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Home My WebLink AboutPermit Building 1973-03-15TANE COUN1 BUII.DING PERMIT MOBITE HC BUILDING MHtr MAII.ING ADDRESS USE PERMIT PERMIT NO.PROPERTY OWNER PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY LOCATION _ INCTUDE POST OFFICE 'BPROPERTY LEGAL DESCRIPTION _ METES, BOUNDS Pil -(ft4gsrr6 RANG E SECTION TAX LOT NO,CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPt. NAME & MAITING ADDRESS LEGAT ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge System New System I STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION se. FT. # BDRMS VALUATION SEWAGE DISPOSAI. PUBIIC tr SEPTIC TANK tr OTHERE PTUMBING INSTATLED BY OWNER n OTHER: NAlvlE $F EES WATER SUPPTY PUBTIC tr tr OTHER BUITDING WASTE DISPOSAT PI-UMBING PI.AN REVIEW PARK TRAILER TOTAL $_ 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 UTIL. EASEMENT BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE B[DG, PERMIT _ WH ITE OFFICE COPY _ WHITE COUNTY TAX - PINK PTUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOTDENROD Conslruction to comply with unif orm building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotement on Reverse Side) (posT THls PERMIT ON MAIN BLDG. AT SITE) TANE COUNTY, B!DG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu !i q 55 - 13 r( B U II.D ING S ITE EVALUAT ION Bu i lding Permit Appl icat ion No. S i te lnspect ion Pre-Permit Invest igat ion Uc - ){zt= k<>P 6rr€.MDArEt-- zor I 7 R-03s ZZ rnx r-or'-e.J:zcFffiffip*@oo fi -7s APP NAH LI ADDRESS ( ) P HONE DATE LANE COUNTY PLANNING DEPART},IENT NOT NO "ppt;cable - YES NA}lE DATE Zoning 0rdinance Compl (Zone Subdivision 0rdinance 'ffi7t C6mp I i ance ()(() () () ( ()(2 3. Requ i red Access 4. Bu ild ing S ite (Area, t/idth, Frontage, Setback) 5. 0ther (see comments) COM},IENTS: () () ) \ ) ) BUILOlNG INSPECTION SECT!ON 6. Plans Submitted 7. Soi I Stab i I ity (foot ings) 8. Flood Plain 9. 0ther (see Conments) NOT NO EF'I'I icable - YES q () NAI'IE DATE () r) k) tl1 () () () () ()3'|t"rj COM}AENTS: SAN ITAT ION SECT ION Sewage Disposal Usable Area Water Supply 0ther (see Comments) NOT NO YES v \n 04 () () () NAME DATE aoo I icable-- rr-(10. ll. 12. t3. ( ( ()) COH}tENTS: TO APPL ICANT: Your B ding Permit / Site Inspecti Can be approved.3-tf- )Cannot be approved at this ti me as indicated on item N0.above. Questions and further information on items I through I contact the Lane- COUNTY PLANN ING DEPARTMENT. Quest ions and further informat ion on iFm-s 5 throug h l3 contact the Lane County Building and Sanitation Division. t/il I be held in this off ice until you can resolve the problems indicated. ls being returned. Your building permit appl ication fee is being returned under separate cover. LANI COUNTY PLANNING DEPARTHENT llt, Sixtlr l\renue F-ast, Euqetre, 0retlon 97401 l'llt\Nt: \lr'.'}-lill LXI. ?il ( ( () () () LANE COUNTY BUILDING 6 SANITATION DIVISION 135 Sixth Avenue East, Eugene, 0regon 97401 PH0NE: 342-l3l I EXT. 4l I 7 q, Date r.tO. PERM IT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the attached application has been fu1ly considered by the Board of County Commissioners of Lane County, and it is the opinion and judgment of the Boardthat the said application should be granted, and that a permit should be issued, now, therefore, it is hereby ORDERED, that a permit be and is hereby issued to for the placing, building upon the right-of-way of County Road No. -- , in strict conformity to the exhibitsattached thereto, _and subject to all terms, conditions, agreements, stipulations and pro.visions contained_in the application and permit, the Rfles and negdtations GoverningFacilities to be Permitted upon County Road Rights-of-Way, dated March 81, 1960 andany amendments thereto, and any other applicable regulation, Iaw or ordinance. Special Provisions: This permit is revocable at any time, and will be strictly adhered to and no workother than that specificalry ,*n1-neo auove'is-trereuy authorized. This permit shall be void unless the work herein contemplated shall have beencompleted before Inspected and Approved Direcror of public Works .9!lNgE - BUTLDTNG & SANtrArroN DEprYELLOW. SURVEYOR Approved by Board of CommrssionersBy , 1g=_---. Date By PERMITTEE ROAD SUPERVISOR c9r s2 WHITE . OFFICE FILE GREEN . RESIDENT ENGINEER PIN K BLUE and constructrng of the following facility: ft Date APPLIGATItrN FOR FAtrILITY PERMIT IN THE BOARD OF SOUNTY SOMMI!'SIONERS OF LANE COUNTY Your appli hereby makes application under Rules and Regulations Governing Facilities to be Per- mitted Upon County Road Rights-of-Way, to construct the following facility: Upon the right-of-way of Gounty Road No., at the folloruing location: as shown on the exhibits which are attached hereto, in strict conformity to the state' ments of the exact nature and amount of work to be done, and to the description of the facilities contained in said exhibits. Your applicant will be the beneficial owner of the facility as constructed, or othenvise primarily liable and responsible to members of the public for its proper maintenance, repair, operation and use. Your applicant accepts al! terms, conditions, agreements, stipulations and provisions, in Rules and Regulations Gwerning Facilities to be Permitted Upon County Road Rights-of-Way, dated March 31, 1960, and any arnendments thereto, and any other applicable regulation, law or ordinance. Signature TYHITE . OFFICE FILE GREEN . RESIDENT ENGINEER PINK . PEBMITTEE BLUE. ROAD SUPERVISOR OBANGE. BUILDING AND SANITATION OEPT. YELLOW . SUBVEYOB Address Phone No.- IANE COUN BUTLDTNG r BUI IDING PERMIT OR MOBITE MHtr H(i USE PERMIT PERMIT NO. PROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION - INCTUDE POST OIFICE PROPERTY TEGAL DESCRIPTION _METES, BOUNDS RANGE SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPP[. NAME & MAITING ADDRESS LEGAT ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewo e stem TYPE CONSTRUCTION SQ. FT New m BDRMS VALU ATI ON SEWAGE DISPOSAT PUBr-rC tr sEPTrc TANK tr oTHERn PTUMBING INSTALTED BY OWNER ! OTHER: NAME BU ITDING WASTE DISPOSAI. PLUMBING PLAN REVIEW PARK TRAITER FEES WATER SUPPTY PUBUC n N OTHER TOTAT COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIELD REQUIRED LIN. FT TRENCH WIOTH FT OR SQ. FT 1.. TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIL. EASEMENT BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG. PERMIT _ WHITE OTFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUITDING _ GREEN SANITATION - GOLDENROD Conslruction to comply with uniform building code ond county covering plumbing ond sewoge disposol. All buildings require of occuponcy before being occupied. (See Stotement on Reverse Side) reg u lolion: o certificoti (posT THrs PERMTT oN MArN B[DG. AT SITE) TANE COUNTY, BTDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu t 655- 13 SITE INSPECTION Appnovro Rruanx s D r sappnoveo Dare I Hspecton FOUNDATION INSPECTION Appaov go Reuanx s ru DrsappRove o 77 oorlj:L,i - '7 'l I Nspecton FRAMING INSPECTION Appnoveo ReuaRx s ry Drsrppnovco D iDarr ,' , llsercr// 7.? ?ia -<,t--1 LATH OR SHEETROCK INSPECTION Aeeaovro ReuaRr s D DrsappRovro Fa DarE I NspecroR FINAL INSPECTION / oatc 6 :6'73Ap pRov E o Reuanxs d Dr sappaovEo I ruseecr f- I CERTIFICATE OF OCCUPANCY Rraov ro lssuE ReuaRx s Nor R:rov ro lssuE 3 7 8'73 3 3 2.t-/ao r\ -/c y'l. & *rl /- bt-rtC- . z -,t *ftal ;r*2} -y3 D Dore_lnsercron_ -_=--I I.ANE COU BUTLD|NG E ITDING PERMIT OR MOBITEMHI USE PERMIT PERMIT NO.PROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCI.UDE POST OFFICE PROPERTY tEGAI DESCRIPTION _ METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPL. 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 ! New System STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION se. FT. # BDRMS vALUATtoN SEWAGE DISPOSAT PUBTIC tr SEPTIC TANK tr OTHERE PLUMBING INSTAIIED BY OWNER ! OTHER: NAME BUITDING WASTE DISPOSAL PI-UMBING PtAN REVIEW PARK TRAITER FEES WATER SUPPTY PUBLIC N tr OTHER TOTAI. COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAI-. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTII.. EASEMENT BTDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BI.DG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUIIDING _ GREEN SANITATION _ GOTDENROD Construction to comply with unif orm buildin covering plumbing ond sewoge disposol. Al of occuponcy before being occupied. (See Stotement on Reverse Side) (posT THls PERMIT ON MAIN B[DG. AT SITE) LANE COUNTY, B[DG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I code ond county regulotions buildings require o certificote s I ronu #C55-t3 -ffi FLOOR PLUMB ING GROUNU^,ORK AppRovro &D r snppnovro Reuanx s o- 2 ? lrusprcroR .*rt4vDart / t GAS PIPING GROUND/ORK AP PRov E o REU aRx s D r sappRovrD Dar E I rusprcron ROUGH PLUMBING AppRoveo N Drseppnovro D oar/=!A)L Reuaaxs lruspecron,-/tJ--a ROUGH GAS PIPING Ap pnov r o ReueRx s D I SAPPROVED Dar r I NspEcron FINAL PLUMBING ApeRoveo N Drsrppnovro RE ulRx s Daref- 3e-29 lNspecroR Dnte I NsPEcroR CERTIFICATE OT OCCUPANCY Rraov ro lssuE ReuaRxs D Nor Reaov to lssue D Dare I NSPEcToR FINAL GAS PIPING AppRoveo D DrsAPPRovE, D Rruanx s \DIVIDUAL SEVTAGE DISPOSAL SYSTE'' RECORD .lstaller: Complete top part ol .rrm to signature and return both copies to Lane County Building Sanitation Department. ta s Name C rui cks hank No r Public lf Otner-List c ropms ( Baths Basement vesE Non Ft. from well- Steel I concrele { No. Compartments Length I width Diameter Depth I cat. capacity oo T Distribution Boxzyespr' No E Other D str Feet F Lot below ,\pplican Name M ailing Address Length 1. 2. L - Ft.er4. 5. 6. J:mes Dean Trench width 5 Totat sqlrt.betweenlrt. -', ltines { I rype 14 F iller Filler depthEIbOV€ rtile A in-Sketch See instructions Date -h For Sanitarian Use Only:R,a Approved: System Installation Conforms to Cur Disapproved: Does Not Conform to Current Standards Standards Date:u/trlz i-.4o qo rr' N€ €,s EI I ture Remarks: IJane County Building & Sanitation Sanitarianrs aq(-rl /t E(EEilV/ E Iti a LANE COUNTY PERMIT TYPE _ BUILDING TLDING PERMIT OR MOBILE HOMT lSE APPTICATION PROPERTY OWNER MOBILE HOME IOSC REG.# MAILING ADDRESS PERMIT s7tr-? 3 PHONE TOCAT _ INCI.UDE MAITING ADDRESS o A-e -Zrso 6a PHONE 7 / METES&BOUNDSEYES 3 6s 3 P2//e,PROPERTY TEGAT DESCRIPTION IOT_BI.OCK_SUBDIV.ATTACHED NO '*17 RANGE SEC &0 TAX I.OT CODE DESCRIBE EXISTING IEGAT TO PERTY SIZE_WIDTH CENSUS ON PROPERW IF ANY NAME OR A APPTICANT NAME AND MAITING ADDRESS A--Q DEPTH AREA FOR MOBILE HOME PERMIT ONLY Number of Bedrooms TO I.T THIS PERMIT ( Connect to Existi TYPE CONSTRUCTION teo9 tr or New Req BEDROOMS VATUATION/).(t/ fr SQ. FT 6t53-d7 0 a{- a-Z/ _t AJ SEWAGE DISPOSAI PI.UMBING INSTAI.TED BY PUBLIC BLDG. WASTE DIS. PTUMBING PTAN REVIEW PARK IRtR. SEPTIC TANK ;)o,oo33,€a OTHER FEES WATER SUPPTY PUBI.IC OWNER OTHER NAME PI-ANS FURNISHED YES NO S OF APPTICANT FACILITY PERMIT NOOTHER PTUMBING FEES /O r,rru*r,3 a,ao DATE s -7-73 CASH [ 561y5p rEE RWBY DATE ,{o CHECK E CONNECTION FEE PUBTIC WATER CONNECTION FEE oO --7,s L,r PERMIT 3?rr3 -7-73 PUBTIC UTIT. EASEMENT TOTAI. MIN. SEPTIC TANK CAPACITY wlIH DIST. BOX: GAL. TYPE OT SIRUCTURE BLDG. SETBACKS _ fT.FROM CTR. OF ROAD RIGHT COUNTY'BUILDING & SANITATION SPECIFICATIONS DRAIN FIETD REQUIRED OO O uN. rr,O rnrxcx wrDTH Fr OR SQUARE FEET R YARD USE CTASSIFICATION form X css-t? ,F- DqteBtDG. IN l-0/) SIDE EXI, d-REARrRONTSIDE INT 7ARIDote reclions to Find ProPertY COPY 2 - JOURNAT COPY 3 - AUDIT P€*-rl ( f'Q-'C,,'g ( TRS, TL JOB LOCATIO Partition ing LANE COUNTY PERMIT Acreage or Lot Si Contractor's O.S. # ) Completed Subdivision Lot- Blo ck APPLICANT'S NAME AND ADDRE qq Phone- Phone_- Phone-OWNER'S NAME AND ADDRESS CONTRACTOR'S NAME AND ADDR Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready STRUCTURES NOW ON THE PROPERTY /t- THIS PERMIT IS FO # B ED ROOIVIS-# PLUIVIB I NG CO N N ECT IO NS WATEB suppLy "' - SEWAGE DlsPosAL ' s.l. # THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEClTYoF.PLUlVlBlNGBY I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: -owner of record; -contract purchaser; - potential buyer; - realtor or agent. I further certily that (iI 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 comply with all applicable Codes relating to this permit. Fee Paid $-Signatu re Date ( )NEWADDFESS ( ) FACILITY PERM lT TO TRANSPOBTATION DEPT.- ( I SPECIAL PUT. AREA. MIN.ELEVATION:- SANITATION BUILDING Minimum Septic Tank Capacity (Gallons)Type of Construction -Group Fire Zone Drainfield Required - Lineal Feet se Classification Maximum Depth Comments: Comments B Date PLANN ING REOUIREMENTS SATISFIED. By:Date: Date Date lssued: ZONE SETBACKS: FRONT SIDE FACING STREET (FROlVl C/L) lNT. SIDE YARD : REAR (FROM P/L) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 POST THIS PERVIIT ON MAIN BUILDING AT SITE C55-13 BLDG. pERMtr - wHrrE; BUtLDTNG - GREEN; pLUMBTNG - GANARy; sANtrATroN - GoLDENRoD: oFFrcE copy - wHrrE PHONE:687-4394 ( trec ll TRS, TL JOB LOCATIO Partition ing LANE COUNTY PERMIT Acreage or Lot Size Contractor's O.S. # ) Completed Subdivision Lot- Blo ck APPLICANT'S NAME AND ADDRE ss Phone- Phone- s.l. # owNER'S NAME AND ADDRESS -_- Phon CONTRACTOR'S NAME AND ADDRESS Mail permitto ( )Applicant ( )Owner ( )Contractor. ( )Prefertopickup. Call-(owner, etc.) when ready STRUCTURES NOW ON THE PROPERTY- THlsPERMlTlsFoR#BEoRoolv]s-#PLUl\4BlNGcoNNEcTloNS- WATER SUPPLY SEWAGE DISPOSAL THlSPRoPERTYlSWlTHlNoNEMlLEoFTHEclTYoF.PLUIVlBlNGBY I hereby certily that the above statements are true and accurate. and that I have the following legal interest in the property: -owner oI record; -contract purchaser; - potential buyer; - realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of record, and that said owner is aware and approves o,f this action. I hereby agree to comply with all applicable Codes relating to this permit. Fee Paid $Signature { )NEWADDRESS I ) FACILITY PERI\4IT TO TRANSPO RTATION DEPT.- () SPECIA L PMT. AR EA. IV]IN. ELEVATION: - SANITATION BU ILD ING lVlinimum Septic Tank Capacity (Gallons) Drainfield Required - Lineal Feet Maximum Depth Date: Type of Construction -Group ire Zone Comments By: c"r,"""* Use classification By Date: PLANNING REOUIREMENTS SATISFIED. By Date Date lssued ZONE:SETBACKS: FRONT SIDE FACING STREET (FROM C/L) INT. SIDE YARD REAR (FROM P/L) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL N/IANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 POST THIS PERVIIT ON MAIN BUILDING AT SITE c55-13 BLoc. pERMrr - wHtrE; BUTLDTNG - GREEN; pLUMBTNG - GANARy; sANrrATroN - GoLDENRoD; oFFtcE copy - wHrrE PHONE: 687-4394 \ Date - SITE INSPECTION AppRovro ReuaRx s Dr sappnoveo Dare I NspecroR FOUNDATION INSPECTION APPRovED REurnxs DrsappRovEo n oore 4- 4' t g I Hspecron FRAMING INSPECTION A PPRov E o Rrulnx s oorrd- 27 -7g rxsprcroR ca LATH OR SHEETROCK NSPECT I ON APPRovEo Rexanxs Dr sappnoveo oorrT-3 -71 Qc,Zv FINAL INSPECTION AppRov ro Reunex s D I SAPPROVED f- f-tI I NSPEcToRDare CERTIFICATE OF OCCUPANCY Rerov ro lssuE RrManx s D Nor Rrrov ro lssue D Dare-I NSPEcToR :, 7F Drslppnove, D I Hseecton \r/-,^r,r, /?6'7r JobLocation /^(4 ^ .Jo.'z A,.t Er*re-.rLnE a2Lo/ Ifritten Directions ,a NFORMATION SHEET lf) auilding Permit ( ) Site Feasibility Study for Septic Tank. Number of sites- Acreage or Lot Size Test holes will be read v Partitioning #- ( )Completed( ) Pending AppLtcANT.S NATME eNo eooaesS /a^na. w D,.Lc-ta^ t>zG Ei-Lle At, E-tc.e & Pnone-2-!.L:A14 OWNER'S NAME AND ADDRESS, if different from applicant's Phone Phone^ONTRACTOR'S NAME AND ADDRESS ,ilpermit or results of site feasibility study to |?f Applicant ( ) Owner ( ) Contractor( ) Prefer to pick up. Call (owner, etc.) when ready.Contractors O. S. # srRucruREs Now oN THE pRoPERTY '{ ,f, }J.*! r, PROPOSED USE (this permit) WATER SUPPLY n^:^I-.^, IJ r-t c, F (existing or proposed well, etc. lf public, name of system) SEWAGE DISPOSA C rt,,ak (existing or proposed septic tank, etc.) S.l PLUMBING B Address Subdivisi ar3-O- enr./) .ql--k { o () PROPERTY IS WITHIN ONE MILE OF CITY (37&. 23 .*1.,i)* oFFtcE usE oNLY BELOW THIS LINE *r*I*r'++R:* I ress Necessa ry Zd N SETBACKS: Front To: Planning/Building lnspector/Sanitarian/Surveyor. ( ) Facility Permit Necessary/( ) Special Permit Area. Minimum Elevati lnterior Side yard f R"u, (FROM PROPERTY LINES) n Side Facing Street (F OM r /r-<-. This applicant appears to have a problem with Your assistance will be appreciated. By Permit Processing Section Response By DEPARTMENT OF ENVIRONMENTAL MANAGEMENT Permit Processing Section 125 East 8th Avenue 687-4394c55-1 2 D ivision