HomeMy WebLinkAboutPermit Building 1986-9-15
f r,.c;t RURAL f\DDRESS~I\lQ
.,~) Lane coun~ AuthOriZatio:H~~;~ ..,-"-;" om" 0'" o~,
'1- Application/ /JCJ/7-' .w
Perm~ t # ~7 ~ -0 le.
,,-on<
j_/k
INSTALLATION OF FIREPLACE INSERT
17
03
SECTION
22.4.2
) T~OWT
LOT/PARceL
OOUT OF
PROPOSED USE OF PROPERTY
~e:Sidential 0 Industrial
o Commercial D Public.
7QWi\SHIP
RANGE
S~BDIVISION/PARTITION (if applicable)
I BLOCK
LOCATIO~ ADDRESS
STREET
CITY
ZIP
2988 Game Farm Rd., Sprin9field 97477
RES CURRENTLY ON PROPEF-:: /f }
. C r~?:7. Y rf/ .//4/r:-7/_I'J / ~
DIRE TIONS SITE ..,
( <)#'EZJ
Corner of Flaminao & Game Farm Rd.
~SSCRIPTION OF PROPOSED WORK - BE SPECIFIC
I DECLARED S VALUE
.n ~.tflVP i!,sprt
: OF BEDROOM~ _ ~ OF STORIES
O;~"NER I 5 NAME AND ADDRESS
I # OF EI-IPLOYEr:S
I-.'ATER SUPPLY
~r7/
o Proposed
~xisting
TELEPHONE NUMBER
PROCIWt Max
CONTRACTOR'S NAME AND aSR ~
same
~4?fi.Q48
TELEPHONE NUMBER
P;:;RNIT TO BE MAILED TO lNAME AND ADDRESS)
TEL1:;PH........:. ......-.BER
1 HAVE CAREFULLY EXAMINED Tl-lE COMPLETED APPLICATION I'OR PERMIT. and ,]0 hcrchy cen.ify that all information hereon is true and correct, and that I
have the following legal interest in the property: Downer of record; 0 contrdct p'ln:hascr; Dauthorized agent.
I f-.;rther certify that any and all work performed shall be done in act:oldanGf.l wi th th", Ordinances 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 ar.j' st.rllcture without the permission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force ,1.no effect. dS re"uired 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 ~.055 will be used on this project. I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY. %'~
Max pro;2: (pl.... print) €;/1ay r ~~ fl-/c.cEb'
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION YAS BEEN BASED ON THE FOLLOWING CONDITIONS:
o PLANNING/ZONING: Zone
Partition #
Parcel #
Parcel Size
Minimum Setbacks: eL, front
eLl side
interior
rear
Date:
/ftf
Record Issued? DYes D No
Maximum Depth
of Trenches
9-15-86
COMHENTS :
NO SPECIAL PLANNING ACTION REOUIRED.
o SANITATION:
S. 1. #
B. P. #
Installation
Installa ticn
Specifications:
Gallon
Tank
Lineal Feet
of nr.ainfield
CQM}1ENTS:
Date:
n
[] PLANS EXAMINATION:
COM>!ENTS: CALL
Type
FoR
Group
Use Lu :::::
JA)<PECT/o.u g
81fes> U I pf:p
Dale, '7 - ,IC/ - e <;. ---",0 n
'PI"'r-- 9-/~-8 ~
PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.805(1)) DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE. OREGON 97401
SPP RPVPRSP POR n,rSppr'l'T01\f T1\f1<'ORMn'l'TON
..... ~ ,...,..~
.
.
SETBACKS A~D O'I'llER CO::OI'I'IO::S OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CA~ RESULT IN REVO-
CA7IO:J OF THIS PER~lIT, CITATIO:. U~D~R PROVISIONS OF LA:':E COu::n",s INFRACTION ORDISA~CE, AND/OR OTHER
REMEDIES ALLOWED 8Y LAW.
WHEN READY FOR INSPECTION, CALL 687-4065. A mNHlU~l OF AT LEAST 24 HOURS ADVA1:CE NOTICE FOR INSPEC-
nO:-l KJ:;Q(;t:sr::i ~;U~T IJI;; GIVEN. Have tne [0110win9 information ready: "ermit number, job address, type
of inspection, when it will be ready, your name and phone nu~ber, and any special directions to site.
BUILDING DIVISION:
REOUIRED ISSPECTI0NS:
1.
Foundation Ins~ection: To be made after trenches are excavated and forms erected and when all
rnaterlals lor tne tOundatlon are dellvered 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
serVlce equIpment, conOult, plplng accessories, and other ancillary equipment items are in
place but beiore any concrete is poured or floor sheathing installed, including the subfloor.
3.
~raminq , InsulatiOn Inspections: To be made after the roof, all framing, fire bloc~ing, and
raclng are ln place ana all plpes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing arc approved. All wall insulation and vapor barrier are in place.
Lath and/or Gypsum Board Inspection: To be made after all lathing and gypsum board, '.nterior
~eXi'Crror, lS ln place but bet ore any plasterin9 is applied and before gypsum board joints
and fasteners are taped and finished.
5. ~ Inspection: To be made after the building is complete and before occupancy.
4.
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~: To be made nfter 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
sewcr-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 8S
recommended by the manufacturer.
2. Mobile home minimum finish floor elevation shall b~ certified when required by a flood-
plain management letter.
3. Mobile home tiedowns, when required, and. sk.irting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedown5 and skirting shall be installed
per enclosure.
O. Swimmin9 Pool: Below grade when steel is in place and before concrete is poured. Above grade
wnen pool~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 NORE THAN 180 DAYS.
SUSPENSION OR REVOCATION 11AY OCCUR IF THIS PE~~IT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POWT or REQUIRED INSPECnm1S WILL DO SO AT THEIR OWN RISK.
SUBSURFACE ~ 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 permit; 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.
Setback~ - Subsurface
From:
Sewage Disposal
Septic ~
la'
la'
'5'
SO'
Drainfield
la'
la'
la'
100'
Interior property lines
Edge at road riqht-of-way
BuildinQ foundation
Wells. other water sources
,
.
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,
;-' ......,;-
)~~y
* NAMEJJ/?y PfiJ~ I~
* ADDRESS FOR INSTALLATION..)?!! )'}a-,~~
* NAME OF MANUFACTURER t1'&?f ,)e-r -:t:ivt. f
'I
Wo.) Stove Pe~mitllpplication
A PERMIT CANNOT BE. APPROVED UNTIL A COPY OF THE MANUFACTURER'S
INSTALLATION INSTRUCTiONS IS SUBMITTED
PHONE 7'-1}~.6,Py f
CITY 'S.~ (/~.~
MODEJ?' (' ./w.t-tt..-Lc.
"IF YOUR INSTALLATION DIFFERS
FROM THESE EXAMPLES OR IF THE
INSTALLATION IS A FIREPLACE
INSERT. PROVIDE A PLAN AND
ELEVATION DRAWING'WITH DIMEN
SIONS OF YOUR PROPOSAl..
\.
EcnJ
* INSTALLER
nRS #
CIRCLE THE SKETCH MOST
CLOSELY RESEMBLING YOUR PROPOSAL.
~ICBO OOther (name)
inches thick. (Material) f!...'-/ f.(rf',c 1"",-
/5e./-fc-
(lined?.ij1es Dna)
CONSTRUCT! ON:
* A,
B,
C.
* D.
"E.
The unit is listed by: OUL
The floor protection is l.J
,
The wall protection will be:
Type of chimney: D Factory
" 0 Other
Type of stove pipe :.. DIFactory
(vent connector)1 ;
-.(.
. -~-
(Material)
[2iJ Masonry
o 26ga (or heavier) ~. sht. mtl.
/
<~ .
HMENSIONS:
~. '.
(i n i,nches)
~..
1. Side of unit to protected wall
{unprotected wall
(unprotected wall
)
)
2. Rear of unit to protected wall
..;:'
3~ Floor prgtecti?n-at side of unit
at rear
in, front
4. Length of wall protection at rear. of unit
/
at side
S. Height of wall protection
6. Edge of wall P!ote~tion to nearest, door or window
7. Air space between wall protection and wall
8. Diameter of chimney and stove pipe'(vent connecto~)
b
NOTES ':
(0
(2)
131
41
OuUide combustion i\fr i~ reouired for -all fuel burninq in~tallatiOlls. A 7 Sq. illch (mill. areal,closable" ven'! loc
ated within 24"-Of the fireplace or appliance on the floor or base of a wall. .
A copy of the approved manufacturer's installation instructions must be on job site at the time of inspection. In-
spection cannot be made with out these instructions.
The 'Approved' plan/application shall be kept on the job site for use at the tfme of inspection.
Not all UllitS are approved for corner installations or reduced clearances with wall protection. (Refer to manufac-
.tl!rer'S llstins..} . . _ __ _ _ _
(5) If masonry chimney Is to be used, it must be lined: {Required by Law} EX1sfing-flues must De approved by-inspector
nDriDr_.tltUse---:- _'itlumust...DrQYi<1P-lliWwt.heinsoectnr ." .' -- , .----. .-. .
(6) It fireplace insert is to be installed. verification Ot wall header location in relationship Ito breast of fireplace
is required by law. - -
(7) fireplace inserts are not permitted fn factory.built or prefatlrfcatecl-metal "0" clearance fireplaces, unless
specifically tested and listed.
(8) Fireplace inserts are not permitted in masonry fireplaces with existing heat form type metal fireboxes unless
specffically tested and listed. .
(9) Unlisted units shall be installed in accord with the State Mechanical Code, utilizing the materials and clearances
set forth in Chapter 5.
C/ll L /OR PRE
C-14-32
)!-JSPEc77oAj Rt:FoRP- /J.JS77/LU,(}($ IAJSt:Rr.
APPROVED AS NOTED
By ---2.fP.
. Date <7" /7 - "8 Co
PERMIT # c.Cj Co 7 - 8 ~
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lAND MANAGEMENT DIV. / PUBLIC. WORKS DEPT. / 125 E.
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8th Ave., EU9. OR 97401 (503)6B7-4061
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UNITS 00' S~ORIES ~BLDCS 0g\ PHONE ?~7
ADDR 2988 GAME FARM RD.) SPRINGF:IELD
~(~ '='1 UNIT COST VA~UI~T:CN FEE
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ACT_TY INFORMATIO~HEET
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
t-
. 1 /!1/i-l-. p~ tJ Ct. LV
: ' . . PERSON MAKING REQUEST
. ;)7fl ;o~~_ I!),
.. /MAILING ADDRESS
SA Pn /J. Of-e
~ 'CITY STATE
~~"-
no (!c '.v
. PROPERTY OWNER
1
I' ,
~-
MAILING ADDRESS
,
I BUSINESS TELEPHONE #
2 PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
97C(77
ZIP CODE
747 6 fYr
HOME TELEPHONE # BUSINESS TELEPHONE #
. c; //,j/~
c::; c ~ _ ,-
(fry
STATE
ZIP COD!:'
HOME TELEPHONE #
3 MAP & PARCEL NUMBER
(REOUIRED INFORMATION)
~02IP
(from tax maps in Department of Assessment and Taxation
Dr from tax statement)
rZGl sii: cf /;; LOT: O~~~ #
ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
ACRES
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
5 REQUEST (~tate exactly what you plan to do)
J/l S t:::~
LOT
hP~
BLOCK ,
~dCE-
""--- - - - - - - " ----- --
,6 DIRECTIONS TO SITE: ('~...A v( /-A_~:,; '.'~A~-r:- k~ ~p{
** FOR STAFF USE ONLY **
- --
ZONE/LAND USE:
14-33
LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061