HomeMy WebLinkAboutPermit Mechanical 1984-1-11
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La>>e couty Authorizati~n for:
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~Z33 ~ET ~ ~ ~ J~ZIP PROPOSED USE OF PROPERTY
STRU/? CU":?,~~ ~~ >..~~ 'l<: ;pi?? ~eSidential DIndustrial
, ,~~~ _ I D Commercial _ D Public.
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Ol~~~~M7 ~ - .;/ ~ , I 'DECLARED > VALUE
. OF BE:OOMS 1'-0i-"'7~ - I # ~ I WATER SOPP~~ .~ ~~~~
O:"':7.1~:.~".e'..":SS ~/~ /./.:/ - /,j ~ ~~/ ~~I TELEPHONE NUMBER
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I TAX1'~OOUT OF
LOT/PARCEL r BLOCK
FOR OFFICE_USE ONLY
APplication/~~__ t?~
Perm~t It 7~ '/1-/
D Two Copies of Plans
[]Three Copies of Plot Plans
I []Mech/Plumbing Checklist
[]Legal Interest Document
D Plan Check Info Sheet
. Nwr';SHIP
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SJBDIVISION/PARTITION (if applicable)
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERMIT, and do hereby certify that all information hereon is true and correct, and that I
have the following legal interest in the property: Downer of record, D contract purchaser;'Q':;'"uthorized agent with evidence of authority attached.
I f::.rther certify that any and all work performed shall be done in accordance with the Ordin~s of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUpANCY will be made of any structure without the pcnnission 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 with ORS 701.055 will be used on this project. I HAVE READ AND
CHEC/'#iVT::J;;;(st1,,;z) ~ M~ /-//-r~
NAME (please print) ~ / ~ / SIGNATURE DATE
READ THIS SECTION CAREFULLY. ~JR~~THORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS:
o PLANNING/ZONING: zone~ Partition # Parcel # Parcel Size
=,~~;'//~'~~~k
v~
rear
Date:
./ -/~rr
A14-
n
o FLOODPLAIN,
In flood hazard area? D No 0 Yes, SEE ATTACHED SHEET.
Date:
Installation
Specifications:
Gallon
Tank
Lineal Feet
of Drainfield
Installation Record Issued? 0 Yes 0 No
Maximum Depth
of Trenches
o SANITATION, S. 1. #
B. P. #
CONHENTS :
Date:
n
(PLANS EXAMINATION,
COMr-1ENTS :
Type
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Group
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Date:
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TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
/ De;iP::
L/#~~
~~/ .f /'
~- -~
Sq. Ft.
Fixed Fee'!
Unit Cost
Floodplain Fee
Subsurface Fees
Build ing Fee
H~ch/Plmbg Fee
Plans Check Fee
State Surcharge
DEQ Surcharge
TOTAL fEE
$
$ ~
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$ '/' -:: {.
$ ; /
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PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456".80'5 (i)l) 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 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 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 tor the foundation are delivered on the job. Where concrete from-a central mixing.
plant (commonly termed Iltransit mixed") is to .be used, materials need not be on the job.
2. Concrete Slab ~ Under-Floor Ins~ection: To be made after all in-slab or under-floor building
service 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. Rramin9'~ Insulation Inspections: To be made after the roof, all framing, fire blocking, and
bracing are in place and all pipes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
4. Lath and/~ Gy~sum Board Inspection: To be made,after all lathing and gypsum board, interior
ano-exterLor, LS 1n-pIaCe but betore any plaster1ng 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
compl~ 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,
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 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. Swimminq 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 PAST THE POINT or REQUIRED INSPECTIONS WILL DO SO AT THEIR 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 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 permiti 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
lot
lO~
5 '
50'
Drainfield
10'
10'
10'
100'
C14-25
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AC~ITY INFORMATION~SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
,. lA~ SAfJr>~{JJJ
PERSON MAKING REQUEST
.% 33 41'\~fu:nD~R~ c.
~1W___.0i.. r; 1-4 i-1
CITY STATE . ZIP CODE
~ '/7 5"~ J.6 74 7 - ,. Jr ~ 7:
BUSINESS TELEPHONE # HOME fEttPHONE #
2. PROPERTY ADDRESS 54(V}1?' RS 4\RfllJF-
(IF DIFFERENT FROM MAILING ADDRESS
-.SAND~~ l(rHe
PROPERTY OWNER
-441 TAvt-f)f{ 5(:
MAl LI NG ADDRESS
I1-SHt..AtJD . nR
CITY
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BUSINESS TELEPHONE #
97~.20
STATE ZIPCODE
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HOME TELEPHONE #
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3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department Df Assessment and Taxation
or from tax statement)
f'OWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
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TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTIUN
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
5 REQUEST (state exactly what you plan to do)
TAX LOT(S) OR PARCEL # ZONING
ACRES
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LOT
BLOCK
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,6 DIRECTIONS TO IS ITE:.--'1:r "'(tifF /1tnEfC.... f)E5;[l~.~ _'-If 1?a-rLHI e f-D /JVb
MThUJI'tV 1il/lAJ NoR.-rH ()"'Fr Bux/r.. 'Jl) 4mF~~~ '11llit~ fltS'lJE....
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** FOR STAFF USE ONLY ** NUMBER
ZONE/LAND USE:
BY: DATE:
TIME IN: OUT:
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LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061
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APPLICANT JOHNSON, IAN
ILl 1703150002800 SUBDIV
.IEW BLDG TYPE' USE R BDF(MS
'OWNER NME
'CODE APPL NO ~CTION DESCRIPTION
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LANE COUNTY DEF'T ENV MGT RECEIPT I
~DDR 3633 GAME FARM RD.,
't5B4 DATE 0111 B4.
SF'F(INFIEl.D, OI:~E
un BLI(
o UNITS 00.1 STORIES '~Bl.DGS 001 PHONE 4B:~ 0102 .
ADDF(
SQ F1 UNIT COST VALUATION FEE DAYSII'
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NO. FIXTURES:
NO.
CONNECTCH,S:
MECHc,N I C,~L FEE
STATE SURCHAf~GE
PLAN CHECI< FEE
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EST. COMPLETION DATE
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APPLICANT JOHNSON.
TLO 1703150002800
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CODE APPL NO ACTION DESCRIPTION
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SUBDIV
USE R BDRMS 0 UNITS 001 STORIES
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95B4 I>AlE 011104.
SPRINFIEL.D. ORE
LOT feLl<
OBLDGS 001 PHONE 48.2 0102 .
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L.ANE COUNTY DEPT ENV MGT RECEIPT 0
ADDR 3633. GAME FARM RD..
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NO.
15.00 EACH -.
CONNECTORS:
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
, 4%
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SDS
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TOT{~L. FEE If'~'
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APPLICATION # -.-GQ:J-5-M.__
LOCATION ~.0"7?J~-fAeM 1212-_
. ..lAbL,_,JQ!ljJ~AJ.__ ____~ ___ NAME
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The above aeplication is being held for the following reasons:
A1TALJ.+~ 1'7 A CLR-f Of;4E. J2ECf-l/l.eMe;A)P fOIL A
REOLl~SC/ CL..Ea-eAZE. 1k5~l.~ pot- F/'SJ-l~ ~-:,.
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APVIitUE:O ~c:;L 'f"a2. fl$t-lGL 12eout.E.O I~AUO(I:?\.)<;' .
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SIGNATURE - J DATE' - .
AVAILABLE BY APPOINTMENT ONLY (NO WALK-INS) 687-4061
PHONE HOURS
This application will be held until Oz..z~~g4 If the information required
above has not been furnished by that date your application will be~~~
DeNIED
RETURN THIS SLIP WITH THE ABOVE REQUESTED INFORMATION.
BUILDING & SANITATION / PLANNING & COMMUNITY DEVELOPMENT DEPARTMENT
125 East 8th Avenue / Public Service Building / Eugene, Oregon 97401 / (503)687-~051
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APPLICATION # _02'i.~.~O) ",<.1/
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The above application is being held for the following reasons:
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AVAILABLE BY APPOINTMENT ONLY (NO WALK-INS) 687-4061 ( )
PHONE HOURS
This application will be held untilJ':7?-,r..n? -I:>_/! If the information required
above has not been furnished by that aat:~Plication will be cancelled.
RETURN THIS SLIP WITH THE ABOVE REQUESTED INFORMATION.
BUILDING & SANITATION / PLANNING & COMMUNITY DEVELOPMENT DEPARTMENT
125 East Bth Avenue / Public Service Building / Eugene, Oregon 97401 / (503)687-~OSl
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APPLICATION # -a21.t;,.-f1!/--
LOCATION _ ~~~~ 4!JI,tl~ flJtlL1f'"O,
. ... _ .4AU--Jo~_.._--- ____ NAME
'?~ tr_~f12. ADDRESS
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~- ZIP CODE
The above application is being held for the following reasons:
o Wlw. ~-fI ~ ~w (~ClN) -s/()t... VI&vJ ~ Pl.JW ViW
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DATE
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AVAILABLE BY APPOINTMENT ONLY (NO WALK-INS) 687-4061 (
PHONE HOURS
This application will be held until (/? ,./1J~Ad If the information required
above has not been furnished by that ffate YDtfr application will be cancelled.
RETURN THIS SLIP WITH THE ABOVE REQUESTED INFORMATION.
BUILDING & SANITATION / PLANNING & COMMUNITY DEVELOPMENT DEPARTMENT
125 East 8th Avenue / Public Service Building / Eugene, Oregon 97401 / (503)687-^OSl