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HomeMy WebLinkAboutPermit Building 1976-3-12 y.,"'-'" ::~l ,;'::"":" .. .;:r' .<M~.:~,,,:~"~~~'~5- :" LANE COUNTYPERM.IT FOR:' PERM 11:, NO,' 374-76; j' , " ':;."f "'~ :;, ,~,' -: " CONST-R,UCTION' [XJ MOBILE HOME [ J PLAN REV'IEW [ J , , " , CHANGE OF OCCUPANCY [ J P OvVn~rt " n Dhnno:~ - ''NAME;;' ~!:: MN/lmnn't ADD R ESS S,nd nnf'ii& 1 rI t:'Jrf.'lnnn CITY' ZIP CODE 7Jl.7_())'A1 1 PHONE ADD,RESS C.ITY ZIP CODE PHONE [!, O.S. Reg. # Si'lmp ".,. " ' ,Twp, 1~ Range n:i~ Section 3rd AdditeDn Filbert 'Grove Subdivision "Lot O?..:r...3j ax Lot 3. tY(j:'O Codp Census Tract .7 ' Block 5 Acreage Width ~: ; Access to Property (Road Name): " 1I".",m^i"l1lo Depth Existing StructiJreson Property: ,Doubl e Ga raae Oirections to Property, Address: , ( :,' .65 Kremont, SDri nafi el d' 0retJon, STRUCTURE (# BEDROOM~} P~nniT ofnr 'YCll1";lm~ <:ht)r1, fW>>Wfc:') SQ, FT. 90 ra 2,HO VALUATION 'l:?I:i? nn .. -. -~.~ .,-'-:.' SEwAGE D:ISPOSAL: PUBLIC [ ] ; SEPTIC TANK [ , BLJI LD ING 5.00' ,PLUMBING 3%SURCHARGE .15 . MOBILE HOME WA'ST,E DISPOSAL PLAN REVIEW, OTHER [ r r:v';",,<l- ,PLUMBING INSTALLED BY: OWNER [] OTHER [,] NAMF WATER SUPPLY: PROPOSED [ ] EXISTING [J [,] PUBLIC '[ ] COMMUNITY" NAME: [ ] PRIVATE VyELL' ['] OTH ER,' SPEci FY: ,TOTAL '5.15 CONSTRUCTION PERMITS 8i JNSPECTIONS AND WATER POLLl!TIONCONl:ROL SPECIFICATIONS MIN,SEPTIC TANK CAPACITY: GALS MIN,DRAINFIELD L1N, FT, Do Not elate storaae shed over ',drainl:fn19s .. MAX. TR ENcH 'O'EPTH , INCHES .:'TYPE OF CONSTRUCTioN~~>5N GROUP,,'.]' 'y , FIRE'ZONF STAY 10'0' FROM ALL WELLS "USE.,CLASSI F, , :SETBACKS- FT. FROM CTR. OF. ~!W: ',fRONT ~t:1Il SIDE EXT, , FT, FROM PROP~,L1NE:, ,,', ' SIDE INT. C' 'REAR ., ~, '" ZONFRA: r~H' .,'" . , ;. ,AUTHORIZED SIGNATURES: /~/J. ' f.. Boss ,by Harll.>,~g€Jh,;, " Petrasek' ' ,ISSUANCE D,ATE: 3/12/76" ' , ,.' dlm ..',r).:.....;....:.'...): . BLDG, PERMIT - WHITE OFFICE COPY- WHITE COUNTY TAX:"'" PINK pLUMBING - CANARY' :BUILDING - GREEN ' 'SAN!T A TION -GOLDENROD IMPORTANT: Call 687-4065 to schedule all required construction inspections, Call 687'4061 to 'schedule all required septic system inspections, AlI'construction shall comply with the State Buidling Code, D,E,Q,standards for subsurface sewage disposal and i.he State Plumbing Code, All buildings requ'lre a certificate of _ occupancy before being occupied,' " , (See Detai'ls on Reverse Side) : .~... (POST THJS PERMIT ON ,MAiN BLDG. AT SI,TE) C5S;13 'LANEiCQlINTY:DEPT, OF ENViRONMENTAL MANAGEMENT <:;bQR~H}j\J,S_E.ANNEX,135 EA~T'6th, EUGENE, OREGON (mar . ...;;.... ',..., . '. '. -....J .'.: .,-t ':;' -; _ , . ", ~'. '. ~ · "",{~~: ,~ ',. ",~':';i~:::~~':~};~~:/~~~~~(,:" ":~~tJ ILiil~ S I.TE-":EVAIL.'UATJ:O:~f'" ..' .' . . .. ~. 6' ..', 1.!: '. t. 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':,;' -~"., ou[7Bu!.ldlng..ISlte',I,nspectlon:,.i",' .;...,:,' . ,;:,:,."~':",,,/,.., ,...,,; : ,'.' . :.: ,,: ;";: ' . ~:Ca'n 'be' a'pp tOlitil~':;~',', ~ '0.::::: >;",:-.''' ~ ,: ;t,.:' :' '..., '/~;:" '~, ::':,\{:: ' " '. , ~,,'" " , ',':: ':," ,',,~.<',C:\A~n,~~': ~~":'a:~'p;r'p'y~:~:~,,a,~"H~.h(S t~.~~',~~>i:n~~ic~t~d~,~~'J~~~:.~~Q'~'.~<, ,:,:<~"'" a~()ve. '.( '.. " . \K;t-. ::0" ~'>, Ql!.es Q'2ns ~a':ld"'furtlier;,: ,hnformat I:Oq~,?1J .. rt~ms.' 1.,.tn,~qlJg~ ,6, ',cont~c,t t,he. LANE~ ;,;'<.. ~ ,Q'?~' . >aD ",,: " ',COUNTV.~ PLANN I NG 'D,lV 1,5 I ON e ~ue~~ i ,?n,s a~d "further' J nfor.mat i~ori'}?n '" i ~~ms 7<",," ,"~ .. ',.'~:;?, ".':''- '~~,....:':t,hro~gh,'12, c:.dt;l.t~<pth,e, LANE.COUNTY"B.UILOING AND, SAN,ITATI'ON: DIVISION:; .. ..,,-',..' '..,.:~ ,.' ,',: ,.: :f')', ~i 1'1 ;;,~~. M~~ 1 d, tn','~Hts '-off ie~ ',uiit i 1 ''y,?,u.,p3n .r.es'o,1.ve'~the, p'rob 1 ~m.s,: i,ncFcat~,d:.:,; :.' , .,:':.,'\f. )t:f{'be'i:r{g;';'ret'~'rI'lJ~9~~'/'?::': '~. ;,.>'?~~~":: ,;':' ""~;:~l/": : ',,', ~,,'" '.',: ,.'... : "," ,"':' ',', ',': j, f:,:o~'i.(;,',l'Y()u,r: dju{J'd'i:n~i; pert.l)t~,,'ap.'pl i cat.i on:l{~.gS~Jls:betn~':ret'8rnecJ~~seD~ar~te, c'Q.,Ver." , ".\OEiPARTMENT.',Of' 'ENVI RONMENTAL ,MANAGE.MENT' ":, '..' ,', ,: '<',' l'3Si:s:fxth Avenue East' _",Eugci:{ne _' 'Oiegob, '97491', . ,', '" " ., j 'PHO'NE-,;":::6'87-406S' ". ':' ..', ':',,~ :,,: T, ':, ' ", , ;; ,.. . _ ',~ . ~ "....... . . 3 " _." l,;A~E;':CO!JNrV,PLANN I ~G,onlJ5 ION. 'P;HQNE:' :68} -4186 ". ,- ,,' ,., '. .'. .' ~ ;...,:: "' . .~'.~. - ' . . ',~ . .. '.~:~~~;~~"F_~-':~":'.':... .~; , '.. _,J. .,_, ~ _' -~ ~ . .C5S~ ?~,., ,":",.., " ' .,..,', ~;. ../ \y~-J , \'\ l)- ". ' \ ,,\]a .;I,' :~frr~ J LANE COUNTY PERMIT FOR: PERMIT NO, J'b~",,1iJ '. CONSTRUCTION [X] MOBILE HOME [- ,] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] I, DOwner n If:tlftrl@t;. NAME "~ 6~~ ICml"Aiiut ADDRESS $ilrina::ftlld U'f~i<Hn CITY - ZIP CO'bE 141...9m'~ PHONE ~O Contractor Sa. NAME ADDRESS CITY ZIP CODE PHONE ~ O.S. Reg. # ':l n )" ,;Twp'~ Range ( .J .Dlrt~ iftt~d~t.fk\n f:llb~rt Subdivision Section arow~ Lot 02 Tax Lot .~': Codp Census Tract '1 k: Block ., Acreagp Width ..... - Access to Property (Road Name): ~~t. Depth Existing S!ructures on Property: Vouble t.lira~~ 05 l(~nt s'l-lringn.ld t)re;n~m \ Directions to Property - Address: STRUCTURE (# BEDROOMS) ;)etmit for StaN. Shed n~~rtIsJ SQ, FT. il'~ n <'i ~f'. l"~'{;;;} IV' .~ to: t1W VALUATION 14m2..30 SEWAGE DISPOSAL: PUBLIC [] SEPTIC TANK [ OTHER [ ] F,:il'i s t. PLUMBING INSTALLED BY: OWNER [] OTHER [] NAMF WATER SUPPLY: PROPOSED [ ] EXISTING [] [ ] PUBLIC [ ] COMMUNITY - NAME: [ ] PRIVATE WELL [ ] OTHER - SPECIFY: BUILDING PLUMBING 3% SURCHARGF MOBILE HOMF WASTE DISPOSAl PLAN REVIEW 5.00 ..I~ TOTAL ~J..15 CONSTRUCTION PERMITS & INSPECTIONS AND WATER 'POLLUTION CONTROL SPECIFICATIONS MI N, SEPTIC TANK CAPACITY: GALS, ' - MIN.DRAINFIELD L1N, F.T, MAX, TRENCH DEPTH INCHES ,;0 !'li"", fHace lr.or~O{t 5t'~i:\i OVt.~!f' iJfl1rH 1ntlS \ ' , TYPE OF CONSTRUCTION .I (t~ 'GROUP ~J , ' " \ \ w.. , \.)\ ~ \ '- \' 'J FIRE ZONE , , ~, '-' :'\;" -\rt \STAY 100' FROM ALL WELLS- ", USE CLASSIF. \', SETBACKS, FT. FROM CTR, OF r/W: "'t t FRONT U;,t SIDE EXT, FT. FROM PROP, LINE: SIDE INT, :S: REAR f" zOi\lF' RA }'l,;;, AQTH0RIZEDSIGNATURES: t t. ~ r~ ~ !:iPSI !/'J l1iU"f~I:J Is/ ~ '~1r~ f-atnliel: 'l/l~'ll" r ~t,j ISSUANCEOATE: dim BLDG, PERMIT - WHITE OFFICE COpy -:- WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD , \., Call 687,4065 t~ sched';jl~ all r~qu!red cons)ruction inspections, Call 687-4061 to schedule all required IMPORTANT' septic system inspections, All construction shall comply with the State Buidling Code, D,E,Q, standards. \.:. . for sUbsu,rface sewag,e disposal and th, e State Plumbing Code, All buildings require a certificate of: '; ..;,' _': occu~ar;"cy before beipg occupied,\, ';"""", . ! I it'.) \,'" \" \ '~ "" ~(~ee,~~,taiis,~onfe.ve;se ~ide) : "i .: f , ' . f -<- ..... (POST THIS PERMIT ON MAIN BLDG. AT SITE) >i;Hi i.,,' C55-13 LANE COUNTY, DEPT OF ENVIRONMENTAL MANAGEMENT COUR:HQ'QSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 ',' , !..c.....!. ",p,.. '1 SITE .1 NSPECT I ON ApPROVED ,"/ 'j ,DISAPPROVED /, / DATE I NSPE0TO'R REMARKS 1 .." FOUNDATION INSPECTION ApPROVED / , , /, DISAPPROVED / / DATE INSPECTOR REMARKS FRAMING iNSPECTION 'ApPROVED I / DISAPPROVED / / DATE INSPECTOR " Ii. REMARKS .:l LATH ,OR SHEETROCK I NSPECTI ON ApPROVED / I DISAPPROVED I / DATE INSPECTOR j , REMARKS FINAL I'NSPECTION ,. :::::'::" It ~D'W~:~ / '1 ~ 'I"it? ... /1 1(1 " \/" I~ ' INSPECTOR , I CERJIFICATEOF OCCUPANCY READY TO ISSUE I / NOT READY TO I SSUE "I / DATE INSPECTOR REM:!ARKS /'/' /-:J //; A K,-,..I / ,--..,<_ / ,,,,,,//..,q,JY !3(tif:..'1 G~, t?6.!~ ;< 'r.. ~ .' .,~.. " ,,' ,'PERMIT ft,J 7V-/b" .AS BEEN: APPROVED" I ' , . NOT~: " J NO PERMIT WIL~ .JE '.'ISSUED UNTIL. THIS APPLICATIG ) . : i' ". , APPLICATION 'FOR:'; CONSTRUCTWN 'J\,', .,,?~I~~ HOME ~- , PLAN RmTI,E~I;.. I C~CE."F.O:CW'ANC~'I OWNER()~ J~' "~j- ~/~.dJ >//'74/7', - " "Name, " ' Address ," v Cid ",' ' ~/' Z~p , , , ' " 1/ , I 'CONTRACTOR" ,1,1 , " '~e, ' , Addtes~ , City , 'I.lQ , ZiP: ' , O. S, 'REG. II , ' ' i'/' , , ,~,', J r: Ra~ge , '(/:3 ~e~.tio~".' 'O.;L..;.. TaxLbt ' 'Code "1:1,(1 , Y~d~' j:"'/l>Be-i~r; h'~;DV-~Lot',7 BIOck'6:proJ!ty Acreage -, , '.,,', " , ,," ~ _.' _ '. '." v. ",. ..', .... ' ','f:~' , . ACCESS TO PR9PERTY'(Road Name)--1:<-.~',12. "'~:o t-r T' '5 L ,'; , '. .. ,if> Existing Structures on' prope'tty; ,'7).;; i., 'Ri... "{2 , lJ.'A A~& ,~' if' f-< R~' ~/~ifv r- '" .I" ,,;I ',: , 'I, i'/, I. ~p~1 I "7/t7,- 9Pf/ Phone '" . Phone Census Tract" Width 'Depth , , , "'/ L'-- " Property Locatio~ - A~dress/Direc~ion~:~ 7 ,', '1' P A ~~ ; tleL~OI(Q. , "r , fI' .. ,II Below 'fo r Off ice Us e OnlyXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX Iv /'. _II '-0 ~_' _ n'~ /1 Sq'J;Ftfif);>.r;o' IIBedrooms , Va~ation ' ~-" ~~fv ~ >Zo, , , ' ::r.& .;1, tJ ,,' " ,I?,' " If," "II fti_..t l Mobile Home , /t' ", ' Existing Sewage Disposal System I~ I f. ' , , Publi'c' ,I' 1 ' " /, '" . ',,,' , ,Community' \~\"Naine of C?mmunity or PubliC. System l', ' , ,. " 1: PLUMBING: . "[ "Installed by gWner If PLuMBING "FEES;~ {.J' ,j:' II' of Fixtures j;' 'l; , ',' it, ' , . PLANS FURNISHED ,FACILITY PERMIT 1& 'I:: C~H " tpUJI,. , ' '''/' ' .. ,.' f'>c;:-I, Vli'<;" ,I, I' 'NO,." ,'I" I YES I D<.INO "I "'k m- , ,I \W, ..".-t.CHECk ~':~ig~a~Ure'of AP~~!'~'a:n't4':e ~"d4 I~~ "\,'JF'::,, Fe~Received ByA~;'. " Date: '3 -y--?c;. , ,:, .r",."'" ,,'.7/,' : . \ '~/! . .' .~ ,~', Sep!f\ T~nk'c~pa~i~y~ L ,.'\L1'Dra~~ieldReqU!Je~'- Li~eal'Frt,i ' " " 0-h ~?-z,rl ,/~~~ ~L: ,~U-JI' h-N, - ',(/ .' I or New System Required l SEWAGE DISPOSAL: S~te Inspection 'II' 'WATER Sl,JPP.LY: Well Spring Other._ ' ~Af), ~~ 'FEES: Bldg.,' ' 0:,,0 2> ' 'I " Other Name ,.,I ,Plumbing ~ i<r" " ~,c . , ,;.., 3 %. Surcharge , .Sewag~. ,Connec tion , Water Connection W~ste Disp., . . ' , . ,Plan' Review' TOTAL -LY'L)' Min~ W' "~,a,xi,m,'um," D,ePth, ". A', \. ~-~ Type of 'Construction 5A/ Group ,~" ~ire Zoi1~< Us'e'Class ification f' + .. . Bldg Setbacks - from Center of,RoadRight ,ofW~y: Front '5'"'n' Side Int.: ~'side, Exterior ,. ., .... .~. . Rear ~, Zone If? -A,,- /W H . t " .. ' P~" ~ ,.' DATE:' ,,-~~g;~ 76 ',g"" SA~iT,Pi. 'T ' N, : ,. , . t .. . ~~i~ ~ ~ J )i~>,?,.qf~4[-5jiJ-1~ ENVIRONMENTAL'~G~:T ,/,' , C55' 12 LANE COUNTY ,DEPARTMENT OF