HomeMy WebLinkAboutPermit Mechanical 1983-12-21
/7 .1 RANGE C3 SECTIO/7L I ~~OF
S:;SDIVISION/PARTITION;f apPliC:le) I LOT/PARCE: I BLOCK
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I t CAREFULLY EXAMINED THE ETED APPLICATION FOR PERMIT, and do hereby certify that all information hereon is true and correct, and that I
have following legal intcres n the property: Downer of record; 0 contract purchaser; Oauthorized agent wi th evidence of authori ty attached.
I f:;. her 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.
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FOR OFFICE USE ONLY
Applicatio~ ~ ~~~ ~
PermJ.t ~L?/~-()~
c=JTWO Copies of Plans
o Three Copies of Plot Plans
DMech/Plumbing Checklist
OLegal Interest Document
o Plan Check Info Sheet
PROPOSED USE OF PROPERTY
~eside_ntial 0 Industrial
o Commercial D Public.
-Po .ebl A If .0 L., 23'tJ Y L f :s'
NAME (please print)
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DATE
READ THIS SECTION CAREFULLY. Y~UR A HORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS~ / ~A
o PLANNING/ZONING: Zone /t/ #-- Partition 11 Parcel # Parcel Sizvl?/ ~
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Date:
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o FLOODPLAIN:
In flood hazard area? 0 No 0 Yes, SEE ATTACHED SHEET.
Date :
o SANITATION: S. L #
Installation
Specifications:
Gallon
Tank
Lineal Feet
of Drainfield
Installation Record Issued? Dyes 0 No
Maximum Depth
of Trenches
B. P. It
CQM!oIENTS:
Date: I
n
. d(PLANS EXAMINATION: Type ~I\) Group 1Z..~
/[ - COMMENTS: r' JH (J ~J2L.,. tZJ{ujo JA >7:;'Ir~MA h
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Date:-11//~l---<i"? D
TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
Description Sq. Ft.
~/p~/7
4~
Fixed Feel
Unit Cost
Floodplain Fee
Subsurface Fees
Building E'ee
f.12ch/Plmbg Fee
Plans Check Fee
State Surcharge
DEQ Surcharge
TOTAL FEE
$
$ ~
: ////:r
$ ij.-
$ /, 7b
$ -- -'-I'
$$~7:'~
M~4fLJ~) -J 7-,1/k~ ~
PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.80 (1)) - DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
.
.
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 INFRACTIDN 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 "transit mixed") is to be used, materials need not be on the job.
2. Concrete Slab ~ Under-Floor Inseection: 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. Framing & Insulation ~nspections: To be made after the roof, all framing, fire blocking, and
brac~ng 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 barrie~ are in place.
4. Lath and/~ Gy~sum Board Inspection: To be made after all lathing and gypsum board, interior
ana-exter~or, ~s ~n place-ollt before any plastering is applied and befo~e 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
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, 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. 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.
SUBSUR~ACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS: I
1. Permits shall be effective for one year from the date of i~~uance.
,
2. Upon completing the construction for which a permit has been lssued, 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 .llules contained in this civision. 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
10'
10 I.
5'
50'
Drainfield
10 .
10'
la'
lOa'
C 14-25
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APPLICANT BOYLES,
JLO 1703140001600
.EW BLDG TVF'E
OWNEr~ NME
CODE APPL NO ACTION DESCRIPTION
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LANE COUNTY
DURWARD
SUBDIV
USE R BDRMS 0 UNITS 001 STORIES
t-,DDI~
SQ FT UNIT COST VALUATION
DH'T ENV MGT I',ECEIPT ':' 2314B3 DATE 121 :iB3.
ADDR 199 DEADMONDS FERRY, SPRINGFIELD, ORE
LOT BLK
'~BLDGS 001' PHONE 746 8444 .
FEE
DAYS l'
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NIJ. FIXTURES:
NO.
CONNECTor~s :
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
1 ~) . 00 EACH ...
.
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651.
LC 231483 WS
19.00
0.76
4.75
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EST. COMPLETION DATE
TOTAL FEElH'
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ACTI4tTY INFORMATIONeHEET
lane coumy
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
V/Ac.
C/ C ITY
/,~..y.(9<
ZIP CODE
.i1/./r lU/LI"/J ~//.. If"'..". <,.
PROPERTv OWNER
:'Z, "1/ / ;8L2/~~ Ue~<~ ~.,4.
- MAILYNG ADDRESS
&,=
., - STATE
,r~TY
ZI P CODE
l' ,J),o /1//7 '~'l It!.~ ~ ('} ~ t!'
PERSON MAKING REQUfST
S~~A~y,B 12//E,
MAlLIN ADDRESS .
St:?,
STATE
2/"J ~
E.h ~ "'t...1.f <! L/ 3 cj -;J- 65/ f 7 9-h. - r:~i ~
BUSINESS TELEPHONE # HOME TELEPHONE # BUSINESS TELEPHONE #
2., PROPERTY ADDRESS /7'Q /7e;or.P.#'Y2h.-->-?J<:" r--er/"U
(IF DIFFERENT FROM MAILING ADDRESS). - /
7&/7-7 'f/O"D
HOME TELEPHONE #
3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
/7 (),i /4'
TOWNSHIP RANGE SECTION
_ /b;?D
TAX LOT(S) OR PARCEL #
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)
LOT
BLOCK
5 REQUEST (state exactly what you plan to do) I/J <:; M // -7/.oL:V.} -') 7"/)//-r.!=.
6 DIRECTIONS TO SITE: .13.__,,/')-.,(,',.., _ 70 hCYn4~..Yrn lfd L~ Lr 0 /7""c>d~.'
~,'''- ?Urn 1f':'5-/'~
** FOR STAFF USE ONLY **
NUMBER
DATE
-
;;0
V>
ZONE/LAND USE:
BY: DATE:
.
~
TIME IN:
OUT:
LAND MANAGEMENT DIVISION / 1?5 F. Rth AVF,. EUGENE. OR 97401 / 687-4061