HomeMy WebLinkAboutPermit Building 1984-6-11
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(' ~#~ 'J S',?;Z) DTWO Copies of Plans
- DThree Copies of Plot Plans
I "'''''SHIP / Y" I RANGE /) /) I SEC~/ / //1 T^J'.>>T ~~ UMech/Plumbing Checklist
/0 /,,/ 0 V"tp,~ 7 /Vj (1('/b/ DLegal Interest Document
S"BDIVISION/PARTITION (if applicable I ./7 l LOT/PARCEIf r BLOCK 0 Plan Check Info 'Sheet
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PROpOSED USE OF PROPERTY
gReside_ntial D Industrial
D Commercial 0 Public.
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLIC~T N FOR PERMIT, and do hereby certify that all information hereon is true and correct, and that I
have the following legal interest in the property owner of record; Ocontract purchaser;Oauthorized agent with evidence of authority attached.
I f-..:.rther certify that any and all work performed aha 1 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 rogiatration 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
CH~.xD};.g;;;;oo~//s /.JJeded uI~ 6--1-tl
NAME (please print) /" / -. SIGNAJ'O.-JE, DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING
o PLANNING/ZONING: Zone QA. Partition II Parcel It
Minimum Setbacks: \. frontIMa.h., Y.::z. CL, s~de interior
COMMENTS, ~~:><ha..QQ. ),e, Lsr..o:J:i.~ ,JA,..}
--y}f\ ; a<'~' Jt..gA~ to .
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CONDITIONS: ~
Parcel Size I ~.~
rear f=) I
o FLOODPLAIN:
In flocd hazard area?~o 0 Yes. SEE
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Date:
ATTACHED SHEET.
Date :
~SANITATION: S. I. #
/\. Installation
Specifications:
COMHENTS,-t1/. p /
a.;-f",~! /
Gallon
Tank
Lineal Feet
of Drainfield
Installation Record Issued? DYes 0 No
Maximum Depth
of Trenches
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B. P. "
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t'PLANS EXAMINATION: Type !;- V. Group_Q-'2., ~--1:1Ir/ use..:i.f't\j-i3P.TJ4C f{- (.!...Af2..Ilr..-P
COM",ENTS, .<;, E F No TB <. () f..) 'PL IIIJ 5 4' 11 TTftC-H FO fJ P LI/ItJ ct-lF'c./L LI ~r--:: ,
WHF~I APPI Yflll(j- ~ol2. /-J. BUILD/ilia. PE/2.mlJ ."\r.J~MIT' 2 CJ.p
tl-lE A PP/2rlUED PLAtUS, {I.1ITH rZFrylllr2F^ AOOITI8'tr1AL. //IIPollmJ4.rloV,! ABr.s
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Date:
$ /.~ /?A/? {)O
TOTAL VALUATION U'7 &!.FLf/
~~riPtion ~2J?7'
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PERMIT APPROVED BY BUIL~~~ rICIAL ESIGNEE (per ORS 456.805 rl)} DATE I
LANE COUNTY DEPA~NT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061, C 14-25
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
DEQ Surcharge
~~~
$
$
$
$
$h~
$
$
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CONSTRUCTION AUTHORIZED BY THIS PERMIT
--
Fixed Fee/
unibc'S-,
I'f, -
Floodplain Fee
Subsurface Fees
~~~
Bui Id i ng fee
r-1~ch/P Imbg Fee
plans Check Fee
State Surcharg~
TOTAL FEE
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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 MrNIMUM 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 toundation are delivered on the job. Where concrete from a central mixing
plant (commonly termed "transit mixed") is to. ?e ,used, materials need not be on 't:he job.
2. Concre te Slab or ,Under-Floor Inspection: To be made after all in-slab or under':'f loor 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 Inspections: To be made after the roof, all framing, fire blocking, and
braCing are in place and all pipes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall insulation a~d vapor ba~rier ~re in pla~e.
4. Lath and/or Gy~sum Board Inspection: To be made after all lathing and gypsum board, interior
..ana--eX"'t'erIOr, ~s ~n place out betore any plastering is applied and before 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 ~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
rnspect~on 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 shal} 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
wnen poo~-rs-installed.
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APPROVED PLANS.~UST 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.'S,USPENOED OR ~f\BANDONED. FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY 9CCUR IF THIS PERMIT ~AS IS~UED ON THE BASI~.OF INCOMPLETE'OR.ERRONEOUS
INFORMATION. ....;.. I J"' \ ..1...
.ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE DrSPOSAL SYSTEMS:
l.
2..
Permits shall be effective for one year from the date of issuance.
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 constructi\on does comply with such
rules, the Department shall issue a certificate of satisfactory completion to the permitlholder.
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'
5 .
50'
Drainfield
101
10'
10'
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. APPLICANT WIRFS.
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LANE COUNTY DEPT ENY MGT RECEIPT 0 146684 DATE '0601U4
ADDF~ 3923 ..JASF'EF: F,!).. SPIUNCF:[I:~LD. OREGON
LOT E<L.I(.
OBLDGS 001 PHONE 746 6567
Ul
FEE DrY. L
UNITS 001 STORIES
A])DF~
SQ FT UNIT COST VALUATION
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, NO.
CDNNEcnms:
t1ECHAN I CAl.. FEE
STATE: SUFCH(.lRGE
Pl..,;N CHECI< FEE
13000
15.00 EACH ".
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64,03
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EST. COMPLETION DATE
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PERSON MAKING REQUEST
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MAILING 'ADDRESS ,;}
<n}~ _!/tf/7cf7o
~r~y -STATE ZIP CODE
2!4.=/tS/~7__ 1~-31dS-
Buif~ss TELEPHONE # HOME TELEPHONE #
2. PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
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.
~r. u-/-lve;ldJ Mis
PROPERTY OWNER
~/L(/
MAI LI NG ADDRESS
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C ITV ~
747-6'10(
BUSINESS TELEPHONE #
STATE
ZIP CODE
ACTIVITY INFORMATION SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
1
HOME TELEPHONE #
I~
'rOWNSH IP
(from tax maps in Department of Assessment and Taxation
or from tax statjment)
OJ- ,()~ 1/' /.f _ )/)800
RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
'rOWNSH I P RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
ACRES
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
BLOCK
- vtJe
5 REQUEST (state exactly. what you plan
datttdL.~ub}ly'
tLfrJ_~~mE
. 6 DIRECTIONS TO SITE:
** FOR STAFF USE ONLY **
NUMBER
DATE
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ZONEILAND USE:
BY: DATE:
TIME IN: OUT:
LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061
.
~r'1e county
-
~
CHECKLIST
PLUMBI NG / MECHAN ICAL
/
7/
Address /
DNoDSelf /
DYes Fi/
,Address
APPLICANT INFORMATION:
(Name or I'1nn-Please Pnnt)
(Ma1l1n
PLlJlIUlING CONfRAcrOR
Finn
~lEa[ANlCAL CONTRACTOR
o NoD Self
Type of Fixture
PLUlYIBING
NWllber of Each
Total
Sink
Lavatory (Wash Basin)
Tub (with or without shower)
Shower, separate
Wa ter Closet (toilet/urinal)
Dishwasher
Disposer (garbage gnnder)
Washing ~lachine
Water Heater
Floor Drain
Sewer--lst 100 ft.
each additional 100 ft.
Ivater Service--lst 100 ft.
each additional 200 ft.
Stonn and Rain Drain- -1st 100 ft.
each additional 200 ft.
Speci al Waste COImection
Se\\age and SWllP PumP (eiector)
~loh:ii e Home Sewer and \Vater
Other (specify)
SUB-TOnL (~lin:iJnWll $15.00)
~
1
,..:)..
I TOTAL FEE
T)l)e of Equipment
~IEG1AJ~ICAL
i\umber of Each
Total
olechanical Penni t Base Fee
Furnace UP to 100,000 BTU/H
Furnace Q\'er 100.000 BTU/H
Clothes Dryer Vent
Bathroom Ventilation Fan & Duct
Range Hood \,j th ~lechanical Exhaust
liood Stove (Wood StOVf' Vf>nt $~, 00)
Air Conditioner Onlv
Heat PunD
Floor Furnace
Gas Piping System 1 to 4 Outlets
Per Outlet Over 4
Other (specify)
SUB-TOTAL
I TOTAL FEE
C74-200
"",,.tt or Town)
OFFICIAL USE ONLY
Appli. /
Penni t #
Cont. OSR#
(Zip Code)
Cont. OSR#
Fee On Each
$ 7. SO
7. SO
7.50
7.50
/.5U
7.50
7.50
7.50
7.5U
7.50
30.00
15.00
20.00
15.00
30.00
u 15.00
7.50
7.50
15.00
Fee on Each
$ 6.00
7.50
3.00
3.UO
4.50
6.00
6.6b
b.UD
6.00
2.00
.50
S 10.00