HomeMy WebLinkAboutPermit Building 1983-2-23 (2)
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CONSTIIcTION/PLACEMEN. J
PERMIT L.- I ~~~;~~~ cf3
0- DTwo Copies of Plans
Cm1PLETE THIS BLOCK. PLEASE USE BLACK INK AND PRINT. 0 Two Copies of Plot Plans
TO\,","HI1' /7 J RANGE /"'J. 3 I SEC~'7 .//-"1 ThX"" ...;;:-[JP'f' 3J'\ O"'echa~icai Checklist
r~ r:;>(r;;:>(, Y',V'<\. ^r-..-/-f~(~ OPlumb~ns Checkllst
~UBDIVISION/PARTlTION (if applicable) . r LOT/PARCEL BLOCK _
. ~ l /J ./ ~/ ~ ,Dplan Ched info Sheet
J TREET _ ,f-d77 ~,.- _ ~$"~ CITY ~ 'l'P~;~i~:n~~:~O?DT;ndustrial
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FOR OF?ICL USE ONLY
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I !lAVE CAREFULLY EXAMInED TilE COMPLETED APPLICATION POR PERMIT, and do h~n'b"f <"Int:if", th.:ll' illl infortlntiOIl heI"':m i'; tnl~ {l carrest il1ld 1 halh"!
certify that any and all work performed shall be done in accordance with t.he Ordill(l:lCCS of I,ane County and t.h<:> J.a",oIS of th'.l St.;'!;c n[ 01,,'pn I_'ll l<1illill'j
to the work d~scribed herein. and that NO OCCUPANCY will be made of any structur'l without the permission of the Building DiviJ;ion. I ful"l"_h~r ccr::.i fy
that registration with the Builder's Board is in full force and effect as rcquir~d by ORS 701.055, that If exempt th'! basis for c:xC'mpticJJj i~ flDtpo
hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be us<'!d on this project. I HA'/E RF.i,D AIID CIlECY..ED THI!">
mLICATION TH ;;tr c ~ >' f dt
N'.HI: (please print) ~ SIGO!;.TU""
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o FLOODPLAIN:
o RURAL ADDRESSING:
~SANITATIO~: s. 1. #
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o PLANNING/ZONIN~: zone~l :1'"'tjuon,,~/.' Parcel ~~" par~~~~
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In flood hazard area?
~NO
o Yes, se~ attached sheet.
Date:
GR1D COORDINATl::
N
E /7, Date, C
..~' te~/~d
ISSUQd? 0 Yes 0 No
B. P.J ~,
Installation
Spec i fications :
Gallon
Tank
Comments:
~
h.1ly'
~--If
,{
Lineal Feet
of DrainfiQld
CYh1.fPi-/ Wr/1'
MaxitnUfll Depth
of Trenches
Comments:
Type~
I
Group
P\~
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Date, .5 r \...._ R3
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~PLANS EXAMINATION:
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Date'_~-1f1.,
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CONSTRUCTION AUTHORIZED BY THIS PERMIT
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vr "P<
Sq. Ft.
Fixed Fee/
Unit Cost
$
$ rf/
$ ~ {/, '""--
$
$
$ --......,.I?~
$ OJ~ (J"""
$~O~
f ~<-:$0
FEES PAID ~ Che~ [ZJqasJ> /
BY'//~~"')~
D{C -;;::; ~%S
(,or' ORJ;(1';'~ OZ"''L~:;E'h?:J
Floodplain Fee
Subsurface Fees'
Building Fee
Sewer/Storm Drain/Water
Plumbing Fixtures
Mechanical
Plans Check Fee
State Surcharge
TOTAL FEE
$ 4. 775 !!!!-
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PERMIT APPROVED BY BUILDWG OFF'ICE\L/:l!::SIGllEE
LANE COUNTY DEPARTMENT OF P~~NING & CO~~UNITY DEVELOPMENT / 125 EAST EIGHTH AVENUE. EUGENE, OREGOr' 97401
SEE REVERSE FOR INSPECTION INFORMATION
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SETBACKS ANO OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVEO. VIOLATION CAN RESULT IN REVOCATION OF THIS PERMIT.
CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE. AND/OR OTHER REMEOIES ALLOWED BY LAW,
WHEN REAOY 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.
BUILOING DIVISION:
REOUIRED 1I1SPECTIONS
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 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-floor ,building service equipment,
conduit, piping accessories and other ancillary equipment items are in place but before any concrete is poured
or floor sheathing installed, including the subf100r.
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
wall insulation and vapor barrier are in place.
4) LATH AND lOR GYPSUM 80ARD INSPECTION: To be made after all lathing and gypsum board, interior 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'bui1ding 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 applicablel 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
connecti ons.
,
(1)' Footings and piers to comply with State foundation requi,rements 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.
O. SWIMMING POOL: 8elow grade when steel is in place and before concrete is poured. Above grade when pool
is installed.
APPROVEO PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE IF WORK OOES NOT BEGIN
WITHIN 180 DAYS. OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PER,'UT WAS ISSUED ON THE 8ASIS OF INCOtlPLETE OR ERRONEDUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIREO INSPECTIONS WILL 00 SO AT HIS 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 iss~ed,the permit holder shall notify.the
Department by submi~tin9 the inst~l\ation record io~. The Depar~~nt shall inspect the construct' on !o
determine if it complies with 'the rules contained in this division. :If the construction does comply wlth
such rules, the Oepartment shall issue a certificate of's~~isfactory,comp1e~ion, to.the permit holder. If the
construction does not comply with such rules, the Department shall notify the perm,t holder and shall requ,re
satisfactory completion before issuing the certificate. Failure to meet the requirements fo~ satisfactory
completion withi~ a reasonable time constitutes a violation of ORS 454.605 to 454.745 and th,s rule.
Setbacks - Subsurface Sewaae 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'
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lane county
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CHECKLIST
PLUMBING/ MECHANICAL
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Cont. OSR#
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APPLICANT INFORMA~
(Name or rlrm-Please Prlnt)
PLUMBING mNTRAcroR 0 Yes Firm
Address /'
MEGlANICAL mNTRACTOR Yes Firm
Address
o NoD Self
Type of Fixture
yLLJMBING
Number of Each
Total
Sink
Lavato~ (Wash Basin]
Tub (with or without shower)
Shower, separate
Water Closet (toilet/urinal]
Dishwasher
Disposer (garbage grinder)
Washing ~1achine
Water Heater
Floor Drain
Sewer--lst 50ft.
each additional 100 ft.
Water Service--lst 100 ft.
each additional 100 ft.
Storm and Rain Drain--lst 100 ft.
each additional 100 ft.
Special Waste Connection
Sewage and SI.lJJ11J PumP (eiector)
Mobiie Horne Sewer and Water
Other (specify)
SUB-TOTAL (Minimum $10.00)
,..-,11\0.\1...
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, TOTAL FEE
Type of Equipment
MEGlANICAL
Number of Each
Mechanical Permit Base Fee
Furnace UD to 100,000 BTU/H
Furnace over 100.000 BTU/H
Clothes Dryer Vent
Bathroom Ventilation Fan & Duct
Ran~e Hood with Mechanical Exhaust
Wood Stove
Air Conditioner Only
Heat Pump
Floor Furnace
Gas Piping System 1 to 4 Outlets
Per Outlet
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M&=..
Other (specify)
SUB-TOTAL
I TOTAL FEE
OFFICIAL USE ONLY
Appli./
Permi t #
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(Clty or 'I'mVIl) (Zlp Code)
Cant. OSR#
Fee On Each I
$ 5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5,00
15.00
10.00
15.00
10.00
15.00
10.00
5.00
5.00
10.00
Fee on Each Total
$ 10.00
$ 6.00
7.50
3.00
3.00
4.50
6.00
6.00
6.00
6.00
.50
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~ PLANNING & COMMUNITY DEVELOPM....
ACTIVITY INFORMATIO'T'f SHEET
Idne county
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
~L <5L;~
PERSON MAKING REQUEST
'54/0 c~~s ~f-
MAILING ADDRESS
~~TY
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STATE
r;7'f6~
ZIP CODE
~ev-c;'" Hul-l-tv--
; PROPERTY OWNER
iq2~ (~ ~ItL
MAILING ADDRESS
S'~;;4
d tip
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STATE ZIP CODE
11.t, -70'15
HOME TELEPHONE #
81')- ,C;W/
BUSINESS TELEPHONE #
s<fJ-22,ej
HOME TELEPHONE #
BUSINESS TELEPHONE #
2,. PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
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3 MAP & PARCEL NUMBER (from tax maps 'in Department ofJlessment and Taxation
(REQUIRED INFORMATION) or fr~m ~ s':"~t ~, 3"~
~O~HIP ~~. ~~LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # . ZONING
TOWNSHIP RANGE SECTION, TAX LOT(S) OR PARCEL # ZONING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
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LOT
a ~CI. ~\fl"ry'V\
ACRES
BLOCK
5 REQUEST (state exactly what you plan to do)
6 DIRECTIONS TO SITE:
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ZONE/LAND USE:
BY: DATE:
NUMBER
DATE
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MARK
SUBDIV
USE ,R BDRMS 2
UNITS 001 STORIES
ADDR
, SQ FT UNIT
~ ,125El3 DATE 01318.'
RD., SPINGFIELD, OREGO
LOT BLK L
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~BLDGS 001 . PHONE, 343 5201 .';
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APPLICANT SLIKE,
. TL~ 1703224201300
.EW BLDG TYPE
. OWNER NME
, " CODE APPL NO A.CTION DESCRIPTION
.p
BP
BP
.p
BP
BP LC 12583 RAAA
.'L NO. FIXTURES:
MECH
SUR
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LANE COUNTY DEPT ENV MGT RECEIPT
ADDR 2924 GAME FARM
~ATG:
SEQU:
TAKEN
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APP
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BY RLH
RA
FP
.SDS
SI
PCK
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COST VALUATION FEE DAYS
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. 4 7'75 50.50 J'
15.00 EACH = .~
4% 2..02
657- 32.83 .
.
OTH ISS .
2 11
TOTAL FEE** 85~ 35 CKI
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NO.
CONNECTORS:
MECHANICAL FEE
STATE SURCHARGE-
PLAN CHECK FEE
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EST. COMPLETION DAlE
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),:'"':"-~~'~"NOT'(( TO BUltOER5 - UHf..r BUILDING OrrlClAl HAS (;OMPL(T[O A fiNAL I
...... INsprcTloN, 1) TH[St (.p1U,W AND R[LATtD SP(c.rlc.uION~ MUST er ItC~T.
'ON""THt JOB rOR.THt BUILO[~ (CURING CONSTRUCTION AND RCAOIU AV.l.llw
II ADU; TO THe BUILDING IN::'P[CTORS, AH.D 2) THf CON~lAUCT ION SHAll or COM-
- 'l[TCO IN COMPLIANce WITH TH[ R(I,A'[O DRAWINGS AND SP(CI'tC.TIONS AS
"'~[HO[O.DURIHC PROCeSSING, AND 3} TH[ CONSTRUCTION SHALL NOT Bt CH"'HC(~
- MODlrl[O, OR AlTER[D rROM THtse DRAWINGS AND RELAT[D 5PtClrlCATIOHS,
.,WITHOUT AUTHORIZATION ,.,tOM THt"BUILDING Orr'Cl"". '. I
ApPIHIVA' a, !lUI......Trro PlA"''' ,'II ...1",' "... APPROVAL or r.....'...e:,''2t1'' Oill' 'ovr~.
~y Tw,,, O,.,.,r., 011 or NON-CONP.I...",cr WITli SU,Tf BUILDING COOt Oil OTH[R I
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PElMITS 'OR ALL B.ECTRI(:Al' WORK
SHAll BE SECUllED fROM THE ST ^ T;:
Of OREGON, Df'PARTMENT OF
COMAEllCE, flECTRICAL
SAfT SECTION.
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APPROVED
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