HomeMy WebLinkAboutPermit Building 1973-12-11
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LANE CO~
BUilDING C"l
BUILOING 'PERMIT OR MOBILE .E
MH [l
MAILING ADDRESS
USE PERMIT
PERMIT NO.
PROPERTY OWNER
PHONE
CONTRACloR
MAiliNG ADDRESS
PHONE
PROPERTY LOCATION - INCLUDE POST OFFICE
PROPEnV LEGAl DESCRIPTION - METES. BOUNDS
TWP
RANGE
~E~'loN
TAX LOT NO
CODE
CENSUS TRACT
APPl.
NAME
EXISTING STRUCTURES ON PROPEIl:TY
LEGAL ACCESS TO PROPERTY
&
MAILING
PROPERTY SIZE - FT.
ADDRESS
FOR MOBilE HOME PERMITS ONLY
No. of Bedrooms
STRUCTlJRES TO BE BUILT THIS PERMIT
WIDTH
DEPTH
AREA
Connect to Existing Sewage System I
TYPE CONSTRUCTION SQ FT :: BDRMS
New System 0
VALUATION
SEWAGE DISPOSAL
.
fEES
PLUMBING INSTALLED BY
OWNER n OTHER: NAME
WATER SUPPLY
PUBLIC fJ
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
SEPTIC TANK 0
OTHER["]
PUBLIC 0
o OTHER
TOTAL
.
MIN. SEPTIC TANK CAPACITY
WITH OISl. BOX: GAL.
c6ur--lTV bUIWJNG & SANITATION SPECIFICATIONS
6RAI~ fiElD REQUIRED
lIN. FT
TRENCH WIDTH FT.
OR SQ. FT.
TYPE OF STRUCTURE
OCCUPANCY
ZONE
PUBLIC UTIL. EASEMENT
BLDG. SETBACKS FT. FROM OR. OF ROAD RIGHT OF WAY
USE CLASSIFICATION
FRONT
SIDE INT. SlOE EXl.
AUTHOR(!~D SIGNATURE - DATE
REAR
DATE
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
Construction to comply with uniform building code and county regulations
covering plumbing and sewage disposal. All buildings require a certificate
of occupancy before being occupied.
(See Statement on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, BLDG. &. SAN, DIV.. COURT HOUSE, EUGENE, OREGON 97401
FORM:: css- t)
(
.
.! .
SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED ;---y DISAPPROVED / / DATE
REMARKS
GAS PIPING GROUNDWORK
ApPROVED / / DISAPPROVED L / DATE
REMARKS
ROUGH PLUMBING
ApPROVED
UZJ
DATE~ -/.U-Jt.....,
OISAPPROVED .Cl
REMARKS
ROUGH GAS PIPING
ApPROVED .Cl DISAPPROVED .Cl DATE
REMARK S
FINAL PLUMB I NG
ApPROVEO W DISAPPROVED .Cl DATE"" '1/-;;,
REMARKS
FINAL GAS PIPING
ApPROVED .Cl DISAPPROVED / / DATE
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE .Cl NOT READY TO ISSUE / / DATE
REMARKS
""'I
.
INSPECTOR
INSPECTOR
INSPECTOR~../. /
. V~
INSPECTOR
INSPECTOR~iY'
INSPECTOR
INSPECTOR
'/'
~
,
LANE COUNTY ~.NG PERMIT OR MOBILE HOME. APPLICATION
TYPE - BUILDING~" MOBILE HOME 0 OSC REG. # PERMIT :#: -2..::? ~.?- -?..:3
/J / MAILING ADDRESS .. /'" . /. PHONE
~A- ff70 ~ (lL--:>f-//d, c V ,0/", /.:. '
MAILING ADDRESS / , V PHONE
71/~- 99/~
, PERMIT
PROPERTY OWNER
J!'/h-"- /
CONTRACTOR
PROPERTY lOCATION - INCLUDE POST OFFICE
Ai ti'7LA' -LA:-
//?tl
.,d/,
)1'1, ,_.J ) /,,1 'P / Y /'CY R METES & BOUNDS DYES
1~-LA'j/ ~ ?,.a.r. 0'\- /,0- / ATTACHED D NO
TAX LOT if CODE CENSUS TRACT 1
3$ -(.5'? /
DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY
~C--
LEGAL ACCESS TO PROPERTY - ROAD NAME OR #
4t>--x-Ly ~.
PROPERTY SIZE-WIDTH DEPTH
PROPERTY LEGAL DESCRIPTION P, / . / I
..LOT - BLOCK - SUBDIV, \. J>La ~.
TWP RANGE SEC.
/r /J2 6C,
APPLICANT ../
NAME ~~-p - ,.;Lj"~ A ~ ....J
AND
MAILING
ADDRESS
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms
STRUCTURES TO BE BUilT THIS PERMIT
~U-~/--IL-r? ~
{/
7ft,g ;11'--
L~h1j~Jd,
~=SEWAGE DISPOSAL
AREA
Connect to Existing Sewoge System 0 or New System Req, 0
TYPE CONSTRUCTION SQ. FT. # BEDR9"MS )VALUATlON
~ //6.s:,tO/-z (..:1' /.39110
)'
-
f/-rb-jQ. J
/3%(.,
~
/ S,~,{,?,
. / -. .-
PUBLIC 0
BLDG.
WASTE DIS.
PLUMBING
PLAN REVIEW
PARK TRLR.
SEPTIC TANK tf
$~~ ~
..::Lo, 4l-O
~ L/..so
OTHER D
FEES WATER SUPPLY
PUBLIC fY" OTHER
PLU?Nt; ~EES
F1XTURESt19..3 ,-,
CASH D s...r.;;
CHECK ~ONN'ECTION FEE
PLUMBING INSTALLED BY
OWNER D OTHER D NA.tl... (# a.-r'~ .J
PLANS FURNISHED UY;2) -'AC~ ERMIT /
YES)c( ,..HOlD ___ YES NO P
S{GN'A~~PP~C~. / DATE
~/..~ ~"";..-..:r~~ /0://7.3
~...;J '::;'RECEIVED BY '25// //.Z/~/77'
PERMIT # ;/-
PUBLIC WATER ~ ..., /_ 0
CONNECTION FEE l .5'b o-r ~ w t7 ..
COUNTY BUILDING & SANITATION SPECIFICATIONS .j
DRAIN FIELD REQUIRED _ I.
UN, FT, '1.C)() TRENCH WIDTH FT, 9...... OR SQUARE FEET 4/0 0
/
/
TOTAL
/~b, .50
MIN., SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
100
IX ,tJ t,S
I
REAR yARD /
\ .
BLDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY , USE CLA'S1'CATION
l~ml.t ,~~i1~J pc;;J;E EX::/~~/;~REA:LJ INSP. fP6 ~ R/i; ~ _/I)D ~
~rections to Find Property' V I
TYPE OF STRUCTURE
-.5!V
OCCUPANCY
1~4
ZONE
PUBLIC UTIL. EASEMENT
COpy 1 - OFFICE
COpy 2 - JOURNAL
COPY 3 - AUDIT
Form # CSS.IZ