HomeMy WebLinkAboutPermit Building 1984-10-1
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S . eTVRES cuINTiv ON?)";;71 v1Jt~mJ ~m1J'
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= OF BEDROOMS [It OF S'I'O{SllS I It OF EMPLOYEES I
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O~rR'S NAME T'f<J.'U:S,s A. , .15. 'iJJlJ ~
C0NTtlWe}AME W Y71 ~ J J }(J )
?E:Rl-lIT TO BE MAl LEU lNAME "~D AU~K1 ^- ~ rflr71.
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I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FO . and do hereby cert~fy that ~ informatlon hereon lS true and correct, and that I
have the following legal interest in the property: Downer of record; 0 contract purchaser.~..thorlzed agent with evidence of authority attached.
I f:.;rther certify that any and all work performed shall be done in accordance with the ordi~~f 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 required by ORS 701.055, that if exempt the basis for exemption
is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY.
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Count' Autho~iz~tion
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FOR OFFICE USE ONLY
Appl~ca tion/ -"'9 '"7// /_ P U
Perm~t # 0< /Y'V. () /
D Two Copies of Plans
o Three Copies of Plot Plans
UMech/Plumbing Checklist
DLegal Interest Document
Dplan Check Info Sheet
PROPOSED USE OF PROPERTY
~eside_ntial D Industrial
D Commercial 0 Public.
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I ~LE~ONE NUMBEit
I TELEPHONE NUMBER
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-,-- / \ SIG~ATURE
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READ THIS SECTION
YOUR AUTHORIZATION HAS JEEN ~ED ON THE FOLLOWING CONDITIONS!
DATE
CAREFULLY.
zone-.EA.
front ~/
Parti tion # Parcel #
eL, side intertm; 5'
l1.MnIfYl~ ~)
[] PLANNING/ZONING:
COM.\lENTS ;
~tYYi
..
Date ;
ftSANITATION: S. 1. I
Installation
Specifications;
4t ~<3475
B. P. I
pa~)h I ~
rear --UJ:::1..l...t
D
Gallon
Tank
Lineal Feet
of Drainfield
Installation Record Issued? DYes 0 No
Maximum Depth
of Trenches
COMHENTS;
)0 PLANS EXAMINATION:
COl>lHENTS:
Date;
9/2-8"/ RV
,
use~AJ
ffj;;]
V
I/-AI'
Group_~- ~
Type
Date, J~ - J -ilL..!
-4'~
TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
--
Fixed Fee/ Floodplain Fee $
Sq. Ft. Unit Cost Subsurface Fees $
ff~~ Building fee $
AI fI1zch/Plmbg Fee S
P'ans Check Fee S
State Surcharge $
DEQ Surcharge 5
TOTAL FEE $5
A-,Bti Description
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PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.80Sli)) DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061, C 14-25
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVEO. VIOLATION CAN RESULT IN REVO-
CATION 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 HOURS ADVANCE NOTICE FORINSPEC-
TION REQUESTS 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:
REQUIRED INSPECTIONS:
1. Foundation Inspection: To be made.a'f-ter trenches .are excavated and forms erected and when all
materials tor the toundation are delivered on the job. Where conc~ete from a central mixing
plant (commonly termed "transit mixed") is to be .used, materials need not be on the jo~.
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 5ubfloor.
3. Framins ~ Insulation Inspections: To be made after the roof, all framing; fire blocking, and-
bracing are in place and all pipes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall ins~lation and ~a~~r ~arr~er are in place.
4. Lath and/~ Gy~sum Board Inspection: To be made after all lathing and gypsum board, interior
ana-exter~or, ~s ~n place ,but before any plastering is.applied and before gypsum board joints
and fasteners are taped and finished.
5: Final Inspection: To be mad~'~f~er the building is complete and before occupancy.
APPROVAL REQUIRED. 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 ~uthorized, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This
rnspection is required for each bond beam pour. There will be no approval until the plumbing
an~ electrical inspections have been made and approved.
B. Wood Stove: To be made after completion of masonry (if applicable) and when installation is
complete. Installation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturer's installation instructions.
c. Mobiie Home: An inspection is required after the mobile home is connected to an approved
sewer or septic system for setback requ~rements,bloc~i~g, . footing con~ecti2-n~ tie~owns,
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 when required by a flood-
plain ~anage~ent_letter.
3.' . Mobile 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. Swimmin~ Pool: Below grade when steel is in place and before concrete is poured. Above grade
when pool-rs-installed
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POINT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK,
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
1. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a.permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installa~ion record form. The Department shall inspect the construction to determine ~f it
complies with' the rules contained in this division. If the construction does comply with such
rules,. the Department shall issue a certificate of satisfactory completion to the permitfholder.
If the construction does not comply with such rules, the Department shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. Failure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
lation of QRS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewaqe Disposal
Septic Tank
From: Interior property lines 10 I
Edge of road right-of-way 10'
Building foundation 5~
Wells, other water sources 50'
Drainfield
10'
10 '
10 '
100'
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ACTIVITY INFORMATION SHEET
COMPLEI~~THIS SECTIONrI~fMPLETE FOHMS WILL U[ HlJlCTEO!
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J 1 ~flJ[S V f<.f?/-uJE-,f .' ~C;::; Am"
PtRSON M)KING REQUEST' - - PROPERTY OWNER
!1!l.C2.Rtr-dI/4L[_ .[J1f
, MAILING AODRESS-
~jJj{/IJ!(,.r/~/d M '97</77
CITY STATE ZIP CODE
7<v7- &J11
HOMETELEPHorlE 1/
.
"5'M>Ik-
MAl LI NG ADDRESS
5A~
CITY
STATE
'7i7-&:J (7'
BUSINESS TELEPHONE 1/
SAAf..
BUSINESS TELEPHONE 1/
SAm;..
HOME TELEPHONE 1/
. 2 PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBEP.
(REQUIRED INFORMATION)
lane county
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ZI P CODt
(from tax maps in Department of Assessment and Taxation
or from tax statement)
J7 .Ql 2.3 33_ 08ZCO
TOWNSHIP RANGE SECTION TAX LoT(S) OR PARCEL 1/
TowrfSiffJ> RMlGE: SECTION
,
(1.esJDeJm/lJ'
ZONING
TAXLoT(S) OR PARCEL 1/ ZONING
TOWNSHIP RANGE SECTION
rOTAL COrITIGUOUS PROPERTY IN SAME OWNERSHIP:
.CO
TAX LOT(S) OR PARC~L 1/ ZoN!NG
1
. 4 SUBDIViSION (if applicable) LOT BLOCK_,____u__!
,j REQIJ,,;;T (state exactly what you plan ,to do) AIlD nf'l/ A'ttCU WAId_* e..xreJllD --,.1
j...\'ultJ6_R,OOM GAl FRDtJ:P_Pot<UON Df:, ~'n;'n3 ttnfYl{-- -Ct5Juu,tJ.l)UfiW!JlsJj
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6 DIRECTIONS TO SITE: ~S.r._9rJ.--'-!A(l.D~Rr;'_.l.9.__~H1~CB LAfJe._T~a)ij8_f111_Dr-Jte.B(,pCK. I
10 G~ OR. TUfUJ.J,g,ff+SirP..f'lQ..HOUse. O\Jn~__..__.._____________
----..-. - - --- . --_.- ".-.-.. - --------.-
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** FOR STAFF USE ONLY **
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NUMBER
DATE
ZONE/LAND USE:
BY: DATE:
TH1E IN:
OUT:
- - ..-----.-. .-_.____.___n____
LAND MANAGEMENT DIViSION / 125 E. Rth AVE., EUGENE. OR 97401 / 687-4061
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LANE COUNTY DEPT ENV MGT RECEIPT ~
JAhES ADDI\ 70 GI\EENVALE DI\.,
SUf.<DIV
USE R HDRMS 0 UNITS 001 STORIES
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ACTIIJN DESCI\IPTION SQ FT UNIT COST,VALUATION
ADDITION 81 34.29 2777
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