HomeMy WebLinkAboutPermit Building 1983-10-17
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VV FOR OFFICE USE ONLY
I Lane County Authorization for: APPlicatio/Y'//"2. 17<
I \ Perml t # /() /' /-OL/
.Px. 11IJr1, f"\(ln OA-rtJ l(11Jet.fkod., l DTwo Copies of Plans
/ \1 ~ A AA -... / 0 Three Copies of Plot Plans
,,,,.,.sH1P TRANGE OQ. I SEC2TI~, .-I. 2, J T~ ~ .... Oo<iT OF DMech/Plumbing Checklist
17 c.J u <.y t::X..JL.) DLegal Interest Document
SJB~Q~:AfT;T~(-1() atP(L~ble~ I UJT~CEL I B~ Dplan Check Info Sheet
LOCATlf)N ~RESh STREET -l D.- _ . _ Q^\ ~/"'\~...-I /l CITY ZIP PROPOSED USE OF PROPERTY
-QG)3D \.-adJm.aJ "'1{ 1nY1 flV.., c1Ur<....N ':::.174-7 (. ~eSide_ntial 0 Industrial
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CONTRA's:IDR' ffAME ANi';:',R 41'.... 1\ - 'i '
P"~T"~%.~~mO}t) rmr:~' I TELEP NE
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERMI~dO hereby certIfY that ~ ~rmat~on hereon lS true and correct, and that I
have the followl.ng legal l.nterest in the property: Downer of record; 0 contract purchaser; C!:fauthOrl.Zed agent "nth eVl.dence of authorl.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 Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUpANCY will 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 subcont ~and ployees who are l.n compll.ance Wl.tJ5Z0RS 701. WiLL used on thl.s proJect. I HAVE REAO AND
CHECKED T APPLICATION THOROUGHLY. ~
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. WfA'E 'It~~ pnntJ ~ - - SIGffATURE '" D~
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS! I O~~J J
o PLANNING/ZONING", zone()ot- I ~r;~ 11':>1./ - parco1):_/"-)1 n C' P;;;[~~~"
'hmmurn Setbacks,~:.o.: L, s,de. (J -Gf') 'nterior~u rear")l!' :....J
CO>t'lENTS, ~cwrl art hu.lo1u h' ~{filr\.) . ." . .
u ,,_ "." _,,~, 0 ". '" ""i,1Dt3:::-I- ')(It ~
Oec=IF~ttUO:Xtlm \:
~~ i 1'{2('fl
Installation Gallon / Lineal Flet
Specifications: Tank of Drainfield
CO'L'lENTS, ~ ~ ~iUA.l/~ IO~~ ~of-~~~
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~~ -~) ~.A'^-" _ ~....L; ./ AP aAP-f.;
.., /J. I Date, /0 -/-"-r..!? ~
~LANS EXAMINATION: Type tJJ.} Group UJ uso~.
COf",ENTS, t?AlL FPt- d~; I~r/p~~, '
o FLOODPLAIN:
cf])
Fl
~NITATION:
S. 1. #I
Installation Record Issued? 0 Yes 0 No
Maximum Depth
of Trenches
bate ,Jl-'J::~/- $3 D
TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
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L? ;scri/? n / /
g;~ ~<€ff
- ~$~~
-f:/~/J~ K ~r
$
$
$ "::i?~_
$ -=--..1;_ ~
$ v:, rh
$ L J;:I-
$
TOTAL FEE $$~ J!):::<. ..:5"[.
/1~MbJJ/) 11-1-3'
PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.~~~ DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
~
//t:;2f'
Fixed Fee"!
Unit Cost
~~
Floodplain Fee
Subsurface Fees
Building E'ee
M~ch/Plmbg Fee
P'ans Check Fee
State Surcharge
DEQ Surcharge
1Ir'"
.
.
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,
SETBACKS AND DTHER CDNDITIONS 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 Mu~7 ~t ~~vEN. 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 "transit mixedll) is to be used, materials need riot 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 subfloor.
,
3. Framinq ~ 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/er Gy~sum Board Inspection: To be made after all ,lathing and gypsum board, interior
ana-exterkor, kS kn place-OUt betore any plastering is applied and before gypsum board joints
and fast~ners are taped and finished.
F. '1 .
5. ~ Inspectkon:
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 ~uthorized, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This
rnspection 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 manufacture!ls installation ~nstructions.
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 ce~tified 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 wheQ ste~l 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. 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
instatlation record form. The Department shall inspect the construction to determine if it
complies with the ;ule~~contained in this division. If the construction does comply with such
rules, the Depar.Op,Qnt\,90a:-11 issue a certif icate of sa tis factory completion to the permi tl holder.
If the construc.ion ooes not comply with such rules, ~he Department shall notify ~he permit
holder and shall require satisfactory comp.l.e.l:;i9rl-:t;>efoi:.,~ lissuing., the cert!'ficat"e. ,Failure to
meet the requirements for satisfactory completion wrthfn a reasonable time constitutes a vio-
lation of ORS 454.605 to 454.745 and this rule.
Setbacks \ s~~s~ Sewaqe 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'
100'
C 14-25
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1,.1: 2 LANE COUNTY DEPT ENV MGT RECE-IPT ~ 184783 DATE 101783
APPLICANT SLUSHER, L.M. AD DR 80824 LOST CREEK, DEXTER, OREGON .
.L;\ 1703224200800 SUBDIV L.OT BL.K.
NEW BLDG TYPE GAR USE R BDRMS 0 UNITS 001 STORIES ~BLDGS 001 PHONE 937 2228
OWNER NME PROCIW, M. ADDR 2988 GAME FARM RD., SPRINGFIELD r::
. CODE APPL NO ACTION DESCRIPTION SQ.FT UNIT COST VAL.UATION FEE DAY.
BP CARPORT 400 4.59 1836
BP
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L..C 184783 NEWR
ND. FIXTURES:
SREF
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CATG:
. I'SEQU:
.'AKEN
APP
0'
BY RL.H
RA
.
.
NO.
CONNECTDRS:
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
FP
EST.
SDS SI
1
COMPL.ETI ON DATE
PCK
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.
-
1836
15.00 EACH ,,;
47.
657.
OTH ISS
2
TOTAL. FEE**
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1. "
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31.00 .
1.24 .
20.15 i
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15
5;!.39 CK .
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ACTI~Y INFORMATION eHEET
, lane coumy
11
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
"1' J.-, ;f1 5 I lis) -R If,
PERSON MAKING REQUEST
'?O <g ;).. <I ~ /..c; 3 i tl):' !~ D
MAILING ADDRESS
11 tv I1l!.s - /l1 - ?~o(!. / t<.J ~
PRut'tK I f OWNER'
OJ. <; fi'? C; /J ~ e F/1-e/1..! 17 l?-
MAl LI NG ADDRESS
/)-ex~'I-
CiTY
ojQ@,
STATE
<;'? t./.,3J
ZI P CODE
5 p t//I)~+J'~Jf)
, CITY
oec...
STATE
ZIP CODE
. 9 3 ?~ 2.22%'"
BUSINESS TELEPHONE #
5 ~M e..-.. --
HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE #
2,. PROPERTY ADDRESS S AA-f c- -
'(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
I 7 0'..3 '2-,2-
TOWNSHIP RANGE SECTION
~ 2 '06 rOd)
TAX LOT(S) OR PAKCtL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION.
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable) rlT:E..1I1 T";e/-
TAX LOT(S) OR PARCEL # ZONING
ACRES
<'
LOT
L- BLOCK "2
5 REQUEST (state exactly what you plan to do)
~ ,4.!2- Po 1-'(-
6 DIRECTIONS TO SITE: /~/.:. I.n E 71 ~ ~ AI e Flit AI rlJ-
!voy71 10 ~ ~1e. ' .~
** FOR STAFF USE ONLY **
--
NUMBER
DATE
-
-I
:;c
V>
ZONE/LAND USE:
BY: DATE:
.
-I
r-;
TIME IN:
OUT:
LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061