Loading...
HomeMy WebLinkAboutPermit Building 1981-9-2 1("rfl CO~STRU~ION/PLACEME~T. FOR OFFICI: USE O:<LY PERMIT {\\0 }v~~~;~~.~tg:-00--.r! . :s tg.. 0 Two Copies of Plans Cm1PLETE THIS BLOCK. PLEASE USE BLACK INK AND PRINT. OTWO Copies of Plot Plans TOI'" 'HIP J RANGE I SECTION TAX LOT OOU'l' OF ..., 'J' 0/- I 4- I tlf'r^^ DHechanical Checklist J B. ~ lO. . ~-^J 0 Plumbing Checklist SUaiv~.::>~N/PARTlTIOtl (if ppliCablef , I LOTl};kEL I BLOCK LA..) _ _ . . j\J\lllflrrr-- ~ ~ DPlan Check Info Sheet L~o;;li-"DRESS L6n1ATJuiiw.-l l/\h.. 7m)?Q. CC:f7477 STrtur ~1l;; 'O:;ROPr(iW} I ( H, U ~ '--' rue ( 0 Conunercial OPublic OESC 'lu'/ld"".JrrltJJD ~ /1~ (] Ih(f .J SGALtJtm. ~ I 0 Proposed WA, . I 1,.)1/ n!YYI 0, 0 Existing OWN~A;;AfN.,v."POIO~ 7 Lon' 1/))". ,~\. 74~~EOOIR2 ~'rl"~TOR'S NI'HE Ailff l1"fsS d I ~ n (J~~/b.... ) 2SrU-'. ';;'Lf~HONE NOMBER -LVU'hLl ) ~)Ct _ _. .,..... L LJ. (-n1J751P9f'/I. _B-b-oO'OI tTl~5b5 I DIRE~l~ ') f)C(j' ~1)1+,l~ ..NjI~;J _ 2Jl- I "^V~~:::'~ EKAMItl~::J:~'~T':1l FOR PERMIT, and do hocnby cc.Uf.,. that all 'nfo.motion he.non 'H ""' ond concct and I funhe' certify that any and all wo erformed shall be done in accordance with the OrdillanCQS of Lane County and the Laws of the Sttlta of Oreq~n I'~Ilaillinq to the work. described herein, and that NO OCCUPANCY will be made of any structure without the permiilsion of the Building Division. I further 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 not(>d hereon, and that only subcontractors and employees who arc in compliance with ORS 701.055 will be us~d on this project. I HAVE READ AND CIlECY.ED THIS APPLICATIO~ THOROUGHLY. '- PROPOSED U~E OF PROPERTY ~sidential [JIndustria1 ~! t>.V\el\p ('., \O,'P-<- NAME (please print) p ~ n.eLPs1GNtf/n} #.-1 ~~{/ DOwner o Cont.ract.or ~gent pe~ Size I J5?f {t{~ interior S- / rear' I~ at\...atJlO..., ~ '" ) I ~. V 0 . '-- - ""f-~'D:t:,' ~.;2.I-Qj ~~""'-- n o Date: o PLANNING/ZONING: Zone RA, ....-:artih~~. Hinimum Setbacks: eL, fron~QCJ.\JY'2:..- ~ ~ . 'Lomrnents:" '--Q> ~\.*"- - Q.~"""!l.. Parcel # t, o FLOODPLAIN: In flood hazard area? o RPRAL ADDRESSING: GRID COORDINA," [JJISANITATION: S. 1. i ~ [] Yes, see attached sheet. N E Date: B. P. i.t.ll5-~S"' Installation Record Issued? [] Yes [] No DJ<~ Installation Specifications: Comments< 147J.prud (4VlrlYllcl((frI) An/P tt /I~d.. ''ipfLhadcA ~] ~ /, \j2.piJ/1 "Jjdfil./M 1M ,\fJrAlM (A-. ~tI j.d-or ,tih..'IV j...cJ) /)tJl/lYlIq r!<fo/Jura;/)Alf . Date, r?7-.s0p:t If) ---r.KflM..} PLANS EkMINATION: TYPe5AL- Group'/Y1:.61~ Use ;:~::;/'~ Comments, ~ (?eQl1lJ'2emp..AA1:' "AI 'fr:nl, <::Qd- '-9i Or~. I Gallon Tank Lineal Feet of Drainfield Maximum Depth of Trenche9 Date: Q- 'L-!f / ~ CONSTRUCTION AUTHORIZED BY THIS PERMIT -- ~ ,;(.i;ft;on V4{~) Sq. Ft. 7 yl) f Fixed Feel Unit Cost ~S-O Floodplain Fee Subsurface Fees TOTAL FEE /f~. /. ~~ $ .sr ~~ PAID BY~l- llia/ By: /-?~ ~ Date: '~~2/-f/ 9-;) -y/ $ $ $ $ $ $ $ $ ~h- ..,.. ;=- ./J ~ &/~/I'/~ ~ - ~ Building Fee Sewer/Storm Drain/Water Plumbing Fixtures Mechanical Plans Check Fee State Surcharge ~ TOTAL VALUATION $ FEES -r. --r: /J1ffl!1~ PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.805(1)) C74-194 SEE REVERSE \ AVENUE, EU\ENE, DATE OREGON 97401 LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT / 125 EAST EIGHTH . . i_ 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 INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOWED BY LAW. WHEN READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST 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: REOUIREO IIlSPECTlONS 1) FOUNOATION INSPECTION: To be made after trenches are excavated and forms erected and when all materials for the foundation are delivered on the job. Where concrete from a central mixing plant (corrmonly termed lItransit mixed") 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 or under-floor 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 and chimneys and vents are complete and all rough electrical and plumbing are approved. All wall insulation and vapor barrier are in place. 4) LATH ANO(OR GYPSUM BOARO INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place but before any plastering Is applied or 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 REQUIREO. 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 fimited to: A. BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured. This inspection 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 masonrv (if applicable) and when installation. is comolete. Installation shall be in accordance with an approved nationally recognized testlng agency dlld the manu- facturer'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 whe~ required by a floodplain ma"nagement letter. . (3) Mobil~ home tiedowns, when required, and skirtinglshall be installed and ready for inspection 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 when pool is installed. APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS_ THIS PERMIT WILL EXPIRE IF WORK OOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANOONED FOR MORE THAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOrlPLETE OR ERRONEOUS INFORMATION. ANYONE PROCEEDING PAST THE POINT OF REQUIREO INSPECTIONS WILL DO SO AT HIS OWN RISK SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS (1) (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 Oepartment by submitting the installation record form. The Oepartment shall lnspect the constructlon to detennine if i.t complies w:ith the rules contaIned"iri this divIsidn. If the construction do~s comply ""ith such rules-. the Depar.tment\sha1l issue a certJficate'.of satisfactory completion to the permlt holder. If the construction does not comply with such rules, the Department shall notify the permit holder and shall require satisfactory completion ,before issuing the certffi~ate. Failure to meet the reqJirements fo~ satisfactory completion within a reasonable time constitutes a violation of ORS 454.605 to 454.745 and th,S rule. Setbacks -' Subsurface SewaQe Oi sposa 1 From: Interior property lines Edge of road right-of-way Building foundation Wells, other water sources Septic Tank 10' 10' 5' 50' Orainfield 10' 10' 10' 100' '-"- '. .. ,~ ,-', ._.'!r,1, . . \ \ ESTIMATED DATE: PURCHASER'SNAM~:Z5:/1 (}V/.J/, .tV ADDRESS:!t6 7.':.. LOA/co ~J.c. P .' '-' ....- CITY:.,.rI'R/~e::.>c,'eld STATE: . - \.DIRECTIONS: .: ,..,~., ' o {)&~- OUOTE'GOOD FOR: ATTN: Silt1/' '7'1 (.. ~.<.,-o I ;2. PHONE: 7q/., .- Rnt.../ ZIP: SLOPE OF SITE: ..1 e f)~ I GR'O'~ND' CONDITIONS:"' C1 I) D,O ,j , . c. . , ~. DISTAN.CE TO POWER: ,. S(.) . BUILDING DIMENSIONS:.2t.. }<.. 30 . EAVE'HT.: /,2 ." " ROOF PITCH:~ / 17 I OVERHEAD DOORS: 3- la)( 10 . ~. t' . . . ACCESS DOORS: J ' ~_ '. SLIDING DOORS: A/J.v-e- SKETCH AREA (f1,)-V / So tp po (2. fJ;? ~ t1I'J (B)/.S'DIf rote {Jtt:/{j~ ui/7 ~_y{... rei ~It~ ~ / WINDOWS: : IV r;..f f". CONCRETE: y,. 'wJu..>/r.!. e. INSULATION: R..Dr] j:: SiDIN'G COLOR: J '3 (l ,)/ /}~~ k_.' '. . " TRIM COLOR: .. J -:t C-a ld.es ROOFING COLOR:/ -:? ~(tJt4G.5 RiDGE COLOR:' I 7? e,l/ ~e..5' :.. '... I, " ' ~,' ~ '" . SIDELIGHT CgLOR:' <l )( .?lJ .' -' \ "' "-. SKyLIGHT COLOR: If/ 4,.,-<:- GUTTERS & DOWNSPo"UTS: r.- . . '. '.i _ PROPERTy'DESCRIPTION I COUNTY:' 'L /:1# ~. /8 :2. G. )it}..- I J:2 no f-e ,..,& "tt' :7 , Ie; 1'-'.II,vc::: a ~ TOWNSHIP: RANGE: SECTION: ' TAX LO+ No.: { (TO ALL V.A. CUSTOMERS) Due to increases all the time for mater- ials we are unable to guarantee this contract for any longer than 30 days. When you receive your commitment from V.A. we will then tell. you if there have been any price increases since the signing of this con. tract. You would pay for the cost only on any increases.. PURCHASER INITIAL. HERE: . '. Down Payment 20% of Contract Price 60% of Total To Be Paid Upon Delivery ot Materials Balance To Be Paid Upon . . Complotion of Work $ .I ., /") ".') . All the above work ii to tie-corripleted'in-a- suostantiai"and'workmanlike manner-according-to.standard praetices..Payments_sre to be.made as per written on the contract.- No other payment schedule will be allowed unless otherwise approved. The contract amount will be paid in fulf ----:- within ten (10) days after completion. Any alterations or extras from the above specifications involving extra cost of materials or labor will only be executed upon written orders for same, and will become an e~tra charge over the sum mentioned in this abovo contract amount. All agreements must be in writing. No contract is valid until all three signatures are on the contract. Purchaser is free of any liability regarding acci. dent of deaths in, conjunction with installation. Metal Clad Builders, Inc. is fully insured and registered with the Workmen's Compensation Board.' Our Oregon State Contractor', Licen,e Numbe, is 18565. If suit is brought by eithar party to enforce the terms of this contract, ec- ceptor agrees to pay the IU~ which'the court may adjudge reasonable as attorney fees. O~Q~. , .,"'" /. ,.F> $ ;:;? /)<,) .~.- CO~TRACT PRICE,. ',; : 't, 600 . $?I': /.i/.J. &~.... .--.- ,.'t,~ METAL CLAD BUILDERS, INC. Representative :- I'( ~Pl,d..l Pc42~......-,.,~ PU-Rl:HASER - (/ I 1-1- / -/- Ei'1 It q,(,mtNt~) .r1lD~ >" rf4.i" ;kJ METAL 'CLAD'BUI DERS; fN\. President or Secretary' ,.: ' , " ,~ .,J Date Signed CORPORATE SEAL " ,~ ., ~ . -'---'---I~"-'--'-:"--------;-'--' --. ~ 7..-..-.----. ._____..u..__,!'. . . - ~. ,-- -'-----'- -.- --,--_._- . ~. . ~ i' I .. . . . . I. ;1 'I'. . . . " "\ , ' '. . r n n .. n b . -- - -!:: 0, -r ,. . LANE COUNTY DEPT ENV MGT RECE;PT 0 180681. DATE 0821U~ APPLICANT GLOVE", JI;NELLE . ADDF, %7 LONGIUDGE DF(., SPIUNGFIEU.l, ORI.!! TLO 1802061411200 SUBDIV WILLAMETTE MANOR LOT 2 BLK 2L NEW BLDG TYPE GAR USE I' NO BDRMS 00 NO UNITS 001 NO STORIES NO BLDGS 001 r CODE APPI" NO ACTION DESCFnPTION SQ FT L1NIT COST VALUATION FEE D,.,{ BF' I ~. HI" t: BF' e~ HI" lW BF' HP PL MECH Sl.m PCI( ~ " . . :' , . . I" I' . 4% . ~}0% 1.44 16l.,00 .~ .r.;' r I: e~ ,~ ." !oJ ^ ,. '" " ~ _.x: u:: 0: .~ I:..C ex: n:- ~ rtj . LC lB0681 NEW I' NO. FIXTI.JI~ES: NO. CONNECTORS: t1ECHANICAL FEE. ST A TE Sl.IRCHf.,RGE PLAN CHECI( FEE 6000 1 ~>" 00 EACH _h :36.00 CIHG: . SUW: TAI([N AF'P o BY F,I...H RA FP SDS ,SI PCK (JTH ISS 1 2 :5 EST. C0I1PLETIOW DATE 090181 TOTAL FEE** ~:>~5,,44 . . . ,. ..\. . . Environmental Managemee ACTf\rITYINFORMATION. SH EET idne county " -.BILLJF'- ,.D. ~PL-~rJ 9 ~ ;ROPEL;::o~~: ~:HASER () fL I v ~ MAILING ADDRESS SfJe:loJo,{t'eid d){2, "1'7'1'7'7 .CITY I STATE ZIP CODE COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE. REJECTED! G) Po P L-'j l\J APPLICANT/REPRESENTATIVE 0civ€ $JLL/~ .f). q(p 7 ~rJc fJi nc;P, :-ilt1.INc ADDRESS SPt'Ii)Ci\~/LLJJ t2eg., . CITY STATE "7L/~ -,?cJ/(;6 q7<!77 ZIP CODE BUSINESS TELEPHONE NUMBER ttTqCE:~~(. o APPLICANT/REPRESENTATIVE 1 t.f {, ~ $;"0 ( 0 BUSINESS TELEPHONE NUMBER ~ROPERTY O\;NER/CONTAACT 7t/t, --.PO {, ( HOME TELEPHONE NUMBER o MAIL INFO~~TION TO, PURCHASER TuX Map Number, / f'- d- &:.- /t/ Tax Lot(s): Q) TAX MAP/PROPERTY DESCRIP'I'ION NUMBER (from tax maps in Department of Assessment (. Taxation or from tax statement): //.;zo?' OOut of TL I Tax map number of adjoining property in same ownership: ~one 1 Tax Map Number: Tax Lot(s): @ SUBDIVISION (if applicable): @ REQUEST (briefly describe information needed) : PE:Q./n i':t 10 BUI/...D GlIt-~~, COMPLETE THIS SECTION FOR LAND USE, CONSTRUCTION APPLICATIONS. OR PROPOSALS . SEE oNOTE BELOW. <D TOTAL c::ONTIGUOUS PROPERTY IN SAME OWNERSHIP, ~ I acres o PROPERTY ADORESS, Q) PAESENT USE OF PROPERTY, US lOt: N II A L GD NUMBER. OF STRUCTURES ON PROPERTY: Standard home~ Mobile home Modular home - RV in use as residence Storage_ Barn Garage_ Other (specify) Shop_ @ ACCESS TO PROPERTY, /..-0 N f\fLi DoIt,6'. D~i I/E:- Public Road Name Private Road Name Road", Easement # of Users Width @ OTHER EASEMENTS OVER PROPERTY: ~ ---~- " (j) N^1'El<nlSTRIC'r, I JJ ILl-llm.e::Tft... @ FIRE OISTRICT; G EXlS'l'lNG PE~IITS ON PROPEATY, - 7/81 (OVER) By partition fi o Unknown BLOCK, LOT: ,:2 C-/+-P .J ""FOR STAFF USE ONLY". NUMBER,. 3""3 rt-Z-D ._~ J /,' AT> TIME INITIATED, TY SlZ... , .., IX '-. .., t' DATE, CHECKED BY: ATTACHED EXHIBITS: o Plot Plan~ (2) o Constr. Plans (2) o Site o Copy o Other Plan of Tax Map SCREEijING VERIFICATION, By, ~M_ Date: <<J. , Time In,' Out 1,iO~ ~ept 0 Reject . Routed to, ",if1J (JJv.../ *NOTE: . ATTACH A COPY OF TAX MAP; SHOWN EXISTING STRUCTURES AND TAX LOTS IN YOUR OWN- ERSHIP. OBTAIN TAX ~mp IN SELF HELP AREA. OR.C~NSTRUC1~6N~~;P~~C~~IO~ nktJ /(),.~~t1. '/J1J,~;'.' - . COMPLETE THIS SECTION:FOR LAl:/D USE, I@ PROPOSED USE OF PROPERTY IN DETA!.L.:, ~ '1f' .A~ ~ (J (J @ BUILDING REQUESTS: Contractor's :it Directions to Site: (for mobile home setup also) Check the type of permit requested: o Dwelling: q Ne\... 0 Replacement o Addition 0 Alteration; D Mod~lar. Home 0 Mob;ile Home - Model ORV ~tional; ?tlA4 -;," D Standard Construction; .0 Plan Check Only o Commercial: Vse q'Ag~'i~u.(t'uia'l: . Use' o Others: Use t 0 Change: of Use -. How?' '@ SANITATION REQUESTS: D- Si,te eV411uation for ',50S feasibility q ~'ew system. ins,tallation q Rel:?air/replace~ent o Alter"ation/relocation DHook to exist;.ing ADDITIONAL INFO~~TIO~: NA-' //" /' /' .__f.109.!_ Atea Floor Area ---.-- " \ , Year I I , **FOR STAFF USE ONLY*~ ZONE/~ USE': By: Date: Time In: o Accept Out: o Reject [] Planning Application [] Construction pcrmi t App. [] Information Only Zoning: Compo Plan Designation: Comments: SiI'NITATION: 'By: Date: Time In: o Accept Out: o Reject [] Constr. Permit Issue o site Evaluation Issue PERMIT ISSUED (SAME DAY ONL~): Permit i By: Date: Time In: ;;J Gt- ..7 ~ \.- ~I & ~O ~b ! //0/ ~-f5 ~.... Out: TRS TL /8-d~~ -N-I/;uJ6 . . Plat: Plan Subdivision Lot Block 'rv~ . . '; ~ Vicinity Map c74-150 Job Location Permit (J Permit 1/ Permit (J '\ () ../ .- ~ N . 'JoJE:lI... (Address) q (,-, '7 For . For For ~ ~q' '> ...... c\c:\{\ Of \ A q_ E' f\-- \ \.J E'd' - So ~ . u,'\ q-.\ . ( 00.1) ~ . () Permit (J F;'r (\ '\j . Permit (J For Permit (J For , , ~o' \f ~~ ,~ i1- 5~ TA>.lV- I ., ~ I'~\-"\ 0 I tlO' 'C\\o'\--\ SK\ ~\ 110& ~O\,)..''::,E. ~CJ'0-~ '~L 6Cl ......, '-> t:XI '0TI 10..)6- C.f't'~r\ -=" IU :11 :J <!: ~ 3 ...&._ .,- J/ v0~ '- ~~--~~W'o~~~v--.-~---,.n'~~-'----~--~~'~"---~~~r-::~"'---~~~"""'."..- ,...-- -~-_.>._- -~-~, ~,......---,.........~_~_rT--' r..'''>i\~! ~r . ".- --.. .:J.;"'''L . . ;lJ! ::''1 .. - .,~(..~ """'~' ....,./'... . .,-. LANE COUNTY 'J fINSPECTION . RECORD OW~~~) p~ ~n'~~-s r~p tSfL~ SET BACK REOU~EMENTS CL. FRONT r<:,.e d- CL. SIDE WORK AUTHORIZ 0 BY PERMIT A.~ ~~~ DIREJ~IC!,N}.)O/Snr // 'If" /7 (~I 10 vfV( /2,~ '-( ? A-ui/ IJ~ jt- l...d/.1.d Al/J I ) vq&1 iUn~~ /0,/ S!;~. (rt1r; -?/ SITE ADDRESS IY U ;;i..~ (p _ 14 _ II..::> c57) / fA) i I / /1..-h. ~;If;. ~E~~R ~ /Sdd FOOTING / FOUNDATION INSPECTION OR MOBILE HOME SET UP INSPECTION Approved Correction Disapproved Date Inspector &7-IL> -,f(! ~~ /-: . . ~Z~~ II.z,t>< _ tflL.L(.,- 'Xi pg,.. ~ 'h ~ ~ *' /'\~ Qz. ~ cONCRETE SLAB / UNDER-FLOOR INSPECTl[ONv Approved Correction Disapproved Date ~,"'A',' . .~j.."'L_. ._ ,.I,~j .'ff; .~",j" "''i\",t'. . .~:.- INTERIOR t;; I I REAR 7 .. oIP If PHONE NUMBER --; t/(tJ - c::;- 0 I -;r- PHONE NUMBER /1/(0 - f.Of" I HPLUMBING FIXTURES '-. ...- Inspector UNDER SLAB / PLUMBING GROUNDWORK INSPECTION Approved Correction Disapproved Date Inspector ROUGH PLUMBING INSPECTION Approved CorrectiDn Disapproved Date Inspector F RAM I NG INS P I;.eT ION (2,_ . J? Approved V Correction DisapprDved DateH ~ 2-<;1 LrnspectDr ~~. 7.- .>f?~?" ..k - /. - -- t!..J J?~ L'rH L...-,-,.7r ~..'.,...V INSULATION / VAPOR BARRIER rMSPECTION / v Approved Correcti on Di sapproved Date Inspector IA _ /) , LATH / GYPSUM BOARD INSPECTION Approved Correction Disapproved //1 fA. ' FINAL PLUMBING INSPECTION Approved Correction Date Inspector Disapproved Date Inspector FINAL WASTE DISPOSAL SYSTEM Approved Correction FINAL INSPECT)ON BUILDING Approved v' Correction INSPECTION Disapproved vi' MOBILE HOME Disapproved Date Inspector Date)D-z.- ~~LInspector ~. CERTIFICATE OF OCCUPANCY Approved Correction Disapproved TEMPORARY CERTIFICATE OF OCCUPANCY Date Inspector Form C74-197 LANE ~OUNTY, Op..SGON . QEPT. OF ENVIRONMENTAL MANAGEMENT 1C(Ql~~IEC"ii"D(Ql1M 1M(Qlii"DCCIE . CONSTRUCTION PERMITS & INSPECTION DIV. JOBAD~RESS q~7 ~dA~- TO:~-A1 rtt",-'~-44./ DATE t::7- //J -;;r/ BLDG. PERMIT: /4?L)-c'- R,L NOTE: _ ~C4.~~- ~ A7~(>{z-.~ ~ ~ (/J ~""'.-.dJ ~ k. Lj ~~~.;J.o, ./.---..",.... ~ ) /l t// _ I' ,tJ ~,~ AA? ~''''J _~J~ @ _~~"": - l'_"~" /2..~_ .rtL__e./ L.._ ~~. rL ~~. ~-d_ ~~:/ ~.~. ///J I ~ /lh~~~~ ~- . . (?L..;r r-4!<) d~~ ~ae.:7 ~ Le..- /-W { ~.L.A L. '?'-<..,..d.-..../ .L~,~ ~..J h ~ ~ --"?l (/7# . U::~ c7 ~ , I ~,Q. /r.'?_AA-/ 7: 0-,-~~~ /~ Ju,J..r- ~ IN"..-- /~."r'n'-:'~.z--!y J.?, / ~ ' J,,__._~o) rr ~ /;;... , .., / ~ ~ ~ r / J./f? ,. - "'7, I .:=. ta.3 I ~ rr ....,- _--4- - f- ~ C55-73 RE-INSPECTION REGUIREO /lA~ ~hlClnlS 1Si1El"'-~IClISi!5 FOR APPROVAL INSPECTOR: \d'1. ......- ~ ~p~.~, t/'-.