 02..5"'00 CluD II fi
f) 2 J-:3 ~ ~~--;Ir- SJ6cfG'f'j 12/ a
RANGl SECTION TAX'LOT(S) OR PARCEL # ZONING ~
1'l,~ -V'fl(q
BUSINESS TELEPHONE #
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If I TV
7C/(-rrOZ--
BUSINESS TELEPHONE #
CJ{(
STATE
'17Y77
ZI P CODE
Jk vre-..
HOME TELEPHONE #
r
MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
/'7
TOWNSHI P
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
.~ ACRES
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
i 4 SUBDIVISION (if applicabl~)
5 REQUEST (state exactly what you plan to do)
L
,?red4 I~ - /H1(q{e/ ---- I
LOT
BLOCK
6 DIRECTIONS TO SITE: lI:--ovt S;Ytt d)'f IYdWf &(tl-JlrJ~J~-') (elf fo/:k.#Jj)r w7,; ~I (~~,
** FOR STAFF USE ONLY **
NUMBER
DATE
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ZONE/LAND USE:
BY: DATE:
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TI M,E IN:
OUT:
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