HomeMy WebLinkAboutPermit Building 1978-11-7
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POST THIS PERMIT ON MAIN BUILDING AT SITE
JOB ADQRESS CONSTRUCTION PERMIT # 3144-78
" .\ 557 Pheasant Blvd.
TRS, TLi7-03-22 n 1900 Subdlvlsion:Game Bird Village Lot 4, Block 1
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This permit for the referenced property is hereby approved. 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 I nfraction Ordinance, and/or other remedies allowed by law.
Applicant/ Address:
Owner/ Address:
Contractor/ Address:
Contractor's OS #
Jack & Neva Baird, 557 Pheasant Blvd. Eugene, Oregon
same
/
/ Total Construction Value: $17,417.00
Telephone: 747-6282
Telephone' /
Telephone: /
C,<;>nstruction approved by thiS permit:
, ~
Water Supply' PI1bJj ~
PLANNING DIVISION
WATER POLLUTION
CONTROL DIVISION
Setbacks,
Interior property lines
ge of road rlght.of.way
"_"lIlding foundation
Wells, other water sources
CONSTRUCTION
PERMITS/INSPECTION
DIVISION
~Dlrections to Site: na
Date Issued: /
11-07-78,
C55.13
Addition at 618 sq ft.; Lower at 100 sq ft.; upper at 518 sq ft;
Storage shed at 576 sq ft.
Structures now on propertl3~drg~mls~hed to b9P1~fn~~ hoJuse & m.l~I~fk
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Parcel Size' (OO~ '~\'~\20' '1...;0
, centerline of road,
Zonlng:AGT_RA s tba Partitioning # Parcel #
Minimum reqUlrefstrutMal setbacks, from. ~~nterline of road, front: 55~a
side exterior: ; interior property lines 5" ,rear property line 5'
Special InstrtMlons.
na
For Information call ~87-4394, 8....:..:.:.:.. Keller
For Information call between 8:00 - 9-00 a.m.,
u3;-~~Gl ureg uray, x.~.
Type of Construc~ond5tH ti GrouR li~tt1d onF~~v~~~~' aide of p.Yfmft!~sslflcation'
4nstructions:Requ re spec ons a e
Septic Tank
10'
10'
5'
50'
I
gal. min. septic tank capacity;
Drainfield
10'
10'
10'
100'
from
Site Inspection # . I nstallation specifications
lineal feet o~ralnfleld reqUired; max. depth of trenches' na
na SpeCial I nstructionst' na
uS tall an additional drain line to tbe existing
distribution box. Drainline is to be U sloped. Stay 10'
the existing drain1ines with additional line. All of the
new construction must be 10' from drainllnes.
/
Addition SFD
. 687-3754
For plans information call between 8.00 a.m. and 9:00 a.m., Roger MacGuckin
For inspections (see back of this permit) call 687-4065 between 8 00 a.m. and 5.00 p.m.
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE I PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
BY:Roger MacGuickin/ly
bne county
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BUILDING PERMH
557' PHEASAUT ~~VD. EOGENrr OREGON
address '-'" phone
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"OWNER JACK & NEVA SAIfW
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CONTRACTOR
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PROPERTY ADDRESS
(i3u'fYding Valuation)
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[]amt. due
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, TOTAL amt.pa1~
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;~; ~~:;:~~~~;r~. Signature of Applicant "1 t'fvtl "'_,~. ;/.111 ~ .yt//i Date 1/:".,_-
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G.Gfii\Yl"'9-79 ' "'. .; i
Fee Received By \ ';', " t \ Dkte ,I' t;:; ["]cash' []ch~ck
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL .MANAGEMENT
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FLOOD PLAIN' MANAGEMENT
Department of Public Works
125 East 8th Avenue
Eugenec,:%'@regon
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1+C~ .:. 687-4195
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TO:
v-- PERrUT PROCESSING
PER~~IT NUMBER
~144'l8
, PLAr~NING
PARTITION NUMBER
,;.t.'
PUBLIC WORKS
SUBDIVISION
...
OTHER
SITE ADDRESS
PERMIT VALUE IS A SUBSTANTIAL IMPROVEMENT.
YES
YES
NO ~
NO:.,
SITE IN FLOOD HAZARD AREA
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/' SITE LOCATION IS WITHIN A FLOOD HAZARD APPROXIMJ\'TE STUDY AREA, EXTRA
PRECAUTioNS MAY BE APPROPRIATE TO ASSURE THAT THE BUILDING SITE WILL
BE'REASONABLY SAFE FRDr1 FLOODING. ~10BILE HOME TIE DOWNS REQUIRED. '
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SITE LOCATION IS WITHIN A FLOOD HAZARD DETAIL STUDY AREA.
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1. MINIMUM FIRST FLOOR -ELEVATION OF (~1.S.L.) REQUIRED.'
2., MINIMUM FOUNDATION ELEVATION 'OF, (M.S.L.) REQUIRED.
3. MOBILE HOME TIE DOWNS REQUIRED IF GROUND ELEVATION THAT MOBILE HOME
WILL BE PLACED ON IS BELOW THE REQUIRED MINIMUM FIRST FLOOR ELEVATION.
4. SITE LOCATED WITHIN A DESIGNATED FLOODWAY CHANNEL, BUILDING PROHIBITED.
RECOMMENDATIONS:
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Application If "3/4-4 -7e,
for 5"'&/fVlE
WORK SHEET
Construction Permits & Inspection
~N Type of Construction
e.~ - M Group
~ Fire Zone
~ ..-7.~ Use Classification
..T..(L,BF 'T'Yl'ED ON PERMIT ~ /
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Date II A h~
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74-164
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Signature
Application
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for
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WORK SHEET
Water Pollution Control
SITE FEASIBILITY REPOJtT
Site L-J meets State standards; L-J does not meet State standards.
SDS INSTALLATION
Drainfield Required
Maximum Depth of Trenches
Minimum Septic Tank Capacity (Gallons)
7({-~ - d1!
Ac' II
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~ Equal! I Serial L-J Other Distribution System
Setback Requirements
From:
S~ptic Tank
Drainfield
Interior Property Lines
Centerline of Road (Front)
Centerline of Road (Side Exterior)
Building Foundation
Wells, other domestic water supplies
except public
Stream, lake, ponds
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Date
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M74-165
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APPLICATION
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m"TilACTO. PIIONl
t.D'IRf:SS CO~T.ACTO.'S OR! STAH llCDlsr
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Dl~CRIB[ STRUCTURES NOW ON 111 [ PRUPERTY NUn N.' HHlIrTt:Rr~ T~-f--:D=~~~~-{-~)n,ryj&1I sire{;
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LANE COUNTY OEPARTMENT OF ENVIRONMENTAL MANAGEMENT
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
LANE COUN- )EPARTMENT OF ENVIRONMENT/ lANAGEMENT
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
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Oc.fmpleted
FEE
PLANNING DIVISION
Partitioning
Parcel No.
Current Zonlng
Dpendlng
PartitioninQ Required
Other,
~,.. 'OLLOT'ON CONT'O:
New Site Inspection(s)
SDS Construction [] New
Number of Bedrooms,
COmmerci~Indq.strial -
Other W
(Q
$
$
. of Sites
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o Repair
$
$
. of Employees
$
~
CONSTRUCTION PERMITS AND INSPECTION
(See above for . of bedrooms/' of employees)
o :~obile Home
FEE
$
[]
q
;f,;::t3Z-~7
Permanent
Temporary
[] Renewa 1
Struc~~e Sq. Ft.
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5'l6'~~..; I ~
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Valuation
A./7/9
1 Ilk)
37iJ
31 h'?
$/7. LlI/}
$,A~' trO Ea~h
~ r:ach
$
$
$
$
$ 3']/; trO
$ --2L~
Total V!lU'lt1on
...3 Plwnb1ng flxtures at
Sewer/Water Conn. at
~
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4\ State Surcharge
Plans Check Fee
Change of Occupancy
$ _9~l (,4')
$ 3;72-
$ .:17, 'i tJ
$
TOTAL BUILDING PERMIT FEE
$/~Lj,?::L
Subtotal
Minimum structural setbacks:
From centerl1ne ot street: Front . ,.t)7~/
Exterior Si~~.~
From interior lot Ilnes. Slde~ Rear~/
[] Co~'l plans sheet to applicant [J Curb cut to
~UBLIC LANDS 0 Address ~ Mlnimum ElevatJon
c=J PUBLIC WORKS [] Facllity PerMlt
o ENVIRON'U:NTAL HEALTH
applicant
$
Cash
Chock ..;:l ~C; K" 0
Rec'd byJ../~/
TOTAr.
$/~ f/, 6::L
AFFIDAVIT: If this permit is for an agr1cultural bU1lding, I hereby declare that this building
will be used for agricultural purpose~ dS allowed by zon1ng and/or the State BU1lding Code, and
for no other purpose. I further cert1fy that the statements and other lnformat1on submitted on
this applicat10n are true and accurate, and that I have the following legal 1nterest in the
property: owner of record; contract purchaser; lessee; holder of an exclusive option
to purChase;- ___duly authorlzea-Eo act for a person w~has the 1OIlow1ng legal interest:
; or that the owner of record is knowledgeable of thiS
application, if I am not the owner I further agree to compl all a~, Pl. able codes relatln;
to this permit. ! ~ A
Date '1- :J.-C, -- 7 Applicant I s Slgnature )G / .I 'ftLJ, . _ W "
THIS IS YOUR RECEIPT, AND DOES NO~ ON'TO'1txL;. ~~
FOR INFORMATION ABOUT THE PROGRESS OF YOUR APPLICATIO~, CALL PERMIT CONTROL, 687-4357 (687-HELP)
C74-170
AVERAGE PROCESSING.
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LANE COUW OEPARTMENT OF ENVIRONMENT', ~ANAGEMENT
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125 tl-\::!T 8TH AVENUE, EUGENE, OREGON ~1401
c=J PLANNING DIVISION
Partitioning'
Parcel No.
Current Zoning /1A,:( J?ft.&~
[]pendlng []~:et~ . ,
reE
AveRAGE PROCESSING
TIME .
I:
PartltlonlnQ Required
Other I
$
~A'E' 'O'L07'OO COO"OL
New Site Inopection(e)
60S Construction [] New [J Repair
Number of Bedroomol
commerC~~Ind~trial - . of Employees
Other )
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~ CONSTRUCTION PERMITS AND INSPECTION
~ (See above for t of bedrooms/' of employees)
o :~ob11a HOIllQ $.
;&~32-b7
$
, of Sites
$
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o Temporary
o Renewal
Struc}'y~ Sq. Ft.
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fi:/f 1/1 ~4, -' J ~
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Total v!lu.ltion
Plumbing f1xtures at
Sewer/Water Conn. ~t
Valuation
/1r '7/ q
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37tJ
,51 h 8'
sf?~ L.//~
s;:?," t:1"O Ea~h
$ r.ach
$
S
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S
s 3''0 o-tJ
$J~d-O
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4\ State Surcharge
Plan II Check Fee
Change of Occupancy
S-2.3l (:4')
S .~2A-
$ ::27,9 tJ
$
TOTAL BUILDING PERMIT fEE
$/~U::L
/() -;Jo-/i'
o
"l
Subtotal
Hinimum structural setbacks:
FroIO centerl1ne of street: Front ,~5/
Exter10r Side~
FroIO interior lot lln~s: Slde,~~ Rear~/
[] Comro'l plans sheet to applicant [] Curb cut to
~UBLIC LANDS 0 Address ~ MInimum E:lev"tlon
r=J PUBLIC WORKS [] FaC1llty PerMlt
Cl ENVIRON'I1;NTAL HEALTH
Address
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applicant
l:ll
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/0-6--717 .-1..
Minimum Elevation I'
C"ah
Check O;:JcC:; 8'0
R<lc'd
bY~~./
$
TOTAl.
$ -L2-fI. 6.::L
AFFIDAVIT I If thio permit io (or an agricultural building, I hereby declare that this building
will be used for agricultural purposes dS allowed by zon1ng and/or the Stale Build1ng Code, and
for no other purpose. I further certify that the statements and other informatlon submitted on
this appllcatlon are true and accurate, and that I have the following legal lntereot in the
property: owner of record; contract purchaser; lessee; holder of an exclusive option
to purchase;- ___duly authorizea-to act for a person wh~has the IOIlow1ng legal int~restl
; or that the owner of record is knowledgeable of th18
:~p~~~:t~~~~1~: I am~ot the owner. I furthe~a~o CO~Pl all a~~abl~:;;9 relatin9
0... q-;;..(, - 70 Applim,'. Si,"^ ,,," ./ / ftLxI _ . ~) 11 -'~_
THIS IS YOUR RECEIPT, AND DOES ':lolttvWo I S ON' TO tslxL~. ~
FOR INFORMATION ABOUT THE PROGRES!j OF YOUR APPLICATIO'l, CALL PERMIT CONTROL, 687-4357 (6117-IIELP)
dne county
~
C74-170
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APPLICATION # ~1#"18
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. ''fi;::{,:.i.:.~j~::J~.' IA'L' ,?f:;(4t..) I
" " . 4 . Zl'p Code
The ~~o8Ie'.ap.Pljcation is bei ng~ by the Permit Processing Section for the foll owi ng
reasons: ' .' .
tl '"fli?VI~~,~". ,Ft.-o.iC.-'.L-.- .~t0 ~,d::XlqJIl._t', ~'t1..-'v.er~- \N'l-\-(C:,t..e...-
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'.,' rJ.CL'~~~f-y:w+1iq,1 T2D:::f'-I~..Ji1 <S (VI~',M 5~I~LL, l?~ U,":::'~-O 11\)'
. ',.. ~p:rZA::f.Jtt'~LL~.t,JZ-, . . , <"
"0 C~')t,I~..tr..I--kJ'Av'^~'l~iV\t' o. 4,t t~~.", ItVbl5r~t1Ji!!!:__ :srltL":(vytft,.
, . " )"." . I Di vi si on: . C, ~ 'f'" ~ 1\
.
Sign at u re : '""j:.I__ " P .t- &i.e.Ji-.i ~,
/ . I
, I ~
/d'~~_,._~ / /
<7--. /~ <
1 Division: '
Name
Address
(0
~;~~ -:.,
, ,
~'.' .
, .' '---"'--"-n~._
:. . I. I
Date I ~"I'1,)/~t~
I. I
Iq' " ....
,~4Iq~fr'
.:,~, .:
~.
Si gnature:
Date
Th.i s' app.Hc~tJ,Qn wi 11 be he,'d Llntil . \ 1- '3- 7 n . . . If the i nformati on
' , require9.abd,ve,}has'notbeenfuDicfshedby thatdat~,your' application wi 11 be cance'lJ.ed.
,Fees pclidfor.waste disposal systems (site tnspectionsand/or applications to install
the sep;ti ctank and drainfield) are nonrefundable., Some refund may be made on 'the
buildingandpl~mbing portion of your application if cancellation is necessary, ,
. .In tQ~ event a Planning or some other 'long-term problem exists over which you have'
. nocontro:r'we,wi,ll hold the permit until. the oroblem is resolved and we receive word
from you as to whether to proceed with PElrrnit issuance or process a cancellation.
P~RMIT PROCESS ING SECTION - 687..;4394
'..:'.-.
. .' 0- pi'
.':, ':le-
lane c~nty"
LI
APPLICATIm~ # ~l#"'18
.~
JAa-~ lJt;UA ~lW
t:?57 ~~~~.
~.( k:"ft::.J...J.t:::, ~l
. '. Zi P Code
Name
Address
The above application is being held by the Permit Processlng Sectlon for the followlng
reasons:
o ft2oV1D12- ~~ l'l"Ct0 cr ~')(l~p~ ~~~ W~~
~LtCV/~~().J O::/(~
D C(Ur"r-t ~~ ~kJ21 ~y~ $~LL aie- U$tW 10
${A~~ ~~\ "
o ~ ~ ~ 0.+\. ~-$ lp...) ";,~ ~
C" P. ~ 14
-P"L I ~ ~",. -- - ,- ,:-"
Slgnature: ~ Ltl.....~
Division:
Da.te~~
Di vis ion :
Si gnature:
Date
This application \'lill be held until '_ll-3-7P'l _' If the information
required above has not been furnished by that~e your application wlll be cancelled.
Fees- pard for waste disposal systems (slte inspections and/or appllcatlons to lnstall
the septic tank and drainfield) are nonrefundable. Some refund may be made on the
building and plumbing portion of your application if cancellation is necessary.
In the event a Planning or some other long-term problem exists over which you have
no control we will hold the permit until the oroblelll is resolved and we rcu:iV(! word
from you as to whether to proceed with permit issL1ance or process a cancellatlOn.
PERMIT PROCESSING SECTION - 687-4394
C74-139
, " , . . ,. ., ,::. { .~ '. _:./
,. .,......',..,' ,'TOTAL', . amt. pal-d-:",amtL":du~'~~
1>: SEf:e.~p'c;~#3r44"78~~":sign'atu;e'd~ :APPlican~,1)~V6t' O~~-,. :/Eei,~jllJ~1~"'l7 0
~~':,.", ~~~Rl~9T~~;:7;NS". Fe~'Rec'ejvedl3y!';i~~,;''\ l\'\), ;D'{~'\!:j2~":":I4>~'>';'['l~hick" .
,,', ~ ' .: LANE C.OUNTYDEPARTMENTOF, ENYIRONMENTAt:MANA~EME,NT,:::'~' . ,', \,'
, ' , . , '. .'~- ,,~ , ,
,..., '.'" ;.' \' ,..,',
~~~~~;t::i~;~~i~~f?~i~~~~i~~i;~L~~t~~5s.J6~ir"~i;it;:~:i~.~~'ii.~\i~i~~~;~~nt~~~t~!,;iiA:~'~;jlli:,~yi~~~~!~~iJf~~:~~4~~~i~i~,ri;f,'j!..%.1;i~~~.~,~~j~~~;i~~.cLAi,..,,~~i:.k~lk~~;A::,:~,:~t~f'c';~',"
~:J~';lg
_'i;~,,: ... ..c''?),'~''i7'~('{''J ;'"?'l'~''''!~);L'''~<
.8 ~ "
. SUPPLEMENT fNpgnn4-n~'
,t,. . JACK 6. NEVA BAt RD
OWNER '
. ..' ._, ,r l
. BUILDING P.ERMilT
. " '-. >:..
557 PHEASANT BLVD. : EUQHJE OREGON'
3144-78
.
. c,
\"
address
SAME
, ," phor:)e
. '.'..: " -....."l. . .
CONTRACTOR
address .
: 'phol1e'
'"
PROPERTY; ADDRESS
, SAME
,,~
t.
l: PriQr'( '.
'. Revised C
n adc:\ftio'n',
. . []correcfi on.
Bldg. ,
Was te,
P1I,Jmb ~
Pl an R.. .
. '3%sur. "
'_....~..i"":'r.--~' .
" "" (i3uildingVa,l~ation.)
. ) ,
, .
[]amt: due
"[I~efun'd' .
i""
r~~,t'~':'~';:;'iij:-,,\ '":
Yr,!" ~.
'. Jt
,"\\
;;::~1" .~\.supp. LE...~.1EN.! 1"0 UPDATE
~',~~""'" '. '.
/. ...... <<'EX}STD~I'NFI ElD .. . . .
~.: ,~. .
~'~.' .
" )~
I}
" .
,'.' ' p /:t
" ~ 1- -
., Rece1pt #
I
() DEPARH1ENT -OF ENVIRONr~ENTAL t1ANAGE1~t.NO
J PSB, 125 EAST 8TH AVENUE I,
~ EUGENE, OREGON 97401 -
~.~'''('~
~O~..
,_~pp 11 c.;'~,lOn Ii "
C C-. _ ~',J
AS~lgnea~N~~~erSV
'.
Job Address .e-=:k; 'I 10 h p Ct \." A Y\ + AL 1/ d C1 ty Sl J () ~. 'r\ ~
Townsh1 p, R':ge-, SectlOn! Tax Lot ,-,..., ~ .... ~'2 - I """ ~ - I q f1 ii \ -
Subd1v1s1on(i?(h"('\,?j,,;~,.l \/ f:} 1/1 ht;. Lot /1 Block
Appl1cat10n ;:~r- ~-~ r.+"C'~ ~Y\ A;".,JA/':" _.. '
Structures now on the-pr~~~rty J-l.-"'I1S~ -;-W "';l . s, h.a.4's:..1 -- f""'........'W.
._ 1- _
Proposed use of property bll Res1dent1al "LI Commerc1al LI Industnal
S CL i ~OI
(please pnnt)
If th1S appl1cat1on lS for an-agr1cultural bU1ld1ng 1t w111 be used for purposes allowed by the State BU11d1ng Code and
Lane County Code Chapter 10 (zon1ng) and for no other purpose. I have the follo~lng legal 1nterest 1n the property
\J owner of record, contract purchaser, lessee, holder of an exclus1ve opt1on to purchase,
., duly authonzed to act for the owner, who lS knowledgeable of th1S appl1cat1on. } d
Slgnature/Address V'l<iAN'J Q~.;ilI..IA_ /?- . ~-.() .?~ry d On ~ A-n+ 1St.:.,Jo, tnCl.E.nf~ (Zlp)Q 7~1J J
. I Y T~l~h~n~ fj LI~ ~~ ~r- , r .. -- - Dat~.oq;oa..r-/~ ~ "? '1
When perm1t lS ready not1fy: YJ'I Appllcant XII Owner ~I Contractor Qy I-I mall IN/I phone
Owner ':lAc.1t l.ll T'.rJ Nfl/fA &nl/l .R/.I /Jt"..d (Zlp) - Ph~-;;c I}tfr)...I....@~~
Contractor (ZlP) Phone
I
....LI Publ1C
Affldavlt'
d"
I, N~,vA. :SU1..Y\
, hereby cert1fy that thlS 1nformat10n lS true and accurate
Contractor's OSR#
Plumb1ng by
DO NOT WRITE BELOW THIS LINE
If Commerc1al # of stor1es
Res1dent1al' # of bedrooms !!l
SI test holes ready
# of employees
# of Unlts
SDS I~I EXlst1ng, BP #
I~I Proposed, SI #
Fee
Code
Descrl ptlOn
Sq Ft. or
# of Sltes
Unl t
Cost
ValuatlOn
Fee
each
$
_..-,4ft~#".,..~
-,-
$
$
$
$
$
$
$
$
$
~ ,. _ /l
( AHY/;? A S/J...J'l 'L
j/ - ..
_ (f
I /J~~~..IA.-/ J?/'"') l/.:?!: .(/'}~A./
l ----,.-/j -.....rAm'/'
tP#n' .f{f'/Li- ~\ \-\\-\.. ,,\p, t/
.. ---
,
~
'....,
I?!~~. ~~ ~
I I Check # '--.-)
~celVed by \ ~,,'\ "'
Total Valuat10n $
Pl umb1 ng f1 xtures at .$
Sewer/water conn. at: $
V ~"V. - "'..,/(
"
I.t.
,/
/ -
"
each
Subtotal
4% State surcharge
Plans check fee
Change of Occupancy
TOTAL
$.,:J~ h-;P"J
~ .."
PERMIT PROCESSING
Mln1mum setbacks
Zone /J/..4
CL, front ..,
Part. #
Parcel #
Parcel SlZe ~?J X / .::2 /
I - - ,
, CL,slde
, 1nt. , rear
Comments
To be typed on perm1t
By /[;, ./.~...-/
... - ..
Date /-R-7q'
/
WATER POLLUTION CONTROL
Installat10n spec1f1cat1ons
. To be typed on perm1t
gal. tank;
ft. of dra1nfleld, max. depth of trenches
Telephone
~€ ~{>~ 3/'14-) (!
By ~ C9-rCU.t if/fI1r' Date. / L C; /7 r;
~ ~.~.
I ,. G ,&.l<4
D1rectlons to Slle
CI SIFO
/-1 CP&I
C~
CI Plannlng
CI Publ1C Works
CI ElevatlOn CI n/a
CI Address
CI Faclllty Perm1t
/~I Env1ronmental Health
Plans to
CP&I
WPC
set( s)
set( s)
Date
Reqdl red
Y 7 (
I '-\
{
'-.
Hold Sllp
to PCC
Date
Completed
Da te to
PCC
,..
I
DEPARnlENT OF ENVIRONt1ENTAL t1ANAGEMENT
PSB, 125 EAST 8TH AVENUE
EUGENE, OREGON 97401
~~
~Oq .
~
-,. ~
A
Receipt '8
Job Address ~~5 '7 f h e- C\--~ A Y\ + .(3L V d . Ci ty ~ €, '() L
TQWfiShip, Range, Section. Tax. lot I'{ -- 3 - .{ -:2.. - I - 3 - 11 () 0
Subdivision G3'-@/x,\\"e,.ib i 'Rr\. . V,' ~ I O,J.q 7' t lot LJ. ,Block I
AppllcatlOn for .3 ~p-r Ie.; .-. '3'~J =- i3.. ~Y\ ~-<U,."'U
Structures now on the property t+O u.S '1. .L' ~ $ h ed -So I
tf~~5ec1 use of property: 111 Residential LI COll1Ilerefal {} 'Industriel CI PubHc
Affidavlt: I, W0vA- :re.o..JY\ S Ov I fCd , hereby certlfy that thlS informatlOn is true and accurate.
(please print)
If thlS application lS for an agrlcultural buildlng it will be used for purposes allowed by the State BUllding Code and
Lane County Code Chapter 10 (zonlng) and for no other purpose. I have the following legal lnterest ln the property:
'I. owner of record, contract purchaser; lessee; holder of an excluslVe optlOn to purchase;
duly autho~d to act for the owner, who lS knowledgeable of thr application. ~{rJ [
Signature/Address -' J14/'t~...r;:)..~ /S;.L,I/'t--j) -6Q~-PLLSAn+ I.Jd~-!..-c~~(ZiQ)q7fal
Tele~?J 4'~ h .;L~ &.-. or Date '/ &g - -:; 1
When permit is ready notify: ~ Applicant ~ Owner I-I Contractor ~: ~I mall I~ phone
Owner SAe-R.. l{) It! fftVA '\rraV1 .f?aj~d (ZiD) Phone ?tfr;Jt:,at'J-:J-
Contractor (ZiD) Phone
Contractor's OSR# Plumbing by
If Commerclal: # of stories
Resldentlal: I of bedrooms ~:.-
SI test holes ready
DO NOT WRITE BELOW THIS LINE
# of employees , of units
50S: I~I Existlng, BP #
I~I Proposed, SI #
fe~
Codfl
Descriotion
Sq. Ft. or
, of Sites
Uni t ~
Cost
Valuation
Fee
~ (__/l_.r 'A<...I
~/L/01 AJ,u4 tZ-d~d4' ~rJ L/~ ;jf~/
~ . u - ~ /J ;I g .~ )
~ " ~r;H" ----::- ~ \. \-\ \-\ . '\~\ i/ './
~6~
I I Check ii _
~ceived bY' ~,"
':'.' {,~: c: R SUP PLY .
,
. .,. "~~c:rD EXISTING
.'.\0.J'JvC.
YEAR INSTALLED:
Total Valuatlon: $
Plumbing fixtures at $
Sewer/water conn. at $
Subtota 1
each
each
$
s&57~r?
~ . .
$
$
$
$
$
$
$
$
$
$d5/L?O
4% State surcharge
Plans check fee
Change of Occupancy
TOTAL
PERMIT PROCESSING
Mlnimum setbacks:
Zone /J/ ~
1., fron t
Part. #
; 1., side
Parcel #
Parcel SlZe-.hZJ )<./ ~I
lnt. ; rear
Comments
To be typed on permit
CP&I Type
To be typed on permlt
Group
Flre Zone
BY~~
Use Classiflcation
Date j-R-79
/
By
Date
Phone
For plans lnformatlon call (area lnspector)
Dlrectlons to slte
CI S I FO
/~I ~~
~
'-I Planmng
CI Pub llC Works
CI Elevatlon I~I n/a
CI Address
CI Faclllty Permlt
CI Envlronmental Health
Plans to.
CP&I
WPC
set(s)
set(s)
Re~
y"- :;ed(
/
~
Hold Sllp
to PCC
Date
Completed
Da te to
PCC
C74-171
SLAB FLOOR
PLUMBING GROUNDWORK
ApP'ROVED / V-/ DISAPPROVED / / DATE 1~t;-79 INSPECTOR
REMARKS ~ /-..:J-S- 77 tPA-
GAS PIPING GROUNDWORK
ApPROVED / / DISAPPROVED / I DATE INSPECTOR
REMARKS ~ .3 -/ f? ~ 71' ~p.
Rti-
/
/
ROUGH PLU'" I NG
APPROVE! / v7 DISAPPROVED / / DATE S-11-1? INSPECTOR d <:LIC
REMARKS I ~ r- ~ ~ sL/,L. '7' /P;t:/-
~r~ _ 4: /t!.. ? 9 /'~d
. -..
ROUGH GAS PIPING
ApPROVED / / 01 SAPPROVED.I I DATE
INSPECTOR
REMARKS
FINAL PLUMBING
ApPROVED /~ DISAPPROVED /
/ DATE 11~-~
INSPECTOR
REMARKS
FINAL GAS PIPING
/
I
ApPROVED / I DISAPPROVED I I DATE
INSPECTOR
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE / I NOT READY TO ISSUE / / DATE
~
\ ,
\
REMARKS
iPJV
INSPECTOR
-1
. .
.. ~T;:'.-o:
JOB AD;n,RESS:
POST THIS PERMIT: ON M;AIN BUILDING AT SITE
CONSTRUCTION PERMIT #
~.~t[~
531 r&C'.ncC'2~51\A2<<>
TRS, TL:111-:93-:J:3 [} ;s%.~
~~
. j.~)-
''l'~,'
.' .-
sJbdivision:t.. nr. . ') - !~\l.''\r-r "
,I ~.' ~ l.;)Gg~ l~_::) PL.::e t;J:o Dll~.cl 1 .
This permit for the referenced property is hereby W"'" 1~ t. Setbacks'a~dother cond~tions of approval must be strictly observed. :'\/iol.ation can
result in revocation of this permit, citation under pr6"\1isi~n's'-'6.vf Lane County's Infraction Ordinance, and/or other remedies allowed by law: .
.~.'
Telephone:
Telephone:
Telephone:
Applicant/ Address:
Owner/ Address:
Contractor! Address:
Contractor's OS #
3~g 8- .o~~D
(gf\c:t)
I
I
~P' !}\1r''-';''Y'~~ m>W~ 11'ZS)C~ Jlj;UG~
{J iJ ~'*-(}~JD2
! ",.
!
Total Construction Value:
$LiI ft)CjJJ.1 o~[tI
Construction approved by this permit:
Water Supply:
~~l7:'...'O_!\~
Ul-'''- ."".....-".~.~.
PLANNING DIVISION
WATER POLLUTION
CONTROL DIVISION
Setbacks
Interior property lines
Edge of road right-of-way
Building foundation
. Wells, other water sources
CONSTRUCTION
. PERMITS/INSPECTION.
DIVISION
Directions to Site:
~
Date Issued:
j1
211.4'?=P3
C55-13
. .
o
(*.2g~~ Q~ 6J1~ c~ 1?~~~' &:rcm:~,.i{d~~, qj. gg:c98 Gf..rJ'3~? of?; $:tl.G C!.:;l $l'.~
~.~ ';~ ..;"<..-../) ""'> rl<:;"lt! - . n('.J '
......~;.;.:u~ ~"". D"& ~i!v ~ "-"..s..,. .
-nl~~?,""''''' .,..... """":.0....,"..J.r""B"d ~A ~~" .,-"""" I'''~PI'I-~."a.::. ~C.,-~,r> " . n.. E'" I" "'
~~"''''"<J,ld...~ ~u '--"-:';~__~T"':>::"#.' e r00ms~~..:;:,Jl ~ 1.,:#' . l:Jm0Ing~r-;;I.><tur.es:~;.:<?-~'''''''} u r::#.:;mp o~ees_;
t2'J ~. ,~~ . .
'I .'-'- .
. Parcel Size: ~O"tl. \')~t~\;iO~ 'tt10Q
; centerline of road,
Zoning: .~ . Partitioning # Parcel #
MinimUlt{~~'u1red2Stffict't'frial setbacks, from: reenterline of road, front: ~
side exterior: ; interior property lines:. ;rear property line: 5>S-G
Special Instructions: S'" ,;}:ll'
~
If .
For information call 687-4394,'
~"N'7"~ tsa.:n. Jt~
gal. min. septic tank capacity;
Site Inspection # . I nstallatioh specifications:
lineal feet o"fEElrainfield' required; max. depth of trenches: ro
Sp~ciallristructions: . ~ ,
&'!D~ ffi a32S([;~::.:'l1\ ~;:t'C;[P;.~~ ~ ~b U'JdL-)~3q'
."(i,~~~2#;~~ ~.1l1 ~,5tq}b~1~~.~ ~ 1':>0 .~. o.I1ryt~Jill' .' t3Cctrf m'tt
. ~~o ~r~~ ~friDl~2D t-r1f;~ cem8{~~::,7h1l.~:h", t~'L't ell ~
iIC'c? @2C~~~~C':3 a~ t81l~~. grr:::;o &EG;.":"~lj!;':::3,"", .
I . . .
For information call
~~~
Type of Construction: . Group:. ~~ Fire Zone: ~ .~.
Ynstructions:r~~j~':@3li"J~"~~ ~ Jri!&'.ro-di .~ ~~ !JSi!(J)..l!!'Jfl
!;'.;Q,
:2U:l::)
Septic Tank
10'
10'
5'
50'
Drainfield
10'.
'10'
10'
100'
between 8:00 - 9:00 a.m.,
~ ~57~ ~g<l>
Use Classification:
'. .,.~,-,-")..('l'~'c,
,~l~
.&~~mEi1))
I
.'
For plans information call ~g~Jll~ .,.,-",:between 8:00 a.m. and 9:00 a,m.,
For inspections (see back of thispermit)cq:1I 687-4065 between 8:00 a.m. anrce5rE>0 hf7rl.~~\;tl,~
';,
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE I PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE; EUGENE, OREGON 97401
B y :t10~ 't;C~;i!1w::a&J!!;y
. '_.,,-;7"'-' ~... ..... -,~-~____,...~ .+">-....J.'."'.f"r-'"? -.-.:.-. _~"_.-.ojJ';-,..."",,", ~;..-_ ...:.-.......-".......~:i....,..~";.. ..
0'.'.:.'
. . .'
" ~. .
,~'. 't. ~:. .
bne county
Ja .<" '
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TRS, TI
)r-
1 ...., ,.. b ~ - ;t.?-. ~ IQo 0
Job Location (Street mile post)$$'1 P~-e'" ~An+-&,;d ~tNtl. ~~.
, \ J
Subd Ivi slon e-Q)(\(\ 'C.-b t' R. cL U " ) / ct.g ~ Lot
1- - Block I
Plat Plan
I, d 1t ~
:v
'f '
oil t/O r:J"~ ~
<:.)- \)l~ Q... "-
~~'f; V" ~ ~ ( ~I
.t~ ~#l ~ ~I
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,,- , ...Q ~ ~p. f.<:\,'S "tr\- & \. i -
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.~ US LD~
a.~ =It
a. ~'- . (", 0..
<X:~, \Jj co
c...>
~
..
~
FOR SANITARIAN'S USE ONLY. ~ System Approved 0 System Dlsappmved 0 Needs Correction
COMMENTS:
_.~,I~nature' ~ ~~~ d Date ;/;3b,
/ -
Filler Depth Below Tile
FOR INSTALLER'S U,S_E.\ Trench Depth
Tank Capacity ~o-o "'~ Manufacturer
Measured distance to well from tank
@
.~ .~
~ -
~~,.. ~
.btI
~
~~
, ~ ~
'\::) ~
l>:>
Scale:
~
"N'
from dralnfleld
~o
1
...
~ ! '~ fO~--"
ri ~"
'- !~
ro r:;-, t '
F-J "I Jl~
"'j ~~~
'~~'J' ~~
~ Of \~
~ ,',
""r"/ '" "'"' ~
\ti 10', .. ~
~.,'<<
_~ t~
t
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~
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~q" ~.
...
-
("?
~
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rfl'j . Y;J -' ,.'~
U. _ J '>-.' ,-' j.
VA!/. ~ .,.." ," ....\ __ \
_ IA/[/ "#,- "2
'//' ~ . i V
- C ~"'t9 -<;:> :i
6- 0');,"',0 /i. .
<~ 0 o~ _~__
/) ..-'~""'--(')
I ~ c .'" '0,> U' -'" .:;
o '0 -
R> ~')t.J- >') ~' '
IN~TALLATlON RECO~~'AND CERTIFICATE 0 SATISFACTORY ~~~:L:~ION'~
When signed by the County Sanltanan, this certificate is evidence as per ORS 454.665 of sat-
isfactory completion of a subsurface sewage disposal system at the above location.
'fJt.. is .f-!' n ~
..}Jous~
Return this form to
Permit Processing Section, Department of Environmental Management,
Public Service Building, 125 East 8th Avenue, Eugene 97401
C55-11