HomeMy WebLinkAboutPermit Building 1984-4-23
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O~~ NAME
~~~ --t1i\ On.A 0 I\/\.
CONTR~CTOR ; S~AM~(j -
SET BAt~UIR~MENTS
Cl, FRONT Cl, SIDE INTERIOR
WORK AUTHORI ZED BY PERMIT I f
J /.J~"(,ALL SOW- WAn::1J.... H~T1J4 ::1-c'~7FM
D.r,g~CTtllONS TO SITE ~ ~~
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SITE ADDRESi
W50 Loi'-\.t:>N.D !::we. 5PeJ.~FiEJ-P
FOOTING / FOUNDATION 0 lMOBIlE HOME PLACEMENT 0 INSPECTION
Approved Date /Correction Date
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LMlE
COUNTY
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J~Fr.O~
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DATE ISSUED: l\ \;:j~\R~ PERMIT#~-f34
PHONE NUMBER
UR")-,')7rQ
PHoNE NUMBER
~iJ "l.' ~.Il\
# PlOMBING FIXTURES
REAR
~
,~ ("\.Jl C' rlQ ,,,a f' I
Inspector
PLUMBING GROUNDWORK INSPECTION /
Approved ./ Date~/correction , D~te
~""'.~ ,. -l!..f.l~ ... ",-,1. ~ ~
DERSlA PlB. 0 /UNDERFlR ~ INSPECTION
Approved Date /Correction Date
SLAB INSPECTION
Approved Date
/Correction
InSp.ector~~
~L
Inspector
Date
Inspector
ROUGH PLUMBING (TOP OUT) INSPECTION
Approved Date /Correction Date Inspector
~RAMING IN~/ION 'j ~ Cl (\ 11 ,
'Approved DateS: '-1- ~f/correction~Date 5-/~-!i'tJ. Inspector ~.~
ROUGH MECHANICAL
Approved Date /Correction Date Inspector
INSULATION / VAPOR BARRIER INSPECTION
Approved Date /Correcti on
lATH / GYPSUM BOARD INSPECTION
Approved Date../ jCorrection
/'
FINAL MECHAN!.CAl0' //WOOD STOVE 0
Approved i/ Date .<'- 2-{ - 8"4--/Correction
-"
FINAL PLUMBINv INSPECTION
Approved ./ Date S'-. /Correction
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FINAL INSPECTION BUILDING IMOBILE HOME []
Approved'/ Da t~ -L~correcti on
CERTIFICATE OF OCCUPANCY 0
Approved Date Insp.
M74-197
Date
Inspector
Date
Inspector
Date
Inspector ~~.
I
Inspector ~
v
Inspector y~
TtMPORARY CERTIFICATE OF OCCUPANCY []
Approved Date Insp.
Date
/ AG PLACEMENT 0
Date
! .
. - L~NE COUNTY, OREGON.
c1~PT, OF ENVIRONMENTAL MANAGEMENT
~1OJ ~ ~ IE CCii'D lQllN! IN! fQJ"ij" D CC IE
.
CONSTRUCTtON PERMITS
& INSPECTION DIV,
JOB ADDRESS ";;tf) S2; ;f., __ ./
TO: ~, ~~_c-_
NOTE: _
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DATE
5"-/b-g..f.-
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BLDG, PERMIT:
-
C55-73
RE-INBPECTION RECllUIREO
~hClnlS 18i1El"-~(Q)18i5 FOR APPROVAL INSPECTOR:
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Lane 'County Authorization
.
for:
FOR OFFICE USE ONLY
~~~;t~a;ion~~~__~~
D Two Copies of Plans
D Three Copies of Plot p~ans
LjMech/Plumbing Checklist
DLegal Interest Document
D Plan Check Info Sheet
'?YJ1n.rL~ nUJl ) hmternf,) ~U
O'J":SHIP i7 'I RANGE D3 'I SEC~, I,;;: T'711)(90UT OF
U!l&'SI't~~:T!26~1 TC~f.1~t()#\A(ll'111Owfrcrl~1~r1tJrt trKl4 ft 1
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'D TI: !ts~W: IV~f-6 W~((rr1L*
(' .u-l-m- ~ri&\ .-tf) tw / ($'
~~pO; OF PRnS~ WORK - h S:E~?tl ))
/',l'tH1r /ltQ.. 1A J) ..
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O7W\r\ANn,.~jh cili.~ 0:6 ~.' e')O ,I
N R'S ~Aff! '732-cu (OM (]' p",' I~~ ':37lUJ
'ERNIT TO "~D TO' 'n~~ ~,D D~ S, . - 1J ~~': _ll(}1?m 0 I~If~NE IlU>lBER" .
/[/""Jry') r X '~, ' , , () ~-."3/1 J
I HAVE ~REFULLY EXAMINED ~E COMPLETED AP~CATION FOR PERMIT, and do hereby certify that ~l information hereon is true and correct, and that I
have the following legal interest in the property: Downer of record; D contract purchaser; 0"authorized 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 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 registration with the Builder's Board is in full force and effect as re ired by ORS 701.055, t at if exempt the basis for exemption
is noted hereon, and that only subcontractors and employees who are in compliance with 5 01.055 will used this project. I HAVE READ-AND
~H~D THI~:'ON TH~GH~~~ ~ ~ j). Ifkk-
""" . I NAME (please print) I SIGNATaiE / Df'/E
ZIP
P~~D USE OF PROPERTY
L6Reside_ntial 0 Industrial
o Commercial 0 Public.
17 V\}t 171I1:t>~rQ-nj_
DECLARED $ VALUE
OJl"6posed
,I tfExisting
T~LEPHONE NUMBER
READ THIS SECTION CAREFULLY. YO R AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS~
o PLANNING/ZONING: Zon Partition It Parcel # Parcel Size
) ~ . ~ "Cbtint1l) mt.JQ~:J
Q,_'JI1f'16 Ol'J@ort , ," "Dat.!.. ') A'A~J~?:I?+f-@
o FLOODPLAIN: In flood hazard area? 0 NoDYes, SEE ATTACHED SHEET. Date: n
o SANITATION, S. 1. #
Inst.allat.ion
Specifications:
Gallon
Tank
Lineal Feet
of Drainfield
Installation Record Issued? Dyes 0 No
Maximum Depth
of Trenches
B. P. It
CGt.\lENTS:
n
u!PLANS EXAMINATION, Type..Y::J...1 Groupe-3)M-1 Use~/"D I..}A-n:;p !:It=.ATT~ 5<....~
CO>"'ENTS,UI.I_ R,Q. Fl2AMI~. MF/.\.4AIJI/'Al I PLUMBlkV1fl=UJAr ,\k)oSPIl:'ZTtnAJ5, f'lzoVIDg" ,
~... 1"'012 /J,KPF'/.rOr? t::>iJEUUGt 11J6r-->-.J.... it)if'>.
I
Dat.e:
"4<" ,A/J.~jPJ4-
o
'l'O'l'AL VALUATION $-
CONSTRUCTION AUTHORIZED BY THIS' PER~IT".-.--
--
CW(ly2ji~~ J
Fixed Feel Floodplain Fee $
Sq. Ft. Unit Cost Subsurface Fees $ ~ ,,v
/, ':J, --
Building fee $
,-
H,ch/Plmbg Fee $ ?s:- --
Plans 'Check Fee $ CD
Surcharge S .:5- ---
State
DEQ Surcharge S
$$' I~
TOTAL FEE /~L-
~ 4//9/84
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
/P
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C 14-25