HomeMy WebLinkAboutPermit Electrical 2002-08-15225 FIFTH STREET
SPRINGFIELD. OREGON 97177
INSPECl'lON REQUESTT ?26-3?69
OFFICE: 726-3 759
1 LOCI\TION OF INSTAILATION
LEGAL DtktrS
o<--ELE. . :CAL PEfu\,IT APPL]CATION
3. COMPLETE FEE SCHEDLILE BELOW
A. Nerv Rcsidential-Single or
Multi-Famill per drrelling unit.
Sen'icc Includctl:
ltems Cost
1000 sq.ft. or less
Each additional 500
sq. ft or portior
thereof
$ 106.00
$ 19.00
CRI?TION7b..(ot ?-o <)Sum
JOB DESCRIPTIONalArb; @'naP sr'c.1b Zo?+M?
Permits are non-transferable and expire
if rr.ork is nor srancd \l itlrin l8fldlUto*,no pror"d as submrtted hFJfi45ffiggf{ Home or
of issuance or if r|ork is suspetrddr&rand does not require spedld€dl*flfi,p6r cll ing
180 da)'s.
2. CONTRACTOR I
Elcctrical Contractor
approval
Zoning
Authoazed Signature
stt lrtton,Iterations or
200 anips or iess
201 an)ps to 100 amps
+0 i anlps to 600 amps
501 illr4rs to 1000 arlps
O,,'er iO00 amps/\'olts
Recourect Only
$ 50.00
s 63.00
$ 75.00
$ 125.00
_ $163.00
_ $3 75.00
s 50.00
, Senice or FeederLglL
NSTALIIITJ ON ONLY ,'BOSrice s or Fecde rs
cit\Phone
Supen isor Licersc Number
iratior Date
Conitr Contr. Number
Expiration Dale
C.. Tcmporary Seryices or Fceders .
Instirllation, Alteralion or Rclocation
Ol ncrs Nirme
Address
OWNER INSTALLATION
The installation is being made on
properry" I olvn rvhich is not irtendcd
for sale. lease or rent.
S?a&nsLD Phone v6-brbl
200 amps or less \f 5 0.00
s69.00 _
$ 100.00
see
D.B
Alteration or E\terlsioll Per Panel
One Circuit
Eacir Aciclitional Circuit or rrith Sen'ice
or Feeder Pennit S 3.00
00$43
l\Iinimum Electric Pemit Inspcction Fcc is SJ5.0{) + Surcharges
4. SUBTOTALOFABOVE L'
01
zv>
Orrncrs Signature
TOT,\L
Citl-.lob
Address
Signaturc of Supcrlising Dlectriciln
1t
E. Nliscelhneous (Serricc/ltcder not inchrded)
-EJClr irrstirllalion
Prlnp or irrlgaLion
-
S5u r)o
-
Sigrlioutlr nc Lightin-s S-i().00 _
Limitcd Euergl.,T{es _ S2-i.00 _
Liuritecl Energr',/Comnr _ 5-+5.00 _
7Yo Stlte Surchilrgc
3'% Administl.atit e Fee
Job Lbcaticn:
Aaoesso?e Map I Ica Lot fl
svbditl,sion:
A)ner
naA.r", $ J 'ryv&b
City:Lip
to - {\-( g val,ueDate of Ap?Licatian
L+1
Ae-5P
T)66. '->
RenoCeL
i,ob":Ze Eane
cene"aL
..RESIE NTIAt..' APPLICATION/PERIIIT
225 Noyth |th Stu eet
Spring fteld, 2negon 97477
BuiLding DLui-ston
726-3753
SPFII]rlGFIEIll
OV
q\1
Y
CC-
Date
Electttcdl
l,lechdticzl
Reaui?ed fnso"cticns
AddresB L
It io the ftsponeibilit! oi tlg peftrit hoAe? b see tlnt al! inopections dte dadp ot lle p"ope? tine, that e.cch c reaa is ?ealu.bie
Iror tho etteet, dnd. Lhat the pe?hit catd. i8 l.ocated at the frant of the Wopett!.rgut\dine N-t)icior apF"o1;ed pZan ehcZZ Penain on tlE Btaldino Stti at aZX tiflrs.
PR1CEDUPE POR INSPT$IO REAUESTTCALL 726-3769 (r'ecorde") etate lour Cit! desi-gnated job
"equested atrd. uhen lou trilL be ready fop inspectiofl, Cant?acto?a ot Atners nane cnd. phane'*iZZ be tade the sone day, lequesta nade aften 7:00 @n LriZL be nade the nest ,o?king da!.
8s 78
ttorber, iob aCitess, type of incpec"icanunber, P.equests "eceited bef,cre ?:00 cr
Iou Cit! Desigtated Job lh.abe? fs:
SI?E I SPEC?IOE: To be tade dfte"
ezcavation, but itia! tc set up of
f,orrne.
UTIDERSLAB PLUMBING. ELECTRIC,IL &
WC AIICAL: ?o be made befo"e anV
Do?k ia eooet ed,
POO?IN1 t F)UNDAIICN: To be tBCeaftet t?enches are etcaoated and
fotna ate e?ected, but pyia? topotying ccnc?ete,
UND2RCPOU!!D PLUM9INC ,n.1i!3
DRAI AeE: ?o prla"to fil-lirg trenchee.
UItDEPFLoAR PLUI.E I:ttC & l.lECltANICAL:
DRYIIALL I SPECIIjII: Ic be nadeafte" al,L C"Uudl'L is it plaee,
but ?viot to cn! ta?Lng.
I|AS1NRY: SteeL tocati,on, bond.
be@ns, gzouting one?ticd.Ls irl
dccota:lolzae iith U.B.c. Sectian
V00DS?01ry: Afte" inatolXation igenpleted.
CURB & APPROACE APPO :
@e e?ecteC but p?io? to pourittg
SIDEIIALK 8 DRI,'EI,/AY: Fo! aXl, can-
FificL - l\4ten aba.te itens ore ccnpleted
and ahen Catclition i.s contplete at st!'uc-
tu?e naoed and ptenrises 3LeaneC up.
bLockTng @14 5et-'rp
PlwtbinA connectians -- aare, @d daie!
ELecfi.tcal Ccfilection - Blocking, set-rpard plunbi-ng eonnecti,ans ust be dpplctedbefo"c l,equesting eLeetr.icdl in6pecai.o'tl
Acces'oq Eu1:U':ng
Fiial - nfh" ?.?cLes, okirtirq, deel,s,
etc. dre cofip|.e:ed.
:1,-lll.: _-l : . : :r l::ut-jl rIo be iade afte! dLL insuleti,cn a-d.requi?ed oqot bd?ie?s @e in pTace
but befate @ty Lath, gvp&on bcard. o?
tnLL aoeriag ie applied, ond. befote
@ry ittsulati,on is conced.Led,
Sdni:al'! sa)e! cdpped .t pnopertg Lire
Septic t@tk p-"rped a . fil1.ed uith ga:;ei
I
I fo be nad.e p?io" to insta.Llation of
floo" insuhtion or deeking,
POST AND BEAI'I: Io be nade pr4or to
installd.ticn of floot, iwt^latior, ot,
decking.
ROUCH PLUEIIIC. ELEC?RICAL & IECH-ANICAL: No 'nork, is to be eo"-etedtatrtil these inspections haoe beer.
nad.e dhd. approoeC.
FIPEPUCE: Pz"iot to pl<:cir4 fccingnctertals and befo"e Ir@,rtng inspec-tinz.
FRA]II|IC: Wst be ?eqteated afterdpproual of "ough plwr,bing, ezectyi-
caZ t nechanical, AZI ,paftzq
bfacang E chimc!6, etc. nst beconpZetcd. :lo Dcrk is to be con-
. cealed. until this ingpeetion has
' beet ttode anC arytooed.
crete pcoing Lrithin st?eet ?ight-of-tall, ta be taCe after att e.xca-oating cdnplete & fofi Lb"k & eub-
fu6e ndte?idl in pla.e.
lE cE: Hher Mnplete -- Proril.e
gates o" ooable eectians th?ough
P. A. E.
Qrq-li-,^,\vl
II
'I
--AIL proiect conditiotls, such ae the irlstallat-:on of sateet t"ees, co:."plet;on of tie
requi"ed la Csccpit"4, etc., iast be sati,sfied before the EUILDIN: FMAL can be requested.
NAL BUILDI c: Ihe Final Buiuing fnspection nust be ?equested,zfte! the Fina.l PlhbirlgElectrieal, o1C echaricdl Inspectaons hqte been nade atd appt,ooeC.
PIIIAL PLUY,BIIIO
?II'IAL IlE'HAIIICAL
FINAL ELECTRICAL
iAI,L I|AIIHCLES AND CLEANOUTS UUST BE ACCES'IBLE. ADJUSTTEII! ?O BE I.IADE r'.? NO CCST TO CITY
drL
Constfiaction Lender
tr
/0 0 > 2b 4,/lD r z0e
C affii<- (iu-/-/-o
Additicn
F;," 1
I
SOLAR ACCESS REQ..L-cocJoB No 88D
Lot Faces -
3e
th
Iot Sq. Ft?.
7 cf Lct Colre?age
! of Storiee
Total leight
fopog"aphf
LOI ?yPE
_ Inte?ic?
_ Conet
_ Panhand.Le
C'uL-de-sac
l.rain
TOTAL VALUE
S.D.C. 1.5 t
Resi-Czntidl, (1 bath)
Sdni SeteP
l,lete"
:la
Ilea/E,tend ci"cuits
lanpcPaV Se?uice
Ftt a:a;::': a
s
E h@lat Hood
Yent Fcol
C(I
a.cG'
--'t .=-
41
Mechq nicol Permit
Ueeltanicel Pe"nit
ate
-. EIICROACEMTN? --
9ec,.t-i sit
Pefirit
si-CedaLk
ElectrLeal Label
l,tobile Eone
Zone:C)Cof-st:tseiroot:s:
Range
Ldee
PLan Check Fee:
Date Paid:
Rec.ipt ll:
5Lq|ed
Taae
Building Volue & Permit
This pennit ts g?dnted oi the e*?tess eondition that the saa-consttactionsllall, in all tespects, confom to the ord'inance adopted by the City ofSpingfield, i,trclud:lng the zafling cYd.ilence, ?egulcting the ccnettucticn
atd use of buildi.n4s, arrd ne! be suspetded ot teookeC at cn! tine uport oic-latioi of dtU p?coisiois of said }rditunces.
Buildina Permit
St4te &Ech@ge
Total claPaes
Pl'lttuing Pefiit
E L
State Sur3
?otal
fotaL
Plumbing Permit
Ilo pe?son El'a|| construct, install, altet o? cl,urqe an! Aed c? e.isting
pllrnL,ifl4 o? d?ainage sUstan in ulale ot in pa?t, t&Le6s such Feraon is the
legal possessot of a oalid plurnbe?'s Lieense, e.cept tlnt a person na! do
plLonbing uotk to p"opertA Lthich is oLned, Leased or oPe"ated b! the apPli-
cant,
Electricol Permit
,thele State Lan ?equi?es tkat the eLectl"ical aotk be done bg ctt Ele!,tticaL
cont?acto?, the eleetrical po"tian af this permit srsll iat be odLU wt1:l
the Label las been sigtted by the Elect?ical lantrdcto?.
Plalt Exaniner
I EAw 1AREFULLY EIAIIINED tle conpleted. application for penit, ard do
heteb! certif! tllat aLL infomation hereon is ttue ard. coftect, dnd I
fitrther cerlify that ar,g ard. d.LL oo"k pe"forned slall be dole it aceol'-
danlre tith the ordinenees of the citf of Spvingfieu' and th2 Ians of the
Stdte of o"egon pertai\ing to the aork Ceectibed he?e.n' cnd tl1a,t llo occ!'
P,tJlcI dill ba rade af cny stzactl&z trithort Petui$ion of the Brilding DL-
Lrision. I futther certii'g thst o.1L! eontracioz,e ard, qtplruees Dho are in
co;trplianee Dith oRS ?a1.a55 aiLL be used on this p"oiect
(l \-.-+r.!SJ
30.7sTOTAL AJNUN? DUE:4
sis
Pendt Issuzrlc2
I e. t. I ttouse I carcge I
fII-r
trEM lsffi
lr;-*". I
lro.
li?EM lnc]l
fT&;A;-T
l
/- Y >
o'*3h$3'?8''ffiHfi (Pq<
3
La,ounty Authorization for'
-7
FOR OFPICE USE ONLY
I]W.-iSHI P FAIiGE SECT TA]{
S', BD IV]S PARTITION /PAr( E:if applrcable)Resident-ial
Com,nercial
I ndus tr iaI
PubIic
USE OF PROPERTY
ss STFEET ai':,YADD
s:CU L!ONP
ITE
/
DECI,AXED S VALUE)jscR-!pTIoN oF pRoposED w9RK - aL SPECI|-C
,Eczu<-4 r'e,/.Uer=r- -{<><zz.c u-Eo,u- ./,2-ez7a
F
IiATER SUPPLY
.(.qrr-o.o Zt),e >* )47-a<-
OF BEDAQOMS * OF STCRIES + OF Ei'JPLOYEES Proposed
Exi s ting
6 . //. ./'.2 a c.-.,2-2r,r ./ 1 I 4
Oi(-ER'S NAME AND ADDR.ESS
coNTRAcroR I s NAME AND osR *
4,,^,ar,.,--, /z).rr r* Eo.^r..*TELEPHONE M]MBER
-2<G-/6>aP:fuIIT T! BE MAILED TO {NAME AND ADDRESS) :.4,*o..- /J.-*. V.,-,-,.,- ,/2.5*s.-14,,,. -, -, /<-4z.rz TELEPHONE N'II!4BER
) /z-za >.
I HAvn CAFcEUI,I-Y EXAMINED THE cotlPLnTED APPLICATIoN !oiL PERJ,1IT, ar,l ,lo h.r.)ir certifv that all
have the following 1e9al lntelest io the plopeity' Cosner of record; n*,""-,. pulchase!;Nautholized agent.
I f:!the! certify tlat any dd at1 ,ork perfomed shall be done in accoldan.E kith tLe ordloances oI Iane coMty ahd the Ians of the state of Oregonpertaining to the hork desclibed herein, and lhat No oCcUPiNCY witl br made of rnl sirrcture without the pehission of the auilding Division. i fu-the! celtily that regiscratio. oith the Buildelts Boald is in fu1I force and effect as requiled by oRs 701.o55. that if exerpt the basis fo! eresption
is hoted heieon, and that only subcontractors d enployees rho ale in coEplianca {ith oRs 701.055 kill be u€d on this project- I HAVE READ AND
CIIECKED IHIS AIILICATION THOROUGqLY.
ilfomation hereon is tlue and correct, and that I
coilENts :
Ar/A-
CO}!.1ENTS:
f
No
bI
tr PLANNIN ZONING:
s. r. *B. P. 1i
GrPLANS EXAMINATIoN: Tlpe pb
wt
5
lnstallation Record Issued?
ORIZATION 'tAS BEEN BASED ON THE FOLLOWING CONDITIONSI
collll}]NTS
of i)rni.nfield
cal1on
Tank
['] snr.:rt,c.rroN,
rnsta]lation
Specif-ications
Maximum Depth
READ THIS SECTION CAREFULLY. YOUR AU
c
PERMIT APPROVED BY EUILDING oFFICIAL/DESIGNEE (oer ORS 456.805(l))
LANE COUNry DEPARTMENT OF PUBLIC WOBKS LAND MANAGEMENT DIVISION, 6874061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION IN!'ORMATION ct4..25 R*
iz?i:i"t.""/rzz{zrz
BI-OCK
zrp
TELEPHONE NUMBER
tt,4
4s/4i,,,.
SETBiCKS AIiD OT:]'R CO\DITIOTS OT APPROVAL I1LIST BE S,IRICT'I OBSERVEO. VIOLATION CA:! RESIJLT !N REVO-
C;TIO:,1 OF !!lIS ?anr1Ii, CITn?IO:{ UNOER PROvISIONS OF L:NE COU)iTY'S INFRACTION ORDIIiTNCE, AND/OR OTIIER
RE|qTJDIES ALLOffED BY LN{.
!iXEN REIDY EOR INSPECTION, CALL 687-4065. A MINIIIUN OT.\1 IEAST 24 IIOURS ADVANCE NOTICE FOR INSPEC'information !6ady: petmit number, iob.ddr.ss, tyP.
of inspecrion, uhen it eill be leady, your nate and phoie nunbe!, atd any sPeci!1 directions to site
FECU t lrf, ri'Pr'lio{s.
I. Fou!4at 9a Inspectron: To be (ade after trenches are excavated and forhs erected lnd,hen all;-ater!ar-fd rhe l ndatton alc deliveled on lhe )ob. ilherc concrete from a central mixinqplant (comobly terhed "tlansit mrxed") is to bc used, naterrals need not be on the job.
2. co.cret. sLab d uncer-aLoo! Inspection: To be made alter aII in-slab or under-floor building6E ]fu;ulpment, c.niurL, piping accessories, and other anctlla!y equipnent ilehs are inplace but before any concrete rs poured or floor sheathing installed, in.luding the subfloor.
l. Framrnq s rnsularro^ Inspectrons: ro be hade afte! the roof, aIl frami^9, fi!e bloc,(inq, aidE;al.q are rr ?lace a.d aII pipes, fileBlaces, chioDeys, .nd vents ate cofrplete and all rolghelecrrica! and pluhbins are approved. Atl *alt lnsulatio! and vapoE balrier ar€ in place.
4. Larn.nd/or cvDsum Bodrc nspectronr ro be hade aiLer all Iathrno and qlpsuh board, .nterror
fia-ere-r rbr,.il-rrl:reiu!--E-r*e .Dy plasLerrng !s app:reo an; be:ole gypsm board tornrsand fasteners are taped and finished.
5. Final Inspectron: To be made after the building is conplete and before occupancy.
APlRovA! REQi,,IRED. ro work shall be done on any part of the building o! stluctule beyond the pointindicated io each successive insp€ction rithout firsr obtaining the approv.! of the bu!Iding off:cial.slch apploval s}!aU be given oaly atter an inspection shlll hav9 been made of e.ch Euccessj,v€ stepin rhe construcriod as indicated by each of the inspection6 required.
NoTE: All buildias permits require inspections for the uork authorized, such as but not linited to:
A. Block fialI: To be hade after reinfolci.g is rn place, but before any grout is pouled. Thisiiiprctf5i is lequi'ed for each bond bean pour. rhere,tll b. no.pploval until the plmbinq
and elecllica! inspections have been aade and .pproved.
B. ltood stove: ro be made after completioi of hasonr! (i! applicable) and,hen instal,lation isaielere. lnstallatiob shall be tn accordance wiEh an apploved, nationally lecoqnized testingagency a.d the nanufacturer's installalion rnstructions.
C. uobile Hore: An inspectio. is lequired afte! the robile hose is connected to an approved
sewe! or septrc sys.eh ior setback requirenents, blocking, foot!n9 connectron, tiedorns,skrr t,^q, and plMbrnq connections.
1. Footinqs and pi€ls to comply,rth stat6 foundalion requirements for nobite homes o!.srecoMended by the ra.ufact!!er.
2. uobile hohe nrnimun tinish f1@r elevation shall be certified when lequired by. fl@d-ptarn manaqehent letter.
3. Mobile hobe tiedolns, ehen lequi.eil, and skilting shalt b6 installed.nd ready fo! inspec-tion trithin at least l0 days after occupancy. Tiedoens and skirtlng shall be insralledpe! edclosure.
o. surmtlg !991| Below grade eheo steel j,s in place and befole conclere is poured. Above glade
;PPROVED PLANS T'UST BE ON TXE JOB SITE HOURS. THIS ?E!.}IIT WILL EXPIR'IF IIOR( DOES tiOT BEGIN I'ITHIN 180 DAYS, OR IF I,,JORX IS SUSPEND'D OR ABANDONED 'OF }IORE TI'AN 180 DAYS.
SUSPENSION OR REVOCATION I{AY OCCUR I' ?HIS P'RI1IT I{AS ISSUED ON lHE AASIS OF INCOHPLETE OR ERRON'OIJS
ANYONE PAOCEEDING PAST THE POIII OI REOUIRED INSPECTIONS 'ILL DO SO A1 TI]EIR OIdN RISX.
SUBSUREACE AIID AL?ERNATIVE 5EI{AGE DISPOSAL SYSTEItlS.
1. P.lnits shaU be elfectlvo fo! one yea! floD the date o! issuance.
2. Upon cohpletios tbe constluction for *hj.ch a pernit has been issued, the pelFit holde! shallnotify th6 Ij.e county Depaltrent of Planning .nd Co'rouairy DeveLopsent by subnittj,ng rh.i.stallation record forn. The Departhent shall inspect rhe conBtluction ro dererhtne tf it.corplies uith the rules contained io thls division. If the consrluction doe. cosply ,ith slchrules, the Departsenr shall issue a certlti.are of satisfactoly conpletion ro rhe pernitiSotde!.If the construcrion does nor comply with su.h rule., the Departn.lt shalt notify the pernj.rholder and shall lequire s.tislacroly cofrpl€rion before iEsui.g thc cerrificare, aailure toneet lhe requilements for sati3lactory completron urthin a rclsonable tim€ constilut€s a vio-1atio. of oRs 4s,4.605 to 45,1.r45 and this !ute.
setbacks - subsu!face !:!399 pisposal
.l.l€ or r.rr rL--i r-oa-,.y
Lur ir!nq io!nia t r od, .1., o!n I rr_... - .r.cs
!-?l.Is i!-u
10,
, 50,
I0,
00..
I
AIr=ttnliEla !
9-
9
t;
!
l:
f
LAi.iE ICUi\i1'Y ][iIT'
r1F!rl...lXrlNT i;ir{i I NBi_}i! tJi+I ;; [,1i]1 ., ADDIi
1_t rL i _:r1?nr'-!.i ia,i'1^.,'1 {rllIrYlTl,
i{ E. i'l tit...iii; IYI-'[ l_1,1'[ i:i E[Fii-t,i: '] uNIT,,r: 00li,Ji.l[ft Nf.lE !:FIflEHNINI, {;. !-l . ADDtl]{li}DE AFI-'t- t'l {l ACTI$tr r}[sl:FiIF Tiiir,l ,stl
11E,
ENV HGT HECEl.t'T ,* ?35t!6 DA'r'I Otr?t]g$
. FO TIOZ 8, 5i:'RINCF]ELN, URECONLOT BLI(1 .!T0tlIE,r +FL..DG.1 0Sr r'HONE 746 1S7$
65? I-!AYDEN :lRlpGi: tJY., SrHIf.{GFIILD,FT UI.i T T I]{]ST UAL.UAT ]:I]N IJEE DA
llrrllnliEloi
;
9
!:r,
t"l I: i- t1
i-'i-!:.
si.'lrt FT. klll(:
:.iL, LHfii{ J LI'IL F LI:
JiAIL "jUF(LHl'iHL,f:
l:,!...,1N IH[{:K FHI:
Fl. ftAl:N II
.J
t-tt l tr . ttF f'
SEQU r 1
TAHf:N El Ri,F!
r,CH OTH
EST. CI]MPLETION DATE
I
l3
I
I;J
3
TOTAL FEE,*T
\.--.
TRS# 17-03_2 2-1 1200 DATE ISSUED: 4/01/86 PERfiT#g% -8G
Ol,lNER S NAME PHONE NUMBER
NHPRN ,TNG
CONIRACIOR'S
IZj',N@u)
. NA},IEWlze.Der PHONE NUMBER
746-167e
SE
C1
ACK REOUIREI'IENTSRONT CL, SIOE
TB # PLUMBING FIXTURES
F I NIER I OR REAR
l,JO K AUTH R]ZEO BY PERI4IT
D I RECTI ONS O SITE
SDS APPROVAL REQUIRED
N1NE CrVnN
SITE AD ESS
?t
FOOTI NG OU NOAT I ON MOBI L HOME PLAC MENT D INSPECTION
DateApproved Date /Correct ion Inspector
pp ro ved Date Correcti on Da te Inspector
UNDERSLAB PLBC.tr/Approved Date
NDER LR PLBG.i NSPECTi ON/Correction Date Inspector
OTHER INS PECT IONApproved Date Correcti on Date Inspector
ROUGH PLUIiI B ING TOP OUT
Approved Dale
INSPECTION
/ Corre c ti on Date I nspector
FRAI4 ING iNSPECIION
App roved Date /Correct'ion Da te Inspector
ROUGH MECHANICALApproved Date /Correcti on Date Inspector
INSULATION / YAPOR BARRIER INSPECTIONApproved Oate_/ co rrec ti on_Da te_I n s pe c tor--
LATH / GYPSU}I BOARD INSPECTIONApproved Date /Correction Date Insp ec tor
FINAL MECHANiCAL[ /I,IOOD STOVEEApproved Date /Correctj on Da te Inspector
I NAL LUI'IBING INSPECTION
Approved Da te /Co rrec t i on Da te I nspector
INAL INSPECTIOII BUILDING D /I.4OBILE HOF1E !Approved Da te /Correcti on
/AG PLACEMENT f]
Date Inspector
CERTIFICATE OF OCCUPANCY fJApproved Date
TEt'1 P O RART CEtrT I F ITTTE O F OC CU PANE]E
M74-t91
Insp.App ro ve d_Da te Insp.
LANE COUNTY II,ISPECTION RECORD
IF
1l'lLr lJl ,URK
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