HomeMy WebLinkAboutPermit Building 1987-2-12
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'W: 5 LANE COUNTY DEPT ENV MGT RECEIPT I 46687 DATE 021287
APPLICANT SPRINGFIELD SAFETY DIV., ADDR 225 N. 5TH ST., SPRINGFIELD, OREGON
TL'iJo 17032512(2) 00 . SUBDIV . L.OT BLI<
~EW BLDG TYPE , .USE R BDRMS 0 UNITS 001 STORIES OBLDGS 00t PHONE 746 4269
OWNER NME HOLMES, CHARLE~ ADDR 7118 N. 'C' ST... SPRINGFIELD. OREGON
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DAYS'["
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Lane County Authorization
for:
FOR OFFICE USE ONLY
Applicationl."'/'/'.~_ ~7
Perml.t # 7bh'(:7,
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I RANGE
03
S~BDIVISION/PARTITION (if applicable)
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I SECTION
'2 5'" 1'2
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I ;; ~0;CJ80UT OF
LOT/~EL I BLOC/.'
LOCATION ADDRESS
STREET
CITY
ZIP'
USE
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STRUCTURES CURRENTLY ON PROPERTY
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. DIRECTIONS TO SITE
':!YOR7,(,l.oN /'9Til 057,/ &.,7' ON LOh?b/v/)
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<1io,.l? /V4"Z2 OF La ,/'Y?.c>/'rfJ A 1I~. -:I / "" -" N'
QESCRIPTION OF PROPOSED WORK - BE SPECIFIC ~ ';..J'.
~-^l""TJ1?V':::" 7" <t/Y6I ~ ~h'//7/L r- /iii=5/Zfi<:"/Y<:.E r &Jfi#c:. iF
7: OF BEDROOMS 1 11 OF STORIES I # OF Er-1P~OYEES. I ~~ER SUP'p~'{. . .
"2.. . . I KA/N'13'OW ~T&"'"
~ A10ZOO7>
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'97 '1.7 '8, ,.
DECLARED ~ VALUE
$"8,0'::>0, c>"
.r- . 0 Proposed
/.--'/sT: ,n. Existing
TELEPHONE "NUMBER
7'/6' 7'<~9
TELEPHONE NUMBER
O;~1'JER I S NAME .AND ADDRESS
- C:#.4~t.25
CONTRACTOR'S NAME AND OSR'#
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P:=;RNIT TO BE MAiLED fa (NAME AND ADDRESS)
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72 5' N.(i? ~T:4 '57.
'7' 70/'/7 ' I TELEPHUNE NUMBER
S:PF?.7J CY? n~~ 3b'b"'7
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I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION l"OR PERMIT, dnd ,10 hereby certify that: all information hereon is true "and correct, and that I
have the following leg~l interest in the 'property, Downer of record; 0 contra.ct: pllrchaser; Dauthoriied agent.
I f:.:.rther certify that any and all work performed shall be done in o.l'COIdil.ilCE: with the Ordinances of Lane County and the Laws of the State of ,Oregon,
pertaining to the work described herein, and that NOOCCUPANCI' wiU b<=! made of aTiI' ST:;rllctlire ;,'~thout the pennission of the-'Building Division. I fur..,
ther certify that registration with the Builder's Bodrd is in full force' <lnLl effect. as rec;u~r,"d by OR.S 701.055, that: if exempt the basis.....for exemption
~#~~lL~:\~~~U~~Z;: ;:oyeeo who 72;?~'h {?It!?~on I~h" prOJeet~>; i;;~
_. NAME (ple'oe pnnt' ( t%! 1 ' ~IGNATURE ! ' DATE'
READ THIS SECTION.CAREFULLY. YOUR AUTHORIZATION ~AS' BEEN BASED ON THE FOLLOWING CONDITIONS!
[J PLANNING/ZONING,
. Zone
Parti tion ~
c~, side "\
Parcel #
Parcel Size
Minimum Setbacks:
C
L, frort
interior
rear
COM..\lENTS:
Date:
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o SANITATION: S. I. # B. P. # Insta~lation RecOrd Issued? DYes 0 No
Installation 4- J Gallon Lineal Feet M.aximum Depth
Spec~fl.catwns' " t..:..) ~tnk 1-..;. _1 . () j of D7fnfie;,ld ,~~. fJ -I of JenChes 1\
CQM.\IENTS: Ri)Jl'1r~J() tJetUDf7}n-,., "rr+ ,-I ~ droi~' (A", Jill is /n '-tIO ./)f~~Y d~e4'
o I - (\ f ^ J ft.'11 . &1"'-- '/ /15 SIIO"~ 0 ~ flM f"~ ,
110....,0\1-(1.. [ltPP (r1':tJ . 9", tJ# n",.o Dlt.. . II! '&'111,- _~ Date: .
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D _ J .. ,.., .IGr~UP'D..l-t';"'" fr,;(....,J f!ijser1. for J"... Spo~.,(J-',
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PLANS EXAMINATION,
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Type
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COM!-IENTS :
Date:
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PERMIT APPROVED BY ,BUILDING OFFICIAL/DESIGNEE (per ORS 456.805(1)) 'DATF
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c;.p ..~. fAN~gOYNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
I t<- aUe,' t,5, .125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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SETS/,CKS A:JD 07!!i:R cO:1DI'rrm~s OF
c;,.':,w:, or THis l'ERH!" CITATIO::
REcIEDIES- ALLOWED,~Bj, !,-,.W.
APPROVAL MUST BE STRIC7LY OBSERVED. VIOLATIO~ CA~ RESULT IN REVO- _
U~DSR PRovrsrO:-Js or LA"!O COw:;TY':; INFRACT,ION ORDII:.;NCE, Mm/OR,OTI:!ER
, '
"HEN READY .!O'OR r~SPEC'lION, CAL:' 697-4065. 1\ :11 t:mu:,\ OF ;,T LEAST 24 IlOURS ADVAr;CE NOTICE FOR INSPEC-
110" .!'(o;r.JL:ES7S l.iLiST lJE -GIVE". Have the following information ready: <permit number, job' address, type
of in.spection, when'"it '....ill be 'ready; your name and phon~'nu::1ber, and' any s?cci/'ll"cirections to slte.
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BYILI?lNG\DI'}ISlqN~ J
RE0UIRED_INSPECTIO~S:
'-
1. . Fou~d"'ti6n 'Irispec-tion: To' be made <lfter trenches are excava.ted *and fo~m~ _erMec_t~d_ a,n? when.alr
~<lter1<lls fOt- the toundat'ion are delivere~d'on:thc job'. llhere concrete from a central m1x1ng
plans (commonly termed "transit mixed") is to be used, rnaterial~ need not be on the job_
conc'retG Slab or Under":?lool:' ,~InS;}ection:"'. To""b~, made aft~'r all in":slab or_ under':'floor building
serv1:.;e e'll,lipment, canau:t::., \JL\Jtng accessories, unci other ancillary eguiplflent_items are' in
:place but betore any. concrete is poured or floor sheathtng installed, including the subfloor.
. ,. .- I' ",
naming ~ InSu.l~atio'n~lnsp~ctio~s: - TO be made, a~fter' the ,roof, all' framing,. fire' 'blocking<and "";:
brac:tng are 1n place ane all.pIpeS, fireplaces, chimneyS, and vents are complete and all rough .
~el~c~ri:,~l aiidplumbing are apiJroved'.. AI..l W~l'l insulati.on and vapor barrier are .~n place.
4. Lath and/or Gvps~m Board Inspection: To be made after ~ll lathing and gyrsum board,. interior
ana-extcrror~n place out Detore.~ny plastering 1S applied and before gypsum board joints
-,'1'n.d fa~ten'e.-r:s are til.;:::ed and finis.hed'; ..:, '"\ ._ .. .. " 7" .
5. Final Insoection: TO be made after the,building is complete and before occupancy.
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3.
APPROV;,L .REQUIRED. ,,",a ,I..ark, shall be, done_ on any_ part o~. the ,building. or structure. beyond the point
indicated ,In each successive inspect:ton without first obtaln1ng the approval of the.building-offic1al.
Such approval shall be- given .only after 'an il~spectien shall h,we been made of each successive step
in the censtruction as. indicated by euch o'f th~ inspecti.ons required. .
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NOTE: All building permits require inspections for the work authorized, such as but not limited to,'
A. Blecil: l,all; T~ be made a:tcr rei'nforcing is in place, but befere: any greu_t is poured. This ~
~ctien is required foI' .each.bo"nd benm.pouI'. There will be no appreval until ,the.pll;1m~ing
and electrical inspe'ctions ,have 'been made and approved'.
B. 1'lOed' Stove:. Te b~ made after cem~letion of masonry.:(i"f .applicablel and wl1en. installation is
complete. lnstallat10n shall be tn accordance w1th an approved, nationally recognized testing
ag'ency and ,the manuiactuI-er's installation instructions.. .
C. Heb'lle' Heme: ,"In inspection is required after the mebile home is connected to <l.n approved
sewer or-5epticsystem for setback requirements, blocktng, feeting connection, tiedowns,
sKirting, an? plumbing connectiens.
1. Footings and,_ Diers to" comply w,_ith State,foundatien requirements for mobile homes.?~ ~:..
recommended by' 'the'manu~acturer.' ~.. - "- .-
2. ~obile_heme minimum'finish floor.elevation:shall.be certified'wh~n required by a flood~
?la\n m~nag~ment .~e~~er.
3. ~lobile heme .tiedowns, when required, and: skirting shall be installed and ready for inspec-
tion within at feast '30' days after occup<l.ncy. Tiedowns' and. skirting shall be installed
peI' enclosure. j
D. Swimminq 1'0.01, Below grade when steel.is in,plac~ and befer~ concrete is poured. Abeve grade
wnen pool-rs-installed.
,
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,W?ROVEO PLANS ~1UST BE ON THE'JOB SITE AT ALL TU1ES~DURING~WORKING HOURS. TillS PER.~lIT WILL:EXPIRE
If' WORK DOES NOT BEGIN WITHIN 180 DAYS, OR If' WORK IS SUSPENDED OR ABANDONED FOR ;.lORE THAN 180 DA'i'S.
SUSPENSION OR REVOCATION :1AY OCCUR IF THIS PERHIT NAS ISSUED ON THE BASIS OF INC.OM.PLETE OR ERRONEOUS
INFORHA1'lON. e,.. - .... . ---~
ANYONE PROCEEDING PAST THE POI~T or REQU!RED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
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SUBSURFACE A:-JD ALTERNATIVE SE\,AGE DISPOSAL SYSTEMS:
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Permits shall' b-e effective fer .one yeClr frem, the, da~e,of' iss'uance.
,Upon.completing the constructien for which a permit has been issued, the permit heldeI' shall
notify the Lane County DeiJartment of Planning and Community Development by submit'ti"ng the
H1Stallation roecordform.. The DQpartment,'shall'l:1s;>ect the.-construction to determine if~it.
complies with the rules centained in thi.s'division. If the construction does comply with such
ru~es, the Department sl1a,ll issue a certific<lte of satisfactory completion to the:,permit; !101der.
It. t~e construction 'does' not"comply '",ith such rules, the Department shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. Failure to
meet the requirements for sati~factory complctien> within a reasonable time censtitutes a,vto-
l~tion of ORS 454.605 to 454.745 and this rule.
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Setbacks - SuLsurf':'ce'
sc~a<lC Dispesa:.... .:;
Septic iank
Drainfield
:~om: I:1lerior preperty lines
Ec(;e""o:' road ric;ht;"o~-way
B\\ilainq toun<l'''t~on
\';ells. other '..-ater source_s
10'
la'
5'
50~
10'
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10'
..,100'..
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Installer
Telephone
License No.
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If Installed By Owner-
v\h"L<''''\. Date t,h:;/.?C!.
Apl?llca~ Name & Address ' ,
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/9fJ-I-I- 7;;;' M'y.5T BE IN BLACK.1tIK
Permit No. ~- Twnshp. /,) _ Range () ~)
Standard System fiiJ Alternative System 0 (Specify Type)
Job Location (Street Addressl
SubdivisionlPartition #~L~",o,... ~ -Ir..-..--.:i'J.- ,f:.'<<c..j. c, .lei,
Tax Lot
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form c55-ii'
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USE BLACK INK ONLY
FOR INSTALLER'S USE: Trench Depth ;;J.<f"
Tank Capacity J\J 1.4 Manufacturer ,vl"-
Measured Distance from Well to Tank IV/A From Drainfield
COMPLETE THE FOLLOWING IF A PUMP WAS USED ON THIS INSTALLATION:
I (installer's namel "ertify that a IMfgl
and Mercury Float Switch (Mfg. and No.1
SignaturA iVI'{---'-I~'ll.o'" L...)..:<--'l n.xj)
Gravel Depth Below TilA
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Total Length of Lines /'c /
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FOR SANITARIAN'{USE ONLY:, .
COMMENTS: ,-- J
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- (Model No.1 Pump
. have b~en installed with this sewage installation.
Date t // ? /5'<'
o Svstem Disapprov~d 0 Needs Correction
,(- ~.,' > '1/ o.J.- 1/;.,-,u ;?<r:u-,SJ.J U ,'.,'";;,,
System Capacity
4 0 !jystem Corrected
~al./day Signature (_b-10. r~.l;~.,~,,~
Datp
Date f~ (( R-( -fi''\
INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian, this certificate is
evidence as per OR S 454.665 of satisfactory completion of a subsurface sewage disposal system at the above location.
Return this form to: Water Pollution Control Div., Dept. of Enivronmental Management, located in the basement of thE
Public Service Buildina, 125 E. 8th AWmlJR Fllnono Q711n1
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