HomeMy WebLinkAboutPermit Building 1976-3-11
C/
.
LANE COUNTY PERMIT Fe
PERMIT NO 397-16
v.if "l..
CONSTRUCTION [X]
DOwner
E. Southworth
NAME
MOBILE HOME [] PLAN REVIEIIy [
, ' I" \.0."" C.
?OQIl '-' ,:...... ',~"v
ADDRESS
CHANGE OF OCCUPANCY
.
~ .
~n~inn~iQ'n n~onnn
CITY . - ZIP CODE'"
71lt:._M77
PHONE
o Contractor B & P Construct i nn r.n
NAME
ADDRESS
CITY
ZIP CODE
PHONE
o S Reg #
Twp 18 Range 03 Section 11 .;;!.f?; Lot .J.- 7 rd
5th Addition Filbert Grove
SubdivIsion Lot 27
Code
Census Tract
EXisting Structures on ProperlY
r",
Directions to Property Address
,
Block Ii Acreago
, Tnl"nrl w"v
Mnhil.. I-Inmc.
?OQ4 Tn"'nrl W~"
.
sa FT
400 ICl ? An
40n kl J; 'In
Width
Access to Property (R oad Name I
Depth
STRUCTURE (# BEDROOMS)
CarDort and Shoo'
/;'
VALUATION
~l1?n nn
2120.00
~':!?Iln nn
SEWAGE DISPOSAL
PUBLIC [] SEPTIC TANK [
OTHER [ ]
PLUMBING INSTALLED BY
OWNER [J OTHER [] NAMF
WATER SUPPL Y PROPOSED [ ]
EXISTING []
[ ] PUBLIC
[ ] COMMUNITY NAME
[ ] PRIVATE WELL
[ ] OTHER SPECIFY
BUILDING
PLUMBING
3% SURCHARGC
MOBILE HOMF
WASTE DISPOSAl
PLAN REVIEW
?A 00
All
TOTAL
?il J:lll
"
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN SEPTIC TANK CAPACITY
GALS MIN DRAINFIELD L1N FT MAX TRENCH DEPTH INCHES
V~^ft ,n Q^^. ~u-_ ft" __~~_ _A ~L_ ~_
--r -.. ,....... vw ". "',."" .......n\4~1i:;; v. O>>~VaQ-1 ~:r:lo \oCIII
TYPE OF CONSTRUCTION
"""
GROUP
FIRE ZONC
STAY 100' FROM ALL WELLS
USE CLASSI F
u
SETBACKS FT FROM CTR OF r/W
FRONT '0' SIDE EXT
FT FROM PROP LINE
SIDE INT ~ I REAR
I::
ZONC
nt\ filII
AUTHORIZED SIGNATURES
/s/ 1 I:' r.:t^ro~ 1..., u...-t..........1o.
-.I - ---,;;r
ISSUANCE DATE
Rnb..rt I nwrv/""nH."..f"n 1/11 17&;
...,~
SLOG PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
IMPORTANT
Call 6874065 to schedule all required construction inspectIOns Call 6874061 to schedule all reqUIred
septic system inspections All constructIOn shall comply With the State BUldllng Code DE Q standards
for subsurface sewage disposal and the Slate Plumbing Code All buildings require a cerhflcate of
occupancy before being occupied
(See Details on Reverse Side)
$/
(POST THIS PERMIT ON MAIN BLDG AT SITE)
C5513
LANE COUNTY DEPT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX 135 EAST 6th EUGENE OREGON 97401
BUll,O ljljG. S liE EVALUATION
~BUILOING PERMIT APPLICATION NO. ~97-7~
() SITE INSPECTION
PLANNING OIVISION Not
Appl icable
1. Zoning Ordinance Compliance: tone_~JQ-~~( )
2. Subdivision Ordinance Compl iance ( )
3. Required Access ( )
4. Building Site (Area, Width, Frontage) ()
5. Other (see comments) ( )
COHMENTS:
T_ .. '2-R D::!> S II TAX LOT
SUBO..'SION:
LOT: '7-7 BLOCK: r_
APPL I CANT
OATE
T) fr 6.
( ) (f~
( ) (-)
( ) ~)
( ) (\)
PLANNING OIVISION ACTION PENDING: YESl ) NOl ) APPLICATJONH
BUILOING INSPECTION OIVISION
Not
Applicable
( )
~P,
(0
7. Plans Submitted
8. So,l Stability (footings)
9. Flood Plain
10. Other (see comments)
COMMENTS:
WATER POLUTION CONTROL
Not
Applicable
( )
( )
II. Meets Department of EnVironmental
Quality Standards.
12. Other (see comments)
COMMENTS:
No m
()
( ) ( )
( ) ( )
( ) ( )
No ~
() 171
( ) ( )
~-
CK 'OB 2.4' .::?.......o ~..U'o
Setba from cll of road:
Front ~ t
~o 1:......Ql"'inr.
Setbacks from
Side
Rear
inter~es .
~~
'.
CK'O By:PI/3-J~v7~
OATE
CK'D BY: ~
'3~(() 1&
OATE
TO APPLICANT:
Xo~ Building I Site Inspection.
~ Can be approved.
( ) Cannot be approved at thiS time as Indicated on Item NO. above.
Questions and further information on Items I through 6 contact the LANE~
COUNTY PLANNING OIVISION. Questions and further information on ,terns 7
through 12 contact the LANE COUNTY BUILDING ANO SANITATION DIVISION,
( ) Will be held ,n this office until you can resolve the problems indicated.
( ) Is be,ng returned.
( ) Your bUIlding eermlt appllcatJ2~_~fe~s being returned un~JU: se~ar~te cOY~T.
~EPARTMENT Of ENVIRONMENTAL MANAGEMENT
135 Sixth Avenue East Eugene Oregon 97401
PHONE: 687-4065
LANE COUNTY PLANNING DIVISION PHONE: 687-4186
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C55-28
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..
~. .
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~ CONSTR UCTION
,~
LANE COUNTY PERMIT Fa
PERMIT NO. 39"1-76
.0 Owner
[X]
E. Sotlthworth
Sor-1n!lf1eld Of'lf:t\!On
CITY. ZIP CODE:
7..tf. <.27'f
PHONE
NAME
MOBILE HOME [] PL-"N REViEW [
\. ,', '~'I
2~r~ !nld~nd 'Kay
ADDRESS
CHANGE OF OCCUPANCY [ ]
'0 Contractor 13 Cl P Construction Co
NAME
ADDRESS
CITY
ZIP CODE;~l'
PHONE.
O.S. Reg. #
TWR lR Range 03 . Section
. ~.~~ I\aGltlo11 flllXtrt !:i.rove
11
Tax Lot
Code
Census Tract
Subdivision
Lot
27.
Blocl<
6
Acreagp
Width
Access to Property (Road, Name):
Ex)sting Structures on Property:
Inland l~y
Depth
Directions to Property - Address:
tlobil 0 Home
20114 Inland Nay
STRUCTURE (# BEDROOMS)
Carport and Shop
SQ. FT.
400 fiJ 2.80
400 @ 5,30
VALUATION
m2.;,~O
~1.<"',~1.i
S324C.OO
,.
....} \
'.
-: '-"~ ') ,.
.\
SEWAGE DISPOSAL:
PUBLIC [] SEPTIC TANK [
28,00
OTHER I
PLUMBING INSTALLED BY:
.OWNERI.l OTHERIl NAMF
WATER SUPPLY PROPOSED [ ]
EXISTING []
[ ] PUBLIC
[ ] COMMUNITY - NAME:
[ ] PRIVATE WELL
[ ] OTHER - SPECIFY:
BUILDING
PLUMBIN(;
3% SURc;HARGF
MOBILE HOMF
WASTE DISPOSAl
PLAN REVIEW
. till
TOTAL
Z8.S4
CONSTRUCT10N_p'ER~ITS & INSPECTIONS AND WATER POLLUT:IP"N. CONTROL SPECIFICATIONS
MIN.SEPTICTANKCAPACITY '\\"''0 ,,\:' _~, '\" ~0:.\~.
G~LS. . MIN. DRAINF~Hb\ ~IN\FT-".--'\ ~ MAX. TR ENQ.h1:S EPifH INCHES
(.,"0:') ili feet fl'tllll an oaW'tNf t.1N! 5"'''''"0", O....M.lll ~""jo""" I'.
\,
\' STAY 100' F ROM ALL WELLS
TYPE OF CONSTRUCTION Sri GROUP .1 FIRE ZONE USE CLASSIF.
SETBACKS - FT. FROM CTR. OF r;W:
FRONT 50' SIDE EXT.
FT. FROM PROP. LINE:
SIDE INT. i;)' REAR
5
ZONE
~t\ ::'dJ
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY "
BUILDING - GREEN \. i' .
SANITATION - GOLDENROD ~_ '
\ '
\
Robert.L,"~Y/~tn1tarfan
-.\_tf, ...... ,',\:, _-0...._). \~"".j .
~, "Call 687-4065 to schedtle all req1med construction Inspections Call 687-4061 to schedule all reqUired
septic system InspectIOns All construction shall comply With the State BUldllng Code, D E Q standards
IMPORTANT: for subsurface sewa.geldispo~al and the State Plumbing Code. ,All buildings require a certificate of:
.:, occupancy before being occupied. . -.\ \ 8.... )
-...i~,\~~, _ : ....,1 \,,~.~.:, \. \ .....\.....).. ,,\(Se.e'~tails~on ReverseSideh -, \~\.;:..
'10 . l' \" J ~.:,..... -\ '\ .....w ,'-.l ~ :....\ ,...." .f" ..
1/"":" -
. .
ISSUANCE DATE:
3/11/76
db
AUTHORIZED SIGNATURES:
Isl J, t. 80$8 by Harnaunh
'"
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
:
C5!l.'3
LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135.~AST 6th. EUGENE, OREGON 97401
".
~
SITE 1 NSPECT I ON
ApPROVED Cl DISAPPROVED Cl DATE
INSPECTOR
REMARKS
FOUNDATION
I NSrN
VI DISAPPROVED 1 1
INSPECTOR~
ApPROVED 1
DATEtc-7 -7 ~
REMARK 5
FRAMING INSPECTION
:::::::~.(Z71ifL;L;1-t 1)~,'U,p(;:;;O"7? ~
LATH OR SHEETROCK INSPECTION
ApPROVED I
1 DISAPPROVED 1---1 DATE
INSPECTOR
REMARKS
FINAL INSPECTION
1./tf" fIR
Cl DATE
, ".([J
ApPROVED
Cl ~ SAPPROVED
i
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE / / NOT READY TO ISSUE / / DATE
INSPECTOR
REMARKS
<~I/;I',"'-(f^ Jftr',
3'Tl-76--J~wZt 21''1'1 ~$'t1
l\
~
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I
I
NOTE
NO PERHIT
-:sq 7 ~y;;--
PERHIT if
~L BE ISSUED UNTIL THIS APPLICA IN HAS BEEN APPROVED
.
. '
APPLICATION FOR
CONSTRUCTION ~
MOBILE HOME c=J
PLAN REVUW c=J
C1UU~GE OF OCCUPAN
,#
i==:I
00
OWNER -,L::::::;'- Ie. II ;: IT:. S /) L{ -U'-JI7 n'r Tl- ;;L 0 t V
Name Address
CONTRACTOR 2? rt P (1 CJ /l <; T fJ {) f,T J' ~ .()
~ame Address
JJ<~,(~~~ W~ll , ?l 77Y77-1v{o;L77
City j Zip Phone
. 0V5-Sf/O-C/J\~()S-fI
I l1p Phone
I
City
c=J
OSR1G!1
Twp /r Range tJ ..,jection I / Tax Lot
Subdivis10n $'9 p~ ~ot ::J 7
ACCESS TO PROPERTY (Road Name) J A/ I A- AJ ~ ,,} f\-II
I
EX1.st1.ng Structures on Property ~ n'"R I I ~ \ oM e --
d--" 9' if ~
,
Block
o
Code
proper~~reage
if
J
(1-i~.A 7/.7_'L
1/ (r
Census Tract
Width______Depth
Property Locat1.on - Address/D1rect1ons
if
Below for Of bee Use OnlVXXXXXX:XXOXXXXXXXXXJO.XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXAXXXXXXXXXXXXXXXXXXXXXXXXXXXJ..
J'/J/J u h ~ Sq !)d'P d.J,dV IIBedrooms liJOonuo
r:u c9& 'I;;Lv L/O-OIOJ ,.:).~CJ o;:?/ ;:}f) (") (')
~ X PO 1/ .. ,?'OZL/O. 0 0
1/
!I
Exist1ng Sewage DisPOsal~ystem ~
Publ1e #c=J
C01IlIllunl.ty I==:J
tt
,y
SEWAGE DISPOSAL
Site Inspection #
--
or New System Requ1.red
c=J
WATER SUPPLY
Well
Spring
Other
Name of Commun~ty or Publ~c System
Mobile Home
,!
f
It of F~
I
I
;\/~/CASH J ~rt Lk:T Y~ c=J NO, yc::J YESO ~
CHECK I! C. S1gnature of A:g;ant .~ ~<X1~
V Fee Reee1ved B ~ f Datek/(j-7~_
, .
~ I
Septic Tank Capacity Drainfield Requ~red - L~neal Feet
V~\to'JJ..~oL4L ~ J>.4 \KJ....... S'o ')
I\J 1/'[;
\ 1/
\ .r I ,)
']- 'XI g.:...--r
......0 1'(. Group r 'J
'--"'"
""7 Pto-rJ
(/ ..
PLUMBING
Installed by Owner
FilES
Plumbing
3 % Surcharge
/
.'K~
PLUMBING FEES
I==:J Name
Bldg
Sewage
Connection
Water
Connect~on
Waste Disp
Plan Review
\/- L
s-:::l k\. '(!L
\
PLANS FURNISHED
FACILITY PERMIT
TOTAL
Min
Maximum Depth
Type of Construct~on
Fl.re Zone
Use Class~ficat~on
Bldg Setbacks - from Center of Road R1ght of Way
Front~' Side Int ~&S t ~3~ v.....n_'~r
05 12
SA~1S6
I
COUNTY DEPARTHENT OF
Zone ~-M H
mING . /~ /ME
(f/~'~~ :3~/CJ '?t,
ENVIRONMENTAL HANAGEHENT
Rear 6'
P~N'Pf.')-_ DATE
C.j;Jr...u 3-1{) -7( ~
LANE
DATE
;/'-10 76