HomeMy WebLinkAboutPermit Building 1975-04-30I.ANE COUNTY
BUILDING ;_
iTDING PERMIT OR MOBITE HOME
MHI
SE PERMIT
PERMIT NO.
PROF;RTY O\ NER MAII.ING ADDRESS PHONE
CONTRACTOR MAITING ADDRESS PHONE
PROPERTY I.OCATION _ INCLUDE POST OFFICE
PROPERTYd"LEGAL,_
GE .i'"oTM CODE CENSU S
e. I
N_
EXISTING STRUCTURES ON PROPERTYAPPt.
NAME
&
MAII.ING
ADDRESS
I"EGAT ACCESS TO PROPERTY
PRO SIZE _ FT
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge System New System !
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ, FT, # BDRMS VALUATION
SEWAGE DISPOSAI.
PUBr.tC tr SEPTIC TANK n oTHER[-l
PLUMBING INSTATTED BY
OWNER n OTHER: NAitE
BUITDING
WASTE DISPOSAL
PLUMBING
PTAN REVIEW
PARK TRAILER
F EES WATER SUPPI-Y
PUBr-rc D D OTHER
TOTAT
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[.
DRAIN FIETD REQUIRED
I.IN. FT TRENCH WIDTH FT.OR SQ. FT.
OCCUPANCY ZONE PUBI-IC UTIt. EASEMENTTYPE OF STRUCTURE
FT. FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATIONBI.DG. SETBACKS
FRONT SIDE EXT REARSIDE INT,
DATEAUTHORIZED SIGNATURE _ DATE
Jot
BLDG. PERMIT _ WH ITE
OFFICE COPY - WHITE
COUNTY TAX _ PINK
PI.UMBING - CANARY
BUITDING _ GREEN
SANITATION _ GOTDENROD
Coll 687-4065 to schedule oll required inspections' All conslruc'
tioi tfi"ff comply *ilt Unltorm liuilding Code, D'E'Q' stondords
IMPORTANT: for subsurfoce'sewoge disposol ond county regulotions covering"' ;i;;ti;s. ltt buildiiss reiuire o certificole of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(POST THIS PERMIT oN MAIN BIDG. AT SITE)
IANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENI
COURTHOUSE ANNEX, I35 EAST 6Th, EUGENE, OREGON 9740I
ronu lf, 655- 13
{.
i,A,{E COI'NTY ENVIRilNMEN iAI I'IANAGEMENT
Name and Address of Owner
Telephone:-_---
The buitding being.constructed under this permlt will be used for
Date this property was P urchased
Do you now, or did you ever own property adjacent to this tax 1ot? If so, please
list those tax lot nurnbers or draw tltose properties on the plot plan below.-
PLOl' I'I,AN
Indicate on your drawing the location of all homes (incl-uding mobile homes) now on
the property, as well as the location of the new building.
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Name of Applicant (if dlfferent from owner):
Telep,hone
Add..""Map
Tax Lot
Applicantrs Interest: BuYer
M74-99
Sel1er Agent Permit /i
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\/Lr t.BUILO ING S TTE EVALUAT !ON
0 BUILOING PERHIT APPL!CATION NO"
( ) srrE tNsPEcnoN
PLANNING OIVISION
Zoning 0rdinance Connp I iance: Zone
T S TAX LOT
?-e. -r- 2-f
Not
I i cabl
SUBDIVISION:
APPL I CANT
DAT F
LOT:_ BLOCK:_
cKfD BY: *;
-?:zz.-nfSetbacksffiFront 1{_
Side Exterior
No YesT-)il 6.
() ()
() ()
() ()
() ()
I
2
3
4
5
Subdivision 0rdinance Compl iance
Requi red Access
Building Site (Area, Width, Frontage)
0ther (see conments)
Setbacks from interior I ines:
Side
Rear
COI{HENTS:
PTANN-lnc 0 t vt s !-0N-TCTIotrTFNDTNGaTES( ) N0 ()_AFPETEA-TION#
BUILDING INSPE cTt0N Dlvlsl0N
7. Plans Submitted8. Soi I Stabi I i ty (foot i ngs)
9. Flood Plain
I O. 0ther (see cornnrents )
COMHENTS:
Not
No Yer
I-t.E() ()
() ()
)
)
)
(
(
(
le
CKI D ,
},ATER POLUT ION CONTROL Not
Aool icable
I
r{r
No Yesr) rTll. l{eets Department of Environmental
Qual ity Standards.
12. 0ther (see cornments)() ()CK'D BY
DATE
COHHENTS:
TO APPLICANT:
Your Building / Site lnsPection:
Can be approved.
Cannot be approved at this time as indicated on item N0
.J(Questions and furt her information on items I through 5 contact t LANE-
P D lV I S t0N" Quest ion rther on i tems 7
rough 2 contact the LANE S ION
ill be held in this office unt
s being returned.
you can reso ve the p
,*4w a above.
s and fu
BUILDING
i nformat i on
SAN ITAT ION D
)
)
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Y
c55-28
our bui ldi
em5 nd i cat ed.
rmi t a lication f is b
E
135 Sixth Avenue East Eugene Oregon
pHoNE z 687-4055
LANE COUNTY PLANNING DIVIS!ON PHONE:
97401
687-4t86
lr------*1--
o rt
,ROPOSED SEbJAGE DISPOSAL SYSTEH .-ORD
INSTALLER: Complete top paif of form to signature and submit both copies-with appli I On.
PERHIT NO JoxN Snoo
Wx rre V/arEn RaNcx Roao
No. L i v i ng Un i ts Bed rooms Baths Basement
Yes No
Water Supply
Publ ic 0ther-List
Septic Tank:
Ft. f rorn wel I Steel
ns
th
ER
NAHE GEone e O'NE t t-
HAILING
ADDRESS
Gneeruwooo Dn r ve
tr Concrete No. Compartments
e sPosa e
Distribu Box Yes No
t er str ut OO-
Feet
Gal .Capaci rt / An
L
ll
Lot L
Front
oundat i on
ne
ABURG On eco Side
Length L es-t.er
6 ile
I CATE PL
as evidence of satisfactory cornpletion of a subsurface sebrage disposal system at the above
I ocat i on.llftI npptoved: System lnstalletion conforms to current standards
[J 0isapproved: Does not conform to current standards
Remarks:
L r
ov,
For Sanitarian Use 0nly:
ln accordance with 1973 0regon Laws Chapter 835, Section 214 this certificate
Date: (-.lt- 77
i s issued /
thD i ameter
tsons:
Width
F I I I
Type
E?T/h pt
lnove Ti I
erTotal Sq.
Ft..r 70'
Ft. Between
Lines / O rTrench
},idth^
iee i nstruct ons
./o'
b9,
,/
0s
/o3'
tlett
oql
o r=6 S I t,0J f)I
c,ar/'+aFv t
I
/o (
pl
tar an
LANE COUNTY
STATE OF OREGON DEPARTHENT OF ENVIRONHENTAL QI'ALITY
sc55-1I re
-
I
t
L
LANE .COUI.ITY
BUILDING -
r.-rtDlNG PERMIT
MHI
OR MOBILE HOME -5E PERMIT
PERMIT NO.
PROPERTY OWNER MAITING ADDRESS PHONE
ILING
t tt
t
PH
PROPERTY LOCATION _ INCTUDE POST OFFICE
_ MET,ES,
RANGE loN TAX LOT NO.CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPPt.
NAME
&
MAITING
ADDRESS
TEGAT ACCESS TO PROPERTY
PROPERTY SIZE - FT
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge System I New System
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION se. FT. # BDRMS VALUATToN
Djt a
SEWAGE DISPOSAL
PUBUC n sEPTlc TANK n OTHER-
PLUMBING INSTALTED BY
OWNER ! OTHER: NAME
(F EESBUII.DING
WASTE DISPOSAT
PTUMBING
PTAN REVIEW
PARK TRAII.ER
TOTAL
I
$__
WATER SUPPTY
PUBUC D tr OTHER
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
DRAIN FIETD REQUIRED
tIN. FT TRENCH WIDTH FT,OR SQ. FT
\
TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTIT. EASEMENT
BLDG. SETBACKS FT. IROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT. SIDE EXT.
USE CLASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
ton* er'{. Hrao*ugn Joq.r Siofrfillrrr*r*t I
B[DG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PI.UMBING _ CANARY
BUITDING _ GREEN
SANITATION _ GOI,DENROD
Coll 687-4065 to schedule oll required inspections. All constr
tion sholl comply with Uniform Building Code, D.E.Q. stondo
IMPORTANT: for subsurfoce sewoge disposol ond county regulolions cover
plumbing. All buildings require o cerlificote of occuponcy be{
being occupied.
(See Detqils on Reverse Side)
(posr THts pERMtr oN MA|N BIDG. AT S|TE)
IANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, I35 EAST 6rh, EUGENE, OREGON 9740Iroau * 655- 13
CONTRACTOR
SITE INSPECTION
Appnovro
REuanrs
Dt srppRovro Dare I rusprctoR
FOUNDATION INSPECTION
APPRov ED
REua nx s
D DrsappRoveo V Dare I rspecton
FRAMING INSPECTION
Drte I NSPEcToR
LATH OR SHEETROCK
AppnovEo
RruaRrs
I NSPECT I ON
D I SAPPRoVED Dar e I Ns PE croR
FINAL INSPECTI
Ap paov s o
REuanx s
,*,/ *//_-7i
ROVED lNspe c
\rt
rr
t'
:t
CERTIFICATE OF OCCUPANCY
Reaov ro lssur D Nor Rraov to lssur D Dort-lHsre cron-
ReulRx s
f;oz ?{-/ilrrtvz<,Ylr /**
APPRovEo
RrttnRx s
D Drsrppnoveo D
NOTE: NO PERMIT WILL . ISSI]ED I,NTTL TIIIS APPLIC'ATION I
APPLICATION FOR:
PERMTT +_7ls-'zS'
BEEN APPROVED
CONSTRUCTION x.MOBILE }IOME PLAN REVIEW CHAi.IGE OF OCCUPANCY
OWNER Lor.t :S "
\qr -'l "l .+ 656 t
zip PhoneNameCtty
CONTRACTOR
Name
O.S. REG. /I
rtlp. lJ nanse 6 ? Sec tion 25
Subdivls Lot
ACCESS TO PROPERTY (Road Name)
Existing Structures on Property: \\O t^ S €-
S City zrp
Census Tract
Phone
Tax Lot Code
lock Acreage wutQf,?loepth-I$LOo
Property Location - Address/Dlrectlons:l? LZ Lrnr^sr^YiL qe
(D , 4 It x ,f ti'rb't'rc ou"*""'" "7"ii7,
v /
S
Slte Inspect lon /l
WATER SI,]PPLY:
Well
FEES
B1dg.
Waste Dlsp.
Plumblng
Plan Revlew
Mobile Home
l% Surcharge
TOTAL
Sprlng
d, oo
Exlsting Sewage Disposal System rxl or New Sys Requlred
Public
CoEmunity Name of Ity or Publ1c Systentr (f,,i-^,rrr-.Other
PLII{BING:
Installed by Owner
PLUMBING FEES:
-'----
# of Fixtures
Other
Sewage
Connectlon
PLANS FURNISHED
NO
Slgnature of App 1 icant : '
Fee Received By:
Water
Connection
FACILITY PERMIT
,06 x lK vnsCASH
CHECK
YES .DKl. ro
?
f, o{
Date
Min. Septic Tank Capacl Drainfleld Requlred - Lineal Feet Maxlmum DePth_
Type of Constructlon Fire Zone Use ClassificaEion
Bldg Setbacks - from Center of Road Right of Way
Fron a-Slde Int. d Side Exterior Rear1l1f llf,
cs5- t2 I.ANE COTINTY D OF ENVIRONMENTAL
Zone
DATE:
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