HomeMy WebLinkAboutPermit Building 1978-03-010 0
TRS, T JOB LOCATIO
Partition ing
LANE COUNTY PERMIT
Acreage:gr Lot Size
Contract6r's O.S. #
) Completed Subdivision
Lot- Block-
Phone-APPLICANT'S NAME AND ADDR
OWNER'S NATVIE AND ADDRE qc
CONTRACTOR'S NAtVlE AND ADDRESS
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready
Phone
Phone
STRUCTURES NOW ON THE PROPERTY
i HIS PERMIT IS FOR
\AJATER SUPPLY SEWAGE DISPOSAL
# B ED ROOIVIS-# PLUIVIB I NG CO NN ECT IONS
s.t. #
THIS PROPERTY IS W ITH IN ONE MILE OF THE CITY OF-. PLUIVIBING BY
--
I hereby certify that the above statements are true and accurate, and that I have the foilowing legal interest in the property:
-owner
of record;
-contract
purchaser;
-
potential buyer;
-
realtor or'agent. I f urther certify that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to clmply with all applicable Codes relating to this permit.
Fee Paid $Signatu re Date
( } NEW ADDRESS l FACILITY PERI\i]IT TO TRANSPORTATION DEPT.- l SPECIAL PIV]T. AREA. MIN, ELEVATION
SANITATION BU ILDING
lVlinimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
Type of Construction Group
-Fire
Zone
lomments
By Date By Date
Use Classification
Comments:
PLANN ING REOUIRETVIENTS SATISFIED. B Date Date lssued
ZONE SETBACKS: FRONT SIDE FACING STREET (FRONN C/L) INT. SIDE YARD REAR (FROM P/L)
LAN E COUNTY DEPARTMENT OF ENVIRONI\4ENTAL MANAGEI\4ENT, 125 EAST 8TH AVE., EUG ENE, OREGON 97401 PHONE: 687-4394
POST THIS PERVIIT ON MAIN BUILDING AT SITE
BLDG.PERMIT-WHITE; BUILDING-GREEN; PLUMBING-CANARY; SANITATION-GOLDENROD; OFFICECOPY-WHITEc55-1 3
trec
SITE INSPECTION
Ap pnov r o
Rruanxs
D t srppnoveo o*, 2-4-d,NSPECTOR
FOUNDATION INSPECTION
APPRoV ED
REMARKS
D r s rppnoveo n o^,,\-l{-ll I rusprcron
FRAM I NG
Appnov e o
I NSPECT I
Drsappnove, D o^r, J - t4-Zt
4#w
I xspe cron
I NSPECT I ON
Drsappcove o [--7 Drr r ^74 _I xspEcton
LATH OR SH
Ar pRov r o
Rruanx s
FINAL INSPECTION
Ap pnov e o Dt saPpnoveo
f /tmA/ ^rG f rUeArqr//a.t-
Drrr / -3O -8{ lNsee cron
CERTIFICATE OF OCCUPANCY
Reaov to I ssue
RruaRx s
Nor Reaov ro lssuE D DorE-I NsPEcroR
d
-4)
"€
Ti,;, T
n/7A, e<*
Acreage or Lot Si
Contractor's O.S. #
APPLICANT'S NAME AND ADDRE
LANE COUNTY PERMIT
) Completed Subdivision
B LOCATIO
Partition ing
Lot- Block-
Phon p
CONTBACTOR'S NAME AND ADDRESS
OWNER'S NAtVlE AND ADDRESS Phone
Phone
Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready.
WATER SUPPLY , , SEWAGE DISPOSAL ;.. 's.t. #
THIS PROPERTY IS WITHIN ONE IVIILE OF THE CITY OF PLUTVIB ING BY
I hereby certily that the above statements are true and accurate, and that I have the following legal interest in the property:
-owner
o,f record;
-contract
purchaser;
-
potential buyer;
-
realtor or agent. I Iurther certily that (iI not the owner) I am authorized 10 act for the owner of
record, and that said owner is aware and approves ot this action. I herebv agree to comply with all applicable Codes relating to this permit.
Fee Paid $- Signature
() NEW ADDRESS I FACILITY PERIVIIT TO TRANSPORTATION DEPT
Date
() SPECIAL PIVIT. AR EA. tVIIN. E LEVATION
STRUCTURES NOW Otrt tge pnOpeRtV ' ' ' -
1-HlsPEBMlTlSFoR+#BEDRooMs#PLUl\4BlNGcoNNECTloNL
SANITATION
lVlinimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
lVlaximum Depth
Date
BUILDING
Type of Construction
Use Classification
Comments
roup ire Zone
, Comments:
1
By By Date
PLANNING REOUIREMENTS SATISFIED. B
SETBACKS: FRONT
Date Date lssued:
SIDE FACING STREET (FROIVI C/L) INT. SIDE YARD REAR (FROIVI P/L)
LANE COUNTY DEPARTMENT OF ENVIBONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687'4394
POST THIS PERMIT ON MAIN BUILDING AT SITE \
c65-r 3 '\--
<----
ZONE:
I,ro,TL )^ee/a / g /a.U
lfritten Directions
(/{ Building Permit
Acreage or Lot Size 7,f x tn
Partitioning#-.__-- ( ) Completed( ) Pending
Job Location
INFORMATION SHEET
( ) Site Feasibility Study for Septic Tank
Test hole will be ready
Subdivision
x/4 €,5L
Number of sites-
Lot
t/to-7 &
4o<-aBloc
,C-C>LLAPPLICANT'S NAME AND ADDRESS
OWNER'S NAME AND ADDRESS, if differen rom app licant's
CONTRACTOR'S NAN/]E AND ADDRESS
Mail permit or results of site feasibility study to ( ) Applicant (p{-) Owner ( ) Contractor
( ) Prefer to pick up. Call
,nrn" 7Yf;- 22 3,f
Phone -!'l- l? ?y'
Phone
Contractors o. S. # f 7
existing or proposed well, etc. lf public, name of system)
STRUCTURES NOW ON THE
PROPOSED USE (this permit)
PROPE BT
3&o
An)
2zfa
WATER SUPPLY a'b/
SEWAG E DISPOSAL / r''7
PLUMBING BY
(,yd PROPERTY rS WtTHtN ONE M|LE OF C|TY ( )
(existing or proposed septic tank, etc.) S.l
Address
*+**r**oFFtcE usE oNLY BELOWTHTS LINE r******+*r**
( ) New Address Necessary
, -ON
\
F
( ) Facility Permit Necessary ( ) Special Permit Area. lVlinimum Elevation
SETBACKS: Front Side Facing Street lnterior Side Yard --- Rear
(FROM CENTERLINE OF ROAD) (FROM PROPERTY LINES)
To: Planning/Building lnspector/Sanita.ian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appaeciated.
By Permit Processing Section
Response
By
DEPARTMENT OF ENV I RONMENTAL MANAGEMENT
Permit Processing Section
125 East Bth Avenue
687-4394css-12
Division
( owner, etc. ) when ready.
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9t/rB FLOOR
PLUMBING GROUNMORK
Apenovro n
Rettlnx s
Drslppnoveo D oarcl-)fi-T6 rNSpEcroR e'n-
GAS PIPING GROUND/ORK
Ap pRov e o
REuanx s
D r sappnovEo Dere l usercron
ROUGH PLUMBING
APPRovEo / ,.'/ Dr sappnovro
RExe nx s
D Dare -78 It'tspcc-ona-=
ROUGH GAS PIPING
Appnoveo D DrsappRovro D
Reuanx s
Dar e I Nseecron
FINAL PLUMBING
AppRoveo H Drseppnoveo
Rr urnx s
oor.J? 8'n txsprcron FIL
FINAL GAS PIPING
Ap pRov e o
ReMenx s
D r sappnoveo Drte I Nsprcron
CERTIFICATE OF OCCUPANCY
Reaov ro lssue
Rrua nx s
D Nor Rrrov ro tssuE D Dare I NsPEcroR
R
n Owner
LANE COUNTY PERMIT FOP_PERIVlIT NO
CONSTRL;CTION [ ] MOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
/.
NAIVIE ADD R ESS CITY ZIP CODE PHONE
tr Contractor
O.S. Reg. +
Twp- Range-- Section
Subd ivision Lot
ADD R ESS CITY ZIP CODE
Tax Lot- Code- Census Tract
B lock Acreage
-
NAIVIE PHONE
Access to Property (Road Name): ,. .-
Width
Depth
Existing Structures on Property:
Directions to Property - Address
STRUCTURE (# BEDROOIVIS)SO. FT VALUATION
SEWAGE DISPOSAL PLUIVIBING INSTALLED BY:
OWNER[] OTHER[] NAIVIPUBLIC [ ] SEPTICTANK t 1 orHER[ ]F
BUILDING
PLUIVIB ING
3% SURCHARG E
IVIOBILE HOIVIE-
WASTE D ISPOSA L
PLAN REVIEW
TOTAL
WATER SUPPLY: PROPOSED t ]
EXISTING t ]
PUB LIC
COIVIIVIUNITY - NAIVIE
PRIVATE WELL
OTHER .SPECIFY
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
IVIIN. SEPTIC TANK CAPACITY
GALS MIN. DRAINFIELD-LIN. FT IVIAX. TRENCH DEPTH I NCH ES
STAY 1 F IVIA E
TYPE OF CONSTRUCTION- GRO FIRE ZONE-- USE CLASSIF
SETBACKS- FT. FROIVI CTR. OF riW
FBONT SIDE EXT
FT. FROIVI PROP. LINE:
SIDE INT.
-
REAR ZONE
c55.13
ES:AUTHORIZED SIGNATUR
lsl
ISSUANCE DATE
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING _ CANARY
BUILDING - GBEEN
SANITATION - GOTDENROD
IMPORTANT
Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all r6quired
septic system inspections. All construction shall comply with the State Buidling Code, D.E.O. standards
for subsurlace sewage disposal and the State Plumbing Code. All buildings require a certificate of
occupancy before being occupied.
(See Details on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY. DEPT, OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX. 135 EAST 6Ih. EUGENE. OBEGON 97401
c
n Owner
tr Contractor
A
CON RUCTION [ ] IVIOBILE HOME [ ]P LAN REVIEW [ ] CHANGE OF PANCY
7/oi
LANE COUNTY PERMIT FOI
ES5
PERIVIIT NO.
2sa3-7L
ZIP CODE PH
NAME ADD RESS CITY ZIP CODE PHONE
O.S. Reg. +5
Tw Rang e Section Tax Lo t /3tr,Code
"t.4tlon
Access to Property (Road Name)
Existing Structures on Property:
L B lock L Acreage Width
Depth
c
Directions to Property - Address:
STRU E(BEDR VIS)
SEWAGE DISPOSAL:
PUBLIC [ ] SEPTICTANK ,1,,,^, ,
FT VAL Tto
PLUMBING INSTALLED BY:
OWNER[ ] OTHER[ ] NAM F
BUILDING
4
J. oo WATER SUPPLY: PROPOSED
PLUIVIB ING
3% SURCHARGE
IVIOB ILE HOIVIE
WASTE DISPOSAL
PLAN REVIEW
TOTAL
,- EX IST ING
LYfusttc
] CON4MUNITY-NAIVIE
] PRIVATE WELL
] OTHER . SPECIFY
tvcJz<.-l
CONSTRUCTlON PERMITS & INSP IONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
GA IVIIN. DRAINFIELD- LIN. FT MAX. TRENCH DEPTH I NCHES
STAY 1OO' FROIN ALL WELLS
TYPE OF CONSTRUCTION GROUP FIRE ZONE USE CLASSIF\,
SETBACKS.FROI\4 CTR. OF rAlV
FRONT I SIDE EXT
FT. FROM
SIDE INT.
PR tI INEP a R.,eREAR (ZONE
AUT
/s/
D SIGNATURE
BIDG. PERMIT _ WHITE
OFFICE COPY - WHITE
COUNTY TAX _ PINK
PLUMBING _ CANARY
BUILDING _ GREEN
SANITATION - GOLDENROD
ISS CE DATE
s. Call 687-4061 to schedule all required
th the State Buidling Code, D.E.O.standards
Code. All buildings require a certificate of
Call 687.to schedule all required construction inspecti
IMPORTANT septic system inspeclions. All conslruction shall comply wi
Pl umbi ngfor subsurlace sewage
occupancy before being
disposal and the State
occupied
(See Details on Reverse Side)
LANE COUNTY, DEPT. OF ENVIFIONMENTAL MANAGEMENT
COUBTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
c55-l 3
l
Census Tract
CONSTRUCTION PERMITS & INSPECTIONS
u.B.c. sEc. 302(d) EXPTRATToN
Every permit issued by the Building Official under the provisions of the Code shall expire by limitation and become nutl and
void, if the building or work authorized by such permit is not commenced within 120 days from the date of such permit, or if
the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a
period of 180 days. Before such work can be recommenced a new permit shall be first obtained to do so, and the fee therefor
shall be one-half the amount required for a new permit for such work, provided no changes have been made or will be made in
the original plans and specifications for such work; and provided, further, that such suspension or abandonment has not
exceeded one year.
a a a a a a a a a a a a a a a a a a o a a a a a a a a a a a a a a a a a a a
a o a o a a a a a a a a a a a a
U.B.C. SEC. 302(e) SUSPENSION OR REVOCATION
The Building Official may, in writing, suspend or revoke a permit issued under provislons of the Code whenever the permit is
issued in error or on the basis of incorrect information supplied, or in violation of any ordinance or regulation or any of the
provisions of this Code.
u.B.c. sEc. 304(d) REQUTRED TNSPECTIONS (CALLED INSPECTIONS)
The Building Off icial, upon notification from the permit holder or his agent, shall make the following inspections (allow 1 to 3
working days) and shall either approve that portion of the construction as completed or shall notify the permit holder or his
agent wherein the same fails to comply with this Code.
(1 ) FOUNDATION INSPECTION: To be made after trenches are excavated, forms erected, and steel reinforcement in
place (if required)AND BEFORE ANY CONCRETE tS POURED.
(2) FRAME INSPECTION: To be made after the roof, all framing, fire blocking and braces are in place and all rough
plumbing, rough electrical and fireplace, chimneys and vents are complete. NO WORK SHALL BE COVERFD UNTIL
THIS INSPECTION HAS BEEN MADE AND APPROVED. There will be no approval for cover until the plumbing and
electrical inspections have been made and approved.
(3) LATH and/or WALLBOARD [Sheetrock] INSPECTION: To be made after all lathing and/or wallboard, interior and
exterior, is in place; but before any plaster is applied or the wallboard joints and fasteners are taped and finished.
(4) FINAL INSPECTION: To be made after the building is complete AND BEFORE OCCUPANCY.
OTHER INSPECTIONS: ln addition to the called inspections speciried above, the Building Officlal may make or require
any other inspections or any construction work to ascertain compliance with the provisions of this Code and other
laws which are enforced by the Division of Construction Permits and lnspections.
MOBIIE HOME INSPECTIONS: A plumbing inspection is required after the mobile home is connected to an approved
sewer or septic system to inspect the plumbing connection and setback requirements.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
You may make your request for inspections between 8:00 a.m. and 5:00 p.m. Monday through Friday at 135 East 6th Avenue,
Eugene, or call 687-4065. Other areas may call the following also: Florence Area, 342-8328, 997-3461 , or 687-4358; Cottage
Grove Area, 942-4493; Oakridge Area,782-1041 .
NO REQUESTS FOR INSPECTION WILL BE ACCEPTED WITHOUT THE FOLLOWING INFORMATION: (A) NAME Of PETMit
Holder; (B) Permit Number; (C) Location of Job; (D) Type of lnspection Requested.
a
WATER POLLUTION CONTROL
OAR CHAPTER 340 Division 7 Subsurface and Alternative Sewage Disposal Subdivision 1 Standards for Subsurlace and
Alternative Sewage and NonWater-carried Waste Disposal.
71-O1S (7) A permit issued pursuant to these rules shall be effective for a period of one year from the date of issuance.
71-Ol7 (1 ) Upon completing the construction forwhich a permit has been issued the permit holder shall notify the Department.
The Department shall inspect the construction to determine if it complies with the rules contained in this division. lf the
construction does comply with such rules, the Department shall issue a certificate ol satisfactory completion to the permit
holder. lf the construction does not comply with such rules, the Department shall notify the permit holder and shall require
satisfactory completion before issuing the certificate. Failure to meet the requirements for satisfactory completlon withln a
reasonable time constitutes a violation ol ORS 454.605 lo 454.745 and this rule.
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Recorc of lnfiviAuat
[.8]E ]Y-lt{5fALLfk
TO: .i
Systera
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A ue-
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8eflding
GL1^, Prqc.rty
SIEIE I(trbtcdnt:
H=o.J 5 t
tih 6 -- inches
N er, )r.aii a f:etcl
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r)
36'
l-
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vl'
F.ec
Pt"
3r"
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IE SURE TO INDICATE NORTHERLY DIRECTIO'.I
l
Signoture -
FOR USE OF SANITARTAN ONLY:
System opporently villT{ vill not !otisfoctorily, snd is lherefore opproved fcr occuporcy'[_1 Disopprove
Remorks
Dote f2-2r-62
functi,
LA
6ANITARIAN
IT
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itils---- l-los.!.nt: Ycc,[] Ho E;?in
---
C*rn nunity irrtr'rt .:i::l - -.. No. of ccnoortrnrntr'f.?.'t ft- lasidevidft .::!9."
t Dirtonco 6rr$:
Wdl- -
Neorgr
Lot liac: Front i_l Side
r-- ft
=-lt.5ft.
-ft
feet
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Degth of filter rnsteriol beneotl
b..-<--
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rg\ ur
a
PROPC )
'EIIAGE
OISPOSAL SYSTEH RECARO /,1nK*Complete top Pa rt of furm to s i gnature submit both copies with APP.i cat
</.L 4 P RM IT NO
L CE
No. L v
Sept c
ng ts edroomsn Basement
Yes Publ i c
v
0ther-L i st
UPP
Ft. f wel I Steel tr Concrete No. Compartments
L
s Posa e
Gal . Capa "rr, #;
lns D mens ons:
h
NAHE
I.TAILING
ADDRESS
t.Jidth Diameter D h
e
Distribution Box:e5
t er str ut On-
eet f rorn
il
t
No
f,ton
ot ne
Front S ide
Lengt L neS-t.
4 6
ot an
Si n
0 SAT
For Sanitarian Use Only:
tn accordance with 1973 Oregon Laws Chapter 835, Section 214 this certificate
as evidence of satisfactory conpletion of a subsurface sewage disposal system
I ocat i on.
fXJ npproved: System tnstallation conforms to current standards
l-l Disapproved: Does not conform to current standards
Remarks:
r
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LANE COUNTY
STATE OF OREGON OEPARTHENT OF ENVIRONHENTAL QUALITY
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LANE COUNTY PERMIT FOT PERIVIIT NO
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PLANREVIEW[] CHANGE OCCUPANCYl
In Owner
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O.S. Reg. +
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Range
ZIP CODE
Census Tract
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Access to Property (Road Name
E;isting Structures on Property:
Directions to Property - Address
STRUCTURE (
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SEWAGE DISPOSAL:
PUBLIC[] SEPTICTANK
Width
Depth
S)VAL to
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OTHER
PLUIVIBING INSTALLED BY
OWNEB OTHEB NAIM
WATER SUPPLY: PROPOSED I ]
F
BUILD ING
PLUIVIB ING
3% SURCHARGE
MOBILE HOIVIE
WAST E D I SPOSA L:*=+=-:-
PLAN REVIEW
TOTAL
CONSTRUCTION PERMI
IVIIN. SEPTIC TANK CAPACITY
GALS IVIIN. DRAINFIE
TYPE OF CONSTRUCTION }fi
CT
AUTHOR I ED SIG TUR
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MIVIUN ITY - NAIVIE
IVATE WELL
ER SPECIFY
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LASSI F ''"{.d-*tn.,-l tcyrat
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Code. All buildi
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CE DATE
to schedule all required
Code, D.E.O. standards
require a certificate of
BLDG. PEBMIT - WHITE
OFFICE COPY _ WHITE
COUNTY TAX - PINK
PLUMBING _ CANARY
BUILDING _ GREEN
SANITATION _ GOLDENROD
to schedule all required conslruction i nspectiohs. Call
IMPORTANT tic system inspections. All construction shall comply wi
Plumbing
Call
sep'
tor subsurface sewage disposal and the State
occupancy belore being occupied
(See Details on Reverse Side)
POST THIS PERMIT ON MAIN BLDG. AT SITE
LANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
& INSP IONS AND WATER POLL ION CONTROL SPECIFICATIONS
MAX. TBENLIN. FT
GROUP FIBE ZONE\,USE
FT. FBOIVI
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FOUNDATION I NSPECTION
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FRAMING INSPECTION
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FINAL TNSPECTION
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CERTIFICATE OF OCCUPANCY
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