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HomeMy WebLinkAboutPermit Building 1975-12-11 r '.... ", , " -. ",'~' "~ " ."." , ~-' LANE COUNTY PERMIT FOP' PERMIT NO, 3176-T5 C,ONSTRUCTION [Xl MOBILE HOME [ ) :PLAN REVIEW (] CHANGE OF OCCUPANCY [ ] a,s, Reg, # Tw;; ,18 \.: oS ~C"I)f?r--' Mr AT~ '. NAME SAM~ NAME * ~7~r ~nllTu A ~TD~~T ADORE?S CITY c:.oo t U"'I!'" I.... ... nn...,....'" ..,h'7_A"711 ZIP-CODE - , Pf40NE II " . ,0 Owner '. '0 Contractor ADDRE$S CITY ZIP CODE PHONE ~. Subdivision Range 0"1 Section FILBERT GROVE LOT '~., , 11.2.2'Tax Lot, ';;1.>07> t:. Coda Census Tract "" Block Acreaga Width Access'to Property (Road Name)' U"no"'~, n...,..... Depth Existing Structures on Property: Nnwt" , , Directions to Property. Address: ';)(\(::1 u........^... 1'\........ c.......~~-::"~:_~: OOt:"IH'''' Q7h77 STRUCTURE (# BEDROOMSI P~RMIT .~R ~6npn~T ANn ~TnQA~~ SQ, FT, ::>O,,!ui Rmlil:;>p'(l VALUATION <t :;>:>hn nn MI1 J':J j- (") SEWAGE DISPOSAL: PUBLIC [] SEPTIC TANK [ OTHER [ ] EXIST PLUMBING INSTAllED BY: \ OWNER [] OTHER [J NAM" WATER SUPPL Y: PROPOSED [ ] EXISTING [], [ ] PUBLIC [ ] COMMUNITY, NAME: [ ] PRIVATE WELL [ ] OTHER, SPECIFY' '\ BUllDINC PLUMBING 3% SURCHARGE MOBILE HOM" WASTE DISPOSAl PLAN REVIEW ~h n"'_ 72 '". ," TOTAL . 24.72 CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN, SEPTIC TANK CAPACITY': GALS, MIN, DRAINFIElD L1N, FT, MAX, TRENCH DEPTH INCHES ~~___ __ Un~... D~......_ ~n~,c ~.~_R__ TANK"ANn 'f()"'~~~T ~~~M :,.~~- ~~d-;'~~I'~(n.-."'~-'~' ~ 'J. . ....... ",~.......... "1:" "'Go'-' .__ TYPE OF CONSTRUCTION "iN GROUP .1 FIRE ZONF STAY 100' FROM ALL WELLS' USE CLASSIF, SETBACKS, FT, FROM CTR, OF rlW: FRONT "iO' SIDE EXT, . '" FT, FROM PROP, LINE: SIDE INT, REAR "i'. ZON" RA. M~I AUTHORIZED SIGNATURES: Isl J. f', Boss BY HARBAUGH GRAY/SAN .TAR IAN ISSUANCE DATE: 1;>111h<; n, IA BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: Call 687.4065 to schedule all required cOllstruction inspections. Call 687-4061 to schedule all required septic system inspections. All construction shall comply with the State BuidJing Code, D.E.Q. standards for subsurface sewage' disposal and the Slate Plumbing Code, All buildings require a certificate of occupancy before being occupied. (See Delalls on Reverse Side) ~'N\I~ /' / ~ y., (POST THIS PERMIT ON MAIN BLDG. AT SITE) C55.13 LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUS~ ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 NOTE: NO PERMIT ,3 /7~--7S- PERMI T iF LL BE ISSUED UNTIL THIS APPLIct"'ON' HAS BEEN APPROVED r .. CONSTRUCTION c====J OWNER h,t!.,I2tJI- Mr:.-lr-s MOBILE HOME CXl-- PLAN REVIEW c=J CIW'~E OF OCCUPANCY CJ ~ APPLICATION FOR: p. Name .ff?:>' ~M AI Address 4-t2/n9&/d City / 9'71/7 :7 Zip '7i/7-f 7// Phone" c=J CONTRACTOR Name. Address City Z~p Phone. O.S'. REC.j " Twp.~Range n3, Section / I ? '~x 'Lot Subdivision /7'/ N;?I- k:'/uJ-Ut!- Lot .:;lS AC!CESS TO P~OPERTY (Road Name) ~ ~ ~ ~ Existing Structures on Property: . #l)/)L-' Code Census Tract }10Ck_ t; I~ Prope~~tr. .A.creage. Wid th _Depth' ~4- I J Below to r Of f ie e Use OnI yXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXPCXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX ~ ....-I- Sq. ft. cr 'C") liBedrooms Valuation - ",' -" 1 () g /J.. y?;c'H :.I ,.:;;~.,z</r) () JC) (J/...JXD , . "5):2 cfD j ~ ~Odt?- . .' dt..a.~&;, ,~^t .f'./L,d- at. Property Location - Address{Directl~n~: ~~) FEES: . ,;;2 C/~O'V PLUMBING: Installed oy Owner 5y~tem ~New System R~'quired c=J c:::J SEWACE DISPOSAL: Site Inspection Ii 1)1,lf-F> 9:3-7J, Existin WATER SUPPLY: Well . Spring Other Name of Community or Public System Bldg. Waste Disp. Plumbing. Plan Review Mobile Home 1% Surcharge 'PLUMBING FEES:' U of , ftI(ge Fixtures Sewage . Connection ,;. Water ; Connection PLANS FURNISHED FACILITY PERMIT ,~7d-_ C=:] CASH ~ WNO , c=]YES ~ ."","" ., ;,,~~ Cl<<~. , Fee Received By:, ' ' 'Date:,/..::J':"/~/.5- TOTAL _Jd -J-:J-~' Mi~/}ld!..Ta'X;pacity " 'Dsr~i:l~ ~eqUired -tt;;tt ",><..,..'1 ,--:4,"J.Z;, ~h~}~ if'.lJ>., ~M.+/4I, . Maximum Depth A.:.. ,J-4- , r~/ Type of Construction .tJ# Croup e:r Fire Zone 'Use Classification Bldg Setbacks - from Center of Road Right of Way: Front 50' Side In.t.~'. c_....:_ :_c-'-~'--'~ Rear IJr'1: .:-} , Zone ~/4-MiI c!P;' /.2.+7< 1- (55.12 DATE: SANITATION: d.lJA".. COUNT; ~PARTMENTt6'F , DATE:' J.L"A~UZ/NJ1/ DAT~: i.-2-3r')JI!13Vi ~//-- -P4r ENVI~ONMENTk( MA~AGEMENT . LANE ~' .., ---.-','.'-- ''\ ,,/ 1 . LANE COUNTY PERMIT F... PERMIT NO, ,",;>" . ,. .-.' '! '~...'" , i CONSTRUCTION [li] MOBILE HOME [ ], PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] o Contractor ft,::.\m... ~:: AVO NAME fi~ttz NAME ., ....~74i s.olln.. A r,T;,t'I"" ADDRESS CITY Q9" 1"1 t~~"'1 1"\0 1'\ (~"...J.-- ZIP CODE \,'..' ,.I': PI-1QNE ,0 Owner ADDRESS CITY I ~ ZIt,.S.OOE PHONE O,S, Reg, # I:, Range f . !.':H:;,f ():~ Section "',' r ~1 t r"C.t. Tax Lot Code , '. . Census Tract' ':.~ t ',' '1.- l....:,...... Twn ,Subdivision (~,-';j'J~ Lot ,,' Block r. Acreage Width , , :':~; \.: Access to ProRerty (Road Nam)),: I,:nc-"" I' "'0' , - Depth \ ~" 'Y::'\'~,\' --~' . \ ~ ...."'-',,-.,J\ ,I ,~-\"" ,,\ '\,~ . '\~ ' ~" .' " ........~....~... -"""''''''~'~' ~ I , Existing Structures on Property: !,~..E ~~~', "'- .\., ~ ~"-y_~......,,,,-,,, ) Directions to Property;~a"$ss':~ \...~~-:.:,~~" :~'{'~~~~.J"n ,_...,..-.."'_' \\.'" ,. <+,&,,-To. ."",,. ~ .~'_ ,,'oJ STRUCTURE (# BEDROOMS) :~ 'r:;t,U 1 ~.(;", ~,4l,:pn~T AND nTC:'~AG<t SQ, FT, l:C 4: ~D ~~:1) C P .;:D " VALUATION -! ?~;JG4~._~- .!',,,~- .,j SEWAGE DISPOSAL: PUBLIC [] SEPTIC TANK [ OTHER [ F.l< JIll PLUMBING INSTALLED BY: OWNER [] OTHER [J NAMC WATER SUPPLY: PROPOSED [ ] EXISTING [J [ ] PUBLIC [ ] COMMUNITY, NAME: l ] PRIVATE WELL [ ] OTHER, SPECIFY: BUILDING PLUMBING 3% SURCHARGC MOBILE HOMc WASTE DISPOSAl PLAN REVIEW ~JJi_OO (~ - TOTAL r.'J.fi.:; CONSTRUCJION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS, MIN, SEPTIC TANK CAPACIT\ ,'\.\ GALS MIN,DRAINFIELD'" 'tiN, FT-, MAX, TRENCH DEPTH'x INCHES ,-'lot'ra-E- 'rn ~...t"u,_~... UQM~"iilr-:~.I:':-JT (~..:"'~~ \.t:";~ifn&.~lI:"1" 5rl(, t--. "I"~T J1I'ltt',U '2....! ~~,,1j> H iA/1K j\/ljD ilj rUT rFON Tile Il~~-I'/' i; ;"J; TYPE OF CONSTRUCTION 4;~ GROUP ,): FIRE ZONC STAY 100' FROM ALL WELLS USE CLASSIF, SETBAC~~j'FT, FRONT .. \ FROM CTR, OF rfW: SIDE EXT, ). FT, FROM PROP, LINE: SIDE INT, REAR \,;t ,c'l ZONF .'~',:, : AUTHORIZED SIGNATURES: /s/ I.:" t:, 'Jt;~..;. ~?1 d\~':;AWr1 GiilH'/'Ml"11 '- Ill': ISSUANCE DATE: .",,/" J I r ','~ _ " "'I:..} ,. .t BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: Call 687-4065 10 schedule all required construction inspections. Call 687-4061 10 schedule all required septiC system inspections, All construction sh,all comply with the State Buidting Code, D.E.a. standards lor subsurface sewage disposal and the Slate Plumbing Code. All buildings require a certificate of occupancy before being occupied.. . .,'. _ \ " ... (See Details on Reverse Side) '. ~ ". '. \ C55.\3 (POST THIS PERMIT ON >.VIAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIi' ONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST, 6th, EUGENE, OREGON 97401 '" " SITE I NSPECT I ON APPROVED.Cl 0ISAPPROVED.Cl DATE REMARKS FOUNDATION INSPECTION INSPECTOR ApPROVEO I) 0' SAP~7;r"E~ 0 DAn." "/, /J NSPECTOR REMARKS ,~-L.~4/l1ft_ZU-* .,v~ d~ /' . V~Y7/ ,. Y _ A// /1 ' " ' ,/I_::~j::r.&,&1,Jf-elA,-fV.fi' Vh..v" 1./A1'--<U' .i/'A.4.-;I?<I // .~. C;,C I 7;1 T v, II FRAMING INSPECTION ApPROVED / / OISAPPRQVED /7 DATE REMARK S LATH OR SHEETROCK INSPECTION ApPROVEO ~I D,SAPPROVEO I REMARKS I DAn FINAL INSPECTION __ ----../' ~ DATE '7 - t;" ....11J~' ApPROVEO ~I :DISAPPROVEO L---f ~ I ~ REMARK 5 CERTIFICATE OF OCCUPANCY READY TO ISSUE ~ NOT , ( ) , .. \" READY TO ISSUE DATE REMARKS /'./ v) C LJr~ cJ/ 7fJt-16- 1J7A~ -j- /7 INSPECTOR INSPECTOR / 6/)/' 'd'l'~ I NSPECT ~ INSPECTOR li~#rRl-ui~ tlD,j/ { 1 \ . " , C'1 "'~ " ., ~,";'~I i:s:" ~;;l';T1 ON:-7;~ ~i (.Av /(;.~ . (~;~lt;lING PERMIT APPLICATION NO. ;<17t.-7<'" . "J () SITE INSPECTION , ,.....~ ~ T_!4 _R C1E sll-2.;~;TAX LOT SUBl ISION: LOT: ~"", BLOCK: r~ APPL I CANT DATE COMMENT,S: , / CKID:[Y.:~ ).i.-.;l-';lc::" Setbacks from c!l of road: Front ....~ ' S'l'de-Exteri'or~ Setbacks from 'i nter i or 'I i nes:' '. Side ;; =<2JI /'~ Rear ~ '7' I1 PLANN I NG D I V I S ION Not : \ , Ayp 1 i cab 1 e No Yes 1. Zoning Ordinance Complia~ce: ZoneA""~-Rt,q() T) if 6. 2. Subdivision Ordinance Conlpl iance () () ( ) 3. Requi red Access .. ,p:() () ( ) 4. Building Site (Area, Width, Frontage) (;{))Crz(t) ( ) 5. Other (see comments) () () ( ') . " PLANNING DIVISION ACTION PENDING: YESl ) NDl ) APPLICATION# .' . . BUILDING INSPECTION DIVISION " 7. _ . 8. 9. 10. ,PI ans Submi tte'd Soil StabiTity(footings) Flood' Plain Other (see comments) Not Appl icable t ) ( ~) ( ) ( ) No Yes T)m ( ) '( )' ( ) ( ) ( ) ( ) CK'D ;0 '. BY:..A Ard~.t--q. 7s' " I . DATE I ! --=' 1::',';. COMMENTS:' --- ,....-.. '.---" ''-. WATER POLUTION CONTROL " Not App] icable (~) , \. ( ) < , , 11. Meets Department of Environmental Qual ity Standards. "'""- 12. Other (see comments) ,/ No Yes T) TI ( ) ( ) CK'D By:dJ. ..a.." /.a,~. 70- {/ DATE COMMENTS: " TO APPLICANT:, /' " /' Xou.!i"'Bu i I ding / SHe Inspect ion: d~ ^ ~ (\0') Can be approved. . C.. {Ii,'1 () Cannot be'approVed at this time as indicated on item NO. above. ~Y" IV: Quest ;'on~, ,"Ad 'further i nformat ion on items 1 t~rough 6 contact the LANE- t7,/' COUNTY PLANN'ING DIVISION. Questions and further information on items 7 ,~ through 12 contact the LANE COUNTY BUILDING AND SANITATION OIVISION, ( ) Will b~ heldiin this office until you can resolve the problems indicated (') Is \b~ing "re"turned. ( ) Your building permit ap'plica..!,i..9.!1_fe~.Luein9__~~tuL!',!l.d undM seoarilte cover, . DEPARTMENT OF ENVIRONMENTAL MAN~GEMENI 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNING DIVISJON PHONE: 687-4186 C55-28 ." . 4l1f SC!31'" NOTE: NO PERMI. ,ILL, BE ISSUED UNTIL THIS APPLICATION 'HAS ~EEN,APPROVED 'APPLICATION FOR: CONSTRUCTION CAJ MOBILE HOME co ~.i.iWL. Name Llht.:-I--d . PLAN REVIEW c:=J' .s"7$.~ A- ", Ad.d~ess Cl~'GE' OF OCCUPANCY c::::::J :,.. .., ..::5p,En"-j/,''L.jd 97,)77 'City./ . .Zip Phone ?~7-t>7 !I c===J CONTRACTOR " Name, Address City ,Zip Phone O,S. REG. II, Twp. / r;! / '-' Subdivision Existing Structures on Property: -.:J..!:} Block 0 Pr'!perty Acreage .;dub-tVl_ ~,Zu.,~,'4/2~'A'&t'~ '. -~. 4uhu ;;B.a:V -c,~ , : ~> / Below fo r Of f ie e Use Onl yXXXXXXXXXXXXXXyvvV"YVYYVXXXXXXXXXXXXXXXXXXXXP~~'Y'r~'1r'\{xxxxxxxx:xXXXxxxxxxx.xxxXXXXXXXXXXXXXXXXXXXXXX m Y~/l rn:z ' Sq. Fc., (300)" Valuation '::1'fJ'S . " " :----....-- /'J 3:Se~tion / I ;:::;/iJ~..& C~Lot 2. 05 I . ~idth_Depth Range ?-' 2--- Tax Lo t Code -~Cen~us Tract , ACCESS TO PROPERTY (Road Name). Property _Location' - AddresS/Dir~ction:S:: ' ,.::)o.t;..-j " FEES: PLUMBING: Installed by Owner c:=J', or New System ~equired ~ SEWAGE DISPOSAL: './2 '-"" Site I~sp~ction /I' rj/) A.-6L/1..J Exi'sting Sewage Disposal WATER SUPPLY:' Public Well Spr~ng Other Community " Name of C~mmun~ty or Public Sy~tem Bldg. Waste Disp. Plumbing Plan Review c:=J, Name c, /1Jd/crf) PLUMBING FEES: C/ '" ,.- II of - 'j.. rr-7 I Sewage .Comi.ection "'J . 'Water Connection ~, , -:In, () D " / 4::::J, CASH ~S Q NO ~D NO I ~ CLL2-t.i4' CHECK Signatur"of APPth~.i-~ //.L/h' , '" Fee Received BY:;r 1',,(rp~te:/;::1-,/_.7 ~ Min. Se~tic Tank }iPpac'ity Cllff)", D:a~1ield Required - L~neal Fee,~ l.tO 'Maximum D'epth,' U, ' Jl!..L..Ztu . ./,~Q / 0u)) ,('~- ~~ ?&ut,;IL ~,~j) ~.N ..4or.4 IL 'T.-..."'M/,_,~-j .IM~/:!jJ,,;,~~. '~/'_;z:.fJ ,qfY~, ~//""/UA"A/ Y~<7AI 'lwJ --c:; _ If) ;d-..l,;;'" (I<7_A~' %- '/YJj/~, . {I r; - -, Type of Construction ~ ~ Group I Mobile Home PLANS FURNISHED FACILITY PERMIT . 1% Surcharge TOTAL Fire Zone Use Classification Bldg Setbacks - , .A_' Front~ from Cn~7:J1fJoght of Way: ",' Side Int. , F"' """;..'l", F.vt""::,,.-t0r. Rear 7 ( Pat:zorie -'<A -/4,--1 ~~N-~ DATE: SANITATION: DATE: 11,/ BUIl.!'IWl: /J./ DATE:_ , _ -:Y1/4..,.-- 1.2-5 7cl--'f'IP MU~P~ /.2 - f! - 7 J COUNTY DEPARTMENT a ENVIRONMENTAVMANAGEMErh ' LANE .'.. INSTALLER'S NAME TfJ) SOy? ilJt-Ii~N": No. Living Units Bedrooms Baths .PROPOScu SEWAGE DISPOSAL SY?TEM RECORD part of form to signature and submit, both copleswith application. '.; ___ .', PERMIT .NO .f--< H sq':h7J. PROPERTY AOORE~~ '1 NSTALLER :', FOI!'P I ete' top, Basement , Yes No -IJ~,~ Water Supply, Publ ic V Other-List .Septic Tank:" Ft. fr()(l1 well Steel 0 __ Concrete g No. ,Compartments Inside Dimensions: Len9th'" Width OWNER . NAME Ft. Dj ameter', Deoth Yn.RYJ.6 L, MF-j:) T;S ~7 -r; f" II rt-:J .A if Y{ I:::r.::-r ,Fou'ndati on , 'I' '\) , ' ,,\ " -i(',_ 'It, ~ J~'" I ~- '\0: " LAf,jE COUNTY, !;NVmONMI'.f\lTAL MGMT. 13 ~ +~ ~ -- , f!' \<'" .:- " , '/ ~., /",. ~ . ---- '<-ifoJ\~ ~~~~, " --- Si Qnature A'L...._.I,....1..&,N..uh"""'" CERTIFICATE OF SATISFACT9RY COMPLETION " I " For Sanitarian Use Dnly: .' Date: 12.-;;?.2--7~ In' accordance with 1973 Oregon Laws Chapter, 835. Section 214 this,certificate is issued as' evidence of satis'j'acfory., ~OI)ipJetion of a subsurface sewage disposal system at the' above 10ca~'AP'prove~: System In~i:'a;la~ion conforms to current'standards " , o Disapproved: 'Does not conform to current stand~rds ' . Remarks: ' Date J.l.v<- ? '1--7 ~ STArE OF OREGON DEPARTMENT OF ~a-~~ ~~~t~b~~;~s sf&ure ENVIRONMENTAL QUALITY C55-11 , ry '{-:I " "..;', I - ,', .,,:.',.. :-.: ,-/' f.....:, "'!",i\i \': r".....~. .,~}.~~~~:,..r~ ':.~.. " . ~ ..' d~ ;.:,.;~ f .$ '. '\ ",," ..b'.II'<:,)".,\,' ,. 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