HomeMy WebLinkAboutPermit Mechanical 1986-03-26RUR^L ADD-RESSING.
CHE-(ED HAR 2 {rLane County
hlOOD STOVE INSTALLATION INTO CHIMNEY
?cK
3"AD
-
fon
)
FOR OFE'ICE USE ONLY
Application,/
Permit *7
03
RANGE SECTION
22.1.3.,
TAX LOT Eour oF
I 2800
i\CwN-SHI P
17
rl
BLOCKa+I
l1
I,OT
PROPOSED USE
ffifu.ia".,
f e,luri.
OF PROPERTY
tial Industrial
Commercial
3100 Oriole St., Springfiel d 97477
L-ITY ZLPi^,CATION ADDRESS \)srnser I
STRUCTURES CURRENTLY ON PROPERTY
SFD
E of Beltline - turn R on Game Farm Rd. qo to Mllard - turn riqht - end olXallard
DIRECTIONS TO SITE
DECI,ARED S VALUEDESCRIPTION OF PROPOSED VIORK - BE SPECIFIC
Stove installed in fireplace openinq and stove pipe to run up chimnev
WATER SUPPLY Proposedri
f OF STORIES # OF EI,IPLOYEES= OF BEDROO|,IS
TELEPHONE NUMBER
342 1821 (JacGRADLE, Penny and Jack
OiINER'S NAME AND ADDRESS
work: 3608same
TELEPHONE NWBERCONTRACTORS NAME AND OSR #
TT]LEPHONE NWBER
,
F:E TT JO--EEITI'ED TO (NAIIIE AND ADDRESS)
-/t -/)
THE COMPLETED
and all work pe
described herein, and
in the
lration with is in full force and effect as required by oRs 701.055, that if exempt the basis for exempti
s uho are in conpLj-ance with oRs 701.055 wiU be used on this project. I HAVE READ AND
3'Ao-E
NO
dd
PENNY GRADLE
of ar.i'sf-ructure without the pemission of tshe BuiLaling Division
and correct, and that II HAVE CAREFULLY
the Iaws of the State of Oregonof
I fur-
have the following
I f:rther certify that
is noted hereon, and
THIS
pertaining to the
ther certify that
I{AS BEEN BASED ON THE FOLLOWING CONDITIONS:
PLANNING ACTION REQUIRED.
interior rear
ParceI ParceI
c .-f. - s rcle
Partition *-
3-20
Lineal
of.e
B. P. *Installati
Date r
TAI
Use
APPfuUNL
tr
tr
Depth
nches
Date
n
Date
COMNENTS:ATtat) tN ,EpFoR tIJgTAUL] I I<'TED AWII S
Cn-I?E IVET.
d?fl v"" flH"
cord\ENTS
TVDeTION:GrouD
A9E T-bT AP/PP6UED
READ THIS SECTION
fl platqnrxc,zzoNrNG:
Minimum Setbacks:
3-ZG- 8E
BY BUILDING srcNEE (per oRS 456.805 (I)
DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INT'ORMATION
DATF
687-4061,
PERMIT
av..25 R*
Penny works for L.C. Mental Health
*
of
D
SETBa\CKS AND OTIIER CONDITIo:-S OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVO-
CATION OF illIS PERMIT, CITATIOII UNDER PROVISIONS OF LANE aoUT*?Y':; INFRACTION ORDIIiANCE, AND,/OR OTHER
RE}IEDIES ALLOTdED BY LAW.
I/iHEN RE.IDY FOR INSPeCTION, CALL 687-.i065. A )lIr'IllUIl OF AT LaAST 24 I'IOURS ADVAIiCE r'OTICE FOR INSPEC-
ffiEN:.-Id';LhE-oIIowinginformationready:permitnumber,jobaddress,tyPe
of inspectlon, when it w.iIl be ready, your name and phone nunber, anC any special Crrections to site.
BUILDING DIVlSION:
REOUIRED IISPECTIONS:
l. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
materials for the foundation are delivered on the lob. lrhere concrete from a central mj.xing
plant (comonly termed "transit mj-xed") j.s to be used, materiaLs need not be on the job.
2. Concrete Slab or Under-a1oor Inspectlon: To be made after a1l in-slab or under-f1oor buildj.ng
iryre eCulpnmt, c(ru'.ft, prpmq rcressories, and other anci-Ilary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framing & Insulati.on Inspectionsr To be made after the roof, alL franing, fi.re blocking, and
braclng are in p.l-ace ard aLl- pipes, fj.replaces, chimneys, and vents are conplete and aII rough
electrical and plumbing are approved. AII HaII rnsulati-on and vapor barrier are in place.
4. Lath and/or Gypsum Board lnspection: To be made aiter all lathing and gypsum board, interior
and exterior, is in place buL before any plastering i.s app)-ied and before gypsm board joinEs
and fasteners are taped and fini"shed.
5. Einal Inspection: To be made after the buil.ding is complete and before occupancy.
APPROVAL REQUIRED. No uork shall be done on any part of the buiLCing or Structure beyond the point
ind.icated in each successive inspection without first obtaining the approval of the buj.Iding offtcial
Such approval sha1l be given only afte! an inspection shaIl have been mage of each successi-ve stepin the construcLion as indicated by each of the inspectrons required.
NOTE: AII building permits require inspections for the work authorized, such as but not Limited to:
A. Block \^ral,L: To be maCe after reinforci.ng is in place, but before any grout is Doured. This
TrelrctT6n is required f or each bond beam pour . there wi 11 be no approval untii the plumbing
aod electrical inspecLj.ons have been nade and approved.
B. l^rood stove: To be made after completj.on of masonry (if applj-cab1e) and when installation isffipfeta fnstallation shall be in accordance with an appiovea, nationally recognized testingagency and the manufacturerrs installation instructions.
C. Mobj-Ie tlome: An inspection j-s required after the mobi-le home is connected to an approved
EEwEFo?-septic systen for setback requirements, blocking, footing connectj.on, tieiowns,
skirting, and pLmbing connections.
1. Footings and p.iers to compLy wi!h state foundation requirements for mobil.e homes or asrecomended by the manufacturer.
2. llobile home minimus finj.sh floor elevation shall- be cert.ified when required by a flood-plain management letter.
D
rting shall be installed and ready for inspec-
. Tiedowns and skirting shaLl be installed
Swiming PooI: Below grade when steel is in place
wlEE n-E6o1-lFi n s ta I led -
."8) is Poured. Above srade
Mobile home tiedowns, when required, and ski
tion ilithin at least 30 days after occupancy
per enclosure.
lnterior property I!nes
EdEe oi' road rlqht-of-way
Buildinq foundation
l.ielIs, other uater sources
APPROVED PLANS UUSI BE ON THE JOB SITE AT ALL TTMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN lBO DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR }]ORE THAN I8O DAYS.
SUSPENSION OR REVOCATION i.lAY OCCUR IE TITIS PER.TIIT I^1AS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORXATION.
ANYONE PROCEEDING PAST THE POIIiT OT REQUIRED TNSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEI{AGE DISPOSAL SYSTEUS:
1. Permits shall be effective for one year from the date of issuance.
2. Llpon completing the construction for which a pernit has been issued, the permit holder shalL
notj.fy the Lane County Depa!tment of Planning and Comunity Development by subnitting the
installation record form. The Department shaLl inspect the construction to determine if it
complies with the rules contaj-ned in this divj.sion. rf the constructj.on does conpLy wi.th suchrules, the Department shall issue a certificate of satisfactory completion to the permiti holder.
If the construction does not comp.Ly with such rul-es, the Departient shaIl notify the permit
holder and shaIl requlre satisfactory completion before issuing the certificate. PaiLure tomeet the requirements for satisfactory completion withi-n a reasonable time constitutes a vio-
lation of ORS 454.605 to 454.745 and this ruIe.
Setbacks - Subsurface Sewage Disposal
Scotic TJnk Drainfreld
Fron:TO'
10,
50"
10'
10'
100 |
r
*l
(L:m,
.:-
f
,a't;?'ri'*::r'1.,lixl3" cANCELLATIoNTREFUND AUTI{oRlzATloN PERMIT
NAME (PLEASE PRI Ex >18
ADDRESS Itcro ORlCIlg S'f. , iPF/ile F/ E/./'_77 4
APPLTCANT ( )
REASON FOR CANCELLING
r' | -
owNER ( )ooNTRACTOR( )
PERMIT (OR APPLTCATION)
Forf /L)fTV/.L AT/o ,U )U cJR i /| /.1 Frfi
"z-+-.<-
^
SIGNATURE
FEES PAID FOR WASTE D_ISPO9AL SYSTEMS (SITE INSPECTIONS AND/OR APPLTCATTONS TO TNSTALL THE SEpTtC TANK AND DRATNFTELD)ARE ORDINARILY NONREFUNDABLE. SOME REFUND MAY BE ON BUILDING, PLANNING, OR PLUMBING PORTIONS ACCORDING TO THEAMOUNT OFTHE PERMIT/APPLICATION PROCESSED.
FEES PAID % REFUND
-%o
Flood Plain Fee
Building Permit Fee
Mobile Home Fee
Plumbing Permit Fee
Mechanical Fee
Plan Check Fee
State Surcharge Fee
Septic Disposal Fee
Site lnspection Fee
DEQ Surcharge
Land Use Application
Planning Director
Recording Fees
Partitions
Copies & Ordinances
Surveyors
an
Minus $25. for
TOTAL AMOUNT
o
o/o
o
%
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
-Yo
')
f)
o/o
Yo
%
Yo
_%
_%
-o/o
Yo
Processing Fee
T?
-.>'
BE BEFUNDED $?r e*
SIGNATURE ?-^l-(!,n".E
TO DEPARTMENT OF FINANCE:
Building Permit Refund $
State Surcharge Refund $
Septic Disposal Refund $
Site lnspection Refund $
Land Use Applications $
Planning Director $
Recording Fees $Partitions $
Copies & Ordinances $Surveyors $
TOTAL AMOUNT REFUNDED $
'l 7-88/Acct. 421201 P rog. 060 Recei pt
./ 6v
.rA
1 7-88/Acct. 42124lProg. 060 Receipt
1 7-88/Acct. 421 33/Prog. 040 Rece
2A-1 7-88/Acct. 46202lProg. 060 Receipt
24-1 7-88/Acct. 46210lProg. 060 Recei
1 7-88/Acct. 4847 4lProg. 060 Receipt
24-1 7-88/Acct. 444191 Prog. 060 Recei
__25-06-74/Acct. 44451 lProg. 01 0 Receipt
\l
.A
PLEASE MAKE CHECK PAYABLE TO:
)SNAME /L F
ADDRESS 7:{-7-7t
72
LAND MANAGEMENT DIVtStON / public Works Department I 125 E. 8th Ave., Eugene, OR 97401 (503)687-4061
L.
---Trd
4
'/uD ??;'/./ ,4 2
hne county
ACTI " lTY INFORMATION SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
6lt'
-
dlq ct\ 64 to L€54n{
PROPERTY OWNERPERSON MAKING REQUEST
3 (oo Dtl ,rLe
MAILING ADDRESS
{,"'r J e ll
MAILING ADDRESS
/(
C ITY STATE ZIP CODE
3qL l7 >l 7q 7 7/Zz
BUSINESS TELEPHONE # HOME TELEPHONE #BUSINESS TELEPHONE # HOME TELEPHONE #
2 PROPERTY ADDRESS
( IF DTFFERENT TnO
3 ruap B PAFIcEL NIJMEIEFI
( REQUIRED INFoRI,IATI0N)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
t7 <z-\ 22 l3
TOI,{NSHIP RANGE SECTION ZON I NG
MENSMP RTNGE SEE-rIOru
MilNSETP RANGE SEETI-ON
TOTAL CONTIGUOUS PROPERTY IN SAME OI^JNERSHIP:
ffi ZON I NG
W ZON I NG
ACRES
4 SUBDIVISI0N (if appljcable)LOT BLOCK
5 REQUEST (srtate exactly what you plan to do) S\.r*- \o \o \,\,,c.*\ ir".
t; n*- o\t qs 9$r,s.\r^.a q q
-T--.--T-
T T
6 DIRECTIONS TO SITE
)-0 Et4c, t D f Lr'ttr(r
n //1 t(,/aJ /d./(/{/
** FOR STAFF USE ONLY **
zoNE/L4l!!_u!-E i
BY :
-
DATE:- TIME IN:- OUT:-
NUMBER
DATE
-{p
U1
-+t:
LAND MANAGEMENT DIVISION / 125 E. Bth AVE., EUGENE, OR 9740I / 687-406I
I
-/ cnY STATE ZIP COUE
I 2 Fo'o
TAX LOT(S) ON PARCEL #
n€Wotd
r.,.
Stove Permit Application
CANNOT BE APPROVED UNTIL A COPY OF THE MANUFACTURER'S
ION INSTRUCTIONS IS SUBMITTED
ntu A PERMIT
INSTALLAT
*
* ADDRESS FOR INSTALLATION C ITY
* I{41{E OF MANUFACTURER
-
MOD
* INSTALLER
.TRCLE TrE Shir*r*
CONSTRUCTION| CLOSELY RESEMBLING YOUR PROPOSAL
* A. The unit is listed by:ur- nrcao [-lotn." (name)
B.Thef.loorprotectionisinchesthick.(Materia.l)
C. The walI protection wil I be: (l''laterial )
* D. Type of chimney tr
tr
Factory f,Nuron.y (lined? flr., f[no)
0ther
)IL
II
1
1-l
I7!c=:L- -L--L-_
t-
L
E Type o,f stove pipe : . nfu.tory I ZOg. (or heavier) galv
(vent connec[0r,
sht. mtl
rl- -tt
Irl-rlrrtr)t/i
DIMENSIONS: (in inches)
l. Side of unlt to protected wall-(unprotected wall-)
2. Rear of unit to protected wall_(unprotected wall_)
3; Floor protection at side of unit_ at rear _in front __
4. Length of walI protection at rear of uni t--at side
-
t
5. Height of wall protectiorr_
6. E<lge of wall protection to nearest door or window
7. Air space between wall protectlon and ra'll_
8. Diameter of chimney and stove pipe(vent connector|_
NOTES:
('l) outside combustion a* is reouired for all fuel burning instal'lations. A 7 Sq. inch (min. area)closabie vent loc
ated within 24" of the firep'lace or appliance on the floor or base of a wall.(?l A copy of the approved manufacturer's installat'lon instructions must be on job site at the tine of inspection. In-spection cannot be made with out these instructlons.(3) The 'Approved' p'lan/application shall be kept on the Job site for use at the time of inspection.(4) Not all unlts lre approved for corner insta'l'latlons oi reduced clearances with wall protection, (Refer to manufac-turer's listing. )(5) If masonry chimneY is to be used, it must be iined lRequired by Law) ExistingJlues must 6e approved by-inspectorlrior tquse. Y,gu mustjroyit' rccpii fq. the insDector(6) lr fireplace insert is to be installed, verifrcatron or wall header location rn relationship Jto breast of firep'laceis reouired by law.(7) Firepiace inserts are not.permltted ln factory-bur tt or pretaDr'tcated-metal "0,' clearance flreplaces, unlessspeci flcal ly tested and I isted.(8) Fireplace lnserts are not.pemitted ln masonry flreplaces wlth exlstJng heat form type mtal fireboxes unlessspeclfically tested and llsted.(9) Unlisted unlts shall be lnstalled ln accord rrith the State Mechanlcal Code, utlllzing the materla1s and clearancesset forth ln Chapter 5.
c-L4-32 APPROVED AS NOTED
By
Date
l-
l-it--.
l-r-
IF YOUR INSTALLATION DIFFERS
FROM THESE EXAHPLES OR IF THE
INSTALLATION IS A FIREPLACE
INSERT, PROVIDE A PLAN AND
ELEVATION DRAWING l.JITH DIMEN
sIoNs 0F voun pnoposnr.
LAND MANAGEMENT DIv. / pUBLIc IIORKS DEPT. / tzs E. Bth Ave., Eus. 0R 97401 (s03)687_4061
PERMIT #
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