HomeMy WebLinkAboutPermit Building 1985-11-20 (2)
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La~County AuthoriZ. ation for:
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""W;;SHIP. / 'C I RANGE /1 ~ I S;;~ON~ '? 13T~ --9A.OUT OF PROPOSEO USE OF PROPERTY
/0 C/'I....J //" C:-, C- ~~~ ~esidential D Industrial
5)'t~;TIT~ON ~:q;~r- ~//& I #427 I BLOCK 0 Cc.rrunercial 0 Public,
LOCATIO" ADORES? / ./:RE:: #J ~ cr.y ZIP ~
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'" OF BEDROOM,h I ff OF S~?y: I #-OF ~~YEr:S "I WATER SlJPPLY'/ 'l ". 0 Proposed
~ ~/.4- /p'~e- / /7.&7/:?:7#/// /V G.{Existing
O;~~'S NAME AN~SS / ~ 'U" ~ - r? I ;:!3E:.~E NUMBER
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CO~CTOR' 5 NAME /.No OSR It ~ . /? ./ I TEJ..~E NUMBER
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P.:.:RN1T :0 BE MAILED TO (NAME AN DRESS) _ ~ _ I TE~NE NUMBER
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FOR OFFICE USE ONLY
APPlicat~~ -;? ~ p ~
PermJ. t # V,.; --0 V
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1 HAVE CAREFULLY EXAMINED THE ca-tPLETED APPLICATION FOR PERMIT, ahd .lo hcrctJy cett.ify t.hat all infol"'lllatioli hereon is true and correct, and that I
have the following legal interest in the prope!"ty~ ~ner of record; 0 contract purchascr; Oauthorizcd agent' '.'
1 f-;.;.rther certify that any and all work perfo~~ be done in accOl-dilUC,-, wi th th~ Ordillanc~!l of Lane County and the Laws of the Stato of Oragon
pertaining to the work described herein, and that NO OCCUPANCY will be made of anr st.rllcture without the permission of ~he Building Div!sion. 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 oxemption
45 noted hereon, and that only subcontractors and employees who are 4n compl1ance w1th ORS 701.055 w11l be used on this project. I HAVE READ AND
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.. 'NAME (p~ease print) J SIGNATURE PATE
READ THIS SECTION CAREFULLY. YOUR1~~~\~TION ~AS~~~~~tFO~~:~;~~TIONS! \I..D<; -V -l
o PLANNING/ZONING: ... "art;:::;;:::> A Parti tion /I' Parcel /I Parcel Size /x: g l.
Minimum Setbacks: CL, fr;;:=: ~ f.......K' CL, side ' interior I ~p_ -\- rear .~~ /
- - ~\\) - ./
COM.'!ENTS, /I/,)#"/, JL:-?" ~A7.Z77V~ =-rr-. rm,r." '. ~ .J.... '. :'\7/
,~.~c.l~.rON'- )~~t-lrL.l'crn ~\i \\'\\<f:J'ate, {\..\ 1:", f'1." EI
~SANITATION: S. t. /I B. P. /I Installation Record Issued?DvesDNo
Installation Gallon Lineal Feet kaximum Depth
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d-1Ji" 7L.1./ ~ - d-<...t<.. ~. _,Mf... AhlA Date, //02 -Jrj ~
APLANS E~INAT;ON~: Type - Group --. Use hh
COM.'lENTs,.B-'C 1.UJ4.7F-R. :>uPPLv PIPE 7>/C'bllln/7liE'D /JIJ/!$R ~.
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~Iol~fl rt:<:;r:'rlnrnH;:mA THE.~TATI
OF OR[~ON, O:Pi.RTMENT OF
N'lV.MC"~.~j:' J:'I ~C'Ttf'l'jU C:;::'l"'Tlnllrl
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~tt RlVI.R.S[ SIDE Of- rlf\~.1lt ~.ND
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PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.805(1))
II-Zo-as-
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-
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SETB,\CKS A~D OTHER CO::01T1O::5 OF APPRO'h\L ~IUST BE STRIC7LY OBSERVED. VIOLATION CA~ RESULT IN REVQ-
C';":'lOCJ Of TillS pr.r<mT, C1T,\T10:1 U:-;OER PROVI5IO~S Of LA(>>E COti~;1'Y'3 INFRACTION ORDI:;ANCE, AND/OR OTHER
RE~lEDIES ALLOWED BY LAW.
IoiHEN RE.;OY FOR r:;SPCCTION, CAL:' 687-.;065. A ~IINnlWl OF' ,\1 LEAST 24 1I0URS ADVM:CE :.lOnCE FOR INSPEC-
nu:, rt!::Qt.:ES7S :'::";ST 1Jl:; GllEN. Have the tollowing information ready: permit number, job address. type
of inspection, when it will be ready, your name and pho~c number, and any special ~ircctions to site:
BUILDI~G DIVISION:
REQUIRE~ I~SPECTIONS:
1. Found~tion InSFcction: TO be made after trenches are excavated and Corms erected and when all
~aterlalS tor tnc toundation are delivered on the job. Where concrete from a 'central mixing
plant (commonly termed -transit mixed~) is to be used, materials need not be on the job.
2. Concrete Slab or Under-Floor Insoection: To be mace after all in-slab or under-floor building
serVl~e equIpment, conault, plpiny accessories, and other ancillary equipment items arc in
place but beiore any concrete is poured or floor sheathing installed, including the subfloor.
3. Framinq ~ Insulation Insp~ctions: To be made after the roof, all framing, fire blocking,'and
braCing are 1n place ana all p1pes, 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/e!:. Gvpsum Board InsDection.: To be made after all lathing and gypsum board, ;.nterior
ana-extcr1or, 1S 1n place cut oetore any plastering is applied and before gypsum board'joints
and. fa..sten,ers <Ire. taped an~ finished.
5. Final Insoection: To be made after the building is complete and before occupancy.
APPROVAL 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 auth~r;zed, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This
~ct:IOii is required for each bond beam pour.. There Io!ill be no approval until the plumbi.ng
and electrical inspections have been 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 with an approved, nationally recognized testing
agency and the manufacturer's installation instructions.
C. Mobile Home: An ins~ection is required after the mobile home is connected to an approved
sewer or sep~ic 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
reco~ended by the manufacturer.
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-
plain management le~ter.
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 pool-rs-installed.
APPROVED PL;..NS :-lUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. TillS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED'FOR-~IORE THAN"180 DAYS.
SUSPENSION OR REVOCATION !1AY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POIllT or REQUIRED INSPECTIONS WILL 00 SO AT THEIR OWN RISK.
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SUBSURFACE AND ALTERNATIVE ~ DISPOSAL SYSTEMS:
1. Permits shall be effective for one yeur from the date of issuance.
2. Upon compl~ting 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
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 permitiholder.
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. F<lilure to
meet the re~uirements for satisfactory completion within"a reasonable time constitutes a vio-
lat,ion of ~S. 454 .605. to 454.145 arilf .thill rule. <: _,'
Setba:~~ - Subsurf~ce ~waqe ?isoosal
'. \ . \ \ } ScPtic. Tank
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f~or.'l: Interior property lines 10'
Edqe of r~ad rlqht-of-way 10'
Buildinq foundation 5'
~el15. other ~ater sources SO~
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"'':Drain~iel~
10'
10'
10'
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A~VITY INFORMATIO. SHEET
Ictne county
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
'1'(" LI'f() Ho?a.i&f'f
PERSON MAKING REQUEST
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MAl LI NGADDRESS
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CITY '- STATE ZIP CODE
5 f/~- $/4/
BUSINESS TELEPHONE #' HOME TELEPHONE #
2 PROPERTY ADDRESS"'- :2cj &J. (p lI,p(r~~r
(IF DIFFERENT FROM MAILING ADDRESS)
L;; /) ;i! () / a. Id r-f
PROPERTY OWNER
1'176 6d/~11 ~t.
MAILING ADDRESS
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CITY STATE ZIP CODE
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BUSINESS TELEPHONE # HOME TELEPHONE #
0,. $;;;/''1/7''''7 y!) eltZ
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3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
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H~: Ft1.q,/A.~ Ie ~ 11-2.2.. 3Y~o {<l'I-llItff
. A. (J', r... b'f TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZelNING
(lA~. l'idS-
~ '\. TOWNSHlP RANGE SECTION
t#-~' . 2 ,\\
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TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
(from tax maps in Department of Assessment and Taxation ,I
or from tax statement)
, I
,
TAX LOT(S) OR PARCEL #
lONING
TOWNSHIP RANGE SECTION
TAX LOTlS) OR PARCEL #
ZONING'
ACRES
4 SUBDIVISION (if applicable),
LOT
BLOCK
5 REQUEST (~tate exactly what you plan to do)
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6ltolRECTIONS TO SITE: 'f~ ~ fU~ -.k ~~ 2.."k.Q (~~~~..
~ tJM.k. 2.~ -k, U .
** FOR STAFF USE ONLY **
NUMBER
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ZONE/LAND USE: DATE -=!
BY: DATE: TIME IN: OUT: \
C;~ 9~\t- t,l4- 2-771../-8r-- ~J
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LAND MANAGEMENT DIVISION / 125 E. 8th ^VE., EUGENE, OR 97401 / 687-4061
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LANE COUNTY DEPT ENV MGT RECEIPT ~ 313385, DATE .11088.
APPLICANT MOLATORE, LEO AD DR 2066 HARBOR DR., SPRINGFIELD, OREGON,
TL~ 1803112203400 SUBDIV LOT, BLK
.NEW BLDG TYPE MH USE R BDRMS 2 UNITS 001 STORIES ~BLDGS 001 PHONE 342 5161.,
OWNER NME MOLATORE, LEO ADDR 2066 HARBOR D8~, SPRINGFIELD, OREGO~~\
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST' VALUATION FEE DAY~'
.BP -Ii
BP H
BP
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'~~~ LC 313385 MH
.MHPL ~FIX/BATH:
MECH
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SDS
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BY RLH
SDAN
FEE
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SWR:
FT. WTR :
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
FP
SDS
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PCK
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2.
EST. COMPLETION DATE
FT.
RAIN:
47.
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TOTAL FEE**
77 .50 !
FT 25,0. ~
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4.10
60.00
5.00
25.00
196,60
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