HomeMy WebLinkAboutPermit Building 1984-10-18
FOR OFFICE USE ONLY J
Application!.J or;(J / OU'
Perm~ t *----'4..11..D./) tl-/-
tJ J...I n ~ J" 75 OTwO Copies of Plans
1 '(1. rI'05.?r'rrrhl _1'1"J'n
( 1 J .,) OThree Copies of Plot Plans
roWNSHIP 1'-"" 1 RANGEQ3 I SE5iR~, 1.-"'7 J TAX, '1"0 pOUT OF OMech/Plumbing Checklist
{ 0u U ~ DLegal Interest Document
S"BDIf'~RTnN (ifJP~l~ I W(!})RCEL I ~K OPlan Check Info Sheet
LOCATION ADDRESS/l WRe E1; ~ ~-Ilt'YZIP PROPOSED USE OF PROPERTY
5qB ! hloYI!/) L) I.. . r lldl In"" L1Lld. ~eSide.ntial 0 Industrial
S~CTU~l:~~NTLY O~PERTY " - .. O' 0
( Xl 01J1f'! r:::J in I ) ~ comm:,rc1al Public.
{'O' (13iBn lo..LJ l j Jf .J
E PECIFIC B~ I DEClARED ~ VALUE
'Tf0R~Q, J ~ O~ I ~~~ VQx\~f"')~ Ptr'11Y\~0 ~~~~~~~~
D;'~~ I\ND ADDRESS........ .r;:,I,-../\ L (j - -"---- ~PHDNE~ER
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CONTRACroR'S~p)~ . LE ONE N1JM E -
PER>lIT ro B~ ro (NAM>; ~.!r ) Wd . ( 1 0 O)~ 77 I\..T L P 0 E I
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICAT T, and do ~erCb';-ccrtifY hat all informaJron her~n ~9 true and correct, and that I
have the fallowing legal interest in the property: owner of record; 0 contract purchaser; authori~ed 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 Lo!Iws of the Stato of Orogon
pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without the pemission of the Building Division. I fue-
ther certify that registration with the Builder's Board is in full force and effect as required by CRS 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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Lane
Couty Auth~r~~ation
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- SIGNATURE I
JR,.
K. WE.~~"-
NAME (please print)
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DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS:
'0 PLANNING/ZONING: zone~ Partition" Parcel It Parcel size~.2t:e
Minimum Setbacks: CL, front ~ CL, side ..interior F/ rear ~ I
C~"'IENTS,t$Ar:I'J(1.L ) ptlxmUOCN Q,Chf'1Y\ I ~ pn 1VU-~ \
uno, ~. II
11
~ f11t1j1)1"\) ~ \f1."
~ SANITATION:
Dat.: (~~
cihn\.....J
s. 1. * B. P. /I I ~':S -(P6 Installation Record Issued? 0 Yes D No
Installation Gallon Lineal Feet Maximum Depth
Specifications: Tank of Drainfield of Trenches
CDM>'ENTS:h ~.lf' J a.L/.d;;.....'./ In!/-- -;j:M../ a#, I~ 1/-.LJj1. _ P~~,/,., a..~
~~_"'_~-_'_'--<:/'~ c4AA..;L'qd.,t ~_ !)o ~ d:,,:..v ~ cl4l./d[1
\ ~~ Date, /0 -/7-?Y V_~
~ ~ EXAMINATION: Typ. I/-AI' Group I-t us...f:3AIlAG;:;:-
COMI>1ENTS:
Dat.: 10.-/';1- J? ~
~
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PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.805(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
TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY ~ PERMIT
~//A';7tion
&N..-ff~
c:/
dtl'Y 61) I
Fixed Feef
Unit Cost
g-.s-
rP--
Floodplain Fee
Subsurface Fees
Building Fee
f,1ach/p 1mbg Fee
P'ans Check Fee
State Surcharge
DEQ Surcharge
Sq. Ft.
/~t?O P
TOTAL FEE
$
$
$
$
$
$
$
$$/~r;..!:!-
10 - / z. e-If
C 14-25
\.
\
.
,
,
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.
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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 REQU~STS MUST BE GIVEN_ Have the following information ready:- permit number, job aadress, 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 lltransit mixedll) is to be used, materials need not be on the job.
2. Concrete Slab or Under-Floor In5~ect~on: To be made after all in-slab or under-floor building
serV1ce equIpment, c~nd~lt, plping accessories, and other ancillary equipment items are in
place~but before any concrete is poured or floor sheathing installed, including the subfloor.
~. Framin9 ~ Insulation Inspections: To be made after the roof, all framing, fire blocking, and
bracing are 1n place and all pipes, fireplaces, chimneys, and vents are complete and all rough
electr~cal and plumbing are approved. All wall insulation.an~ vapor barrier are in place.
4. Lath and/~ Gy~sum Board Inspection: To be made after all lathing and gypsum board, ';.nterior
ana-exter1or, 1S +n p1acft but before any plastering is applied and before gypsum board joints
and fasteners are taped and finished.
5. Final ~pection: 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 perm~ts 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
compl~ 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.
O. Swimminq 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 DUR~NG WORKING HOURS. THIS PERMIT WILL EXPIRE
IF ,WORK DOES -NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN.ISO 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
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 permit(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
Septic Tank
From: Interior property lines
Edge of road right-of-way
Building foundation
Wells, other water sources
10'
10'
5 '
50'
Drainfield
10 .
10'
10'
100'
"
"
.
ACTIVITY INFORMATION
.
SHEET
W1e courty .
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL UE HLJECTED!
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aTTO K. lJ.lG.t>U
PERSON MAKING REQUEST
5'1f: Cl:>LONIAe.. D~,
MAILING ADDRESS
S/~)AJt, "P,i.C.O () R-
CITY STATE
S l'9 ..... k...
PROPERTY OWNER
MAILING ADDRESS
97177
ZIP CODE
CITY STATE
ZI P CODE
1"7-0 I/S' 8'7e17 -5'u, '9/
BUSINES~ TELEPHONE # HOME TELEPHONE D BUSINESS TELEPHONE D HOME TELEPHONE #
2 PROPERTY ADDRESS' S 1'9--' dE. 4'" -rF'
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER
( REOU I RED I NFOR/oIA TI ON) .
(from tax maps in Department of Assessment and Taxation
or from tax statement)
r;e
it 03 '2. 7-,{, ''(, 0\ I.f OJ
TOWNSHIP RANGE SECTION T~T(SI OR PARCEL D
"
RA
ZONING
TOWNSif!p RANGE' SECTION
TAX~OTISI OR PARCEL U ZONING
TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
TAX LOTIS) OR PARCEL # ZONING
ACRES
4 SUBDIVISION (if applicable) LOT BLOCK
5 REQUEST (state exactly what you plan to do) B,v,e..d) A R6.SIl:>~".rrl"fl'-
lice ~SSCIZY' !5,j/(,.fJl-.>ti. - q~e<"-<;L-- -r~j.-/) - . )~c.....s <2.
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· D';ACTI"S;;)~-~i/~,~ cb----c.:t::! t21J
-"-;f, .' T '~~R -::::: USE ONLY _ _ _n_?f!~'" '-1'
ZONE/LAND USE: ~ 91/Lu..r.s;'Tl.,v( t..... "L<7 DATE
BY: DATE: TIME IN: OUT: ~ ~ p ~
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LAND MANAGEMENT DIVISION / 125 E. 8th AVE.. EUGENE-. OR 97401 , 687-4061