HomeMy WebLinkAboutPermit Building 1985-9-25
ca-
Lane cotty Authorization
.
for:
p. p c.~
q_19
FOR OFFICE USE ONLY
'Ronf A 1 tpr~r; on
Application/ ~/ r-rf O-~
Perm1t # p<"'f&',? /-n....:../
I RANGE
17 03
S~BDIVISlbN/PARTITION (if applicable)
roW..SHIP
25.2.1
I TAY.. LOT DOUT OF
1o{,700
I LOT/PhP.CE!.. I BLOCK
PROpoSED USE OF PROPERTY
Gl Residential D Industrial
D CCJmmercial 0 Public.
SECTION
LOCATIO~ ADDRESS
STREET
CI'!'Y
ZIP
1819 Havden Bridge Rd.. Springfield 97477
STRUCTURES CURRENTLY ON PROPERTY
SFD
DIRECtIONS TO SITE
'1'~k" 1 Q.h North - '''nl 1 "ft. on H~vden Brid"e Rd.
vESCRIPTION OF PROPOSED WORK - BE SPECIFIC
h\
~,
(/
~~RE'pd VNiC
o P.P=l'Posed
~xisting
I TELEPHONE NUMBER
,J_ '_' -":_". ~.~r 747 0870
-r-' ?'Vcrf::l...:;) TELEPHONE NUMBER
9 7~77
P"}.....4=
= OF BEDROOMS
.1 Ol'; oriE:~lJ,;~csTMC ( "ATER SUPPLY
~'f-Ol!:).,...;nn f,..............
If OF SroRIES
.
O;~~ER . 5 NAME AND ADDRESS
CONTRACTO\~ALiJ:;X:~~p f?& same;;~,
P:;RNIT TO ~E MAILED TO lNAME AND AnDRESS)
above
......'.."...0....0
I Tt;LEPHONE
NUMBER
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION t-'OR PERMIT, and ,10 hen.1!Jy certify t".hat all infoL"lllation hereon is true and correct, and that I
have the following legal interest in the prope~ty.liJo""ner of record) Ocon':ract: purchaser; Dauthorizcd agent' .
I f::.rther certify that any and all work perform~d shall be done in aCl:OtdilllCf.: ....ith th1,l Ordinances of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will he made of anj' structure without the pcnnission 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 70t.055, that if.exempt the basis for exemption
is noted hereon, and that only subcontractors and etllployees who are in compliance with ORS 701.055 will be used on this project. I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY.
NAKE (please print)
y?~d,,_
SIGNATURE
Q-/3-jfC
DATE
L ;Sa. f'" J,._
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION qAS
~ PLANNING/ZONING: zone-R..A- Parti tion #
Hinimum Setbacks: eL, front CL, side
CO""'ENTS~""<M J .~.,....,,,.,
BEEN BASED ON THE FOLLOWING CONDITIONS:
Parce 1 # -.
Parcel Size
interior
rear
Ins talla tion
Specifications:
Gallon
Tank
Lineal Feet
of Drainfield
Date'~ ~ ~ 0 \- }l~KJ
Installation Record Issued? ~es 0 No
Maximum Depth
of Trenches
o SANITATION:
S, 1. "
B. P. It
CQWIENTS:
Date:
.
n
o PLANS EXAMINATION: Type Grouo
COMHENTS, CAL L loR 'R~(J I ~aD / JJ r R:c.T1o.(J<:;:
use~E fR (bel,t:
Oale, q - ZS""- es-
-4':1a
1
FEES ])lJ~ '1:0.07 rp)~ 9-2S-~
PERMIT APPROVED BY BUILDING OFFICIAL/OESIGNEE leer 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
C 14-25 R84-
,
.
SETB,\CKS A~D OTHeR CC::OITIO::S Of APPRO'IAL ~lUST BE STRICTLY OBSE!l.VED. VIOLATIO~ G.~ R!:SULT IN REVQ-
C';7IO,J OF T!lIS r>!:r,~lli. CIT';TIO:: U:':OER PROVISrO:.lS Of Lt\l'E COU:;T\"j INFRACTION ORDI:;ANCE, AND/OR OTflER
REMEDlES ALLOWED BY LAW.
~llEN READY FOR INSPtCTIO~, CAL:' 687-4065. A }lINHlU:-1 OF ,,1 Lt:AST 2~ !lOURS ADV,\::CE NOTICE fOR INSPEC-
no", l<t;QL'~S,'S ;",'...i::iT ElE GIVE:;. Have the tollowing infor:nation ready: pcrr:lit number, job address, type
of inspection, when it will be ready. your name and phon~ number, and any s~ecial directiOns to site.
BUILDING DIVISION:
REOUIRE~ INSPECTIONS:
1. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
rr.aterlillll lor tne toundation are delivered on the job. \'Ihere concrete from a cC:1tral mixing
plant (corrunonly termed "transit mixed") is to be used, materials need not be on the job.
2. Concrete Slab or Under-rIoor Insnection: To be mace after all in-slab or \lnder-floor building
serVl~e equipment, conDUit, piping accessories, and other ancillary equipment items are in
place but beiore any concrete is poured or floor sheathing installed, including the subfloor.
). Framino & Insulation Inspections: TO be made after the roof, all framing, fire blocking, and
braCing arc 1n pLace ana nii pipes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier arc in place.
"')."
4. Lath and/or Gvpsum Board Insoection: To be made after all lathing and gypsum board, ~nterior
ana-eXiCrTOr, is in place but berore any plastering is applied and beiore gypsum board joints
and fasteners are taped and finished.
S. Final Insoectio~: To be made after the building is complete and before occupancy.
A~PRO~AL REQUIRED.~ ~o,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 limited to:
A. Block Wall: TO be mace 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 Qade after COQpletioo 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. 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. ~obile home minimum finish floor elevation shall be certified when required by a flood-
plain management 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
wnen pooi-rs-installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PE~IT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN~IBO DAYS.
SUSPENSION OR REVOCATION :1AY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POIlJT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
. .~
!'
SUBSURFACE AND ALTERNATIVE ~ 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 co~~unity Development by submitting the
installation record form. The Department shall inspect the construction to determine if 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 permit, 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 certific~te. Fuilure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
lation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface
From:
S~waqe Disposal
SePtic ~
10'
10'
5'
50'
Dr.:linfield
10'
10'
10'
i,lOO'
Interior property lines
Edge of road rlqht-of-way
Buildinq foundation
Wells, other water sources
.
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L.lNE COUNTY D'EPT ENV. MGT RECEIPT ,~, 26S7E15 DATE 09:5ol!
. A'PPL.ltANT' COLE,.. 'USA. I. ADDH1819 HAYDEN BHIDGE HOAD, SprUNGFIELD,
.,. TL.~' 1 7(J32521 f270(> SUBIHV . . . L.OT BLK.
. ., lllEW BL.DG .TYPE . USE. R FDRMS O. UNITS 001. STORIES '~BL.DGS. 001 I':HONE 747 0870
..: .'O.WNERNME COLP.::" pSA. ADDF~ 181'71..IAYDEN E1ruDt;E ROAD, SF'RINGFIEl...rO,li
. CODE Ap.PL NO, AcnON DESCF(IF'TION SQ FT UNIT COST VALUATION. FI~E DAY."
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LC, 265785. SUPP
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. i1ECHANICAl.. FEE
STATE.SURCHARGE. .
. PL.AN CHECK FEE:.
FT.
RAIN:
3,8.50
FT
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41.
.651.
.1.SA
25.03
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TOTAL. FEEl(.*
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TRS/TAXLOT
OWNER
APPLICATION # 2(a57-as-
ADDRESS
PHON(
APPLICANT
(IF DIFFERtiil)
t1UUKt~~
PHONe
JOB ADDRESS
VALUATION . . . . . . . . . REVISED P'q9R [ ] Refund
[ ] Addition [ Dep. Only ['1Amt. Due
[ ] Correction
CoJJ 7RJ.K.r 2';.80, Bldg. 58 .~o '25,0 c::> n.sCJ
- - Invest/
Db 1 Fee
Mech.
Plmb.
Fi xtures
..SHR FT
I1TR FT
RAIN FT
PCK '2.5, C:13 --C> Z.S.e>J
Surcharge f . $71- -D } .S4
Sidewalk
. Fldpln
SDS
DEQ
Other
TOTAL (p5:07 2.5'.0= '10;07
(AMT. PAID) (AMI. DUE)
DATE:
~!P
q - ""Z.5"" - as-
REVISIONS CALCULATED BY:
...... .' .0
AC.ITY INFORMATIO'SHEET
kJre county
.
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
II.
Lis,,- Calr.
PERSON MAKING REQUEST
J~lq Haytf.ILIN~~'fif!r.~s &1
Spfi~P~,..J,p QL, 97'12?
. trTY' STATE ZIP CODE
)Ja1J.~.!L".LiSJL UJJ~..
PROPERTY OWNER
];319 Hay")"')? ~r;~p- .!?d
MAl L NG DRESS
Sprl'''Qr. P,-dr.l
TY /
.~
STATE
Q7'177 .
ZIP CODE
') '17 -O$PO
BUSINESS TELEPHONE #
)l/)-Q!1.?O
HOME TELEPHONE #
'/4)- O~70 .J.!j7-0:PO
BUSINESS TELEPHONE # HOME TELEPHONE #
'.
., .. 2 PROPERTY ADDRESS Som,...
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORMATION) or from tax statement)
~n~~ J7 _.:$5:.:2.' , / Z. /fJ " gg-
01 QQ2Q.n
TOWNSHIP RANGE )tl..lluN TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
~(}Y
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: . u_ ACRES
4 SUBDIVISION (if applicable) LOT BLOCK
5 REQUEST (state exactly what you plan to do)
~ Ap;t-~' ( r1 .f
.,,/}.// ~
- .~
6 DIRECTIONS TO SITE: 1aK,. icrtn North bJcn...k.fLoXL)-ItJ.y.Jon fJr,d.yp RJ.
~
** FOR STAFF USE ONLY **
NUMBER
DATE
-t
:;tl
U>
ZONE/LAND USE:.
BY: DATE:
.
-t
...-:
TIME IN:
OUT:
LAND MANAGEMENT DIVISION / 125 E. Bth ^VE., EUGENE, OR 97401 / 687-4061