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HomeMy WebLinkAboutPermit Plumbing 1980-10-01INSPEC--TION RECO RD FIEL-CARD TO[^JNSH I P 7 SUBD I V I S I ON/PARTi TI ON SECTION TAX LOT ? zoo PERMIT NUMBER LOT/PARCEL BLOCK OI,/NER'S NAME AND SITE ADDRESS (A -4 J/A, CONTRACTOR"S NAME AND ADDRESS # BEDROOMS Serial Equa 1 SDS INSTALLATION SPEC I FI CATI ON:Tan k . Drainfield rench depth n. ft Nevu _ Repair rati on TELEPHONE NUMBER "7/o 6 TELEPHONE NUMBER WATER SUPPLY Max. t MINIMUM SETBACK REQUIREI4ENTS:cL. frontcl-, sioe I nteri # PLUMBING FIXTURESI # EMPLOYEES DIRECTIONS TO SITE INSPECTION TYPE APV/DISAPV DATE INSPECTOR RET1ARKS hre ccurty ACTIV^ fY INFORMATION .-.{EET COMPLETE THIS SECTION. INCOMPLETE FORMS t,JILL BE REJECTEDI ** r9B STAFF USE ONLY ** BY: - DATE : TIME IN: OUT:c:P NUMBER DATE E(,t eqr2 e- 3 MAILING ADDRESS s CITY STATE ZIP CODE ffi HOME-TETEPHMET BUSINESS TELEPHONE #HOME TELEPHONE # 2 PROPERTY ADDRESS 6+R S {(IF DIFFERENT F 3 ruae B PAFTeEL NUMBEFT (from tax maps in Department ofor from tax statement).2 ^^, 27,t V Z7o Assessment and Taxation ( REQUIRED INFoRI,IATI0N), 11 trOWNSHIP frar MNGEsEeTMN ffi ZONING TOilNSE-TF MNGE SEETI_ON ffi ZONING MINSHTF RAN.GE SECTMN TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: ffi ZONING ACRES 4 SUBDIVISI0N (if applicable)LOT BLOCK 5 REQUEST (s;tate exactly what you plan to do)o D 6 DIRECTIONS TO SITE: LAND I'TANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 9740I / 687-4061 1 Crr.r4,tu At/ur*-r:( PROPERTY OI,INER Z0NE/LAND USEi ,d t7-ob-6To lane county U K T PTUMBING/MECHANICAT 1ng SS 6l!' -APPLI CANT INFOR},IATION : or ease PLT]NtsING CONTRASTOR Yes Firm Address f] uo E s"rr MEGTANTCAT CONTRACTOR t]Yes Firm Address fl No fl serr cont. osR#\3'r6} oun 1p Cont. OSR# PLT]MBING R&Loea-t-c, O^r\d- ,r k)tfCIJ.nJ V...aOt.wX Ll,.ln.,ll- MEGTANICAL OFFICIAL USE ONLY App1i. / Permit in*J 2t Type of Fixture I'hmber of Each Fee On Each Total Sink $ s.00 5. CID J-avatory Wash Basin s. 00 Tub (with or without shower)5. 00 Shower. separate 5. 00 ter oset to 5. 00 s .00 Disposer (r 5. 00 l,V s. 00 c;.0 Floor Drain 5.00 Sewer--lst 50ft.15 .0 each additional 100 ft.10.00 lVater Service--lst 100 ft.1s.00t110. 00 Storm and Rain Drain--1st 100 ft.1s.00t1onal 1 t 10. 0t Special Waste Connection s.00 E e ector s.00r1C0( Other C1 SUB-TOTAL (Minimum $fO. OOl TOTAT FEE 5.dD Type of Equipment N\rmber of Each Fee on Each TotaI Mechanical Permit Base Fee $ 10.00 Furnace up to 100"000 BTU/H 6. 00 1".(x) Furnace over 100,000 BTU/H 7. s0 Clothes Drver Vent 3. 00 Bathroom Ventilation Fan & Drcf Range Hood with Ivlechanical Exhaust 4.50 Wood Stove 6. 0uAir Conditioner Only 6. 00 Heat Pur[t b. u0 Floor Furnace 6.00 Gas Pipi ng System 1 to 4 Outlets Per Outlet 50 Other (specify) STJB-TOTAL IG, OD TOTAL FEE $ nt lDr^.1 ' ' J- + pc-,<- S"UII+ TDrn u{&r P* 2Zt LWV 5. UU - It'J[. t;{-11-.11.]1'Y fl!i,t}]' [::i'jv ]'lt;'f f":f IF'I '] 3.50:180 0Al'ti 1;10?80 dr'r'lrcANT ADK INs, cL-firn ADDR t 680 BEst uhi ' , r;u{;HNE ''rL4i 1?0:13?{ SStl?00 ,su$Drv NEtJ tlt.DG I'yFH tJ.lH: R i.lil BllRi.lii 00 i'l{j LJNI'rS'.-101 N{l "I'Tr-}ftIIsInr,E Al-,1-,L lilt Af,]'l:t]N Dt:scFil:F1'l:nN s8 F1' L]NIT i:U"11' Vfll.tJATInN T}RE6ONL$T F[-l( NCI T{LDGS OOlF'EH T.}AY Bl-' t.r. ttl'' fr r' I:rE,l.r I IIF, Bfl [j l_. i^,lt'-CH iiul;: ;3CK 'r' ('f!l-dd t.l 1't-]l'Al* r:'r:'F ** r...c 330:tl0 r{AAA F'LHB.1t'tF-t:t'l Ntj" F'l:XI'Llt.rES: I Nfi"t-:t)Nt{l!i. u 1' t}ft s' : l'1t:i:FlAf'l l: UAI-. f-'tiE. jl 1'r:r'IH. .i't.Jl;tLl l-lAlt G[: tlL-rtN ill-ltiuH l- Ht: { ::i " i:'i,il 1,;6r-:l"l ;s t+L 50u t.t I't 1er"tt! t:, . i:{ il 1 a.l 1'\ t.t UATG : AF F SEGTJ: 0 ].AKHI.I I.JY CAU Fr.' sDS Sr HSl'. CUl,lF'l-ti1'l:ilN DAl'[i I..CK UTH 1:t0?80 i r,H :1:t ".$4 l: 7