HomeMy WebLinkAboutPermit Building 1980-10-28
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CONSTRU,-- :ION/PLACEMENT
PERMIT
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FOR DFFICL USE ONLY
17
03
I SEC'l'ION
22.1 3
I
LOT/PARCEL
AND PRINT.
TA< LOT OOUT OF
17400
I BLOCK
14
CITY
~~PhCd;~'9W~
~COPl~S of Plans
o Two Caples of Plot plans
DHechan1.cal Checkl1.st
OPlumblng CheCY!lst
DPlan C~ck Info Sheet
COMPLETE THIS BLOCK.
PLEASE USE BLACK INK
TOI\'NSHIP
I
SUBDIvISION/PARTITION
RANGE
{If apphcableJ
3rd add to GamebrId VIllage
LOCATION ADDIlliSS STREET
26
zrp
PROPOS? U~L OF PROPERTY ,
~e51dentJ.al []lndustrlal
433 Grouse St . EUQene. OR 97401
STRUCTURES CURRI,;NTLY ON PROPER'! Y
o Cormnerclal
Dpubhc
HOllse
DeSCRIPTION OF PROPOSED WORK
1$
VALUE
W}'l Orl PV
Ii OF BEDROOMS - I'
"l~
O'l'lNLR'S NAHE Ar'D ADDRESS
N^
N^
o Proposed
o EXJ.stlng
TELEPHONE NUltHER
N^
I ' or
EMPLOYEES
WATFR SUPPLY
OF STORIES
'B',rl),qni 11- Rp.f'f'.f' ~~mp ~.~ .<:lhrnu=>
COdTRACTOR'S MAIlE AND l1.DDRESS
7?fo-fof;PR
TELEPHO,'E NUl'-lBER
CONTRACTOR'S OSR ~
DIRECTIONS TO SITE
Be1tI1In~ to Game farm rlght of FlamIngo -Corner of Grouse and FlamInQo
I !lAVE CAREFurLY CXAMH1EO TilE COMPLETED APPLICA'lION FOR PCRMIT, and do h....r....by (('ttlf, thilL all lnrormat10ll hereon 1" tnl.... and corn.ct illld I further
cert1fy that any and all work. performed shall be done in accordance w1th lhe OrU11lance<; of L-.ne CoUnLy dud the IdW9 of tilt St tic o~ Or"q::>n pCIllJI!!n',!
to the work. descr1bed hereIn and that NO OCCUPANCY w111 be made of any structure l,"lthout the perm1SS1on of the BU11d1llg DIV1S1on I fU1thf'r ct.rt1[y
that reg1strat1on with the BU11der S Board is in full force and effect as requ.l-rcd by ORS 701 055, that if exempt the bas.l-s for exemption 15 not,..d
hereon and that only subcontractors and employe(,.s who are 1n compl1ance w1th ORS 701 055 w111 be used on tllls prOJect I HAVE REi\O MlD CIIECY.ED THIS
APPLICATION THOROUGHLY
Rid r1..:c:cLM \ 'Ke.e..c J? '
NA~~ (please prlnt)
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SIGNATURE
41/l'O
~r
D Contractor
D Agent
J
o PLANNING/ZONING:
Zone
PartlllO'"! lj
Parcel #
Parcel Slze
l>llnl.mUm Setbacks
C
L, front.
C
L, sl.de
lnter.l.or
re<lr
Comments
#.4
o
o
o
FLOODPLAIN: In flood hazard area?
RURAL ADDRESS ING: ORLD COORDr,^n
Date n
o No DYes, see attached sheet Date n
N E Date 0
S.MHTATION:
S I ~ I
.
-'
B
p
#
Installatlon Record Issued? 0 Yes 0 No
lnstallatlon
SpeCl.flcat.l.Ons
Gallon
Tank
L1neal Feet
of Dra.l.nf1Cld
Max~rnum Depth
of Trenches
Comments
[X) PLANS EXAMINATION: Type12iJ-
Comments j~ UJ
Jc.
\ .
Use wo/~T
I
o
*
Date
CONSTRUC1ION AUTHORIZED BY THIS PERMIT
Descr~pt~on
F~xed Fee/ Floodpla~n Fee $
Sq Ft Unl.t Cost Subsurface Fees $
Bu~ld~ng Fee $ /(p
I
Sewer/Storm Draln/Water $
Plurnb.l.ng F~xtures $
Mechan~cal $
Plans Check Fee $
State Surcharge $
t70
(\....l.on T,le:,
,
,(4
TOTAL VALUA'I'ION
$
TOTAL FEE $~
FEES PAIDk! ~k ^ 0 Cash
By {~~ _
Ij7d-:V~
IO",~fJ"'8D
Date
1:~~
PERMIT APPROVED 81 BUILDING OFFICIAL/DESIGNEE (per ORS 456 805(1))
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT / 125 EAST EIGHTH AVENUE,
DATE
C74-194
SEE REVERSE
t
OREGON
97401
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SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED VIOlATION CAN RESULT IN REVOCATION OF THIS PERMIT.
CITATION.UNDER PROVISIO~S OF LANE COUNTY'S INFRACTION ORDINANCE. AND/OR OTHER REMEDIES ALLOWED BY LAW
-.
WHEN READY FOR INSPECTION CALL 687~4065 A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST MUST BE
GIVEN Have the fol'owlng lnformatlon ready Perm,t number, Job address, type of lnspectlon. when It wl11 be ready.
your name and phone number, and any speclal dlrectlons to slte
BUILDING DIVISION
REOUIRED IIlSPECTlONS
1) FOUNDATION INSPECTION ~ To be made after trenches are excavated and forms erected and when all materlals for the foundatlon
are dellVered on the Job Where concrete from a central mlxlng plant (corrrnonly termed Ittranslt ffilxedll) 15 to be used.
materlals need not be on the~job
2) CONCRETE SLAB OR UNOER-FLOOR INSPECTION To be made after all ,n-slab or under-floor bUlldlng serVlce equlpment.
condult, p'p,ng accessorles and other anc,llary equlpment ltems are 1n place but before any concrete 15 poured
or floor sheathlng installed. ,ncludlng the subfloor
3) FRAMING & INSULATION INSPECTIONS To be made after the roof. all framlng, flre block1ng and braclng are In place and
all plpes, fireplaces and chlmneys and vents are complete and all rough electrlcal and plumblng are approved All
wall lnsulatlon and vapor barrler are 1n place
4) LATH AND/OR GYPSUM BOARO INSPECTION To be made after all lathlng and gypsum board. lntenor and extenor, 's, In place
but before any plaster1ng 1S appl1ed or before gypsum board J01nts and fasteners are taped and f1n1shed
5) FINAL INSPECTION To be made after the bUlldlng lS complete and before occupancy
APPROVAL REQUIRED No work shall be done on any part of the bU11dlng or structure beyond the pOlnt ,nd,cated 1n each
succeSSlve 1nspectlon w1thout flrst obtalnlng the approval of the bU1ld1ng offlclal Such approval shall be glven only
after an 1nspect1on shall have been made of each succeSS1ve step In the construct1on as lndlcated by each of the 1nspect10ns
requ1 red
NOTE
All
A
C
bU11d1ng perm1ts requlre 1nspect1ons for the work authorlzed, such as but not 11m1ted to
BLOCK WALL To be made after relnforc1ng lS 1n place, but before any grout lS poured Thls lnspectlon lS
requ1red for each bond beam pour There w1ll be no approval unt1l the plumblng and electr1cal lnspect10ns
have been made and approved
WOOD STOVE To be made after completlon of masonry (If appllcable) and when 1nstallatioQ lS comolete
Installat10n shall be 1n accordance w1th an approved natlonally-recogn1zed testlng agency dnd the manu-
facturer's lnstallat10n lnstruct10ns '\ 1..
\\1' ~~'-,. 'J')
I~OBILE HOME' An lnspectlOn lS requlred after the mob11e home lS connected
systemtfor setback requ1rements, block1ng, foot1ng connectlon, tledowns,
connect10ns
(l) Footlngs and plers to comply wlth State foundat1on requ1rements for moblle homes or as recommended
by the manufacturer
(2) Mob,le home minlmum flnlsh floor elevat,on shall be cert,f,ed when requ1red by a \loodplaln
management letter
(3) Mob1le home tledowns, when requ1red, and sk1rtlng shall be lnstalled and ready for 1nspectlon
wlth1n at least 30 days after occupancy Tledowns and sklrt1ng shall be lnstalled per enclosure
to an--apiPro~ed ~ewer' or
sk1rtlng, and plumblng
l \1./:
septl"c"
B
D SWIMMING POOL Below grade when steel lS In place and before concrete lS poured Above grade when pool
lS lnstalled
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES OURING WORKING HOURS THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN
WITHIN 180 DAYS. OR IF WORK IS SUSPENDED OR ABANDONEO FOR MORE THAN 180 DAYS SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PERMIT WAS ISSUED ON_THE BA.~IS OF INCOMPLETE OR ERRONEOUS INFORMATION
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT HIS OWN RISK
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
(1)
(2)
Perm1ts shall be effect1ve for one year from the date of lssuance
Upon complet1ng the construct1on for WhlCh a permlt has been lssued the permlt holder shall not1fy the
Department by subm1ttlng the lnstallatlon record form The Department shall 1nspect the constructlon to
detenmne lf 1t complles w1th'the rules contalned ....In thlS dlvlslon . If the construct1on does comply \'Ilth
suc~ rules, the Department shall~lssue a cert1flcate of satlsfactory completlon to the perm1t holder If the
cpnst.uctlOn does not ~compfy~w1lth s~ch 'i'ules. the Depai'tment sha 1l_not1 fy the perm' t hoMer an~: shall requl re
sat1sfactory cOffiRletlon before lssu1ng the certlf1~ate Fa1lure to meet the\requlrements for satlsfactory ,
cdmpletlon wlth1l1 a reasonable tlme constl1:qtes' a v,olatlOn of DRS 454 ~05 to 454 745 and thlS rule '>', '.
~ .; J..
Setbacks - Subsurfa'Ce'Sewaqe Dlsposal . 1 _, :
,
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From
Inter10r property llnes
Edge of road r1ght-of-way
BUlldlng foundat1on
Wells~ other water sources
,
.., ..\
Septlc Tank
10'
10'
5'
50'
Dralnfleld
10'
10'
10'
100'
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SUB-JOJ \1
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( [),1l
lont
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$ S 00
S DO
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Apf'1. JCANr REFCE,
II /U:- 1703:'21317400
m:w BLDG Tn'E
CODE AF'PL NO
BP
I~P
BP
BI'
BP
BP
\ l~p
PI.
I M,E.CH
sur,
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LANE. COUN 1'( lJLI 1 rNV MG r I(UT H' r .g, 294BBO DA I I. 1 0:'_~8
RICHARD M. nDDP 43~ GROU~E S1., lUGENE, OR
SUI<D I v :~kD ADD 10 l,f'lMUI I RD V I LLAGE LOT 'Jb fll K 14
USE X NO BDRMS 00 NO UN[rS 001 NO STORIES NO BLD~S
ACTlON DE.SCFW'IION SQ FT UNI1 LOS1 VAL UATION FrE
LC ::'<,>4BOO WS
NO. F 1 XTlmES
CATG
SEQU
TAKEN
M'p
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BY CH
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PI,I.E Y
NO.
1b.OO
CONNEcrORS
MF CHAN I l'A'L' FfE
sr(\rr: SURCHAI~Gl:
F'LAN CHECK I II
15.00 EACH ~
41.
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ISS
SDS
SI
PCK
1
102';>80
OTH
2
FST. COM~I.ETION DATE
rorAI. FEE**
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