HomeMy WebLinkAboutPermit Septic Tank 1986-8-14
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RURAL ADDRESSI!\!2 ~ ~ ..[
CHECKED .I.\uo 0 5 r t /"...>
, FOR OFFICE USE ONLY
County AuthorizatlOn for:, V>f
Application/ "'J u' // /
Perm~ t #: ~ "'-7/-
SEPT! r. nT S.E..QS.AI
.
SYSTFM TNSPFr.TTON FOR IN
R~\f.l.EW
NW:;SH71 RAN:E//,- I S/7}2, /l T~t' OOUT OF
S:.rBDIV:e;9~/~AR~ITION (i~plicable) I I..OT/PARCEL I BLOiK
~r~ ,It
=ATlO~t- s~ jJ;;~/ ~$/ ~~/$I/
STRUCTURES C";;!)'~C%Y
01",,/F':' TIJ 7J2,4;:C he'
I
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zy~#~/~
PROPOSED USE OF PROPERTY
~idential D Industrial
o Commercial 0 Public.
/
~/t7/J/
::. OF BEDROOOS
OF EMPLOYEES
I WATER SUPPLY
.
f;J'~ t:7:.////~V
I DECLARED ~ VALUE
o Proposed
vr~~~';-~-
TELEPHONE NUMBER .
u~SCRIPTION OF PROPOSED WORK - BE SPECIFIC
SEPTIC INSPECTION FOR LN.
J # OF STORIES I II
O;'~ER'S~~ g~
CONTRACTOR'S NAME AND OSR II
P':;RfoIlT TO BE
MA~~
ADDRESSJ
)
TELEPHONE NUMBER
I HAVE CAREFULLY EXAMINED THE COMPLETED ^PPLIC^~I ~'OR PERMIT, ,U1d ,10 hcrcoy eert.ify r_hat all infol"lllation hereon is true and con::ect, and that I
have the following legal interest in the property: owner of record; 0 ccmtraL:t pl1rchaser; Oauthorized agent.
I f::.rther certify that any and all work performed s all be done in accoldancf, wi th the Ordinances of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will b<< made of ar,i' structure without the permission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force amI effect as required by ORS 701.055, that if "exempt the basis for exemption
~~~~~j)ju~~mPl~..S who '~l.~iS pro;.c:;;;.....: p
NAME (please prlnt) V SIGNATURE DATE:
READ THIS SECTION CAREFULLY. YOUR .AUTHORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS:
[] PLANNING/ZONING:
Zone
Partition fI
Parcel fI
Parcel Size
Minimum Setbacks:
eL, front
CL, side
interior
rear
COM:.\1ENTS :
FnJLUl
RFVlli/ PllRPllS.E..S....nNI V
Nn ,D~TTnl
01 J\MMTMC
~'SANITATION: S. 1. ..
Installation Gallon
Specifications: Tank
C"");'ENTS' . ~ tJ,tV~ <OS.
tJ.A /flU! ;f<<~-:o - _ ()
B. P. fI
~
/~ .
Installation Record Issued? 0 Yes 0 No
Lineal Feet Maximum Depth
<=<;;:::f;;- L-~~O::~
Oate, 0 ?-('f-p~ ~
Date:
'l,CU('" 0:1"'0""
.-s9-4/-r-C
[] PLANS EXAMINATION: Type
Group
Use
COMHENTS:
Date:
n
~J. ~~P\\ ~-IV-rc
p-ERRIT APPROVED B'1 BUI~1>>G OFFICIAL/DESIGNEE (cer ORS 456.805 (1)) . DATE
LANE COUNTY D5PARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
Cr."D O'C'''1t:''Det:'' PAD T'II.""C'nT''''''''T'''''''T T'I\TDf"\'DM7\IT'Tf"\l\"I
.
.
SETBACKS A:-JO OTHER co:mITro,:s OF ;"PPRQ'lAt. ~lUST BE STRIC':'LY oeSERVED. VIOLATIO~ CA~ RESULT IN REVQ-
C;..710:1 OF .IIIS PERHIT, cnATIO:l UlmER PROV1SIO~S or LA:-;E COl.i::TY'';; INFRACTION ORor:;';NCE, AND/OR OTHER
REMEDIES ALLOWED BY LAW.
o;HEN REAOY FOR I:15PECTION, CALL 687-4065. A ~lINH1Wl or AT LEAST 24 1l0URS ADVA:;CE NOTICE FOR INSPEC-
TIUCl IU:;Ql,;t;S,S ~lUST Ill:: GIVEN. Have tne lollowing information ready: permit number, job address, type
of inspection, when it will be ready, your name and pho~e nu~ber, and any special directions to site.
BUILDING DIVISION:
~EOUIRED INSPECTIONS:
1. Foundation Ins~ection: To he made after trenches arc excavated and forms erected and when all
rnatcrla~s Lor the 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-?loor Inspection: To be made after all in-slab or under-floor building
serV1~e equipment, conou1t, ~lp1ng accessor1es, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Frllmin.9!. Insulation Insoections: To be made after. the roof, all framing, fire blocking, and
brac1ng are 1n place and 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.
4. Lath and/or Gvpsum Board Inspection: To be made after all lathing and gypsum board, ~nterior
ana-exterIOr, 1S 1n place but before any plastering is applied and before gypsum board joints
and fasteners are taped and finished.
S. Final Inspection: 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 b~ 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 made after reinforcing is in place, but before any grout is poured. This
IniPiCtlOn 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 masonry (if applicable) an~ when installation is
compl~ Installation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturer's installation instructions.
C. Nobile Home: An ins?ection 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 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 )0 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
O. Swimmin9 Pool: Below grade when steel is in place and before concrete is poured. Above grade
wnen 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 SCSPENOEO OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION :1AY OCCUR IF THIS PE~~IT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POI::T or REQUIRED INSPECTIONS WILL 00 SO AT THEIR OWN RISK.
SUBSURrACE ~ ALTERNATIVE SEWAGE DISPOSAL ~:
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 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 complet}on before issuing the certif,icate. .~Failure to
meet the requirements for satrsfactory.completioft ~lthin a rcasOAable time'constitptes a vio-
lation of ORS 454.605 to 454.745 and this rule. ., .
, .
.Setbacks - Subsurface Sewage Disposal
Septic ~ Drainfield
'-
'.
From: Interior property lines
Edge of road riqht-of-way
Buildinq foundation
wells, other water sources
10'
10'
"
50'
10'
10'
10'
100'
,
x
ACTI_TY INFORMATION.HEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
1 .~ g/fft5 &Ij-Te5'
PERSON MAKING REQUf~ ~~
J;N 0, /~///.~ /
~JADD'~ ~/j{J-Y
CITY STATE ZIP CODE
:lIP -- f3/~
BUSINESS TELEPHONE #
--
.
~
~c-
PROPERTY OWNER
MAILING ADDRESS
CITY
ZIP CODE
STATE
BUSINESS TELEPHONE #
---' i
HOME TELEPHONE # I
HOME TELEPHONE #
2 PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER.
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
/7 0 J- f 9, J. /
TOWNSHIP RANGE SECTION
TOWNSHIP RANGE SECTION
TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
5 REQUEST (state exactly what you plan to do)
(6-r L Y\.
JOe)
TAX LOTlS) OR PARCEL #
ZONING
TAX LOTlS) OR PARCEL #
ZONING
TAX LOTlS) OR PARCEL #
ZONING
ACRES
LOT BLOCK
~/V' ff:7/~/l/
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p;?-~ 4/YLJ ~c::P!/ ,C?#'~~ ~/~
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6 DIRECTIONS TO SITE:
** FOR STAFF USE ONLY **
- --
ZONE/LAND USE:
14-33
r
LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061
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LANE COUNTY DEFT ENV MeT I:~ECEIFT ,~, 2441 B6 DATE 0B048.
ADDR 1136 E. 19TH AVE., EUGENE
, ~T
o UNITS 001 STORIES OBLDGS 901 PHONE 342
ADDR 1136 E. 19TH AVE., EUGENE
SQ FT UNIT COST VALUATION
. 'A,JI:'f.',5[('ANT cA1'leS'
.. ..' " ..... ,,1- I ,;1.. C:.., 1
TL~ 1702193100200
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OWNER ~ME BATES, URSULA
CODE APFL NO ACTION DESCRIPTION
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SWF:, FT. WT::C'
MECH,'<NIU,L FEE
STATE SURCH{~f~eE
F'L.ANCHECI< ICEE
FT.
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4%
2~:}i.:
U: 244186 SDSV
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COMPLETION DATE
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';jf: /~;~~~?t:i:s:?7:;,:,,., -- ~~ [GIfT ~_F.,!:~I N · _,,~,~_~'I_~__H 1 </-04.
.~) ~'~;I{l: PROP ClASS/~'::'1 STAT CLAS...!J:.Z. . DWElLING ' . -.....------e------ -.. " -';.... .'. ';"'.;:", '!" ''''~~!
. 2!1l t"iClASS '.d'?' .'"(7::'",,, QUAL ADJ - % J;.: : SQ FT 1 ST flOOR /f' U 7' '" PHYS COND ~ _j-.'. "-'q,,,.~'i:~ii:"-_,
.1 'Zl ~-StoRIES-;;-1_3~.:, .SHAPE ADJ % ~'",~.: SQ FT. 2ND flOOR . .,.". FUNC UTIl. . :':. 'COMPlfTE~'1r?".ii;"
<:'~ '.~ c?\'; SQ F.TG:IST flOOR' /1SS/7 " "',, .0,,:,._ SQ FT FIN ATTIC ,.:If,:: 'APPEARANCE ',,:,. "I,~-;..Jf_f';".~.."..';,
.4""iw..~, YEAIi BUILT 19 600 7,:"Jo!"',,~ ,:' ".';- ..',','~ SQ FT FIN BSMT . ..',.., DEPRECIATION ;_~'.':',' ;, ,~."~~};;,~1~
_~f !::f!<:l;; EFFECTIVE AGE"',',"',:-q,il!l\,',':", ">.' ";'~, T_OTAl L!VIN(U:~REA / y !/-t '.' NORMAL ...: .~% '. >~2'c<
.;, Q,'l REMODE\ED. X'D. NO 0 ,I ., CLASS OF SURR IMPRV . I FUNCTlONAL'.'--~% " '''.;,;''''{;';'
,,: ',. YEAR 19'-:J',._. PERMIT NO, :J"''' NBRHOOD LOCATION ' LOCATlONAL. % ,,': :.:_."':-:.:";.
; . RENTAL $ ",:""-- MO. >.'l'/' . ."" INT It-jSPEpED .' YEsr:::r-Nol2!l PERCENT GOOD~%' .., -:"~'-'''i:.'-~l
SOLD 19~ AMOUNT $ <1.7 q,;w 4c:. l'/1317'l .. '. ' ..-=-- . ~,'o,
- . . ,A'I""..:.G ..... / "COST INDEX' - "'c':
. ~~,. , .:..Jrf/y/-6k_ . Yf5~.I~ 'Q__~l_ p %
FOUNDATION '~,. PARTlTlOr,S F tl A B VA. Jr SUMMARY. " "_.. ,"' "';:',."',.~""..'i"'.,,.,
CONCRETE- PLASTER I BASE VALUE o./{..73 is "1)0
CONC BLOCK DRYWALL UPPER flOORS I:J , __ .' .
CONC SLAB COMPO 5HAPE ADJ %
BRICK ~. Cto & PA NET LUMP SUM 'I?\ 7 ^
STONE T & G QUAlIT'. ADJ % ." c.:.{.
FRAME PLYWOOD TOTAL REPLACEMENT C~ ,,<"7.'1.... ,'.'__
WD BLOCK FUR'D PERCENT GOOD ,jX % _ .. , . .
PAN[~ING DEPR REPLACEMENT COST ':if/ a.Y I:)
ADJ $ TRIM, ,... " GARAGE DEPR. REPL COST ''/ '(~,~ :-',:
I' .' ~ - , ~XTERIOR.', '>.'" I , FIR OTHER IMPRO'JEMENTS DRC '" $' 2. 9.' '7 I () '..;,:i'.
" WOOD FRAME . . HD WOOD. 19..:L:Z... COST INDEX ,1..:2&>_ %..; u ,'. . __ '(kg.,
DOUBLE.' ~ "1 $ , tOTAL DEPRECIATEO REPL CLlST <Lz. ''''~;'/''
SINGLE ADJ. ". '"
SHEATHGONLY -~ FLM~p"-!:: h1. '>.~!ING',' ~'BUllT-INS'::':"i~'~J~!j:"''''''
BEVel. :.,' . . .,.'.. DOUBLE ~ . I CLASS v 2 - 'I . SS /'" <::. ~ CLAss /c:, Z _ Y"M' ,',
RUSTIC'" SINGLE' I SQ FT L'iY7:' ''- "'''~';:.
VERT 6--Q':', ,'. . elECTRIC .' CABINETS ~ll>AS "'" ":';;'('
B & B:..., FIR GAS FIR "7.ELECTRIC. ',"'" ..:<t:I: .
WD SHAKE " . HDWOOD - OIL' ., HD.WOOD -'~OVEN'SGL :'i::i ."
ASB SHAKE TILE HARD FUel METAL : OVEN.DBL:'\fi.... ..
STUCCO ' CONCRETE e (p CAB. TOPS COOKTOP _<,::.'
COMP SHGL CARPET CEIl CABLE . ORMICA 'Z RANGE H' ,-..'.,
METAL PLYWOOD BSBD/W. UNITS lINO '. DiSHWASHER....
PLYWOOD lINO ~,. NO. WAll UNIT PLASTIC GA,RB DI5P .
MASONRY SUB ONLY HEAT PUMP , HOOD & FAN .
BRICK VEN EX: . CEN AIR C VAC CLNR '~FAN _ KIT
BRICK ADJ $ NO. TONS INTERCOM FAN. BATH. .
STONE r-" ROOMS ' l F U "'UU F. AIR t':' . . -'-t'.
CONC BLK C - - LIVING,... II Fl/W FURN ADJ $ ADJ $ 1\ 30 +"
PAINT. , DINING HOT WATER ,,-.,. ~LEC:TRICAL' :' "'.J I -to "FJREPlAC~"':j;
~~~~CO c..,~~I~YT~:~ .~ ~::'V~~~T ICLASS Cz.-C; (fLASS. ,';;r::"j'!itt
FAM/REC/STUDY m .k~"" PLUMBING '. .... . I.. '{,. 1 STRY SGL:: .r....
BED ROOMS CHIMNEY jCLASS /". ~'. '" ,. I STRY BKD '. ~'o i
ADJ $ FUll BATHS.2. PORTABLE Cl EXTRAS 6,?-</ . 2 STRY SGL "~,:o 1
. ,-. I" ,ROOF. . I . HALF BATHS ...J. RENTAL ~~ LAV. ,TORY I~ 2 STRY STKD j"-(,I (
'v GABLED J!,1'1JTllITY ROOM",,-- lIt. 0-' _ z. TOilET . - NO. OPENINGS:;~'" ;
wHIP ",' . ' ,'. OTHER I ,ADJ $ --" _' W. HUNG ~ PLAINz. /ZIJ ::';';-'Y
.' --...... " I . I... ." ._ -A'4~J €. .
~CIL;:~;R'~~~~ ,\,'. '.J~~f'~~'_ , C;';'~~:_::'S~--~;-::-:~,:-~~;S:..: - r ,i ~~~:T~~'::-; -" =-~.::.;~- ~~~;~~~~~~~;~I~
FlAT ..':.~.:". '.,1 '~.EALED I I I i SOT .-> . ~.. ..rJ.."t:r"~*"I' ,.~
COMPLEX :~:::i .:-~_-Llil -,fULL fiNISH _ . ..: ST SH CEIL.,:..; _ ,.;. .".-:;:.,!f"!'~:;"I.~;-i$" : ~
EXP BEAM "';' '-..: ~I'~S;, /.:;;;;:', ',' '''CLASS''~;_'.~5Q FT'",,'\,..;'....ADJ ~'J<_:s.i: ST SH f.B'~:,~t::.. ADJ $ "/:l6'D".tf.:! ",.
"- PITCH..'- c..1 IUNFINISHED I I I 1-1;, ST SH METAL<"" ,. _ Ma;';~~
lOW .~.::; -';1 SEALED . ~ I I I~ '. ."._ ...:".t-:.hjt~;.:'.;I"i''''-r,' .. . - CONC.bRJV6
AVE '1 fULL fiNISH I I I" -. GLS DOOR::';:':" - ". .B:.r.~DR.1 -
STEEP. . I . ~ . PORCH'
HINGLE '4SINK KIT ~l..:, \ -..' CO'lfREo
WOOD q"" BAH...,EPIT.. CLASS , 5Q fTo, - ADJ ~.. ',.1" SINK. W. BAR:,..... _. I ,. '!"ENdoSE
COMPO 'j' I"TOTAi 1"-", ,.~'t"'~~::'~.~"",~_!: !!An...r,,:~
METAL . I 5EAlfD , ~WATER HTR ':::..; .co: , ".. "CO:vER_
SHAKES e,.[O I 1'1 IFUlI FINISH I Z LAUN FAC~;>"' ,", ' ..: c"'i"<\o
ROnEe ROO~G LJ'1 LAUN TU.B :",V1!.... : .'" 5"",: . .
B~ TILE L" , " :"i;<.~~;~\:c :" BUiilt~.r.S
;h.~,r~,rr:s ; ..,J;'.J;.t~~~.:i;8;. OTH M
DORMERS . d"'., .'." SITE AND AREA INflUENCES l i 1,1.,.., ,."":.i..'r:' , '-" 'J':
LFT -.. VIEW I::'STRTYPE CONTOUR ,ADJ$ "tv.-. f . ",.,,,,... ..__ _
ADJ $ '1J-::;. +- ~ONE X ~N ~~\FF I: , W.PI1OVf~~\A;'::llf"~O~'"
I, SirE IMP~V' .~..,.: I MOD -RES NEG'I .
PAVED ACCESS . ~~ , IT~~~F1C S~c3g:AIN COil """0_ o,;.C:;-.~.~-;:;,~1 ~ 2
~1~~V;~tE~;ES~ Z~~E CON .25,.' ~66 ~~~'! 1NC01IIf APl'IOACII.....,. ,'~N~ J
g~~f~RS N~I~H TR L~iNTYPE ~NOD~~APING ".um APPtOACII, _civt~~~I"-~~~ ~
~~~~A~~~V r~T -;- r~AR ~~~R 1....OVEMlMTYAlllfco..a_'-;'r1i/~~11
~~R~~~~RS . ~~S L~~~HAPE ~6~D AS Of .".",SoU CAT: ,,~ 7 7'~~~~"'. .
UNO CABLES .. . NEIGH DES REG
STREETliGHTS", ~~ :;~ 71- '1" Yo ~ J~,.3S0"'~~l ~
""7GAIIl'~J--' I ~w I I' I, /LUMP I QUAL~EPL I PHYS'" - "~'~fiJ' ~
CLAS'S /~e-</ FOUN flOOR ROOF EX WALL INT WALL OIMEN AREA SUM INDEX COST Ull" .D,R.C;: ~l,
YR BLT 19 I'D? .--" c...o (...( . I GOOD ~ ".-:'~ ,'H:. ~ J.f
~~L c~':::t~ ~gi~' UN;:~~' NO.CARs...:<;'j/~r'Z. "2.1,~ 1::5'~ '- f'{ ":"{A~"(."
. 8SMT WOOD BEV DRYlPl ~Jl/.""""l'I,OD I ~;'.\:~~:~': :~
SHK l( WB IU"".?O v-( A;;, //v r. ~ ."/~1 _ 10 0 '. .:,":;;~* ~}.
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RESIDENTIAL APPRAISAL CHARACTERISTICS
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BUILDING DIAGRAM AND OUTBUILDiNGS
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REMARKS,
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DESCRIPTION
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DI'-lENSIONS
"RE...
S.F8A.SE
AOJ.BASE
REPL
COST
LUhtPSUhI
TOTAL
QUAL
INDEX
REPL.
COST
. DE', ...., DEPA.
rlHS :::: IlEPL.
'" COST
GOOD'll,
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Lt22_ 6'00
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1000
& OTHER IMPROVEMENTS
RECORD OF LAND APPRAISAL
I REMARKS:
I
I
I
TOT AL D.R.C.I$
'11 0
l;l...~,<,.'
- ,. ~,' ,..,':,..... '.,~
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OIMENSIONS
O.
ACRES
LAND
CLASS
aASIC
UNIT
VALUE
ADJUSTMENT FACTORS I ADJUSTED I
UNIT
VALUE
TOTM.
VALUE
TOTAL APPR V,t,L.
1/, /0.0
09X l/rJ
I/") /00
~PPR. BY
.;2<1/
r.lATE
'1-1-g ,?7
::"OIo1P. BY
OATE
.~,.o~I"G
AREA
IIo'IPROVEM[NTS
ELEe. I SWR.
,/ ~/-r
INCREMENTS TO LAND '"B'"
\- .:
I STREETS
"3;-
...liTER
!:lIGHTS
PERMIT NO.
".HUR~l
.:jESERVES
TYPE
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TOTAL
ACHE;S
.
. sue TOTAL !'~~::~~?~:;~~;~~'"
ITRANSFER TO VAL.UE,SUMMARYI
I
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