HomeMy WebLinkAboutPermit Plumbing 1987-9-18
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Lane County Authorization
SEPTIC INSPECTION FOR LOAN REVIEW
(;;cG
9-10
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for:
FOR OFFICE USE ONLY
Applicatio~~~~~ c;7
Perrn~t #r:;><"O oc-J' 0
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row;;SHIP/Z I RN1GE~3 IdZ~ 3'1 T(YcWT?/ I
S:!BDIVISiDN/ ARTITION (~PPliCable) I LOT/N,RCE' I BLOCK I
/ZZJss .(JP~r/?#4~E. V~~h -e~ /A-~
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'JES~~I{~t I~sP~c~SIot;oR ~COA~tREIJ I EW' I DECLARED 5 VALUE
" OF BE~RO~Y /J I # OF s~~/ I # OF E~IP~~7: I \-IATER :;UPPLY /' /' - ~ 0 Propo~ed
//// ~ /V'/~ d7/.#-- ' c-.L./ /' IXtEX1stlng
O;j'E7./-AME AND AD~ A~ ,,;:? /) . /?'/. #-. . ~. I TELEPHONE NUMBER
?1 r;,( /7/77/,1(/ r L:/. /-1""#Y ~.d!:j>~ //7~b-_:-lf?d//' ..<;=-, /f'~
e:2)hi)i/E:&# L~~<y ~ a ~~A-J I ~~~JJh"
~~~;(NAMEAN;g:D~db"'e/?C vLe 97~"27/ 1_(3~~
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__ I HAVE CAREFULLY EXAAINED THE COMPLETED APPLICATION FOR PERMIT, dr.d ,]0 hcr;:"J\' certify t~hdt a information hereon is true and correct, and that I
have the following legal interest in the property: Dowoer of record; OCf.;I'":t:dct. polrcha:>et:; authorized agent.
I f-..:.rther certify that any and all work performed shall be done in aC<":Qt(.1aaG~ "d th tb~ 0rd 1ance~ of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will b", :nade of ar,;' St-.Tllctllre without tile pcnnission of the Building Division. I fur-
ther cert~fy that re9~5trat~on w~th the Bu~lder's Board lS In full force dod effect as resulred by ORS 701.055, that If"exempt the baslS for exempt~on
~7)~54f~%=;;;;Ym who are '" ciJ A /SQ' /jn th~' proJect. I ~VE ~ ~D
---- . NAME <plea.. pnnt) - ' ~ - _ ~ DATE
PROPOSED USE OF PROPERTY
~ Residential D Industrial
o Ce,mmercial 0 Public"
Parcel #I
CONDITIONS! " '" / /
Parcel Size.~ / .#
READ THIS SECTION CAREFULLY. YO~5f~THORIZATION 9AS
o PLANNING/ZONING: Zone $/ #- Partition #I
C - /
Minimum Setbacks: L, front
BEEN BASED ON THE FOLLOWING
CL, side
/'
interior
rear
COM.:'1ENTS:
SEPTIC INSPECTION FOR lOAN RFVTFW--NO S~AI
PI ANNI~CTION RFOlI,TRFn
Date, ~-r7 ~
rVSANITATION: S. I. #I
IT . Installation
Specifications:
COMHENTS'~ ~~.~---....~DS ~r"-l><'1-:ec L..L
d ~",y~--, '~~.._.~'V'~ ~
o PLANS EXAMINATION: Type Group
Installation Record Issued? DYes D No
Maximum Depth
-. of Trenches ..J:- /J --IJ"-'. /.
.L<<rr,...;__ f' ~~
Cf-;1-:.P7 1I c~-
B. P. #
Gallon
Tank
Li neal Feet
of IJr:ainfield
Use
COMNENTS:
DaLe;
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~pdOOED i3Y BUILO- OFFICIAL/DESIGNEE (oer ORS 4S6,805(1)) 9 -~,;;,f7
LANE COUNTY D RTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISIQN, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION ~1t._?~ Ql'l4.
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SETB/,eKS A~m OT!!:" CC:;DITIO~;S OF' APPRO'.r,\L ~:lJ$T BE STRre7:"" OF.S.sRVEO. VlOLATIO;.J c,;:, RESL'LT IN RE\;O-
CX:~IO:: OF ':'lirs pr:!'\~-lI7, CITi,TIO:; li:;DER PROVISIO::S OF L,\;;;E;:Oi.;::TY'J I:,FR;,CTIO~ OHDI:;,;:;C!::, ,\;:D/OR OTHER
RE~EDIES ALLOWED BY LAW.
\\flE~1 RE.:"DY FOR 0.!:.E.~.:~:..!g..:!, c,;:.,:., 6a7-';065. ,\ :.l!;;;Vll':.: OF ;,T L::;,5T 2~ IlOuRS "DV,,\::(E ,<OTICE FOR rNSPf.C-
,lU:: 1\1";',",0.::":' ;.,~ST ill:; GIVE::. ;13.v(' the ~ollo,,,'ing in:o:.-:nat.ion :::-eady: pcr::\it number, job address, type
4 of inspection,-when it-'..ri'l'l be re<ldy,'~'our :J<lmc anci ?;-.b,.c :lu::\ber, <tOlC ;:Iny s;:JcciuI circc"tion'S-tO site.-
BUILDI~G DIVlSlO;.J,
REQU[R:::D r::sPCCTIO:,S:
1. Found..tio:l Inspection: TO be n:!d_oe after .,!;rcn9hcs aj"e,excavated a.nd t:orms erected .and when all
~aterlals ~or the toundation are delivered on the job. ~here concrete fro~ a central mixing
plant (commonly termed "transit mixed") is to be used, materials need not be on the job.
2. Concrete Slab or Under-?loor_ Inspection: To be mace after aU in-slab or under-floor bnilding
serVl~e e~uipment, conoult, p~plng a.ccessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3,
Framinq & Insulation Inspections: To be made after the roof, all framing, fire blocking, and
bracl~g are in ?lace a.na all pIpes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
....... ok ..... .
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4. Lath and/or GVDsum Board Inspection: To be made after all lathing and gypsum board, 'nterior
and exterIOr~n place but before any plastering is applied and before gypsum board joints
and fasteners are tapej and.... finished.
'5. .Final Inspection: TO be made after the building is complete and before occupancy.
APPROVA~ REQUIRED._ ~o ~ork.shall be done on any ,pa~t of the~buildin~.or structure beyond the-~oint
indicated in each successive inspection without first obtaining the approval of the building official.
Such approval shall be given ~nly after an inspection shall have been made of each successive step
in the construction as indicated by each of the inspections required.
NOTE: '"-Ail building permits .require inspections for the ~ork auth"orized, such as but not limited 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 unti~the plumbing
and electrical inspections have beep 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 ~ith an approved, nationally recognized testing
agency and the manufacturer's installation inst~uctions.
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 ~equirements for mobile homes o~ as
recomr:lended"by the ma'nufacturer.' ~ - .-- - -. . '
2. ~obile home. minimum finish f~o~r elevation shall be certified when required by a flood-
plain management letter.
:3. ;'lObile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
D. Swimminq Pool: Below grade when steel is in place and before concrete i~ poured.~ Above grade
wnen pool-rs-installcd.
i\PPROVED PLA:JS :.lUST BE ON THE JOB SITE AT ALL TIMES DURING NORKING HOURS _ THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SVSPENDED OR ABANDONED FOR ~ORE THAN 180 DAYS.
SUSPENSION OR REVOCATION :'IAY OCCUR IF THIS PE&\IIT WAS ISSUED 0" THE BASIS OF INCmlPLETE OR ERRONEOUS
INFOJU.IATION. . -
At,YOllE PROCEEDING PAST THE POIlJT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
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SUBSURFACE A~D ALTER~ATIVE SEWAGE DISPOSAL SYSTEMS:
1. Permits shall b~ 8ffective for one year from the cate of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holdcr shall
notify the Lane County Department of Planning and Cow~unity Development by submitting the
installation record form. The DGpartm~nt shall inspect the construction to determine if it
complies with ,the' rules'contained in...!-his division. If the construction does-comply' with such
..:' _" -. ~rul~s!.,th)~ Deparl;.men,t.,sha~J. issu'1!,_u c,eitificate O;f ~atisfactory ~completion to the. pennf_ti-bol,der. ~
'''Jftl1e constrcct'to-:1 does- nbt complSi wTth.... su~lt -rules, ~~"Oe~.,aitffiQnf" shall nottfy the 15ermft. -
...... ,holdy.r and shall require 'satisfactory completion before issuing the certific;lte. Failure to -
llJeo.t .tthe...requlrements for sa ti.:'.;fact{:lr.y _completion. ~i thin a r;ca.sonable JJ-ml! COfU. tj.tu~s a VIO-"
l).tlori:of"ORS '154.605 to ~5CI45"aI'I<J thIS r\;10.- -- - . - - -.... -,--". -
..-~
Setbacks - Subsurface
So:>',.rd'lC Disposal_
Septic Tank
10'
10'
5'
50.'
10'
10'
10'
100'
Drai:1field
Fro:n:
l:1terior propert~ Ii:1cS
Edge of road rHjilt.of-w,ly
Builuinq fcund.:<tion
\.;.:;lls, other ......:Itcr sources
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ACT.ITY INFORM.o/t'IOt-aSHEET
.
COMPLETE THIS SECTION, INCOMPLETE FORMS WILL BE REJECTED!
<7)..tlJ..LH. ~.EA;(V
~ . PERSON MAKING REQUEST
% hSh a/!-/7Q.4:r X/-
MAILING ADDRESS
~~/1 e
~ - / CITY
/!h.,,- 9?Yd /
~ STATE ZIP CODE
~~ /icPn_~'
. / PROPERTY OWNER
. }'~, ~)( 2- z 3 J 'Z.--
MAILING ADDRESS
/Jl/W'JI~.Jr;e fJre~t[)?_.9 7 zz-z.-
CITY P"STATE ZIP CODE
BUSINESS TELEPHONE # HOME TELEPHONE #
2 PROPERTY ADDRESS /bt!) 0n:ehvd/e
(IF DIFFERENT FROM MAILING ADDRESS)
653/'53'87
BUSINESS TELEPHONE # HOME TELEPHpNE #
- ~/~ ~eq.~ '
,/Tv. /
3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
/7 b3 ;2.3 - :3 3 ~g<9-0
TOWNSHIP RANGE SECTION TAX LOr(S) OR PARCEL #
~,
ZONING
TOWNSHIp. RANGE SECTION
TAX l.oT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
ACRES
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable) LOT BLOCK,
5 REQUEST (state exactly what you plan to dO).5:jA1_____. 7~ - ~FI-I1)
f..r-.-.__ _
4~A) tE/ ~ -~,6--r ~R_
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,6 DI RECTIONS TO SITE:
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** FOR STAFF USE ONLY **
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ZONE/LAND USE:
14-33
LAND MANAGEMENT DIVISION / 125 E. 8th AVE:, EUGENE, OR 97401 / 687-4061
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IN: ~:5
. AF'I"LICANT KE':Y B,~,NI<.
TLI, 1703233308800 SUBDIV
NE':W BLDG TYF'E':USE': R BDRMS 0
. OWN,,:!,! NrlE I<EY BANK.
CODE AF'F'L NO ACTION DE':SCRIF'TION
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LANE': COUNTY DEPT E':NV MGT REC[IPT
ADDR PO BOX 122352.
1 283387 DATE 090987
MIUJ(,UI<IE:, ()F(EGON .
LOT BLK
'IN'I'l'~ !)!) , ""fl]f"]""'" ,'till)I-,' !,)(,)1 I"f.l l)N I::' 4"1'^ "'''-l':'!::' 'I,'
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. . I 'U ~....... ,;) M) ~.. I t. ... 11. ... .. I . ._ ..
SQ FT UNIT COST VALUATION FEE DA'S
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. MECH
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F'CI(
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~'FIX/BATH :
SWE:
FT. (..rm:
MECH{~N I CAL FEE
STATE SURCHAf::GE
F'L,~N CHECI( FEE
FT.
EAIN :'
FT
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LC 2B3:5B7 SDSV
60.00
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EST.
COMF'U:TION D,nE
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ACTIVITY INFORMA TION SHEET
ElMO
l"""''''~'''''''''_-'y 0'''''''00l'0
o.-c....._.....,__.....~,
Please complete all lIems above dolled line
FILLING OUT * LINES WILL GET YOU INFORMATION ONLY
*DATE I I
* PERSON ACTUAL
MAKING PROPERTY
REOUEST OWNER
ADDRESS ADDRESS
CITY STATE ZIP CITY STATE ZIP
TELEPHONE (BUSI tHOME) TELEPHONE (BUS) (HOMEI
*PROPERTY ADDRESS
OR
MAP & PARCEL NUMBER (Found on tax maps in the Assessment & Taxation Dep!.)
STAFF WILL DETERMINE_
Township
Range,
Section
Tax Lot
Zoned
Flood Plain
Township
Range
Section
Tax Lot
Zoned
Flood Plain
Township
Range
Section
Tax Lot
Zoned
Flood Plain
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
ACRES
*REQUEST(descrlbe what you went to do)
Directions to site
....................5taff Use On~....................
Comments:
Land Management Division, Public Works Department 125 E. 8th Ave., Eugene, OR 97401 phone 687-4061