HomeMy WebLinkAboutPermit Septic Tank 1984-5-11
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Lane County Authorization
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-row:;SHIPI7 I RANl)3 I SEZO~ j 'W4;6
SJB'N'V~A'1'~ON {if apP'licrilil () . LOrt/CEL I (j)K
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~~1.?1 ~DDRESS n ",!, STREET...-rD_ - - ~ riP7: ~p~. ?<y"OS USE OF PROPERTY
~7 y 1) mo.,:...-t( 1JTn - ') ./ ~fc; L1'Reside_ntia1 0 Industrial
5 .TUFES U~TLYONDlY\~~d 9P1~', wbt~. DpUblic.
. ~~;y';f,~rm t7d, 0{l 1't~1~'I?OYij(J*
~10.Tf-, ( nrrllnaL J
t~;'5tf/ Pr{~ -t)~Er11o, _ _ _ . I DEClARED S VALUE
; 0 EDROOM · Otr'm r /~~~~S./ I. Z5K1U?tu~?<i H Lhll q ) ~~~:
. -, NAME AND ADDRESfj , l?t ~ 0'J3 3= -I~ W_~ V ufr lJ ~ciNE M R
" -"~'iI1 ':{J, (~ . ... <074 ~.io", ....
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have the following legal interest in the property: Downer of record; 0 contract purchaser; Oauthorized agent with evidence of authori ty attached.
I f..:.rther certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the La....s of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY ....ill be made of any structure without the permission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for exemption
is noted hereon, and that only subcontractors and employees who are in compliance ....ith ORS 701.055 ....ill be used on this project. I HAVE READ AND
CHECKE"--,"" "U_\IO~~
v,L. 'Y-~ ,X'i)""nr1'~" S--;f-<j<y
I~ ~ME lplease print) ~ I ~ DATE I
.
for:'
FOR OFFICE USE ONLY
Application/~~~ ~-.~I'~
perm.t # ~~~ ~ 1'"
o Two Copies of Plans .
DThree Copies of Plot Plans
DMech/Plumbing Checklist
DLegal Interest Document
o Plan Check Info Sheet
:~1;,,::~~
-- ~
READ THIS SECTION CAREFULLY~~~IZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS~
o PLANNING/ZONING: Zone partition 1* Parcel #I Parcel Size
.::;;~s~R(()"'~~ ~~-()JD1~u&h~~ ~ct (N\ )
1'Jli.l< l ct~H ITlJ I
o FLOODPLAIN, In flood hazard area? 0 No 0 Yes. SEE ATTACHED SHEET. ::::: A ~ II > Iq~ ~
~~~ Gallon
Tank
B. P. 1*
Installation
Record Issued? DYes 0 No
Maximum Depth
of Trenches
Specifications:
Lineal Feet
of Drainfield
;7)M;;,~df!f:::.'F
aJ~/~L~ J
~~;;g;-/<A/ ~~_
~h.Y"f.J J,~,,~t1'- .Yo.I1.D /il.L
Date, 5"-_) S--/'f ~
o PLANS EXAMINATION, Type
Group
Use
COM.'tENTS :
Date:
n
TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
--
~~~
Sq. Ft.
Fixed Fee'!
Unit Cost
Floodplain Fee
Subsurface Fees
Building ~ee
Hsch/Plmbg Fee
P'ans Check Fee
State Surcharge
DEQ Surcharge
~
."7U ~
TOTAL FEE
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~aJ. ~~-R-, c . r:~)Z:-ry
~ ptRMI'1' APPROVED'BY BunDEFIC'IAL/DESIGNEE (per ORS 456.805(1)) - -DATE'
LANE COUNTY DEPAR NT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061, C 14-25
12 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
.
.
I
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 INS~EC-
TJ:ON REQUESTS MUST BE GIVEN. Have the following information ready: permit number, job aadress, 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 tor the foundation are delivered on the job. Where concrete from a central ffilxlng
plant (commonly termed "transit mixed") is to be used, materials need not be on the job.
2. Concrete Slab or Under-Floor Inseection: To be made after all in-slab or under-floor building
service equipm~nt, conduit, pIPIng accessories, and other. ancillary equipment items are in
place~but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framinq & Insula tion Inspections: To be made after the roof, all framing, fire blocking-, and
bracing are in place and all plpes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall in~ulation and vapor ~arrier are in place.
4. Lath and/~ Gy~sum Board Inspection: To be made after all lathing and gypsum board, interior
ana-exterlor, 1S 1n place but betore any plastering is applied and 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 structure beyond the point
indicated in each 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 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 masonry (if applicable) and when installation is
complete. Installation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturer'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,
skirt-ing, ana. plumbing connections. - -..'
1. Footings and piers to comply with State foundation requirements- for mobile homes or as
recommended by the manufacturer.
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-
plain management letter.
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
D. Swimmins Pool: Below grade when steel is in place and before concrete is poured. Above grade
when pool-rs-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 P~ST THE POINT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
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 Lane County Department of Planning and Community Development 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 permi t{" 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 vio-
lation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewaqe Disposal
From: Interior property lines
Edge of road right-of-way
Building foundation
Wells. other water sources
Septic Tank
10 '
la'
5 '
50'
Drainfield
10'
10 '
la'
100'
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March 24, 1984
I Durward L. Boyles hereby assign and authorize
Dennis Carney to sign permits for all my properties
in Lane County.
Sin,rerely,
. .. f C ~ .'7
/, /r:A/.t~?4.//",-7 ,;c},.~",,-
. 'Durward L. Boyles ~-
3411 Baldy View Lane
Springfield. Ore. 97477
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APPLICANT BOYLES,
A TU' '1703220001300
NEW l,\UlG TYPE'
. OWNEf! Ni'1E
CODE APPL NO ACTION DESCRIPTION
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~ANE COUNTY DEpT ENV MGT I,\ECFIPT ,", 1 ~)6"8' flATE 0'-1 iel
DURWMW, MDR 3211 GAME F't~f!M RJ5., ,cSf.RJ:N(; :'1E:I~D; -\)1,1::'-
SUBD I V .un BLI< H:,
US'E: I, DDRMS 0 UNITS 00\ STORIES', '~BLDGS 00\ PHONE 74 .
ADDR '.
SQ FT UNIT COST VALUATION
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PL NO. FIXTURES:
MECH
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PCI<
SDS LC 126384 SDAN
SUI!
NO. CONNECTORS: .
MECH.~NICAL FEE
STi'iTE SUI;:CHi'.I!GE
PLt,N CHECI< 1"1::[
\ ~). 00 EACH -,
4;':
65%
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50.00
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EST. COMPLETION DATE
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55.00 CI<
TOTAL FEEJH'
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CONSTRLerION/PLACEMENT .
PERMIT
FOR OF?ICL USB ONLY
COMPLETE THIS BLOCK.
PLEASE USE BLACK INK AND PRINT.
~~~~t~7~/~? 2-
o Two Copies of Plans
o Two Copies of Plot Plans
DNechanical Checkli.st
[JPlumbing Checklist
[JPlan Check Info Sheet
TOWNSHIP I ? I MNGE ~ ~ I SECTIO:;? ~ T~~ ~OUT OF
~UBDIVlS!ON/PARTlTION (if applicable) I LOT/PARcEL BLOCK
/J 4' .......,1
_L~(l~ A STR;; ~/ ~ ~~~ / CIT' _ PROPOSED us~ Or PJ.-OPERTY
. ~(~, ~~~/~~~ . _ ~Residential []lndustrial
"TRLOT':;;;;'~ ~~ 4M ~~ Dconunercial DPu~lic
hrlON~~ ~#fl; ~ / -~~~ ISm~~
-, OF ~'1S-:::Z' 'q W.;TPPJ~ ~'OF E 11' '7"17 I WATER SUPPLY ./'./ /' J /~ ~ py>posed
. /? /. V /'{//h '/7 J /?!~f/~..-c:/ lP"'mtlng
. Q\'NE . 0~7~ ?5 A?/~. $.-??/'/a ~ 7~~E-':77..r/
l ,~;ft'<D'~~ . ~,d: '/ _97f/C//_77?/~'9dtrJ
"TAACTO"'~~ 0 prI~~TE -'J~ / ~/ /~ .--.:.7
~ ~U~ A '/'5#~~f~~;/ ~-?~~-
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I HAVE CAREFULLY EXlI.MIl1ED TilE COMPLETED APPLICATION FOR PE;,i(:. and do h~["('by "(~rt'ifi' thilt i'; trll'! ilno corrc,:,t ilnd I furth"r
certify that any and all work performed shall be done in accordance with the Onlilla:1CC5 of L .. County and t.he 1,<,\',,5 of the 5t"t:c of 01("1".)11 I"~lt,'il]il1'J
to the work dcscribed hercin, and that NO OCCUPANCY will be ml3de of any structur~ without thC' permission of the Building Oivision. I furth~r (', rt:ify
that registration with the Builder's Board is in full force and effect as required by QR5 70l.055. that if exempt thl;! basis for (.:xempti(Jll is llot.'d
~:~~~~;~!..,:~'/:");;:""'A.~~~~I1JIoYceSsWhO .'0 co ~o~:nC~Hh O~ 70m 7/ on th" P,oJoct I Ilm ~,'D ~Do~::::Y~D TillS
_ Y r-~~ ~~onmcco'
NAME (please print) ~IGN;'TURE 0 ASf;nt.
o PLANNING/ZONING: ZOO" 61'/$ Palutlon ,#J~ Palce' ,u4.. Parcel s,"e#~
C ~C / / '
r ~C/ ~~::::~to~~;;;) ~/) u{:'d'~ ~~~~2~
'--7~ ~/4 ~ - '~.~.:DAfto'). \' Date, e?,/?rJPZ-9r-
,. 0 ~ FLOODPLAIN':\: - '. flood haz~tar~a? see attach-ed sheet~ Date: ' n
o RURAL ADDRESSING: GRlD COORD".n N E Date, 0
o SP.LNITATION: s. 1. 11 B. P. # Installation Record Issued? DYes D No
lnsr::allation
Specifications:
GaJlon
Tank
Lineal Feet
of Drainficld
Maximum Depth
of Trencher;
Comments:
Date;
o
~PLANS EXAMINATION:
Comments:
t1.ppL.V'Va,.L Udbt:::.U
rAT.T. "nll llRnTTTllTm
Type SN
Group R3
Use re.build/fire. 10b
UU I..Lt:::.~u Vt:::..L.L.,L1.,\";;d.L.LUlL U.L \.,;;UUbL.LUL:L.l..UU p~J. .LL1.~P~(;LUJ:.
TN~?Rr.'1'TnN':;
Date, m 09~29.,....82
@fc
CONSTRUCTION AUTHORIZED BY THIS PERMIT
-bh
/-);~/~/ /)
r;~::::~~/ ~~""
Sq. Ft.
Fixed Fee/
Unit Cost
Floodplain Fee
Subsurface Fees
Building Fee
Sewer/Storm Drain/Water
Plumbing Fixtures
Mechanical
Plans Check Fee
..2 L.-- ...
dO..;L...
$ rs: 3S-
FEES PAID BY:~ GC9SV
By: /?'~jJ~_
Dat!;' / {j7-/t? ~/ 2-
'f --tA~
DATE
$
$ )'0
$ (~O' ~
$
$
$
$
$
~ .-,
f?
State Surcharge
TOTAL FEE
PERMIT APPROVED BY BUILDHlG OFFlCI.'L/DESIG"':E <,or OilS t:1;~
lANE COUNTY DEPARTMENT OF PLA..IIJNING & COHNUNITY DEVELOPHl::NT / 125 EAST EIGHTH AVENUE, EUGENE,
SEE REVERSE FOR INSPECTION INFORMATION
?GON
97401
.
.
.
.
SETBACKS AND OTHER CONDITIONS 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 of inspection, when it will be ready,
your name and phone number, and any special directions to site.
BUILDING DIVISION:
REOUIRED I1ISPECTIONS
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 mh.ing plant (col1111on1y termed "transit mixedll) 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-floo~.building serv;ce equipment,
condult, piping accessories and other ancillary equipment items 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 framing, fire blocking and bracing are in place and
all pipes,.fireplaces and chimneys and vents are complete and all rough electrical and plumbing are approved. All
~~11 insulation and vapor barrier are in place. .
4) LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, inter~or and exterior, is in place
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 pa~t.df the building or structure beyond the point indicated in each
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 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 ma.onrv (if applicable) and when installation is comolete.
Installation shall be in accordance with an approved nationally recognized testlng agency alld 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) Footings and piers to comply with State foundation requirements for mobile homes or as recommended
by the manufacturer.
(2) Mobile home minimum finish floor elevation shall be certified when required by a floodplain
management letter.
(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
PE~~IT WAS ISSUEO ON THE BASIS OF INCOrlPLETE 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 pennit has been issued the permit holder shall notify the
Department by submitting the installation record fonn. The Department shall inspect the construction to
determine if it complies with the rules contained in this division. If the construction does comply >lith
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 requlre
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: Interi or property 1 ines
Edge of road right-of-way
Building foundation
Wells, other water sources
Seotic Tank
10'
10'
5'
50'
Drainfield
10'
10'
10'
100'
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~NNING & COMMUNITY OEVELOPMENT~
ACTI\r!TY INFORMATION SHEET
6ne county
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
1 ;:= P<. c..,C '- COA.I.:> O~ / fD/f-r Sf)
PERSON MAKING REQUEST
Z 6/ () ,tJ I ~ r.!2 "-
MAILING ADDRESS
E u.. e-, &A.J ~ ~t!1
CITY 'STATE ZIP CODE
#4~?tfJift
BUSINESS TELEPHONE # HOME TELEPHONE #
2., PROPERTY ADDRESS
(IF DIFFERENT FROM MA1L1Nb AUUKtS~)
3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
I
t.. OI!-C)J,f KII-R-d Aile-He (.,s bel
, PROPERTY OWNER
~3e7 cSIN4GF&.M ~(I
MAl LI NG ADDRESS
8/'PP,
CITY
BUSINESS TELEPHONE #
c2J/l.e.,
STATE ZIP CODE
726-77rf/1
HOME TELEPHONE #
(from tax maps in Department of Assessment-and Taxation
or from tax statement)
~~ sff-T~ rniG1(~ OR PARCEL #. 4i/ilk
Jw21P
TOWNSHIP RANGE SECTION
TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
TAX LOT(S) OR PARCEL # ZONING
TAX LOT(S) OR PARCEL # ZONING
ACRES
4 SUBDIVISION (if applicable) _ (' LOT BLOCK
Y.I..Y\e ,~a...V ,
5 REQUEST (state exactly what you plan to do) $J;:PL/hJ# CDMP JZ.o.o t:. l' A./et.J
. (
W 'I G.. vA f4)() F s tft! ~ T H.Jft/ (,7 ' IZ e FM~e 13" ~A1 a:-D g. ~ n oAl
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6 DIRECTIONS TO SITE: Bt!!:L.T L-11!.lt5 7tJ c'-,lfA.A6 FJ1r2.M( /ZP- 'R./qhr;; w"tt.Ei; s
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dt:J./..J.1I ~,u L-F- P r
NUMBER
DATE
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** FOR STAFF USE ONLY **
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FIRE DAMAGE REPORT
OR
ELECTRICAL HAZARD
FD-16
DATE: Q-/.<.,~~fi:'Y
TO: Bu il ding Depa rtment
FROM: Springfield Fire Department
SUBJECT: Structural Damage to Building
Address or location of building
h-" \,. F -==Fa ~~
Name
~-~
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of owner ,(LJ.uJrPMr~ /. ~rW~l'ru,
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.J) P ": P rr Ld.f-j
(Dwell i n~, Store, Harehouse)
etc. )
Type of building
Estimated value of building $
_)?f .. ~I) r96!1J
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Estimated loss to building $
Date of fire
9-/3 -?J-.
Location of damage in building _ '.$PCf)~ CI t0n y-
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(Reof, Wall, Exterior, Interior,
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etc. )
fl. [--h, v- <, - -<.-t.ds e h
'Structura1 weakness as a result of the fire
(Burned rafters, Beams, Joists, etc.)
Additional pertinent information ~~/,o//i-;.rn_/ IJ";r'~,...,'-
11AZ.-Jc:., d. Sia,'b(-aU I'f:;(/ UtV.Vtrnn') I
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Electrical Hazard
(Wiring, Outlets, etc.)
Signed
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cc: .s/ko en !Jf/;Jdll;7 O~-ft
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ROUTE SLIP _
TO, ~-- rf~J- '
FROM, ( _ ,__ C. ~~
RE, - n7lfJ,;-_,.f~~' .
DATE, 9 - 7.-(1 ~t".-
CHECK~ (~~ ~~~E
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o AS REQUESTED
o COMMENT
~ FOR YOUR
, INFORMATION
o INITIAL/RETURN
~ NECESSARY ACTION
o NOTE / FilE
o SIGNATURE
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