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HomeMy WebLinkAboutPermit Building 1976-3-12 . "fl1i .f ...",-\ ~ '.. Ii,," '.. '/1, ." ! ~ S'~i'! ': '/ "GONSTf,l'UCT,ION [J MOBILE HOME [X'J ' "IV' , S. r4. Terpin LANE COUNTY PERMIT FOr' " PERMIT NO. MH i'2":76 ,oOwn~r NAME Same NAME PLAN REVIEW [ J 23451 Highway 36 ,ADD'.RESS CITY CHANGE OF OCCUPANCY [ J Cheshire' :Ore'gon ' 998-C067 ZIP CODE, '. PHONE, , !o Contractor ADDRESS CITY ZIP COD,E" ", PHONE ,'", , O.S, Reg. # Twp',18 Rangp:l Filbert Grove, 5th add Subdivision ' NA , ' ' , , " ,,' , ',' 1f'.'.?3" ";/~()fd '~ ~1f!r /. ~~ Section ,', ,.Tax Lot . . Code ~ t. ,,.;",r Census ',Tract Lot 45' Block Acreage, Width. Exjsting Structures on Property' ',2021 Inland:'~lav Nane ' MH Renlac1na r40bile '~iOIilE! ' D~pth I Acc~ssto Property (Road N,ame): , , ,.Directions to Property'. Address: . . ~ , , lVil arid Wav' ,:STRUCTURE(# BEDROOMS)SQ, FT. , Permit toPal1"k Mobi1i.~ Home , :' Hook to the ExiStina Sewaae DislJosaLSvstem VALUATION O;"......1...,..""....,;...-G; . .-t' '---"'-"- SEWAGE DISPOSAL: PUBLIC [] SEPTIC TANK [ , BUILDING PLUMBINC? 3% SURCHARGFl , oJ MOBILE HOMF WASTE DISPOSAl PLAN REVIEW OTHER f] , Exi$t ' PLUMBING 'INSTALL'ED BY: OiNNER [] OTHER'[] NAMF' 'WATER SUPPLY: PROPOSED [ r ExiSTING [,] Il nf\ ,., D ._ [ ] PUBLIC . '. . [ ] COMMUNITY-.'NAME: [ ] PRIVATE WELL [,] OTHER - SPECIFY: ':In,,,,,,,, ""'10,1""", TOTAL;. '.lJi , ., CONSTR UCTlON PERMITS &1 NSPECTIONS AND WA TE R POLLUT ION CONTRO L 'SPECI FICA TlONS MIN. SEPTIC TANK CAPACITY: GALS. MIN, DRAINFIELD' L1N. FT. MAX. TRENCHoEPTH INCHES' flit ,f", '~n+, ...1 "',.... M...hoC'Y '" U......... ,....;.;.:r...:'.... 1n $,.,.,,,,, ,.$ ~u.l_~':..._ .Ji..._'.:...D.!l_'i..." .....--- ..-......- I._nl_,"'.""".""", ........,... ..,......,"'.....::1 ""!fU...,.'.....".., TYPE OF CONSTRUCTION GROUP, FIR E ZONF STAY 100' FRbM ALL WELLS' :~SECLAS$IF. " . 1 SETBACKS, FT. FROMCTR, OF r!W:- , , FRONT e::1 SIDE EXT: . ""-a FT. FROM PROP, LiNE: ' .' , ' SIDE INT, 5 '", REAR 7 ZQN!=,~~ 'AUTHORIZED SIGNATURES: 'Is/: ' J .E. Boss by ,H~rbaugh McKay for"Gr.ay ISSUANCE DATE: :' 3/12/76 ,. 'dlm .;','! l ." ,";:0"",'.",-' BLDG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX':'" PINK ,PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORtANT: ' , ' I ' Call 687,4065 to schedule all required construction inspections, Call 687-4061 to schedule all required septic system inspections, All construction shall comply with the State Buidling Code, D,E,Q, standards 'for subsurface sewage ,disposal and the State Plumbing Code: All buildings require a certl.ficate of "occupancy before being occupied,' (See'Detailson Reverse Side) .~.. I ""-i-. (POST THIS PERMIT ON MAIN BL:DG. AT S,ITE), , ".:T'~", '; " :'c. ',,, ' " ".. '" \ ',":';'lrlANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENT, ,,\;,:',;,:'::;~:~;~~~J~Ql:JS~ANNEX; 135 EAS:r. 6th, EUGENE, OREGON 9?~01; ".....,..\l~...:.:~...~ttl.j,:.;.:.'.~~!..., , "". ' C55.13. BU(LOI"l;SITE EVA:UATION . u j M (; /bF e!-f '/~~03 s // e\{. , -:' , ,', . , ,'n-, ,,) 7 ~' SUBO'I..SiO'N:5rh /l.d.d..c .~~ WILDiNG PERHITAPPLlCATlON...No-,r11v "'%- f" .. ',. . ,.LOT: ~~ 'fi,(T> , ~ITEINSPECTlON ' ' AP,PqCANT ~ ~"'.+.,,- .~ .DATE':. -- TAX LOT, , BLOCK:I , ~.~PLANNl~G' .0 I,V IS ION . , . , ~ .. - ... ApD 1 ~~~b le 'No Yes" :C~'I:O' BY: ' f4&f " () , ,"[") ( ) (6~' ;Setbacks frOm cl1 t), ,d':'- ,C) (J :;.~;. ,", ' ". Front (. ) . ,: '(.)' (:').., ,Slde Exterior f-y', '(J() (, :,'Setbacks from interior ;<) . .t ) (:)}: <:;' : itfh/ of road: . ' . ~ - ",L 'Zoning,OrdinanceCompliance::'Zon~ , '~2; .,Subdivi'sio!1 Ordinance Compl.Jance , ,3." Required Access, ," ' '4~ ,'Bui ld'i ngS i te (Area'.Wtdtb~ ,'Fro~tage) :<>:~." Other, (s'ee comments)' 1 i n8S: -. -",', . Side' ,Rear :' :' ':~.: COMMENTS: .'. , .i,. : PLANNING OIVISION ACTtONPE~DING:~YESl ,) NOt )dAPPL:ICATlON#,' : 'BUtLDI~G INSP~CtION~IVIS10~. ' 7. Plans Submitted " ~Q. Soil Stabflity (footingsf ",9. FloodPlain' ',$, 010. Other (s,~e commeflfs), ,.",' :. . '~":'-'" -- ". . ' l' '. .- ,Not,.,',.' .',..', ' :'ADPl i(a~l~;:',"r) :~" '.. '(y> (J:() _.' ',' "-,.>,.,~. . () , C,').( ) >, ',:..,,~ .' :',' ,.,' .;V' ".. , '.') "<:) ;('): ,':...,:CK,"b Bv:6/#a 3.1-?~ I ':~':"," . " . fDATE , '~Ot1~ENTS: ,. " t- ", . .,..; }. ~ WATER POLUTION CONTROL Not ";'" App 1 i cab 1 ~:.:' No 'Ye~~' (if .,,'r). ( ..) " (),.., \J) ( ): - . . . . .." . - 11~' Meets Departm~cit'of E.nvi'ron:inerital , Qual i ty' S,tarldards .:' ' 1 i .,Other,(see c;:omments,): .C'OMMENTS.:' ,c, . :, . - .--. . , C~'DriY:~~ g'AT~ -7f, :'t'. ;l .. : .-rP"APPL I CANT :" " ',,', _ , ' ,; ,~' , ' ~ ~9u'r Bu i 1 ding) s,j,te, Insp,ect ion: ':, ," :'", , ',' :, ,~.~an be'approved~, ,~", _ ,;~-~ ,',~ ',' () Cani1ot'be.,,.approv€:d atthi.s ,tiine::a~:'i:,ndica~ed:'6.niteni 'N6~ above. , /}: to'," f ~'" Que'st ibns, ~rid: further i nfo'rm, at i., o~' o~~ it.em, S,,'l,,;thfO~,9.ho,' 6 c, o~~.act ~~eLANE- ~':., ",COUNTY, PLANNING DIVISI.ON~ ' Questions and further Inforl!1atlon-on Items 7 ' . <..>', ,,:thr'ough 12 ,'contact the' LANE CouNty BUilDING AND'SANITATlON DIVISION. ' ( ), Will:be'he'ld'in,this office-unt-i-lyo'u can,r,esol"e the prol>lems ind,icated.- (,) is' being: r~turn~d~ ' ", . ' ,;" ',".' ,', " " '(.)' Your ohu i 1 d'i ng.,'perm i taE'pl i c~.!J2!:'_Je.~,is be i nq :r~tur:n~d unsler:se\?arate cover, ,', ' , 'DEPARTMENT OF ENVI RONMENTAL MANAGEMEN)", " ' ': ,.:, ",:".,C'l'35 Sixth Ave~ue East Eugen'e: Oregon 97401' ". , ' " P-HONE: ',687-4065 ' ., ;:_/ " ' " 'LA~E COUNTY PLAN~HiG DIVISlo'N:,P,HONE:'687,..4186 -! " '. :'. ~ 1 w C55-28 ":-"" . ~ ';.r~ :... . -, ., .1.;," , r,,\ . -. ... ~., c_,~ ~~, ,,;;;.. '~' , J':' '. .. '~J , ~., CONSTRUCTION [ '] MOBILE HOME Lit]..., PLAN REV:lEW [ ] .i ".... , 0 Qwner So ~o1QV'pin 2~1$~ Ui{!JltJQy, 'SJ5 NAME ADDRESS CITY SaG! ..1 .,,:LANE COUNTY PERMIT ,Fa' '0'" ...:'01 PERMIT NO. CHANGE OF OCCUPANCY , C~$hftre Orog4m ZIP CODE, , 116 Contractor 1,' 'O.S, Reg. # NAME r~~ ADDRESS CITY TvJp, ~8 Range!l S~ction ,! wn OO~ @NtlO G~&l a@lQ'l' -Subdivision 'Lot ~~ n Tax Lot Code " Bloc~ , Acreage , , ,',Access to Property (Road Name): ~fj2t I1illoo~Wmy ..~. Existing Structures on Property' , ' r~O ~Q4 .~lae~n~p~b~1GW~~ lIft 1 ~dl t1mf .Dire~tions to Property\~ Address: ,,\ 'STRUCTURE (# BEDROOMS) " ' SQ. FT, ' ~lfill~t ~fPtlrk f.f'.eM'lle ~ ~09~ to t~o [X1~~1~W ~~gQ ~~s~~~l $~Bt~ ,', " RmlGlll.tl<<!f'~ool1: . , ,SEWAGE DISPOSAL: PUBLIC [] SEPTIC TANK [ BUILDING PLUMBING , 3% SURCHARGF] MOBILE HOMF WASTE DISPOSAl PLAN REVIEW ':, ..~.gBt OTHER [,] : ' PLUIYIBING INSTALL,ED BY: OWNER [ ] 'OTHER [] NAMF , " WATER SUPPLY: PROPOSED [ ] EXISTING [] [ ] PUBLIC [ ] COMMUNITY , NAME: [ ] PR IVATE WELL [ ] OTHER. SPECIFY: LLf}t1!, ."iI~ "lfi nfll TOTAL ~-~~ , ZIP CODE Census Tract' Width Depth '" VALUATION 'l.. CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION ,CONTROL SPECIFICATIONS MIN,SEPTICTANK:CAPACITY:" :':Y, '. '\' '......; GALS MIN, DRAINFIELD L1N. FT, ' MAX, TRENCH DEPTH INCHES @t{ €i1n n~~ KlJ~n.tJ:} r.s-05>>nGl~fi');;'lA f~~J)l~rtt' 'ifil ..7",oi..> (i),t;F,,,,<)e{Hll1il,7,1 If1tlli'\"i1l\.g.,'!.....~AQ, ", . .~-- -- - - -..-...-....-.~-"O --... - ....... "-'.-" , 1 r~~ 1~..1~,j [ ] lBOO.,,((;t:lffi'1 , PHONE . , PHONE TYPE OF CONSTRUCTION , GROUP FIRE ZOI'JF STAY 100' FROM ALL WELLS' USE CLASSIF, . SETBACKS - FT, FROM CTR. OF r!W: FRONT l1,iil SIDE EXT, FT. FROM PROP:L1NE: SIDE INT, " ~ REAR AUTHORIZED SIGNATURES: /s/ ' ~.m. >>moa, ~J!.\~t,!~~~ I e;{, ZONE~P: , . r~~ f@f ,,~r~ ISSUANCE DATE: 1 ;$./J fJ.I,'1 [f, ,41J~ tn SLOG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD -. IMPORTANT: Call 687-4065 to schedule all required construction inspections, Call 687-4061 to schedule all required , septic system inspections, All construction shall comply wilh the State Suidling Code, D,E,Q, standards for subsurface' sewage disposal and the State Plumbing COde, All buildings require a certificate of: ,occupancy before being occupied, ' (See Details on Reverse Side) (POST' THIS PERMIT ON MAIN BLDG. AT SITE) C55.13 LANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENT , COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON W401 '-;. ,1.1 9wftl I ' f,J f SLAB FLOOR PLUMBING GROUNDWORK .r:., . ApPROVED I I DISAPPROVED I INSPECTOR I [ATE REMARKS' GAS PIPING'GROUNDWORK ApPROVED, .I / DISAPPROVED, I I D,TE I NSP'ECTOR REMARKS " ROUGH PLUMBING ApPROVED I I DISAPPROVED I I DATE iNSPECTOR REMARKS ROUGH GAS PIPING, ApPROVED I I ~IS~PPROVED I INSPECTOR I DATE REMARKS ~ ~ . ' , . ~\~,~ ~o.-SL-SL ,( "t.1 . " \ r~' D~ V 'CV, c...\L ~ 0 . Cl \ \ '. '1D 0~'t.\C:~P,ERM~T, ,# \'i\.~ ":l-~k ~ NOTE: NO ,PERMI1 .LL BE ISSUED UNTIL THIS A}?PLIG. I,ON HAS BEEW APPROVED' , 'APPLICATION FOR:' , ' ~,. STRUCTION I, ,I MOBILEHOMEIXlm~b\/1 ClW.GEOF,OC~ I 1"'1 ~WNER~' \'{\ (~'eX"'B.,"\,n ., 7~UJ~ ;:JO~~~, '. ' .....,- ~ Nam~ ' Address', / ,City ',.Z.l'p , Phone - I I CONTRACTOR '- ~ fY--rV..-', \ ,', '/ Cft,ey--~DCo~', '. ~' ~; Name ' Address' City II zip-- Phone '" " $ O. S. REG. II'" ,i ' , . ^ ~' ,Tw .'\ 'P\ Range,-~', S:9tio~ \ \. Tax Lot ',Cqde , . 'l' cen'slfs Tract \ ' \ ';'\ ~'e"* <6 "Cl->,.l , T'\ , " " l,...- , , " f/ Subdl.v'isl.on .s,;;.l~acf)Q\VLot ---\:'LJ _Block 'Property Acr,eage Width Depth ACCESS TO PROFERTY (RnadN~,) ~::;. \ ~ \ o..~. ~. . Exi,U'gSotuctu,"' On P<oP"'Y' ~ ~ {'~ ~ / ~\:( (9-p '~l':-:~\. ffi Id. ,Property ,Location - Address/Directions':, ' ," " .-'1/ . - , ' ,'... '\ '\ / . /'!I .-L'"" o.~CJ ~("'I\,' ,'/JZ ' ,', ' '-/ ~ , .--: ' /". " ,~f!' " , ' ~el-;; ~ Office Us e Onl YXXXXXXxxxxxxxm~XXXXXXXXXXXXXXXXXXXXXXXXXXXX'XXXXXXxxXXXXXXXXXXXXXXXXXXXXXXX:XXXXXXXXXXXXXXX " '.~ ':/' ,.," \ ,J,~' , (' J Sq. F" \f\. Aft',. '" flBed~oo~ " Valuat,ion ~e"Y'i\.--~' :\~ '\.~Q)~~, \\c-\\;.\:''\\.t\ \~\,,,\. U("'.~r)K 4r_) b '/!. ~ -:(. "" ~ ~l.~" ." ',' '. '-,~l/ ...' " ' "' ~_ N~ \_ ' , " \"" 'i: ;P'x.2Yp. Q:. - n, , , SEWAGE, DISPOSAL: ,tSS" ... '. ..,,'. .". /Y l ~~ ' ~', ' Site Inspection' Ir- \y... G,... Existing Sewage. Disposal Sysrem V ' , or New Sy~. Required -,...-- - , " I.'! , Public I. l/ ' I '.'.1 Community ~y I f/ ;.y PLUMBING: ' 7i~ "t,\ Installed by Owner I .1'\' Other I ',I Name Bldg. '. I!I Plumbing ~DQ, P:..UMBING FE~S:' .,/. '\':4- ,\ 'fI of F~xtures 3 %~Sur^charge ' /1 ,'. "'; \." , if ;~::.~~:: ...... .. ..t~l Mobil. Hom. - '::=>C'\C2<? \1l.LJ CASH I ~~ \ \' ./-- ~. II ., , , 17 ~_' ~ "t\ ,\ L 'Ill"" CIfECKI . ,~~:'~'<~ [I," 11;/ , . ,~l.' y/ . I I!! " , ' , . . " 'I prainfield Required - Lineal, Feet ~b6~d.V.dJ,' IJJ"~~ '/ {') ( 'iJ ' '1 ~~~, WATER SUPPLY: Well Spri~g , Other , Name of Community or ,Public System FEES, "" " ',' 'se~ag~~ Connection ' ~ Wat~r :::t Connection . \J)( b+-FU~D I\.,hs ., I FACILITY PERMIT I NO , .,..,/ I YES ,'Il,...---" I NO', , 'TOTAL ,.,:.t:n::~:~v:: ~~ ' Date: ~\ ~ \l \ ~ , Min.' Septic Tank Capacity ~_ - rio' Y!.o-D Ma~imum Depth ~,^_I\ '1-/ A...'~'\ dA r' . V ~~tl:t d. " Type of'Construction ';t. fl.' Group I , Fire. Zone' Use Classification Bldg Setbacks ~l from Center ~f,Road ~ight of Way:, , ,Front \0 \ Side Int,;~, , Side Exterio,r , "- i Rear~" ' Zone 'R/J -/1114-- C55' 12 7Z'" . ~4f;';l<1M 'ht;~ LANE 'COUNTY~EPARTMEN; OVE~IRONMEN,TAL 1,W51 IANN G. :. '-I~, /