HomeMy WebLinkAboutPermit Building 1980-8-15
LANE COUNTY
BUILDING
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PERMIT..
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CONSTRUCTION PERMIT H LC 1899-80
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POST THIS PERMIT ON MAIN BUILDING AT'SITE
JOB ADDRESS: 1Q95 Dixie Drive, Springfield, Oregon
TRS, TL: 18-02-05.2.4~100
SUBDIVISION: Mount Vernon 'Estates, Lot Eight, Block One
CONSTRUCTION APPROVED BY THIS PERMIT: None
CONDITIONS OF APPROVAL: PERMIT CANCELED. VOLUNTARY CANCELLATION PER APPLICANT
7/28/80. .
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.PERMITTEE: Richard_Evenson
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DATE ISSUED: August 1, 1980
BY: Roger McGuckiri/Candi Hart
WP 28305-5E-2
* * * * * * * * * * * * * * * * * * * * *
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION
CAN RESULT IN REVOCATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S
INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOWED BY LAW.
WHEN READY FOR INSPECTION (see attached) call 687-4065. 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.
~NVIHO~JMlN'^L M,o.NA(J[MENl DEPARTMENT
125 EAS r HI!-t AVENUE I EUGENE. OREGON 97401
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,. ~N~LLATION/REFU~AUTHO~TION · Permit # /~99-c;f:)
Name (please print) /~#...g4-/ ~ _ ..ef~~ _ "
Address ~~~y /~~::';./A ,,/~/~ ,,~A""./~fi~~9.7y;j7
App1 icant ]X) Owner () Co tor ( ) / 4 ~ n./.-/
Reason for ca~lling permit ~~~~~ ~~~~~ ~
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c/7Y" __~~n /' . ./ .. .; ..
Signature Date ~~~~~
Fees paid for waste disposal systems (site inspections and/or applications to install the
septic tank and drainfie1d) are ordinarily nonrefundable, Some refund may be made on the
building and plumbing portions according to the amount of the permit processed.
(DFFICE USE ONLY)
CONSTRUCTION PERMITS & INSPECTIONS
Authorization for possible refund:
/}V;
% Building permit fee $
% Mobil e home fee $
% Plumbing permit fee $
% Plan check fee $
% State surcharge fee $
TOTAL AMOUNT $ -0 -
Date ..P- /.... -;?!"'....
,
Signature~.1 ~~
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WATER PO~TION CONTROL
Authorization for possible refund:
Signature
% Septic disposal system $
% Site inspection fee $
TOTAL AMOUNT $
Date
TO: DEPARTMENT OF FINANCE
Building permit refund $
Septic disp. syst. refund $
Site inspection refund $
TOTAL TO BE REFUNDED $
PLEASE MAKE CHECK PAYABLE TO:
Name
Address
Signature
24-08-24/Acct 46960/Prog 021 Receipt #
24-08-25/Acct 42133/Prog 011 Receipt #
24-08-25/ Acct 42134/Pi'og 012 Recei pt #
Date
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE/PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
C74-179
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" . . .' ~NCELLATION/REFUND AUTHORIZATION .~ .' Pennit # /cf'19-J::J
Name (please print)/~~/~ ;:;:, C~~ _ ,
Address ';ff~V /m-/'..-/.//./ ./~/y vkd"'../~A,L~~ 9.7)/"7
Applicant (~) Ow~er (~) - Contr.afto~' () - ,. / ,,.;-e~
Reason fo; cancelling permit ,~~/~/r'~~~~ ~
//1~/./7A~/_.-?~f ...~../~
C/77 - - - - - /' . f - -
Signature ,- Date ~,-.?-~
Fees paid for waste disposal systems (site inspections and/or applications to install the
septic tank and drainfield) are ordinarily nonrefundable. Some refund may be made on the
building and plumbing portions according to the amount of the pennit processed,
(OFFICE USE ONLY)
CONSTRUCTION PERMITS & INSPECTIONS
Authorization for possible refund:
'/)'0 ~r?
% Building permit fee $
% Mobile home fee $ ,
% Plumbing permit fee $
% Plan check fee $
% State surcharge fee $
TOTAL AMOUNT $ --- 0 -
Date .-P - /... - ,Q,'n)
,
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Signature _~.u:,. /,~--
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WATER POLLUTION CONTROL
Authorization for possible refund:
Signature
% Septic disposal system $
% Site inspection fee $
TOTAL AMOUNT $
Date
TO: DEPARTMENT OF FINANCE
Building permit refund $
Septic disp. syst. refund $
Site inspection refund $
TOTAL TO BE REFUNDED $
PLEASE MAKE CHECK PAYABLE TO:
Name
Address
Signature
24-08-24/Acct 46960/Prog 021 Receipt #
24-08-25/Acct 42133/Prog 011 Receipt #
24-08-25/Acct 42134/Pl'og 012 Receipt #
Date
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE/PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
C74-179
4541
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DICTATING INSTRUCTIONS
CONSTRUCTION PERMIT # 1
JOB ADDRESS: 2
TRS, TL: 3
SUBDIVISION: 4
CONSTRUCTION APPROVED BY THIS PERMIT: 5
CONDITIONS OF APPROVAL: 6
PERtUTTEE: 7
DATE ISSUED: 8 BY: g
WP 28305-5E-2
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This is , 24-08-25, Program 011, extension , dictating
a building permit lor buildinq permits) on Word Processing Form #28305-5E-2, with 4
copies. These are final copies to be single-spaced. I will need them by
morning, afternoon. I will come and pick up. Please call when ready.
Just leave message. Note: Please type all numbers in numerical. unless otherwise
noted,
Variable 1
Variable 2
Variable 3
Variable 4
Variable 5
Variable 6
Variable 7
Variable 8
Variable g
Directions to
Capital L- Capital C Space I g11 hypen 80 (All caps TMH or MH)
~A 1 '
I 8 hyphen nx- hypen I"JS- period 2. _ periodCC;;;;;;;a space If)o.
(If none, just say N/A) If so, give sub name, Lot, Block. SA
Go to notes or applicatio~~ iliA
Go to notes or applicatio~ ~~~~~
Applicant's Name ~ _;'
(Day after dictation date) ~n(
Plan Checker/Sanitarian/Permit Processing Clerk (You must ~a "slash" between
names, and not all names are necessary., see notes). /2J41, C f/
site, colon
End of permit.
'---
~ permit. Start over.
NOTES:
Variable 5:
Variable 6: Text:
WPC: (Repeat below if applicable, plus text, if applicable).
Subsurface sewage disposal system installation specifications colon gallon
tank semi-colon feet of drainfield semi-colon'maximum depth of trenches
semi-colon period. Keep drainfield at least 10' from all foundations and
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property lines comma and 100' from all water sources period, Keep septic tank at
1 east 5' from bui 1 ding foundat i on comma 10' from a 11 property 1 i nes comma 50' from
all water sources comma and 10' from edge of right-of-way period.
Paragraph (written comments)
Paragraph
Planning:
Minimum structural setbacks colon from centerline of
semi-colon side interior property lines comma
property 1 ine comma semi -co Ion or peri od (si de exteri or
of road comma ) period. .
road comma front comma
semi -co Ion rear
comma from centerline
Paragraph (written comments)
Paragraph Directions to site colon
End of permit.
NOTES AND SUGGESTIONS:
Variable 2:
Variable 5:
Variable 6:
Variable 7:
Variable 9:
Suggestions:
If on a new SFD please look at addressing's copy of new address. If
on a septic installation only, there usually is not an address, just a
road name. Spell out unusual road names.
Spell out SDS (subsurface sewage disposal system) don't abbreviate.
Sbmetimes there is not room on the application for the construction and
the septic so the clerks write it down by the fees so be sure to look to
see if the permit is for septic also. Always hypen and put the square footage
of the structure(s).
Prepare this before dictation. Sometimes it
instructions (not always the regular format)
(not always in order). Always say paragraph
Spell unusual names.
These names will differ due to who is involved. One permit may be all
3 names and one permit may be just 2 names. For septic only put the
sanitarian slash clerk, building only put plan checker slash clerk,
Spell names if unusual (McGuckin, Cruickshank, Weiderhold, etc.)
(a) Speak clearly and say s as in Sam and f as in Frank for those type of
letters that sound like other letters.
(b) Always say comma or period if there'is one; also parenthesis.
(c) If you make an error please see Dictation Instructions sheet
(d) BE PREPARED, Hava all applicable notes ready. You do not have to
write down everything you are going to say, on sheet just write "see app".
Just be sure you have the papers in order to dictate from.
varies,
and the
between
such as the septic
setback requirements'
different texts.
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LANE COUNTY DEPT ENV MGT RECEIPT 0 189980 DATE 071480
APPLICANT EVENSON, RICHARD A. ADDR 4824 DAISY ST., SPRINGFIELD, OR .
TLI 1802052400100 SUBDIV MT. VERNON ESTATES LOT 8 BLK,
NEW BLDG TYPE USE X NO BDRMS 00 NO UNITS 001 NO STORIES NO BLDGS 001
CODE AF'PL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DAV.~'
BF'
BF'
BF'
BF'
BP
BP
BP
PL.
MECH
SUR
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LC 189980 WS
NO. FIXTURES:
BALZE KING
NO, CONNECTOI~S:
MECHANICAL FEE
STATE SURCHARGE
PL.AN CHECK FEE
15.00
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0.60
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2
OTH ISS
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TOTAL FEE**
15.60
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BY CH
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FP
SDS
SI
PCK
EST. COMPLETION DATE
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-<W"..N:."7: ,p, n "0/74/77
Zi p Code
Name
Address
The above application is being held for the following reasons:
o i~C./~C::;-F.4./e.; ~/~.:: ~ (3& /1J.~Pu 13.0 /J.,) /l'-'2~//t3S
{/If/U$5 L-/~/6t:?, -:7J?,tZ.c'/?/t::/u 7 L~Ll FO<..... ;j('eve
//./<-PU-I{IOIJ, ffr"//,v& ~~v~ o--<~,':1IC,(.,'J7'//VI
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Division 3L//LI.~i.4 / );.1'vIh'?'7?/J{)
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Signature ;(. j. J?/!../~.L'LJW Date 7.-/): !!('
Telep~/-:""G (, 1- ~"'h /
This application will be held until /- ,.-.'~tI. If the information required
above has not"geen furnishe9,by thaLd~te y~ur,application will be cancelled. /
Buildinlfees~id 70r permits cancelled under these circumstanc~s will be oro'rated
according to the work that has taken place as of the date qf cancellation._
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ENVIRONMENTAL MANAGEMENT OEPARTMENT
125 EAST 8TH AVENUE I EUGENE, OREGON 97401
form C74-139
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DEPARTliENT OF ENVIRONI1ENTAL t1ANAGEMENT
PSB, 125 EAST 8TH AVENUE
EUGENE, OREGON 97401
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f$~lj~!I~I~r~' .' ""'" ":'_/;7~ ~J k-^. iii'illii K :!ljp~k1 1
Appl ication for n
Structures now on the property ;:;:~~ /
p " 's!ldtuse1lifNe,,7t:U /-/ IReMderit.liiij. n \:(lllllIiji'C1Tfl / / fll\llt . a]1 /_-/ IPiili......lJi:,;
\A::~i7;.'7,"1),;.~~'~J 1vi~~~~EI,Jt1-~SO;:)-~ ,~e::;U:.:~if~ that th~s ;~~f:rmation is true and accurate.
If this appl 10n is for an agricultural building it will be used for purposes allowed by the State Building Code and
Lane ou Code Chapter 10 (zoning) and for no other purpose. I have the following legal interest in the property:
. owner of record; contract purchaser; lessee; holder of elusive option to purchase;
duly author~to ,a~t for tJJ.e owner, who ;s knowledgeable of ~iy~C~i~ ... (' 0I'7f ~
Signature/Address -.*\'v.1a./l,dl tJ. t-f UUA ~VO ,,:::;-y.lt c-\ (zi~)" rv-" /
Telephone or Date
When permit is ready notify: /~/ Applicant /~/ Owner z=t Contractor
Owner
Contractor
'Contractor's OSR#
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H......".~.,.;, ,W>-" ... ... ... _~
(zip)
(zip)
Phone
Phone
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Plumbing by
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biscf.lllfloii;
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DO NOT WRITE BELOW THIS LINE
# of employees jWOt,nIiiltiN
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f$i!$Jh 0 Existing, BP #
/~/ Proposed, 51 #
t'u1fll
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If Conmercial: [jhlfitWtl'6i
Residential: ~lla1J=~1~1w
SI test holes ready
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Valuation
Fee
PERMIT PROCESSING
Parcel #
Parcel Size
~
$
$
$
$
each $
each $
$
$
$
$.
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~-/f"':@!l 7
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Recei~;d by (1M _
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Total Valuation: $
.lIiiJliItl!i:: :
Subtota 1
Water Supply
Proposed
Year Installed
Existing _
4~ State surcharge
Plans check fee
Change of Occupancy
TOTAL
=
Zone .~A-Part. #
It, front 1.. side
Conments. d /.h<~ # -.? () ( .,~
To be tyP::-J';:": t-
into
rear
Minimum setbacks:
Fire Zone
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BY(~~
Use Classification
CP&I
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To be typed on permit ~ /~//.J ~
A7//.//'::;;~J;~~n~. #Y~/?4P!:.IZ'/~/~
, / / G, . #
By X-:L-./Ir"':'h~. Date /-?'K-[5t)
ctor) _ /1 }'ho')Y t" '
~a.4-?r-:./ J... .I:I#~..R/' ,=-!'/~y::7~y-
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set(s) Date Hold Slip
set(s) Required to pee
Type ,W
Group
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For plans information c 1 (are i
%,o;t);/A',/ y~ ,.
~-/ SIF Plans to: ep&1
- WPC
,- P&I
C/ WPC
C/ Planning
C/ Pub 1 ic Works
/~/ Elevation C/ n/a
C/ Address
C/ Fac il ity Permit
~I Environmental Health
Date
Completed
Da te to
pce
C74-171
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1. Site Inspection
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2. Foundation Inspection
3, Framing Inspection
4. Lath or Sheetrock Inspection
5: 'Final Inspection
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6. Slab Floor, Plumbing Groundwork
7. Gas Piping Groundwork
8. Rough Plumbing
9. Rough Gas Piping
10. Final Plumbing
11. Final Gas Pi pi ng
Remarks:
12, Ce~tificate of Occupancy: '
ready to issue;
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INSPECTION RECORD
Approved. ,Disapproved
not ready;
date;
Date
. .
Inspector
,
inspector.
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