HomeMy WebLinkAboutPermit Building 1984-9-13
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Lane County Authorization for:
Mr{LbrfnJ ~ O~I?5h n7<n-lrlll~(lll DTWO Cop>es of plans
! I l 7) 0 Three Cop.les of Plot plans
roW'SHIP I RANGEO~ I SE~03N .3, -'? I TAX~";:'~CJOUT OF~ DMech/Plumb>ng Checkhst
17 .;...,J -~ v..::2C..X-U DLegal Interest Document
SJBDIVISION/PARTITION (d apph.cable) . I LOT/PARCEL I BLOCK D Plan Check Info Sheet
LOC2JjZ1SS rb0 t O(l1A- ~ Oen n M d CITY ZIP PDO:::>~S:n:::1ROPD\ndustnal
~~~ONo;~ ',~' Bltt~:n;j ~er~ DPubhC
Al\Q~ ~~nri _\..1r)-'Qyd.k'Cw._
nR~ Dt P';;,':.o.:,"\ W':(\j BE~CIFIC ..J...,..,. .....-I. L'
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R'S NAME ~ADDRESSb2f It fYYVL (]'7{ f1~ ,) L) ~~N~
N CTOR'S NAM:t?pR # rf~. . ~I()_ I ~ ~j in 1 /m::~~b'
~^fh1~. i '.c. (rl 1 rn I~ELEPHONE mmBER
I HAVE CAREPULLY EXN~INED THE COMPLETED APPLICATION FOR PERMIT \and do hereby ccrtlfy that all lnformatlon hereon lS true and correct and that I
have the followl.ng legal .l-nterest 1n the property Downer of record 0 contract purchaser ~"iuthorlzed agent wlth eVldence of authorlty attached
I f_rther certlfy that any and all work performed shall be done ln accordance 'iolth the ordl~ of Lane County and the Laws of the State of Oregon
pcrtalnJ..ng to the work descrlbed hercln, and that NO OCCUPANCY wlll be made of any structure wlthout the pen11SS10n of the BUlldlng Dlvls10n I fur-
ther certlfy that regl.stratlon w1.th the BUllder's Boilrd 15 10 full force and effect as required by ORS 701 ass, that 1.f eKempt the bas1S for CKemptlon
15 noted hereon and that subcontractors and employees who are J.n compl1.ancc wl.th ORS 701 ass wl11 be used on th1.s proJect I HAVE READ AND
CJj;;:JlCATI ;~~ ." -r- N'-A t ~. ~h6JI-t}
-NAME (please pnnt) - ~ SIGNATURE DATE
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-
FOR OFFICE USE ONLY
Appl>cat>OnL~/' ~/'~ __ t/~~
PermJ.t It_7fi'//~' /17
,
DE~S $ VALUE
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READ THIS SECTION CAREFULL~YO R AUTHORIZATION HAS BEENJ\SED ON THE FOLL~NG
~ 0 ~\
o PLANNING/ZONING L.vne Part~ t~on # . Parcel # T'l
,. I>I~mmwn Setbacks eL, front \...\~~\ncL~L' s~dei'\.~~ ~ntenor '-- ~U~
CO'L'lENT00.A. k., ~ >--' ~('\ ~~ U
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CONDITIONS'
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S I # / B P # . Installahon Record Issued' 0 Yes 0 No
Installat~on Gallon L1.neal Feet Max~mwn Depth
Spec1.f~cat~ons Tank of Dra1.nf~eld of Trenches
CmL'IENTS kR~ '),0",) n~Jh../ /O!r~ #V.P*&;'-:'--~__~/~.J
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~(,(1t>AA..~ t&r/A_._ ' , Date -311-''1 ~
)( PLANS EXAMINATION Type fA,) - Group ~ Use -
COMflENTS J!1~~~.m..I,6A-k} ~.# r -&~!.fl
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Date
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TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
--
Descr1.ptJ.on
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LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MA~AGEMENT DIVISION, 687-4061, C 14- 25
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
Sq Ft
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FJ.xed Fee/
UnJ. t CO~ Z.
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Floodpla1.n Fee
Subsurface Fees
TOTAL FEE
$
$
$
$
$
$
$
$$ ...L2, C J!.-
(::;W~<d
lf~~h~Kee
State Surcharge
DEQ Surcharge
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SETBACKS AND OTHER CONDITIONS-OF APPROVAL MUST BE STRICTLY OBSERVED VIOLATION CAN RESULT IN REVO-
CATION 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 HOURS ADVANCE NOTICE FOR INSPEC-
TION REQUESTS MUST BE: GIVEN Have the follow.lng lnformatlon ready permlt~ numl5er, .,Job address, typ~
of .lnSpectlon, when lt wlll be ready, your name and phone number, a~d any speclal dlrectlons to slte
BUILDING DIVISION
REQUIRED INSPECTIONS
I
1 Foundatlon Inspect.lon To be made after_trenches are excavated and forms erected and when all_
mater.lals for the foundatlon are,del.lvered on the Job Where concrete from a central ffilxlng
plant (commonly termed "translt m.lxedll) lS to be used, materlals need not be on the Job
_ _ ___ _.44_ _
t .
2 Concrete Slab or Under-Floor Inspect.lon To be made after all In-slab or under-floor bUlldlng
serVlce equlpment, condUl t, .p-!-plng_ac~essorles,_andJ. other anclllary_ equ.lpment 1. terns are In ~
place but before any concrete lS poured or floor sheathlng lnstalled, lncludlng the subfloor.
, '
3 -Framlnq ~ Insulatlon Inspectlons -Tolbe-made after the~roof,~a~l-framlng, flre blocklng, and
bracing are In place and all p1.pes, flrepIaces, chlmneys, and vents are complete and all rough~
electr.lcal and plumblng are approved All wall lnsulat.lon and vapor barr.ler are In place" .
-- .-- -- - - ..... - - - - - I f' -- :-- I ----
4. Lath and/or Gypsum Board Inspectlon To be made after all lathlng and gypsum board, 'nterlor
ana-exterIOr, is_in place but before any plasterlng .lS applled and.before_9Ypsum board JOlnts
and fasteners are taped and f.lnlShed
5. Flnal Inspect.lon
To be made.~fter the bU1ldlng lS complete and before occupancy
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APPROVAL REQUIRED No work shall be done on any part of the bUlldlng or structure beyond the pOlnt
.lndlcated In each succeSSlve .lnSpectlon wlthout flrst obtaln1ng the approval of the bU1.1d.lng offlclal
Such approval shall be glven only after an ~nspectlon shall have been made of- each successlve step
In the constructlon as .lndlcated by each of the 1.nspect1.ons requlred
NOTE All bUlldlng permlts requlre lnspectlons for the work authorlzed, such as_~ut not l~mlted to
A Block Wall To be made after relnforclng lS 1n place, but before any grout lS poured Thls
1nspect1on 1.S requlred for each bond beam pour There wlll be no approval untll the,plumblng
and electr1cal lnspectlons have been made and approved
B Wood Stove To be made after completlon of masonry (If appllcable) and when lnstallatlon .lS
compl~ Installat1.on shall be ln~accordance wlth an approved,~_nat.lonally recognlzed testlng
agency and the manufacturer's lnstallatlon 1nst~uctlon?
C Mohlle-Home An lnspectlon lS requlred after the moblle home ls-Connected to an approved
sewer or septlc system for setback requlrements, block.lng, footlng connectlon, tledowns,
sklrtlng, and plumb.lng connectlons.. - - ~ - -.... . - ---
I Footlngs and p.ler~-to comply w1th State foundatlon~requlrements for mob1le-homes or as
recommended by the manufacturer
2 Moblle home.mln1mtun fln.lsh floor elevat.lon shall be certlf.led when requlred-by a- flood-
p~a.ln _rnaz:ag;:.m~n_t_letter ,_.... _ _ _ _ _.... .
3 Moblle home t.ledowns, when requ1.red, and sklrtlng shall be lnstalled and ready for .lnspec-
t10n W.lthln at least 30 days after occupancy Tledowns and sklrtlng shall be lnstalled
per enclosure
~
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SW1.mm1.ns Pool Below grade when steel 1.5 In place and before concrete lS poured
when pool-rs-lnstalled
APP~OVED,PLANS MUST BE ON-THE JOB SITE AT ALL TIMES DURING WORKING HOURS THIS PERM~T WILL EXPIRE
IF_WORK DOES NOT BEGIN WITHIN 180 DAYS~ OR-IF~WORK~IS SU5PENDED~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~'~". _i j .J !'..... .....~..\...~......J ':.h.4~' \.. ..I_)~ .....1\0.,. \. V ~_..
~r~~NYONE PROCEED!NG ;PAS~ THE POINT or REQUIRED INSPECTIONS WILL DO SO AT TtIFIR. qWN R,ISK J)... J '_ J ~
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WE AGPEE TO FURNISH THE ABOVE ITEMS FOR THE SUM OF $ 7 ~ U
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PROVIDED THIS ESTIMATE IS ACCEPTED WITHIN
FROM THIS OAT'
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AS WE AGREE TO FURNISH ONLY THE ARTICLES NAMED
AND DHCl!18ED HEREON All AGREEMENTS CON 1
. . T1NGENT UPON STRIKES ACCIDENTS all OTHER CAUSES .
OF DELAY BEYOND OUR CONTROL
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BY~\
CUSTOMER S COpy
MOOI1l 8IJ~.""f~ f()llM$ INC M
Lne COU'lty
ACTIVITY INFORM^TION SHEET
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COf,IPLETE TH IS SECT ION I NCOMPLETE FORM, WILL III HlJlC flU I
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PERSON MAKING REQUEST
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~JSINESS TELEPHONE #
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PROPERTY OWNER
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j'fci~f i' .1 J f);;"JE ZIP CODE
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BUSINESS TELEPHONE #. fiOME TELEPHONE #
. 2 PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER
(REQU I REI!. I NFOR11A TI ON)
(from tax maps ln Department of Assessment and Taxatlon
or from tax statement)
17-117- :I-j-J-),.
TOWNSHrP' RANGE SECTION
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TAX LOT(S) OR PARCEL #
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ZON ING
To1Msjffp RANGE SECTION
TAX LOT(S) OR PARCEL #
70flING
TOWNSHIP RAriGE SECTION
TAX LOT(S) OR PARCEL #
ZONING
TOTAl CONTIGUOUS PROPERTY IN SAME OWNERSHIP
ACRES
4 SUBDIVISION (If appllcab1e) . LOT-6 oltlr BLOCK
5 REQUEST ('tate exactly ~Ihat you plan to do) ()lJ {f-'f.(j 0 Dc""..." H'lO >",
l~':7-~J~d!L~ u.'~_~J~ h,~.. ~.:; <f.
DIRECTIONS TO SITE . _ _ _ __
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------ ------- - - ----- ---
** FOR STAFF USE ONLY **
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NUMBER -i
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.
DATE -i
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ZONE/LAND USE
BY DATE
l.-\l(
T H1E IN
OUT
- - ------ -- --- --~-
-- - -- ------- - ------ ----
LAND MANAGEMENT DIVISION / 125 E Rth AVE EUGENE. OR 97401 / 687-4061
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