HomeMy WebLinkAboutPermit Building 1984-8-27
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,aJrL ?47~ ~~ 1 71-rE/671
I E FULLY EXAHIN~ THE COMPLETED APPLICATI FOR PERM an do hereby certlfy t~11 i~ormation hereon is true and correct, and that I
have the follow1.ng legal 1nterest 10 the property: Downer of record; 0 contract purchaser; uthorized agent Wl th evidence of authorlty attached.
I f~rther certify that any and all work performed shall be done in accordance Wlth the Ordl nc 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 Oivision. 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 cOIlIpliance with ORS 701.055 will be used on this project. I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY.
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~IOSo {2JPGl~
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for:.
FOR OFFICE USE ONLY
Applica tio.o/-t A.-c::. <:::> l .
Perm.l.t i~....J-()4
DTwO Copies of Plans 1-
c=JThree Copies of Plot Plans
L-]Mech/Plumbing Checklist
DLegal Interest Document
D Plan Check Info Sheet
row:.>SHIP
18
. ~CITY
, -
ZIP
PROpOSED USE OF PROPERTY
o Reside_ntial D Industrial
D Commercial D Public,
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"Lb/ll .p".rr~c ~ I'?
~ NAME (please print)
f1(])~
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~ SIGNATURE
DATE
READ THIS SECTION CAREFULLY
ORIZATION HAS BEEN BASED ON THE FOLLOWING
o PLANNING/ZONING: -mln,e'l, :~Y~II#"" L\ t!-'
Minim~acks: C~_ ~ . ~~u T'\::") interior
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B. P - *..2QZcl---?, L
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Installation Gallon Lineal Feet
Specifications: Tank of Drainfield
COMMENTS, 6:p "'''} r.--'.t/:.;"",/ lOft- ;(w1>V dt I~ f _/L'.LL;:J"'~~---
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gPLANS EXAMINATION, _ Type V{J Group ~
COMMENTS, ~ ;t:r5! -=- ~-? -~JP~IIA. ;kAlh-fLJ'JU R/fJ. i!t ~
Date,_%/~7~
/ tLC7L]'
Parcel #
CONDITION~~ ~
Parcel SiZ~ X. ~
rear~~ll'" _
~ANITATION ,
./
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~
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S. 1. #
Installation
Reco~d Issu'1ld? 0 Yes 0 No
Maximum Depth
of Trenches
~
Use
o
TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
--
Fixed Feel Floodplain Fee $
~i:8f~1pn Sq. Ft. Unit Cost Subsurface Fees $
Building J;ee $
~ }1~ch/Plmbg Fee $
1A II/') ;y. ,&I Plans Check Pee $
V State Surcharg~ $
,-
DEQ Surcharge $
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PERMIT A;;;U~EDIB; ~~~~G~NG OFFICIAL/DESIGNEE
TOTAL FEE $$
(per ORS~~' 1;{r.t~
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
C 14-25
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SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSE-RVED. 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 informa tion ready: - .'permi t '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 erecte..d and when all
materials tor the foundation are delivered on the job. Where concrete from a central mixing \
plant (col!lffionly termed "transit mixedll) is to be used, materials need not be on the job.
. ,
2. Concrete Slab or Under-Floor Inspection: To be made after all in-slab 0; under-floor building
serv~ce equipment, condu~t, p~plng accessories, and ot~eF ~ncillary equipme~t items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framinq & Insulation Inspections: To be made-a~ter the roof, all framing, fire. blockiDg, and
braCing are in place and all p~pes, fireplaces, chimneys, and vents are complete and a~l rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
--- -"-. -" --_.-... - .-------
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4. Lath and/or Gy~sum Board Inspection: To be made after all lathing and gypsum board, ~nterior
_ ilnd .e)CterIOr, ~s ~n pla!;:e. but b~tQr~ any plaste;.ring_is ...appl!~d .and before gyp~um board j9ints
and fasteners are taped and finished.
5. Final Inspection: To be mad~ !a~ter 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
I"ii5'f)ect~on is required for each bond beam pour. There wi'll 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 approv~Q, nationally recognized testing
agency and the manufacturer's installation instructions.
c. 'Mobile Home: An inspection is requireil after the mobile home--iS" connected to an approved
sewer or septic system for setback requirements, blocking, footing connection, tiedowns,
skirting, ana plumbing connections. . -
1. Footings and piers to-comply-w~th-State foundation requirements_for mobile homes or as
recommended by the manufacturer.
2. Mobile home minimum finish ffoar elevation shall be certified when required by a flood-
plain manag~ment lette~.
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. Swimmins 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 EOR.MORR THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION,
I. ANYONE PROCEEDING_PAST !HE POINT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNA~IVE SEwAGE DISPOSAL SYSTEMS:
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2.
Permits, shall be effectiv~ for one year from ~he date of.~ssuance. .
. . . , , ' '. , ,\." . '. . \ ..' "
Upon complet1ng the construct~on for wh1ch a,perm1t has been ~ss~ed, the perm~t 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 certifica te of sa tisfactory completion to the permitI' holder.
If the construction does not comply with such rules" .the Department shall notify the permi t
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
Drainfield
From: Interior property lines
Edge of road right-of-way
Building foundation
Wells, other water sources
10 I
10 '.
5 '
- 50 I
10'
10 '
10'
100'
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RSUM REAL' PROp~ACCOUNT SUMMARY
ACCT: 565091 1984 ASSESSMENT YEAR
INDEX: F MAP EQ 180~061407700 ACCT X
ACCT STt,T: iiD(~T, VI...CHG, ,OOPF(, S,'iD,.1
PROP DESCR: 18 02 06 14-07700,
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LAND
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1~: 1 STilT C1.JISS
",CF,ES CYCLE
TRUE Ct~SH
11,820
~36} 430
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48,250
B3T10 047446
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7/17/84
COUNTY: L.ANE:
YF~(:':1 LE: D4
NMIE ADNi:
L.p,ST ACT I V I TY
140
4 ZONE
tlSSESSED
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:l4,970
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46 I ~;?O'
MCBRIDE BRAY & G
%I...E:BKOWSKY ROBERT
4011 J"SpU, I'm
Spl,INGFIEL.D OF,
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10-1S-83 CONTROL GROUP
LEVY CODE 19-01 'TAX
T(.,X CEF,TIFIED:
(.}!) Vi'lLOREM Ti\X:
SPECI!\L. ASSMTS,
1 '184 YEAI', TAX:
TAX DUE 1984 YEAR:
TAX DUE PRIOR YEARS:
INTEREST AS OF 07-17-84
TOTAL BAL.ANCE DUE:
OLDEST DEL.INQUENt YE:AR
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. RSUM HEAL. PHOP ACCOUNT SUMMARY
,. ~CCT: 565091 1984 ASSESSMENT YEAR
INDEX: F MAP EQ 1802061407700 ACCT X
.. ACCT STAT: MDAT, VLCHG, OOF'R, SADJ
'PROP DESCR: 18 02 06 14-0T100
LEGAL:
7/17184
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COUNTY: LANE
YF,A LE 84
NAME ADDR:
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PROP
MCBRIDE BRAY & G
ZLEBKOWSKY ROBERT
40,11 JASPER FW
SPRINGFIELD OFi
EF,LAEN
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974'7'7
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YRLA .84 LAST ACTIVITY 10-18-83 CONTROL GROUP 57
121 STAT CLASS 140 LEVY CODE 19-01 TAX RATE
ACFiES CYCLE 4 ZONE TAX CEfiTIFIED: .
TRUE CASH ASSESSED AD VALOREM TAX:
LAND 11,820 11,350 SPECIAL ASSMTS: 000
. IMPS 36,430 34,970 1984 YEAR TAX: .
..:. _ --1' I MBEE.... _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ ~.AX_DUE'~ _1.2...8..i. J:..EAR-'.- _ _ _ _ _ _ _ _ __
TAX DUE PRIOR YEARS:
INTEREST AS OF 07-17-84
TOTAL BALANCE DUE:
O~DEST bELINQUENT YEAR
ADDR:
78
CLASS
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1901
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. GROSS:
EXMPTS:
o e n NET:
. L RTSSHE000 ~
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48,250
46,320
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48,250
833,70 047446
46,320
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. I~SUM HEAL PROF' ACCOUNT SUMMARY
.. ~CCT: 565091 1984 ASSESSMENT YEAR COUNTY: LANE
INDEX: F MAP E(~ 1 8020tii 40"1'100 AeeT X : YF~A LE, 84
. ACCT STAT: MDAT, VLCHG. OOPR. SAD,J
PROP DESCR: 18 02 06 14-07700
LEGAL:
7/17/84
NAME ADDR:
MCBRIDE BRAY & G
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4011 JASPER RD
SPRINGFIELD OR
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& KAFWN
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YRLA. 84 LAST ACTIVITY 10"-18-83 CONTROL GROUP 57 .) 19'
121 STAT CLASS 140 LEVY CODE 19-01 TAX R~TE
ACRES . CYCLE, 4 ZONE TAX CERTIFIED:
TRUE CASH ASSESSED AD,VALOREM TAX:
tAND 11.820 11.350 SPECIAL ASSMTS:
. IMPS 36.430 34,970 1984 YEAR TAX'
, TIMBER TAX DUE 1984 YEAR:
-----------~----------TAXDUE~m~~~mr----------
. . GROSS: 48,250 46, 320 INTEr~EST AS OF 07--17..-04 .
EXMPTS:TOTAL BALANCE DUE:
~ti u NET: 48,250 46,320 OLDEST DELINQUENT YEAR
.L RTSSHE000 ~ 83370 047446
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PROP
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ACTIVITY INFORMATION SHEET
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COMPLETE THIS SECTI~ON' INCOM~LETE FORMS WILL BE REJECTED! .
~oYL. e.l-~ ~. " )/1/1 R J ILl .1_ .h '
/ ~iddi. ~~<C/ T, Jr I f'Y7-z4 - V ' e-1}ff".....aJ>>J/C-<J
PERSON M KING REQUEST ,;' PROPERTY OWNER' r-
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,=17S5 YnClt:U ":f> \.J ..L/ oil VMpev ~
MAILING ADDRESS MAIL1NG ADDRESS
SPt""'{de,/ 12uaM./ 971./7 F Sj;f-/~lie.ite bfe,/>-1- 171'7f
,~7iTy , SyUE ZIP CODE I Cyv ~ATE ZIP CODE
2hg-7~ t/ 7~/-/J71 7t.t/ ~e3
BDsiNESS"r11ElfHOmr-ff HOME TELEPHONE # BUSINESS TELEPHONE # HOME TELEPHONE #
, 2. PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER
(REQUIRED INFORr1ATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
" -1 F/J2 (J~ - / ,,/ '77tPO
TOWNSHIP' RANGE SECTION ~(S) OR PARCEL #
/(e.~ .
ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOr(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~ ~ ~~~
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'6 DIRECTIONS TO SITE:
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DATE -f
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** FOR STAFF USE ONLY **
ZONE/LAND USE:
BY: DATE:
TIME IN:
OUT:
,0
LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 ? 687-4061