HomeMy WebLinkAboutPermit Building 1982-08-25fiI r--
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CONSTRL -TION /PIECC
PERM IT 4
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Plan Check Info Sheet
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FOR Crf':'ICl USLI ONLY
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I IIAVE CAREFULLY EXAI.IINED THE COMPLETED APPLICATION FOR PERMIT, and do hcrctry,:r,'rtify that .alI informatiol herccn i:r trrrc ard c()rre.t. ir.l I
?.1lvuYeU_
D"CIENAME (please print)
certify tlrat any and a.l.l. work perforred shall be done in accordance
wi tto the work descrlbed herein, and that NO OCCUPANCY will be made
that reg.istration with the Builder's Board is in fu11
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1)rdilraxcos of Lane Courrty alld tho Lar,i.f rl!'Stilr: rf r,rr,,,rrr I :l,rr i
cr rt-l l)'the. pcrmission of the ts!i-Idirig Di./1slon. I Iur il),rl
055, that if exr'mpt thc baeis for ex.ml,t-r(,;r i:- r).rr, d
be usod on this project. I HAVE READ AllD CIIE(!:liD TIITShereon, and that only subcontractors and employees
APPLICATION THOROUGHLY.
,".", 7-)y'.2.V E?
tr FLOODPLAIN:In flood hazard area?f| v.r, see attacfied sheer Dute r_
Date:
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trD nunar, ADDRESSTNG: cRrD cooRDrNArE N
ITATION:,. ,. o ,/5'/-ZZ rnstallatiorr Record lssiuld? [ v.,= [ r.r.,
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s. r. #
Insta Ilation
Speclfications:
Ga] Ion
Tank
Lineal Feet
of Drainfielil
Maxrmur Deptlr
of Treriches
corunents, 4). nol A,', l0 ,,,rfl.'- loA.t of cx,st- d.m,^P;.0 . Rol,,.oln a*, 2l^-,J.'0
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x PLANS EXAMINATT
Coments
,"o" 5l)croup i4 Use
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CONSTRUCTION AUTHORIZED BY THIS PERMIT
crf ption 3/a f 4ZZ.
Floodplain Fee $
Subsurface Fees $
Building Fee $
,w,:ffi,:;111::::: :
Mechanical S
Plans Check Pee $
State Surcharge $
Sq
Fixed Fee/
Unit Cost
a,/7
TOTAL PEE
FEES PATD BY:
By:
Date:
$
TOTAL VALUATION S tr
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PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNTJE ' oE $ESoBrrn D/'\TE
LANE COUNTY DEPARTI'iENT Of PLANNING & COI,I-NIUNITY DEVEIpPMENT / 125 EAST EIGHTH AVENUE, EUGENE, Op€cON g74OL
SEE REVERSE FOR INSPECTION INFORMATION
ZIP
,rrror*i o* orrr* cQNDTTT,NS o, orrooroi*sr BE sTRrcrLy
'BSER,ED.
vroLATroN ro* ii*r, IN REvocATI'lj 0F THIS or*il'r1]"- -
€ITATION UNOEN PNOVTSIONS OF LANE COUNTY'S INFRACTION'ORDINANCE, AND/OR OTHER REMEDIES ALLOI'IED BY LA'd.
iI,'TN READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION RIQUESI I'IUST BE
GIVEN. Have the following information ready: Permit number, job address, type of inspection, when it will be ready,
your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED IIISPECTIONS
l) FoUNDATION INSPECTION: To be made after trenches are excavated and forms erected and when a'll materials for the foundation
are delivered on TIE*3ob. Where concrete from a central mixing p'lant (commonly termed "transit mixed") is to be used,
materials need not be on the Job.
Z) CoNCRETE SLAB 0R UNDER-FLooR INSPECTIoN: To be made after.all in-slab or under-floor building service equipment,
ci11aryequipment.itemsareinp1acebutbeforeanyconcl^ete.i5poured
or floor sheathing installed, including the subfloor.
3) FRAMING & INSULATIQT! lXSMzurN!: To.be made after the roof , al'l framing, fire blocking-and.bracin':j 3!^e in p1 ace and,sandventsarecomp1eteandaI].roughetectricalandp1umbingar.:oppr5ved.Al]
wa l I insu lati on and vapor bami er are i n p lace.
4). LATII.AND/CR GypSUM BQARD INSPECTi0N: To be made after all lathing and gypsum board, interior and exterior, is in place'ior.before9ypsumboard.jolntsandfastenerSaretaped'andfin.ished.
5I.FINALINSPECTI0N:Tobemadeafterthebui1d.ipgisc-omp1eteandbefop.occupancy...
AppRovAL REQUIRED. No work shall be done on any part of the building or struc_ture_beyond.the point indicated in each
successive-inspectidn without first obtaining tire'approva'l-of the 6uiJding of.ficial. Such ailproval shall be g.iven only
ait"r an inspeltion shall have been made of 6ach successive step in the construction as indicated by each of the inspections
requ i red
N0TE: All building permits require inspections for the work authorized, such as but not limited to:
A. BLoCK WALL: To be made after reinforcing is in p1ace, but before any grout is poured. This inspection is
required for each bond beam pour. There will be no approval until the plumbing and electrical inspections
have been made and aPProved.
:
B. W00D STOVE: To be rnade after completion of masonrv (if 6pplicable) and when installation is comolete-
Installation shatl be.in accordance,with an approved nationally recognized testrng agency arrd the manu-
fact.urer's instal lation instructions-' ' '
t:C. 1,ISBILE'HSME:' Ah inspbction is required after the.motif.leiortre is connected to an approved sewer or septic
system for: setback'requirements, Utock'ing, footing connect'ion, tiedowns, skirting, and plumbing
. connecti ons.
(f ) Footings urUipi.i. to comply with.stite foundation feguirbments for mobile homes or as recommended
' by ttre manufacturer \
(2) N'Otiil i;;;;i;i,r* finish floor el'avatidn shall be certified whqn required bv a floodplain
management 'l etter.(3) M;;ii; hil. ii"ao*nr, when required, and skirting shall be installed and ready-for inspection'-' ,iittn at least SO Aiys after'occupancy. Tiedoarns and skirting shall be insta'lled per enc'losure.
l)" sWIMMING p00L: Be.low qrade when steel is in place and befgre concrete is poured. Above grade when pool
is installed.
AP?AOVED PLANS MUSI BE ON THE JOB SITE AT ALL TIMES DURING I'IORKING HOURS. THIS PERMIT WILL EXPIRE IF I'IORK DOES NOT BEGiN
lri-i,rrr , _,. DAyS, 0R tF WoRK IS SUSPENDEP 0R ABANDoNED FoR MoRE_THAN l8O DAYS. SUSPENSIoN 0R REVOCATIoN MAY oCCUR IF T,HIS
pinr;ir r,rni rssuio oN ru'E-eASis 0F INCOTIPLETE 0R ERRoNEoUS lNFoRMATIoN.
ANYONE PROCEEDING PAST THI PO]NT OF REQUIRED INSPECTIONS I'JILL DO SO AT HIS OtllN RISK
. SUBSURFACE AND ALTERNATIVE SEI,IAGE DISPOSAL SYSTEMS
(1) Perm.its shall be effective for one year from the date of issuance.
(?) Upon comp)eting the construction for which a permit has been issued the permit holder shall notify the
Department by submitting the_instaitation record form. The Depqrtment-shal1 inspect the construction to
determ.ine if ii-;;,rriii'd;'with the +uies contained in this diviiion. If the construction does complv with
such rutes, th;.;;;;;i*[ni ir,uii-iltr.-u-i".iiiiiule ot iaiisfactory campletion to the permit holder' If trte
€onstr.r)ction does not conply wittr iucn iri.s, thg.0rinar:tment'.shal t iotity the permit ho.'lder: and shal 1 require
satisfacto.v .Jn,preiion u'br6.. irtrinb it.-i.riiii.ut.. Fhil'ure to iheeC the requirements for satisfactorv
conipIetion-j;;i';;'.;;';;$i;i;ili6nstitutesaviolationof0RS454.605to454.745and.th.is.ru.le...',
drfac Dis
From Interior propertY lines
Edge of road right-of-way
Building foundation
l.lells, other water sources
Seotic Tank Drainfield
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-ANNING & COMMUNITY DEVELOPMENI
ACTIVITY INFORMATION SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS I^JILL BE REJECTED!
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CITY STATE ZIP CODE
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BUSINESS TELEPHONE # HOME TELEPHONE #BUSINESS TELEPHONE #ffi
2 PROPERTY ADDRESS 2 0(IF DIFFERENT F
3 rvrarr Gi PAFIcEL NLTMBEFI
( REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxationor from tax statement)
11 ov Lal
TO},INSHIP RANGE SECTION
,Z #Loboo
TAX LOT(S) OR PARCEL # ZO-NTNG
MINSHTF MNGE SEETION
MuINSETP RTME SETTT_ON
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
ffi ZONING
Tmtw ZON I NG
ACRES
4 SUBDIVISI0N (if applicable)LOT BLOCK
5 REQUEST (state exactly what you plan to aol ADAflON 1O Fff€inN(r
6 DIRECTiONS TO SiTE:
ZONE/LAND USE:
** FOR STAFF USE oNLY **
NUMBER
DATE
-{Tl-rt
BY:DATE:TIME IN:-- OUT:_-
. CONSTRU- fION/PLACEMENT
PERM IT
CO}TPLETE THIS BLOCK. PLEASE USE BLACK INK AND PRINT.
FCR CFF]CE USI] JNLY
Appl-icati
Perrnit *i
Oll/13*rfz
f]rwo Copics of Plans
[::wo Copies of Piot Pians
fil.techanical Checklist
f] elumbing chec):lisi:
Iefan Check Info Sheet
P 7 4
,ISI ARTITI
STREET .4
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ZTP
7-.[_l Residential
f] commercial
Irndustrial
flruuric
VALUE
SUPPLY</Proposed
j- s+-ing
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'2-sdcTELEPI{OI,]E NUTIaEli
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to Lhe work described herein, and that NO OCCUPANCY will be made of any structur. without the permission of th(: Bui-Idirlg Di./ision, I f'rrLh,rr .rr r'rrf,'
that registration with the Builder's Board is in fu1l force and effect as required by ORS 701.055, that if exempt the basis for exempf-ic,n is not,'d
hereon, and that only subcontractors and employees who are in conpliance with ORS 701,055 will be used on this project, I HAVE READ AllD CIIECIiED TIJIg
APPLICATION THOROUGHLY.
NAME (llease print)
! or,,e,,
ffo.tt'.*-n.
i-l ase.t
PLANNING ZONING i zone : rjar-Litron i,.Dar-al :
intericr_
;lr- . : _
rear _Ili,:rimum Setbacks
Conments r
t", fro.,a c_l,, sao€-
fl pr,ooopr,arN:EI ," fl v.s, see attached sheel:
Date:
Date:
Date:
In flood hazard area?
EI nunal ADDRESSING: GR1D COORNINATE N
tr SANITATION:B. P. #Installatiorr Record Issued? f v". I n"
lnstallation Gal"Ion Lineal Feet
of Drainfield
Maxim'trr Depth
of TrerichesSpecifications I
Coments;{.t
It,. A
Date:u
I plaus EXAMINATION: rype Group
Coments:
Date:
Description
CONSTRUCTION AUTHORTZED BY THIS PERMIT
Fixed Fee,/
Unit Cost
Floodplain Fee
Subsurface Fees
Building Pee
Seffer/Storm Drain/water
,,r,.'.;'+"Plumbing Fixtures
,r..fr..ri "ufPlans Check Fee
State Surcharge
TOTAL FEE
EEES PAID BY:
Sq Ft
$
$
$
$
)
$
$
s
$
/df 7c
! crrec:< [ cash
TOTAL VALUATION S
By
Date:
I\
pnnr'lft APPROVED BY BUILDING OFFICIAL/DESIGNEE {i'er.&s-Z3lolao3 tu I !tri o
-TINTY DEPART}IENT OF PLA}INING 6. COI'':}IUNITY DEVEU]PMSNT / 125 EAST EIGHTIT AVENUE, EUGENE' OFfGON
-,-F SEE RBVERSE FOR INSPECTION INFOITMATION
9,440"L
RAI']GE
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LOTIPARCEL ,"oc* ,4
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PIiOPUSLU USi- t)i l"huP.Lc,l r
DXSCIiIaTION OF PROPL'SED W'JRK $*ffi
+ OF STORIES
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SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATICI.I OF THIS PE?hIT,
CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, ANDIOR OTHER REMEDIES ALLOI'IED BY LAIJ.
llJ''EN READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST MUST BE
GIVEN. Have the following information ready: Permit numberr job address, type of inspection, when it will be ready,
your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED II{SPECTIONS
f) F0UNDATI0N INSPECTI0N: To be made after trenches are excavated and forms erected and when all materials for the foundation
ffiob.Whereconcretefromacentra,lmixin9p1ant(common1ytermed,'transitmixed,,)istobeused,
materials need not be on the Job.
2) CoNCRETE SLAB 0R UNDER-FL00R INSPECTIoN: To be made after a'll in-slab or under-f'loor building service equipment,
Eon-uit,pipingaccessoi]eiandbtherancil1aryequipmentitemsareinp1acebutbeforeanyconcreteispoured
or floor sheathing instalIed, including the subfloor.
3) FBA!|II{q &!LS!!AIIQNIXS!E!LI_QI9: To be made after the roof , all framing, fire blocking and bracing are in place and
@cIimneysandventsarecomp.leteanda.lIroughe1ectrica.landpIumbingareapproved Atl
wall insulation and vapor bamier are in p1ace.
4)LATH AND/CR GYPSUM B0ARD INSPECTION: To be made after all lathi ng and gypsum board, 'interior and exterior, is in place
but beforr: any plastering is applied or before gypsum board joints and fasteners are taped and fini shed
5) IIIAL IMlIlQj{: To be made after the building is complete and before occupancy.
APPR0VAL REQUIRED. No work shall be done on any pant of the building or structure beyond the point indicated in each
successive inspection without first obtaining the approval of the building official. Such approval shall be given only
after an inspection shall have been made of each successive step in the construction as indicated by each of the inspections
requ i red .
N0TE: All building permits reguire inspections for the work authorized, such as but not limited to:
A. BLOCK WALL: To be made after reinforcing is in p1ace, but before any grout is poured. This inspection is
required for each bond beam pour. There w'ill be no approval until the plumbing and e'lectrical inspections
have been made and approved.
B. ul00D ST0VE: To be made after completion of masonry (if applicable) and when installation is comolete.
Installation shal'l be in accordance with an approved nationally recognized testrng agency arrd the manu-
facturer's instal lation'instructions.
C. I'10BILE H0ME: An inspection is required after the mobile home is connected to an approved sewer or septic
system for: setback requirements, blocking, footing connection, tiedowns, skirting' and plumbing
connecti ons.
(l ) Footings and piers to comp'ly with State foundation requirements for mobile homes or as recommended
by the manufacturer.(2) Mobile home minimum finish fioor elevation shall be certified when required by a floodplain
management'letter.(3) l4obile home tiedowns, when required, and skirting shall be installed and ready for inspection
within at least 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure.
D. SWIMMING P00L: Beiow grade when steel is in place and before concrete is poured. Above grade when pool
is installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE iF I,JORK DOES NOT BEGIN
!JIT'rlr ;-: DAYS, 0R IF l,lORK IS SUSPENDED 0R ABANDONED FOR MORE THAN I80 DAYS. SUSPENSION 0R REV0CATI0N MAY 0CCUR IF THIS
P[RiiIT bIAS ISSUED ON THE BASIS OF INCOI1PLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS I,JILL DO SO AT HIS OI,IN RISK
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
Permits shall be effective for one year from the date of issuance.
Upon completing the construction for which a permit has been issued the permit holder sha11 not'ify the
Department by submitting the installation record fonn. The Department shall inspect the construction to
determine if it complies with the rules contained in this division. If the construction does comply vtith
such rules, the Oepartment shal'l issue a certificate of satisfactory completion.to the permit holder. If 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
completion within a reasonable time constitutes a violation of ORS 454.605 lo 454.745 and this rule.
Setbac ks - Subs Urf aqe_ JtUa_gg_ljSpgSi_L
(r )
(2)
From:
Septic Tank Drainfield
-T0r--Interior property f ines
Edge of road right-of-way
Building foundation
Wells, other water sources
'10'
'I 0'
5',
50'
10'
l0'
I 00'
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LANE COUNTY iNSPECTION RECORD
OWNER'S NAME PHONE NUMBE
E
ET BACK REQUI
L FRONT
REM
C
ENTS
L SIDE I NTERIOR REAR
#?L UMBING FIXTURES
Y PERMiT
DIRECTIONS TO SITE
SITE ADDRESS PERMIT NUMBER
N UN T N IN E N
Correc ti on Di sapp roved Date q-7-?z lnspector
Correct i onr_ D j sappro ved DateV //i-62 tnsoec tor
7
App roved
NC E
Approved
UNDER SLAB / PLUMBING GROUNDWORK INSPECTION
Approved Correcti onr Disapproved Da te I nspector
ROUGH PLUMBING INSPECTIONApproved Correctjon Djsapproved_Date I nspector
FRAMING INSPECTIONApproved Correct j on---.Di sapproved Date _l nspector
r--t\rffimApproved Correcti on Di sapproved Date I ns pec tor
LATH / GYPSUM BOARD INSPECTION
Approved Correct j on Di sapproved_Date Inspector.
FINAL PLUMBING INSPECTIONApproved Correct'ion _--Di sapproved_ Da te I nspector
FINAL WASTE DISPOSAL SYSTEM INSPECTION
Approved Correct'ion Dj sapproved Date Inspector
FI
Ap
SPECT BUILDIN LE
Correctj on Di sapproved Date
r
E.
proved I nspector
CERTIFICATE OF OCCUPANCY TEMPORARY CERTIFICATE OF OCCUPANCY
Approved___Correctjon Disappr:oved Date--=--._--.-_Insp
Forn C74-L97
ector
zi,1-.1:'r f
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lC ftrt I
x F
LANE COUNTY INSPECTION RECOKU
PHONE NUMBEOI^INER'S NAME
NUMBE
ET BACK REQUIRE NTS #PLUMBING F I XTURESc
C
ME
C;L SIDE I NTE RI OR REARFRONT
IZED
DIRECTIONS T SITE
a
n
SITE ADDRESS PERMIT NUMBER
FOOTING / FOUNDATION INSPECTION OR MOBILE HOME SET UP INSPECTION
App roved Correc ti on---D'i s a pProved Date Insp ector
CONCRETE SLAB / UNDER-FLOOR NSPECTIONApproved Correctjon_ Djsapproved Date Inspector
UIIDTR SLAB / PLUMBING GROUNDWORK I NSPECT I ON
,Approved Correcti on Di sapproved--Da te--_----I nspector
ROUGH PLUMBING INSPECTIONApproved Correction Disapproved-lDate Insp ector
FRAMING INSPECTIONApproved Correction---.Disapproved Date I nspector
INWION / VAPOR BARRIER INSPECTIONApproved Correction-Disapproved Date-insp ector
LAIH / GYPSUM BOARD INSPECTION
Approved _ Correction Djsapproved IDate Inspector
FINAL PLUMBING INSPECTION
Approved*_-_-Correction_-.---D'isapproved Date I nspector
FINAL WASTE DISPOSAL SYSTEM INSPECTiON
Approved C orrecti on Di sapproved Date Insp ector
FINAL INSPE N
Approved Correcti on
MOBILE HOME
Di sapproved Da te 4=!g:87l n s p ec to r
CERTIFICATE OF OCCUPANCYApproved___Correctjon Disapprove
TEMPORARY CERTIFICATE OF OCCUPANCY
Inspector
Form C74-L97
d Date
,4/l
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