HomeMy WebLinkAboutPermit Building 1983-7-22 (2)
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\ I 'Lane, County Authori~~tion for:
APphcatwN-::z."f q:::2
Perml..t #~, - (J- '_
C(r-ldJ j!by(jlJ-l tl~/71'rrTrYi ~r( B~~:e~o~:::e:f o:l:~:t Plans
roW"SHlP Iv-? I RANGOE -::>. I S~T~ ~ /;1 I TA;..,L~T_lJOUT TIF DMech/Plumbwg Checkhst
I :.J 0 ~ -.L U ~") 0 Legal Interest Document
SJBD:~.1~;raacr t6a~t~ .-) t1DYPOT?5CEL I B,"3 Dplan Check Info Sheet
LOCATION ADDRESS/i) ST.Ji,~' l' R~ C PROPOSED USE OF PROPERTY
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J~("TI1AJRa~D WORK lli(E't)a wJ1U ' ~ Ll : ObmJreLAREO S VALUE
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O'T'su*;tb)RE~d_. !Jt.O ~dm C;(l},lU'Jl1fll)J)~~ TELEPHONE NUMBER
CONT~CTOR'S Nhmf n~!1'.g)~c8'l._L~n Jti ()r.
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I ~E CARErULLY EXAMINED THE COMPLETED APplICA~lO FOR peRMIT and do hereby certl.~ that: all l.n[ormal:l.on hereon lS true a~d correct and that I
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have the followlng legal l.nterest 1n the property owner of record Dcontract purcha<>er Dauthor1zed agent w1th eV1dence of author1ty attached
I f_rther cert1fy that any and all work performed shall be done 1n accordance w1th the Ord1nances of Lane County and the Laws of the State of Oregon
pertaln1ng to the work descr1bed here1n, and that NO OCCUPAr..CY w.1ll be made of any structure w1thout the perrn1ss1on of the BU1ld1ng D1v1s1on I fur-
ther cert1fy that reg1strat1on w1th the BUlld~r's Board 1S 1n full force and effect as requ1r~d by ORS 701 055, fthat 1f exenpt the baS1s for exempt10n
15 noted hereon and that only subcontractors and employees who are 1n COmpl1anCe w:Lth ORS 701 055 w1ll be used on th:LS project I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY
FOR OFFICE USE ONLY
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READ THIS SECTION CAREFULLY
YOUR AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS'
o PLANNING/ZONING ~. '~.~ ;"""": .
H.ln1murn Set!Jacks L, nt L, slde
CO'l'lENTS R::.or. ti. ill (1/fjYl
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c~lillt?fY Q LGea:arce5'te
~OODPLAIN
In flood hazard area? IX! No 0 Yes, SEE ATTACHED SHEET
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Date .::J7.- ~-A ~ ~_
~ITATION
8 P # (72$- (a.fa.... Installat10n Record Issued? DYes 0 No
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L.lneal Feet Maxlmurn Depth
of Dra.lnf.leld of Trenches
COlmENTS ~ /0 ~ ..t.".....___ ~ PM.Td~ ~A~..Lp/g IZ""'A0L AA~h
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~M'~ CLVJI!.. A, '">A./~ or h ,A.-'! ~ ,)-, J-.2--L AJi-AA~ ~ ,
/' Date/::J ~2. '7--/7
~NS EXAMINATION Type-!5l) ;. Group---ldl Use C!./lt:-:AtjV,
COMNENTS f'P....<1t'L ~L RF.D? /IihPW-r'"fIJAh '
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Installat.lon
Spec~f.lcat.lons
Gallon
Tank
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lJate
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I"-~-/?Y
n
TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
--
Descr~pt~on
Sq Ft
F1.xed Fee/ Floodplaln Fee $
Um. t Cost Subsurface Fees $
BUlldlng fee $
1~2;Ch/P Imbg Fee $
plans Check Fee $
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State Surcharge $
DEQ Surcharge $
TOTAL FEE $$
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PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 45SL805(lJ) DAtE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE ~TRICTLY OBSERVED~ .VIOLATION~CAN RESULT IN REVp-
CATION OF THIS PERMIT I CITATION UNDER"PROVISIONS OF LANE COUNTY I S,INFRACTION\ORDINANCE" AND/OR,"'OTHER"
REHEDIES ALLOWE-O BY L~W ' '- . _ \ J.. J 11' \,.-# ,~ . I _ . '... ~ ~
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WHEN READY FOR I~SPECTIOli, CALL 687-4065 'A, MINIMUM OF AT l-'EAST 24 Hp~RS l\DVANCE N..OTICE,FOR 'INSPEC,. '
TION REQUESTS MUST BE GIvEN Have thel following ~nformat~on"""ready -permlt number, Job-address~ type,....."
of lnspection I v;-hen i 1 t wllr be ready,,. your I nal!le and .phon~ nUm!?er, ,:nd -.any speclal, dlr'ectlons to 51 te y-
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BOI~D~NG ~I~ISIO~ !"t l' 1)/
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REQUIRED INSPECTIONS ... I ,
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Foundatlon -Inspectlon ..To...be. made after_ trenches are...excavated and forms 'erected and when...all
mater1al!3 ,t<;r ",the foundatlon a,re de!lvered ~on the Job, t..tVhere ,concrete from "a, cent,rpl m1x1ng
plant (commonly termed ".translt mlxed") 15 to be used, materlals need' not be on'the' Job
.. .. , . - .; , ", - - \ . ..... t ....J -' "l 1 ~ ~ ~... -- - - - ,..,,.,
Concrete Slab or Under-Floor~Inspectlon To be mad; af~er all In-slab or ~~der-floor b~ltdlng
serVlce equlpment, condult, P1PLQ.9 ~ccessorJ..es,_ and, otheS anc1llary equlpment ltems~are \11)_
-place but before any concrete lS poured lor floor..sheathlng lostalled, loclud10g the 'subfloor
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Fram1n~ ~ Insu at10n Inspectlons -To be ma?e afte~ the roof, arl framlng, flre block1I)g,_and_
~braclng are 1n place and all plpes, flreplaces, chlmneys, and vents are complete and all rough
electr1cal and plumblng a~e approved All wall lnsulatlon ~and vapor barrler are 1n place ~
. 1 ...- - ~ --r- ;' - - . .. ....-.. - - ~-'I
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4 ILath and/or- Gypsum Board Inspect10n ITotlbe road,e aft~r all,lath1ng and gypsum board, lnter10r
-pnd,exterIOr, is,ln place but before any p~a~terLng~lS~ftPplled ~n~ be~ore_gypsum Qoard_JolntE
and fasteners are taped and fln1shed
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2
3
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5. Flnal Inspectlon
To be made after the bUlldlng 15 complete and before occupancy
APPROVAL REQUIRED No work shall be done on any part of the bU11d1ng or structure beyond the pOlnt
lndlcated 10 each succeSSlve lnspect10n wlthout flrst obtalnlng the approval of the bUlldlng off1clal
Such approval shall be glven only after an 1nspect1on shall have been made of each succeSS1ve step
1n the~coostructlon as lndlcated by each of the lnspect10ns requlred
NOTE All bU1ld1ng' perrnlts ~requl.re lnspectlons for the work author1zed/~ such as but not llffilted ,to
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A Block Wall To be made after re1nforc1ng lS 10 place, but before any grout 15 poured ThlS
lnspect10n 1S requlred for each bond beam pour There wlll be no approval untll the plumblng
and electrlcal lnspectlons have been made and approved
B wood Stove To be made after completlon of masonry {l.f appllcable)l a,!ld when lnstallatlon lS
complete Installat10n shall be 1n accordance wlth ~n approved, natlonally recognlzed testlng
agency.... and the. manu~fe..cturer} s :-n~ta"ilatlon lnstruct10ns ' ~ <>- _
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C Mobl.le Home An lnspect10n lS requlred afte:r th..e mO~llt. home l\s.conn..ecte4 to @.I1,. approied
sewer or septlc system for setback requ1rements, blocklng, footlng connectlon, tledowns,
sklrtlng, and plumblng connectlons . - -- ... ...... - - - -r - -- .... j f
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1 ~Footlngs and plers to comply wlth State foundat1on requlrements for moblle homes or as
recommended by ~he manufacturer
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2~ Moblle home IDlnlmum flnlsh floor elevat10n shall be cert1fled when requlred by a flood-
j.:g~aln 1i)a:oage\'O~nt~letter \. I
Mob1le home tledowns, when requ1red, and sklrtlng shall
tlon wlth1n at least 30 days after occupancy Tledowns
per enclosure. '\ " _ -. '" "
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Sw~mm1ng Pool Below grade when steel lS In place and before concrete lS poured
when pool-rs-1nstalled
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be'lnstalled
and sklrt1ng
and ready for lnspec-
shall be lostalled
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Above grade
APPROVED PLANS MUST ~E 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 PE~1IT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION ~ .. . ; ~.. ... -'
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pNYONE PROCEEDING PA~T THE POINT or REQUIRED INSPECTIONS WILL DO so AT THEIR OWN RISK
SUBSURFACE AND ALTERNATIV~ SEWAGE DISPOSAL SYSTEMS\ \ Y
1 Permlts shall be effectlve for one year\from the date of lssuance
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2 Upon completlog the construct1on for whlcn a permlt has been lssued, the perm~t~holder shall
not1fy the Lane County Department of Plann1ng and Communlty Development by subrnlttlng the
lnstallatlon-record form The Department shall lnspect the construct~on to determlne If 1t
complles w1th th~ rules conta1ned In th1S dlvls~on If the constructlon does comply wlth such
rules, the Department shall ~ssue a certlf1cate of sat1sfactory complet1on to the perm1tl holder.
If the constructlon does not comply w~th such rules, lhe Department shall ootlfy the perm~t
holder and shall requ1re sat1sfactory complet1on before lssulng the certlflcate Fallure to
meet the requlrements for sat1sfactory complet1on w~thln a reasonable tlme const1tutes a V10-
latlon of QRS 454 605 to 454 745 and thlS rule
Setbacks - Subsurface Sewaqe D1sposal
From
Inter10r property llnes
Edge of road r~ght-of-way
BU1ldlng foundatlon
Wells, other water sources
Septlc Tank
10 '
10'
5'
50'
Dralnfleld
10 '
10'
10'
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C 14- 25
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ACT. }lTY INFORMATIOI\ SHEET
, lane coumy
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C6MPLETE THIS SECTION INCOMPLETE FORMS WILL BE REJECTED'
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PERSON ~A~~QUEST
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MAILING ADDRESS
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(CITY 0 STiltE zrPcIJiJE
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BUSINES3 TELEPHONE # ~LEPHONE #
. 2 PROPERTY ADDRESS ,f\ ) (j
(IF DIFFERENT FROM MA1LING ADDRESS)
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PROPERTY OWNER
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MAILING "ADDRESS
CITY
STATE
Zl P CODE
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BUSINESS TELEPHONE #
&VY)~
HOME TELEPHONE #
3 MAP & PARCEL NUMBER (from tax maps , n Department of Assessment and TaxatlOn
(REQUIRED INFORMATION) or from tax statement)
---.lL ill .:). '6 " ~ _ 2- 03 'tOO
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
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TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
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TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
ACRES
LOT BLOCK
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TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP
.4 SUBDIVISION (If appllcable)
5 REQUEST (~tate exactly what you plan to do) ~m(3 S2
6 DIRECTIONS TO SITE _f.-\n1,,~<s=>~GriJ~9 Wr&AQO;::.l-+n C=n~+le .
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** FOR STAFF USE ONLY **
NUMBER
ZONE/LAND USE
BY DATE
DATE
TIME IN
OUT
LAND MANAGEMENT DIVISION / 125 E 8th AVE, EUGENE, OR 97401 / 687-4061