HomeMy WebLinkAboutPermit Building 1974-6-4
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LANE COUNTY
BUILDING [[]
BUILDING PERMIT OR MOBILE HOME USE PERMIT
MH D PERMIT NO
MAILING ADDRESS
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d~O- 7Y
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PROPERTY OWNER
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CONTRACTOR
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MAILING ADDRESS
PHONE
PROPERTY LOCATION - INCLUDE POST OFFICE
O;~ l~bhtHJ,< ~'dr.ST :;F' 2~2t\1;".} i,1MlCOlA
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
ADDlrlCSS 1.1N~E::~~USE~~ J;8D ~.~HAU;\
TWP RANGE SECTION
n/;;)o A''30UT 500 f[(!;7 Oe-. Soc.'t.., S I Dr. 0 t1,-I 1"i: NOUS!-:o
v7
02
30
TAX LOT NO
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CODE CENSUS TRACT
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1~~04 20=[D=u~~
EXISTING STRUCTURES ON PROPERTY
SHAJ[ MI~L AND 5~~T!C SYSTEM
LEGAL ACCESS TO PROPERTY
ff.::>!-I t:\ 17I( R~ 0
PROPERTY SIZE - FT
C1::fiC[ Af\;D
APPL
NAME
&
MAILING
ADDRESS
FOR MOBILE HOME PERMITS ONLY
No of Bedrooms
A3'JlV!::
WIDTH
DEPTH
AREA
STRUCTURES TO BE BUILT THIS PERMIT
ECUI~ME~T ~E~AIR..GARAGE= A~O O~fICE
Connect to EXlstmg Sewage System D
TYPE CONSTRUCTION SQ FT # BDRMS
5=N 2016 ~5o))
New System D
VALUATION
j"-
~ ~ pC,)v
STRO~G~ HLDG.
5760 Gll~. 50
~:9 ~l"'~
;'. p~u~m:r'r, FD~TUR(5
SEWAGE DISPOSAL En I S"i'
PUBLIC 0 SEPTIC TANK ~
BUILDING ~.
WASTE DISPOSAL
PLUMBING 1
PLAN REVIEW
PARK TRAILER
VUfDfTV OF THfS PERMIT
IS CONWJGENT aN APPROVA
CONSTRUCTION AS REQUIREDL ~y"
ORS 479.155.
17 ~Cj~;,
OTHERD
1?1.~ FEES
PLUMBING INSTALLED BY
OWNER 0 OTHER NAME
WATER SUPPLY
PUBLIC ~
o OTHER
10.00
~t:\ 7~
TOTAL
~
1cn ?i::\
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
MIN SEPTIC TANK CAPACITY
WITH DIST BOX GAL
UN FT
TRENCH WIDTH FT
OR SQ FT
Do .,,~T S~I;'-D :'11v.llrl ~O ,,'[[7 E3f (!)t'STH,'C rr:PT'C SYSTcr.1.
TYPE OF STRUCTURE
OCCUPANCY
ZONE
r.A
USE CLASSIFICATION
I~~"C\ I" GiJi'l.!\GE (:., HAf'lf':Ot)~,.
PUBLIC UTlL EASEMENT
")~I'J t=!; (\~ r =2
BLDG SETBACKS., FT FROM CTR OF ROAD RIGHT OF WAY
l,flPCO:.A :<lD.
FRONT ! n ~I(")O SIDE INT SIDE EXT REAR
AUTHORIZED SIGNATURE - DATE
DATE
! ~~ , .t S. S.. BY. D. ~'.n..; '1'E:
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BLDG PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
Construction to comply With uniform building code and county regulations
covering plumbing and sewage disposal All buildings require a certificate
of occupancy before being occupied
(See Statement on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, BLDG & SAN DIY, COURT HOUSE, EUGENE, OREGON 97401
FORMitC55'13
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Pl?OPERTY SURVEY
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JOE BALCO/vl
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REGISTERED
PROFESSIONAL
LAND SURVEYOR
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M"'~7 19"7
CLYDE A. RANDALL
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I PERI~ IT IS 3E I NG HELD FO~ THE REf,SO:lS
Lhl~[ rC'il,HY LUIL~,I'" - "
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EUG EdE, OR EGQr~ 97401
YOUR BJILlJlNG r ~~BILE HOME i
SHIED ON THE BUILDING SITE
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THE REQU! RED ! NFORt1AT70N, AS
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E\lALlIATlIn! SHFl:.T. \~E WILL HOLD THIS APPLICATION
UNTIL
!F, AT THAT TIME. YOU HAVE NOT FURNISHED
SHO\JN ON THE ATTACHMENT, YOUR APPL I Ci\T ION HI LL
BE CANCELl.ED AND ONE-HALF THE HE. REFUNDED TO YOU.
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T /"":2 S ,50 TAX LOT 9t.n;
CENSUS TRACT
~ Building Permit Appl ication No.
() ~ i te Inspect ion
() Pre-Permit Investigation
APPL ICA~/
N/\ME l5a (0 rn
ADDRESS
PHONE
DATE
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L/\NE COUNTY PLANN I NG DEPARTMENT
I.
Zoning Ordinance Compl iance
(Zone-H~ )
Subdivision Ordinance Compl iance
NOT
app I icab I e
() () (~ ~/;!:::>
( )
( )
( )
() () ()
ADD'IU DE-O, (~I..J~t r:z:::tr:::., cJr-r'-', )...,nloJ.-A'lLi 1'-. ~)
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NO
YES
NAME
DATE
G-2./-74
2.
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Required Access
(\~
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(,)
( )
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4.
Building Site (Area, Width,
Frontage, Setback)
Other (see comments)
5.
COMMENTS:
BUILDING INSPECTION SECTION NOT NO YES NAME DATE
apD I icab I e
6. Plans Subm i tted () () ~
7. Soil Stability (footings) (I) () ()
8 . Flood P I a i n () () ()
'9. ( .) ,." () ,... ~ / . .# ~ 8~- 3 -7 ~A
Other (see Comments) ~ ~ 5-:.-ZI-7j,
COMMENTS: _ ~F:P 1<!F:TIhi"IED~S.~., ~l~ED "S\re. PLA.k,) ~ DETAIL f<a'Q'~. "t':s.
~~ A~I \ t'Lr<. 51~ . ,)
'\ TH-E PEl?M.lPt::, 2F..ADM I 50 A~ 5DQIJ A~TH-E A5oV!i" ~IPE.MEJ.;T3
AJ!.E" }.o15T , f F
SAN ITAT ION SECTION NOT NO YES NAME DATE
appl ic#le
10. _. Sewage Disposal .0 () ( ) /
11. Usable Area <y< ) ( ) ~/ ,71/
12, Water Supply ( ( ) ( ) . ~tJf . rP
~ ?t
13. o t he r (see Comments) ( j ( ) ( )
COMMENTS,
TO APPLICANT:
1'( Your Building Permit / Site Inspection
(t ,/~~ Can be approved. .0
1-) '\ '~cannot be approved at this tIme as indicated on item NO. 7 above.
'0 \ Questions and further informat Ion on itenls 1 through 5 contact the L<:lne-
/ COUNTY PLANNING DEPARTMENL Quest ions <.'lnd furt'ler information on items 6
through 13 contact the Lane County Building d:ld ~anitation Dlvl',ion.
Will be held in this office until you can resolve llw problems Indicated.
Is being returned.
Your building perrllit appllCc.1tlon fee is oeing returned under separate Luver.
Lt\Nf (flllNIY f'U\NNING DEPI\RTMENT
13') ~cxth Avt'llut:' Ec'1~t. EUljelle, ()'~9l>n 9]401
/?tWNt. 341,IlII 01.21'
LANF COUN1Y BUilDING & SANITATION DIVISION
131) SIxth t'lv~Il/(~ East, EII~ICI](" Olcqnn 97401
/')~KHJI Jl12-1311 DT. ~rl
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PROPERTY OWNER
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CONTRACTOR
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LANE COUNTY BUILDING PER/~IT OR MOBILE HOME USE PERMIT
BUILDING [?;J, MH D.' PERMIT NO.
MAILING ADDRESS ,
. \l~',,~'-f:/ 1'~~9~lf :~71.: J .~c,:rJf.;l~:Jf" I leO',
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MAILING ADDRESS
PHONE
:~~:~t~'.~~~: .
PR9PERJY lOCATIO!'l- INCLUDE P,OST OFFICE
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PROPERTY lEGAL DESCRIPTION - METES, B9.UNDS
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RANGE
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SECTION
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TAXtL~~ NO,
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CENSUS TRACT
<:~:':~)~r s
EXISTING STRUCTURES ON PROPERTY
Dt-D,~,{-~f~' !~I \. '!.:, ,~/';':~~ ~ ;~::'l/; ': (.: \- ""11 ~
APPl.
NAME
&
MAILING
ADDRESS
FOR MOBILE HOME PERMITS ONLY'
No. of Bedrooms
-lEGAL ACCESS TO PROPERTY ,
t~:tii'f_~~:~ ~
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_. ''1
PROPERTY SIZE - FT.
WIDTH
DEPTH
AREA
STRUCTURES TO BE BUILT THIS PERMIT
,Connect to Existing
TYPE CONSTRUCTION
CJ"'" ~~
Sewage System 0
SQ, FT, # BDRMS
"~~~(: C'~)~;
New System 0
VALUATION
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VALIDITY IJf Tn," ,..-
IS CONTlNGEN oJ nRMn
CONSTRUCTION T A~N :::RPVAl OF
6ftS "/11.'55. lIJREO, ut
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h""'-'~>""'_A-ft!"".<t~,,i-::,~'-~~ _
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0" -; ~:~;:, .;:r,:s
SEWAGE DISPOSAL
PUBLIC 0
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAilER
i:'c1 ~ f;':;,
SEPTIC TANK EJ
"
;:
, OTHERD
. \:'~' i ~ ,~~i}
FEES
PLUMBING INSTAllED BY
OWNER 0 OTHER,-,NAME
WATER SUPPLY
PUBLIC dj'
o OTHER
n
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TOTAL
~
COUNTY BUILDING & S.l\NITATlON SPECIFICATIONS
MIN, SEPTIC TANK CAPACITY
WITH DIST, BOX: GAL
DRAIN FiElD REQUIRED
I
lIN. FT
TRENCH WIDTH FT.
OR SQ, FT,
{'~')
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OCCUPANCY
~~., rf: 7,.-",';".,
"".. -
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ZONE
rQ::;
USE CLASSIFICATION
dQ }~r.;~:~J S
PUBLIC UTll. EASEMENT
TYPE OF STRUCTURE
("."
B~.o.G";~f,:'i-B~<:K?:~"p, FROM CTR, OF ROAD RIGHT OF WAY
FRONT Y: '" !'T;P SIDE INT, ~~"" SIDE EXT,
AUTHORIZ,ED SIGNATURE - DATE
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DATE
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BlDG, PERMIT - WHITE
OFFICE COPY - WH ITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUilDING - GREEN ,
" SANITATION - GOLDENROD
Construction t6 comply with uniform building code and county regulations
covering plurribirig and sewage disposal. All. buildings require a certificate
'of occupancy Ibefore being occupied.
(See Statement on Reverse Side)'
(POST THIS PERMIT 0" MAIN BLDG. AT SITE)
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,lANE COUNTY, BlDG, & SAN. DIV., -:OURT HOUSE, EUGENE, OREGON 97401
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SITE I NSPECT I ON
ApPROVED 1;/) DISAPPROVED I I WATE ~ -b-?~'INSPECTOR ~
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REMARKS /WJ-/Pk;,.L.~ ~--l-7 ~ ~
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FOUNDATION INSPECTION
REMARKS
I .-;~' 01 SAPPROVED I I DATE 7- / 7-?c/ I NSPECTOR lY-~:~
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ApPROVED
FRAMING INSPECTION
ApPROVED I I DISAPPROVED / / DATE
INSPECTOR
REMARKS
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LA TH OR SHEETROCK I NSPECT I ON -. ~ t7. ...r!- /l I -/Z.l
....~'-1 ~- ...~ ,-J7Sep
ApPROVED / / DISAPPROVED I DATE INSPECTOR
4"J ,1'-:r- - .0 ~. J- A , _ ~ (/ -:J - 0
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REMARKS
FINAL INSPECTION
ApPROVED I I DISAPPROVED I I DtTE
REMARKS
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CERTIFICATE OF OCCUPANCY
INSPECTOR
READY TO ISSUE / / NOT READY TO ISSUE I I DATE
INSPECTOR
REMARKS
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LANE COUNTY ...JILDING PERMIT OR MOBILE HOME USE APPLICATION ~~
PERMIT TYPE - BUILDING}g( MOBILE HOME Dose REG # PERMIT # J '-/0--7 Y
PROPERTY OWNER MAILING ADDRESS PH 0 t-tt:
~~ , O. /9fo /U1/ I dp'~q-4-(~, (~.J_/~~'
CONTRACTOR "/ J- MAILING ADDRESS 7.J' # I V_!HONE
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PROPERTY LOCATION - INClUDE POST o/FICE ) ", j, /J // ~ /. .../ r
#-71_ YJ1d~~( ~7L/;L/LP(_ )J!-~j/~/C~/:--'u~~~.,~^-,
PROPERTY LEGAL DESCRIPTION ~tI...~-- ~, - ~ ~ .~~TES & BOUNDS DYES
LOT - BLOCK - SUBDIV . - F - ATTACHED D NO
TWP RANGE SEC TAX LOT # CODE CENSUS TRACT
/7 (}2J 30 CYCJo /9.-od.:::20 -EO/SO
APPLICANT ~ DESCRIBE EXISTIN6STRUCTI,JRES ON PROPERTY IF ANY "-..-_ '
NAME J'J4~,v~-~,/ ~ d~,/ V?Aj~ ~ "d.42~,
LEGAL ACCESS TO PROPERTY - ROAD NAME OR #
'7h~~_A_/~ ~,
PROPERTY SIZE-WIDTH DEPTH
AND
MAILING
AREA
ADDRESS
MIN SEPTIC TANK CAPACITY
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms Connect to Existing Sewage System 0 or New System Req 0
STRUCTURES TO BE BUILT THIS PERMIT . GIJt2~C-EtYPE COt:!-STRUHI.0N", SQ FT # BEDROOMS VALUATION
7 0/ ,tU~ Ynl' /71/p, ~ tf..A/$.J'1 ~"C-L . b:;:.:,:J~./\ - (3b X; .t;-T &:0-10/ 6 fi~ 50 '/ .
t7 /' - / I ,- Ii' f' . '. ./ . - ,o-j fA -' /4 &,? ~
/~' -' ' - {~~, _eQ(j/f::::./:'p(T t? is. tJj ;t
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(CtL--:r~/' /.,~ f ) tlDO~65 --( v4i2bfflfl}$C - 3 580 MhHAuJ~ ,/:fjJ;7o
/ C>f1:u:E: ~t.SttoP - 3 cj eLl M-o~( " -:YJ
// 3/f.tJoJ>
/ ./
OWNER D OTHER D NAME /"
PLANS FURNISHED //> FACILITY PERMIT
YES '56 NO D ftS ~ NO D
,S~GNATUVF A7L~!~'r 8p? J DATE f'---~"'"
~ D/l / / /' ~ c.J-,.,2(/-7~
FEE RECEIVH B't' ..... DATE
M lS,,/I
PFRklIT #/" ..
PUBLIC WATER iF' "
CONNECTION FEE ....:::;, ~
COUNTY BUILDING & SANITATION SPECIFI-CATlONS
/'
DRAIN FiElD REQUIRED I~
lIN FT TRENCH WIDTH J/
:b~~~ IP ;_\,~. 4~ l ~ ji) rv~{ h f
- II
I
/
,Ii ZONE
H~
PUBLIC D
-bL~
SEPTIC TANK t;f OTHER D
$ /.::2/.$6' FEES WATER SUPPLY
PUBLIC )(
/ i'J, rJ" PLUMBIMG FEES
t?5. "'/..? ~ FIXTURES
CASH D ,~
CHECK .;('CONN'ECTION FEE
PLUMBING INSTAllED BY
SEWAGE DISPOSAL
BLDG
WASTE DIS
PLUMBING
PLAN REVIEW
PARK TRLR
OTHER
/7 -" A...,(.J
(:!:::. 0,).
(P.~
J:I.~
TOTAL
/9?,~.5
WITH DIST BOX GAL
OR SQUARE FEET
I
~<:/r/~J-
~s
i'\
...t lr\~
Vl01
TYPE OF STRUCTURE oCCUP'!6.NCY
:5-~ E--4 sli~-Z.
BLDG SETBACKS - FT FROM CTR OF ROAD RIGHT OF wJ,~ I USE CLASSIFICATION
H~a..A A.J". · .. f D ~
FRONT~ ~lCf': SIDE INT D SIDE EXT (2) I REAR C f;..epA.t~GtA~ WA~~
SANI.TARIAN Date PLANNING~ \) . !Date BLDG ~S~ ./ )~.. Date
}~5~hi~ J.)f~6 7,'1 \M --- \,-/~U.74- ~ ~-3-71
j
Directions to Find Property ViiLHii'J Of THIS PERMIT
IS CONTINGENT ON APPROVAL OF
r.rms'ltUCTION AS REQUIRED BY
ORS 479.155.
REAR YARD
PUBLIC UTIL EASEMENT
COPY 1 - OFFICE
COpy 2 - JOURNAL
COpy 3 - AUDIT
\ Form # C55-12 ,