HomeMy WebLinkAboutPermit Building 1984-10-15
II ,bnO. JrTn P01n
~l) Je'fnpTION OF PROP()SED WORK - Bnp IFIC
'T1.tY'J- Wlj_ r1 _ q"rtr ~ ) ~
- OROOMS l.) /I' OF STORfES # F EMPLOYEES WATER SU~
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CONTAAcTOR'SN~ _ _ d~ 1?()(wL~ ~ll
~r lu BE MAiLED ro (NAME 0" (~ ~ - V
I lIAVE CAREFULLY EXAMINED THE CooPLE EO 'APPL~~~~'~/dO hor.:-~:tif}-'(::~info=ation h."on Is true and cOHect. an t at I
have the following legal interest in the property: Downer of record; 0 contract purchaser; ~t~orized agent with evidence of authority 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 subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY.
-.P()~tj/'~ .
Lane Couftry Authorization for:
~h~, ('ruw.~I~~,(~)
TO"';SHIP) 7 I AA1lGE(J)3 ~ I SEc~!tz .1. 3 J T~OUT OF
S~BDIVISIO~PARTITION (if applicable) I LOT/PARCEL r BLocK
-
r:<d" _" ?)~ (nzf) " b;{
Jiirl J~
{l.&~ ar,d
FOR OFFICE USE ONLY
Application/".I~/ f-I.ll'.
Perm.1.t # ~&7 /-(j c..r
D Two Copies of Plans
o Three Copies of Plot Plans
UMech/Plumbing Checklist
D Legal Interest Document
D Plan Check Info Sheet
SE OF PROPERTY
D Industrial
D Public.
(b.t~J'fJh..
D Cormnercial
f
~)/jrJ, ,Au.."'m~~ i.J4.h '" I;"'!j
, NAME (please print)
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l' /z 4frSJ-
DATE
READ THIS SECTION CAREFULL~JL~ORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS!
o PLANNING/ZONING: Zon Partition # . Parcel # Parcel Size
:::~r;p~C:;" I ,pi1;;~~.rz Q.Mi;:r ~li \UI i
~ .Aj,
Date'~'fur
o SANITATION: S. 1. !
o
Installa tion
Specifications:
Lineal Feet
of Drainfield
Installation Record Issued? DYes 0 No
Maximum Depth
of Trenches
B. P. #
Gallon
Tank
COl>L'1ENTS :
n
Date:
~~ EXAMINATION: Type\l-l~ Group A 2...1 I useCuntll'..L.l t2E12€:C1F
cOMHENTS, c.~ RJl2. F<<'AMI#JG.I ~ SHeET"('''I~PWlAl2p AI.lD F/#.M-IIJ/<;,ptiL."11.Q1,j..!::,
~~~
Date, Jolts/~
Floodplain Fee $
Subsurface Fees ~ -"f' ~
Building ~ee ~Z $ t::7< 0
".ch/P 1mbg Fee $'1. / / .?0-=-
pl ans Check FeA()r- / cp - ,,..,. _
State Surcharge 'Z ~ / r
DEQ sur'iOr~~ $ -' L - ~
faTAL FEE $$ ~~
?€Enlt!:;!fo:J~UILDING OFFICIAL/DESIGNEE (per Oii.~# Jo./'5!AfTE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061, C 14-25
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
TOTAL VALUATION
$ fa 7 f>..n g;z.
CONSTRUCTION AUTHORIZED BY ~ PERMIT
Description
Fixed Fee"!
Unit Cost
Sq. Ft.
/JEW 1200r=
I fDPln
4.00
o
.
.
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:- 'permi t number I 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 pnd when all
materials tor the toundation are delivered on the job. Where concrete from a central mixing
plant (commonly termed "transit mixed") is to be used,. material.s .n~ed not be on the job.
Concrete Slab ~ 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.
2.
.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
electri~~l ~nd ~lumbing are approved. All wall insulation and vapor barrier are in place.
Lath and/eE. Gy~sum Board Inspection: To be made. after all lathing and gypsum board, ;.nterior
ana-exter~or, lS In place but b~tore any.plasterlng is applied and be~ore gypsum board joints
and fasteners are taped and finished.
'j
4.
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
rnspectlon 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, tie~owns,
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. Swimming 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 SYSTEMS11'
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l.
2.
Permits .shall ~e ~f~ec.tive for one yea.t; from the..date of iS7uanc~. '.
. ..' ., , , . .
Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane county Dep'artment 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 permitlholder.
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
Eqge of road right-of-way
Building foundation
Wells, other water sources
SePtic Tank
10 '
10 '.
5 '
50 '
Drainfield
10 I
10'
10 I.
100'
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APPLICANT IMMANEIL
.TL.~ 1703221302500
.JEW r-lLDG TYPE
OWNER NME
CODE APPL NO ACTION DESCRIPTION
.IP
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-I.\; LC 269184 SUPP
."L: NO. FI XTURES :
MECH
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LANE COUNTY DEF'T ENV MGT f~ECEIPT '~269184 DATE 101684.
BAPTIST CHURCH, ADDR 3050 GAME FARM RD., SPRINGFIELD, ORE
SUBDIV . LOT ElL.K
USE C DDRMS 0 UNITS 001 STOI~IES '~BLDGS 001 PHONE 746 2974 .
ADDf~
SQ FT . UNIT COST VALUATION FEE DAVJOI
.
.
.
37.50
.
NO.
CONNECTORS:
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
15.00 EACH ....
4%
65%
1.50
24. ~~8
-0.01
.,
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TOTAL FEEx..x
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EST. COMPLETION DATE
. 63.37 CK
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SLIP
lane county
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APPLICATION # 21091-B4-
LOCATION &:;50 GrAM€: FAAvt f2D.
f-te.? TJ.WeAAN. lA.<.t1-l11\\b
via I "'MAN "€.I... CiW\15TC-I<u~'"
/}:05rJ 64M€ F~ gD.
:5pe.II.J6F1ELV. a..
NAME
ADDRESS
97471
ZI P CODE
The above application is being held for the following reasons:
T<\4:. PWR):s€D 24' ~ 70' $T!2.UCTU/2AL.. A.uc.eA.T10N. It> 1l-\E:. eooF Cf'" ~ E"llI'5Tl,;J~
8,0(;,6 ~Ae.E- Fi?C'\ C::I-\LJ~ ~UI/?E.$ Tl-l4T"l1fE; F"l.A,us BE PeEPAeED 6'f AN
012l:t:-o--l 6.1U-,.j\ re:c.T oe ef..191 N.EE.e.
BA.S€[) 0'-1 ruE PL.ll,,(lS ~U5MITTE.D RJ/2-lDUlL.DItx:::r PEI2.MIT 1519-18, mE..A-f-lW-\E..
I~ ~\'J/-l A'S l3E.!/-IG-j A 2. -::'TOlZ.'l13U1l....D1NG:., Ot-! TI-\€ ~U~ ":>1 DE. AND T\-\E
I-JOe.T\-l -::'IDE: 5\-\CWS NO El'-l?TIJJ'4 FLAT fUJoF. T\.\E: ~K.E.;r~ -::'U5MfTTED~IJ6&.J.S
AtJ EXI5ilAlGf I<ror HE:I~\tT OF 9'. .
Pr<oVID6 TWO SETS OF PLANS PI<.~eED AND -::'Tl\M.pe;!) /5'( AN 0eE40~J
Al2GHln:.cr Oe. Sf..l411JEeR c.u=.Aay (.Oc.ATI~ -me: Al?_E,o,.OF TIle PROfO::e.D
WOQL or-I A PWT PLA/-..l \ ~PEC.I \=''(1 ~ '"[tIE I<.i.X.JF Sf'-EAm/f,.\C=r) 5PCCIF'( IN<'=!
l1-l~ ecoi""INe:, M4TE:.f2lAL DET41UNcq Tf.lE. PKOFCJ$IW It--lTEe.(Oc.SVPPoe.T5
FOe... iHE: fZC.Op eAFTr=d AN D OETA./L.rF TKE: c..oJJMI--I":T10N TO l'1.(c
e)<\ 5 TI "-'(q 1<L.ur. () 'V\ 6[<t)f .
to ~
f)~u
SI GNATURE
9/2'-8/84
. DATE
AVAILABLE BY APPOINTMENT ONLY 687-4061 (
PHONE HOURS
This application will b~ held until JoJ/S/B4. If the information required
above has not been furnlshed by that date your application will be cancelled.
RETURN THIS SLIP WITH THE ABOVE REQUESTED INFORMATION.
BUILDING PROGRAM / LAND MANAGEMENT DIV./PUBLIC WORKS DEPT.
125 East. ~th Avenue / Pub 1 i c Servi ce Buil di ng / Eugene, Oregon 97401 / (503)687-4061
t
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..::::t:MM.AN. U {;-L. Ef'-d3il"::>\ CAA1..J J2.tM'\
3050 c;f",l"\f;.. ~ f2~
Sf1<\~ FIP--U:::-. (')1<.
. EMILE MORTtEl(, P.l:.
Engineer Code Consultant
474 Willamette St. 503484-9080
P. O. Box 139 Eugene, OR 97440
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ACTIVITY INFOHMATION SHEET
icJne county
COMPLETE TH IS SECT ION. INCOMPLETE FOHMS WILL UL HLJECTLU!
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-"''''''-TITf--- STATE
J
ZIP CODE
'J:ml'YJa nu f' I ,e~1>-sr rv~"rCh
PROPERTY 'OWNER .
3050 GCtme {;.tJll Rd
MA I Ll NG ADDRESS
C:::::::'\.n'" ~ \d \~ 97cf11
~ CITyJ sf ATE ZIP CODE
PERSON MAKING REQUEST
MAILING ADDRESS
;.
BUSINESS TELEPHONE #
HOME TELEPHONE #
BUSINESS TELEPHONE #
HOME TELEPHONE #
2 PROPERTY AODRESS
(IF DIFFERENT FROM MAILING ADDRESS)
. 3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEc-#
ZONING
T(i~irrsjfij:> RANb"E SECTION
TAX LOT(S) OR PARCEL #
ZONING
TOWNSHIP RANGE SECTION
TAX LOT(~)'OR PARCEL #
lOi'm.G
TOTAl. CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SIJBDIVI5IO'N (if applicable) rfl ~ LOT
J.ii.'.j,:.r;UEST (state exactly what you plan to':~'6).:~./"'7''''~-''- .__1'"":0_0\1..
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BLOCK
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.6 DIRECTIONS TO SITE:
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** FOR STAFF USE ONl.Y **
.,
NUMBER
ZONE/LAND USE:
BY: DATE:
DATE
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TH1E IN:
OUT:
LAND MANAGEMENT DIVISION / 125 E. Rth AVE.. EUGENE. OR 97401 / 687-4061
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APPLICANT IMMANUEL BAPTIST, CHURCH
.A ~~ i70~',0470?~~00 SUBJIV
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