HomeMy WebLinkAboutPermit Building 1983-11-07Applicat
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PROPOSED USE OF PROPERTY
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IOCATION c CI ztP
SPECIFOF
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TELEPHONE NUMBER
Proposedisting
NAME
Ithatandtruef5correctandthatcertifyherebyandPERMITFORAPPLICATlONCOI4PLETEDTHEEXAMINEDCARTFULLYIattachedofauthorievidencewithtyzedagenterownertheof1npropertYinterestofSlatheLeOreqontheandfoItheIegaIlowingofLaneCowtybeshaIIIfur-and work onperfomedthatDiv1anyf:rther of Bui 1di ngthecerti fy wa thethout pemiss j-onstructurebeofmadewi-11OCCUPANCY anythatandNOtnhere forworkthedescribedbasthe exempttainitoIthatefn9xempt701055oRsperffectasbyforceeandrequiredanfu11BuilderBoardrhwatheREADIHAVEthatectrtheregistrationceonthisbeusedrtifyprojI70.055thanceINconpliarewhoedu-bcontractorsthathereonnotedonlyand &
THOROUGHLYCHECKED 'rt,
Two Copies of Plans
Three Copies of Pl-ot Plans
tlech,/Plumbing Checklist
Legal Interest Document
Plan Check Info Sheet
YOUR AUTHORIZATION HAS BEEN BASED ON THE TOLLOWING CONDITIONS:
READ THIS SECTION CAREFULLY.
Partition *-parcel #ParceI Size
l-l plawtNc,/ZoNrNG:Zone D"o, =id.interior
t'linimrm front
CO}LUENTS
rn flooal hazard .t.^, ff*o fl Yes,SEE ATTACHED SHEET.
Date:
Date rI rr.ooopr,nlN,
Lrru
SANITATION: S. I. l{B. P. #7 rnstallation Record rssued? [ vt" [ *"
rnstallation Gal-Ion
Specifications: ---- Tank
Lineal Feet
of Drainfield
Maxinum DePth
of Trenches
COM}1ENTS:
Date:lo
EXAMINATION: rYPe Group.
COI'I}IENTS:
Date
TOTAL VALUATION S CONSTRUCTION AUTHORIZED BY THIS PERMIT
Sq. Ft.
Fixed Fed/
Unit CostDescription
PERMIT APPROVED BY BUILDING OFFIC
Floodplain Fee )
s
$
c
Subsurface Fe-es,wt{atrz(
I\tech,/PImbg Fee
Pr ans Check Fee
State Surcharge
DEQ Surcharge
TOTAL FEE
s
)
s$
J
I
LANE COUNTY DEPARTMENT OF PU BLIC WORKS LAND MANAGEMENT DIVISION, 687-4061'
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
"5<> . rrt-a"f \s-tl- \o-
Lane Counry Authorization for'
I
1S AND
PLANS
tr
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVO-
CATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND,/OR OTHERREMEDIES ALLOWED BY LAW
WHEN READY FOR rNSPggTrO!{, CALL 587-4065. A MrNr}4UM OF AT LEAST 24 HOURS ADVANCE NOTTCE rOR TNSPEC-ffiul-HEvE-TEE-TorIowin9inioimationready:permitnumber,jobaaar.;"l.tip.of inspection, when it will be ready, your name and phone nunberr'and'any special directions to site.
BUILDING DIVISION:
REOUIRED INSPECT]ONS :
1 Foundation rnsDection: To be made after trenches are excavated and forms erected and when allmlGTEirEE-fo;-tTE-ou;a"iio"-.r.-Ieliverea
"n d; J;;. where concrete from a centrar mixingplant (commonly termed I'transit mixed") is to b;-";;e; materials need not be on the job.
2. Concrete Slab or Under-Floorservnt, conduj.t, pplace but beior e any concrete
To be made after all in-slab or under-floor buildingsories, and other ancil lary equipment i tems are in
Inspect.ion:+rpLng accesis poured or floor sheathing ins talled, including the subfloor.
3
5. Final fnspection:To be made after the building is complete and before occupancy.
SUBSURFACE AND ALTERNATTVE SEWAGE DTSPOSAL SYSTEMS
4
Framing & rnsuration rnspections: To be made after the roof, alr framing, fire bilcxing, andbracing are-Tn !IEE6 anti-a1T-plp-_es, tirepia;;r;-;;;eys, arrd vents are complere and ali.roughelectricar and plumbing are "ppio""a. ar:- wari insuiition and vapor barrier are in p1ace.
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.Ii f i":tS:,ff .i: :ii, i:;'tt3 i::"3ro;i}" tfi "rS;.;";:il::
APPRoVAL REQUf,RED' No work sharl be.done.on any part of.the.buirding or structure beyond the pointindicated in each successive i""p".tio" without'fi;;; outaining-$;";p;;""ar of rhe building officiar.::'in:o::;:?1":ii:i :: ii;i:"::]i;':::"*;'Hi"iiil:":iii:"::i:,:i;:"fiIu" o, ""cr, ",,c"""":i" ",.f---.NorE: All buj-lding permits require'inspections for the work authorized, such as but not limited to:A' Brock warl: To be made after reinforcing is in place, but before any grout is poured. This*f::**,::.'iffi:;t,*: ;*:-*:l':#: #r,"i:ii!.iiir"Il'iI "oo,o,,al untii the prumbins
B. Wood Stove: To be made after completion of masonry (if applicable) and when installation is!3S.';-- lil:'i:iiij:4":::ii ff"i:;il:i:F#:.:iil,:l"d;l;i!3i'i".i"n"rir ,;;;iii,ta res,ins
c' Mobile Home: An inspection is required after the-mobile home is connected to an approvedSiliitil,'ifli'iriiliff;:H"::ll:;!.'"n"i'",u"t"1-rrocr<ingl-r;"1i";'connection, tie'aiwns,
1' ::::#S.::uoi':il: ;:":?HlLwith state roundation requiremenrs ror mobire homes or as
2' xi:ii'-*:;.il:lt-il.ft1:"" floor elevatj-on shall be certified when required by a flood-
3' Mobile home tiedowns, when reguired, and skirting shatl be installed and-5eady for inspec-;::""X:i::1,31 t"""t 30 davs irt.. ;.;;;.;;;: riedowns i.,a-=xiru.ns sharr be instarred
D' #ffiHrT$i""::ii:u:rade when steel i-s in prace and before concrere is poured. Above srade
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURTNG IVORKING HOURS. THIS PERMIT WILL EXPTRErF woRK DoES Nor BEGrN wrr'rN igo DAvs, oR rF woni-rs-suspENDED on eiar'roouED FoR M.RE THAN r'o DAys.susPENsroN oR REVocArroN MAY occun-ir rurs prnuir-wa! rssuED oN rue iilis oF rNcoMpLErE oR ERRoNEousINFORMATION.
ANYONE PROCEEDTNG PAST THE POINT OF REOUIRED TNSPECTTONS WILL DO SO AT THETR OWN RISK.
1.
2.
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 horder sharrnotify the Lane county oeparunent-ot planni"g'i"d-ior*y"]!y Development by submitting theinstalration record f6rm.' rir"-o"pu.t*ent shirl in"pe"t the conltruction to determine if it- comp{ies wish the;rures "o',t.i',"J'r; ili; iiii"riii]"'rr ah; ;;;l;il;;ion does compry with suchrures'l. rhe'Departrnenr shhri-i;;;; a cerrif icut"-oi-."li"i"Itllv-;H;i;;r"" to rhe permiti holder.rf the constructi.on' does'r"t-."*pry ;;U;;;;-iUii.l..r,e oepar.tmer,{-"["r.r norify the permirholder arid sharr 'require satisfactory cqrtrpret:.or,-ueto.e ir;;;G-tib-certitlcate. , Failure to1.,."lni,.E$,.;ff;;; f:,,;i:;;i.:::;i.i$iiiji; iiii,in ; .";;;,,;;r"_ti." cbnstirures a vio_
Setbacks - Subsuff_____-_-__-__.:-_ i .. _ace Sewage Disposal
fnterior property lines
!dg: gr road right-of-wayBuilding foundationWells, other water sources
Septic Tank
10'
10r
5t
50,
c t4-zs
From:Drainfield
10 r
10t
10!
100 t
0ctober .I9, .I983
TO I,IHOM IT MAY CONCERN:
This letter is to verify our intent to have Mr. M. p.
"Chuck" Fortier, license #4706,fkbuild an addition to our
residence Iocated at 3340 Raleighwood, Springfie'ld, 0regon.
The residence was formerly I isted as 840 Raleighwood, Eugene.
ou i se F. Karther
Richard C. Karther
Gdl {tPsotg
.afGilVtu
0CTZ S l$83p
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ldne county
ACTI ITY INFORMATION JHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
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MAKING REQUEST PROPERTY OWNER
er//-7'
C.,
TMRILING ADDRESS
Oa 7 7?as-€-r-*-@--*
TCIIY STATE ZIP CODE -----wY-STAF ZIP CODE
/?z /'6 tv'z2a^*
HOME TELEPHONE #BUSINESS TELEPHONE #BUSINESS TELEPHONE #HOM_-IELEPHONE #
2 PROPERTY ADDRESS
( IF DIFFERENT D
3 uae a PAFIeEL NUMBEFI
( REQUIRED INFoRI4ATI0N)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
/? 3 2L-/2 _{ v 94
TAMSH]tr FANM SMTITN ffi ca*/ AZ",lr'
ZON I NG
f300
m-11NSHTp mNm gTION ffi ZONING
MTNSHTP RANE SEETTOru @ ZONING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSH IP: //d ACRES
+ SUBOIVISION (if aPPlicable)tn/nD.LOT {BLOCK
d*4.*,y&tA,e 49 <>tTtAl
lzouJ o( Teao ,€..u.rA t<a L +.2Yt
6 DIRECTIONS TO SiTE:
h
** FOR STAFF USE ONLY **NUMBER
DATE
ZONE/LAND USE:
DATE:- TIME IN i
-
our:-
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BY
LAND MANAGEMENT DIVISION /I 25 E. Bth AVE. , EUGENE, 0R 97401 / 687-4061
9 9z/o 7o*/"t?huooD
MAILING ADDRESS
5 REQUEST (state exactly what you p'lan to do) Eeaon ,toucT EX ttTl'vt y''
POST THIS PERMIT ON MAIN BUILDING AT SITE
JoB ADDEf,Ss: 840 Ralelghtrood Avenue , Eugene coNsTBUcTtoN pE RM tT # 2379-80{-
TRS, ,-L: '-03-22.1,2 TLN 53OO Subdivision: Ra'lelghwood park, 2nd Addition Lot 6, Block 7
I!f",Slrn]] 191.1h" *Jerenced propertv h hereby cancel l ed Setbacks and other cohditions ot approvat must be stricfly observed. viotation canresult ln revocation of this permit, citation under provisionsof Lane County's lnfraction Ordinance, and/oi other rernedies allowed by law.
lpql:lYi99*", Iilarianne Nance 90 Silver Lane #2c, Eugene 97404 Tetephone: 689-7294uwner/Acdress: Dlck and XIXXI Loulse Karther 840 Ra'leighwood Avenue, Eugene Tetephone:Contractor/Address: Telephone:Contractor's OS + Total Construction Value:
Conqlruction approved by this permit Remodel family room and breezeway enclosure
Water Supply:+ Bedrooms +t Plumbing Fixtures + Employees
PLANNING DIVISION Zoning: .Partitioning + parcel n
Minimum required structural setbacks, from: centerline of road, front:
side exterior: ; interior property lines: ;rear property line:
Special lnstructions:
For information call 687-4394
Parcel Size
; centerline of road,
WATER POLLUTION
CONTROL DIVISION
Site lnspection + lnstallation specif ications:
Iineal feet of drainfield required; max. depth of trenches
Special lnstructions /-%-a
Septic Tank
gal. min. septic tank capacity;
Setbacks
I ^teiio-r property I i nes
,e of road right-of-way
tsuilding foundation
Wells, other water sources
10'
10'
s',
50'
Drainfield
-T0,-
10'
10'
1 00'
a
For information call between 8:00 - 9:00 a.m.,
CONSTRUCTION
PERMITS/INSPECTION
DIVISION
Type of Construction
lnstructions:
Group Fire Zone Use Classification
For plans information call
For inspections (see back of this
between 8:00 a.m. and g:00 a.m
permit) call 687-4065 between 8:00 a.m
By
. and 5:00 p.m
6l!'
-
Directions to Site:
Date lssued:
c55-1 3
hne county
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE / PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
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$,DEPARTI1ENT OF ENVIRONI4ENTAL I,IANAGEMENT
PSB, I25 EAST 8TH AVENUE
EUGENE, OREGON 9740'I
AVa lWfi94o.imUliUinpui;.iffi $r,sl.
e-rri*ffi1ffifiiftfi.-.t.I.$i r_ri,ffiffiftr*slli
hereby certify that this information is true and accurate.
Job Address
Appl ication for
Structures now on the property
,:fi mmgr#;:;, lli*ii.iiCIf i'.,ipffi et.'rff iiii,
Affidavit: I,
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If this application is for an a cu tura building it will be used for purposes allowed by the State Building Code and
Lane County Code Chapter l0 (zoning) and fror no other purpose. I have the following lega1 interest in the propertyof record ; contra
to act for the
ct purchaser;lessee;holder of an exclusive option to purchase;owner-X-outy
S i gna tu relAddres s
Te1 ephone
When permit is ready noti fy: /-/ Appl j cant
0.rner
Con tractor
Contractor's 0SR#
If Corrnercia'l :
Residential
SI test holes ready
owner,'ls le o sa ication
or
er l-l Contractor
Plumbing by
# of employees _
17 Proposed, SI #
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au thor i
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SEitil$iurrilii.i Va l uati on Fee
Total Valuation: $$
4% State surcharge
PIans check fee
Change of 0ccupancy
at $-
at- $-
Su btota'l
TOTAL
each
each
$
$/_/
nec ei ved
$
$
$
$
Water Supply
Proposed
Year Instal led
Existing _
$
PERMIT PROCESSING
Minimum setbacks:
Cornments
Zone
t, fro nt
Part. #Parcel #Pa rce 'l ze
t, siae int rea r
To be typed on permit
By Da te
Fire Zone Use ClassificationCP& I Type-Grou p.
To be typed on permit
By Da te
PhoneFor plans informati il rea ins
Di ons si te
Plans to/_/SIFO CP& I
l.lPC
set(s)
set(s)
Da te
Requ i red
Hold Sl ip
to PCC
Da te
Compl eted
Date to
PCC
CP& I
/ P1 anni ng
/-/ Pullic Works
/7 Elevation
/-/ Address
/-/ Faci I i ty Permi t
,// Environmental Health
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I NS PECT ION RECORD
Approved' Di sapproved' ..:
Site Inspection
Foundation InsPection
Fram'ing Inspecti on
Lath or Sheetrock InsPection
F'inal Inspection
Slab Floor, Plumbing Groundwork
Gas Piping Groundwork
Date Inspector t-O
C)
-{
Ho1
2
3
4
5
8. Rough Plumbing
9. Rough Gas Piping
10. Final Plumbing
ll.Final Gas Pip"ing
Remarks:
!mu
=-{
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1?. Certificate of 0ccupancy:
ready to issue; _ not ready;date;i nspector.
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Plot ]rlan
Subdivision
Lor 53rc Block '(
Job Locatlon
Permit /l
Permit
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MINIMUM PLAN REQUIREMENTS [-- sets of plans are required to: I the following:]
Pl ot Pl an to i ncl ude:(see examp'le )Property boundaries and dimensions and north point.
Existing structures and dimensions, distances from boundaries and other structures. -
Proposed structures size, location and distance to boundaries and other structures.Location of septic tank, and drainfield or sewage systern hookup.
Location of water supply.
Location and dimensjon of utility easements (if applicable).
Location and dimensions of off street parking and vehicle access to the site.
Locatirrn of al1 signs (if appljcable).
Townsh.ip, range, section number, tax Iot number (and nretes and bounds description
i f not an ent'i re tax lot. )
a
b
C
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Buildin g Plans to inciude:
l. Foundation Plan:
a . S i ze and I ocat'i on ofb. Size and location of
TqtS ! tr"r tri cATrorrr5 fr,NLW ffi?Aeni,.,
LtcPPgUA b\
ar r foot i nss, r.iH?fr&H*'mlffi-rsall foundation vents vlE..*r%t@)lt
oor Plan oI Each Fl00r tn jnc]ude: (and t'rasenent rvherr apllicable)
Location and size of all coors, w"inCows and openings
Direction of door swing.
Use of each space.
lnJhere al terat'ions or add'itions to an exi sti ng structure are proposed, showfloor p1a.n of entire building.
3. Elevations of all sides of the bui'ldin
FI
b.
ga. Depth of wall footings, foundations, or piers,b. Finjshed grade at bu'i'ldings.
'if stepped or m orc than one level.
Cross Section suffic'ient to show construction materials, rnethods, and heights oftn-f1oors, cei l ings and roofs.
Details which clearly show sizes, materials, connect'ions and construction method.
a .-FiFepl ace drawi ngs and deta i I s (i f appl i cabl e )b. Details of roof trusses if proposed, including connectjons and stress or testdata. Trusses must be designed jn conformance with Standards Engineering
Practi ces .c. Shotr size, direction and spacing of all floor, ceiling and roof framing
members, beams, and columns.d. The drawings sha'll sholv all foundation, floor, wall and ceilinq insulation
and indicate the R-factor of each (when applicable).
6. lieatin Venti I ati on Pl ans and Deta'i I s to i ncl ude
a ocat on, size and materia a p'iping, air ducts, air inlets and a'ir outlets.
ocation of all fans, warm-air furnaces, boilers, absorptir:n units, refr"igerant'compressors and condensers and the weight of al1 pieces of such equ.ipnrent
weighing 200 pounds or more.
Rated input and output capac'ity or hoursepower of a'll boilers, warm-air furnaces,
heat exchangers, blower fans, refriqerant compressors and absorption units.
Location, size and matei"ial of all cornbust'ion products vents and chimneys.
Locatjon and area of all ventilation and combustion a'ir openings and ducts.
Location of al.l a'ir dampers and f ire shutters.
Details showing actual nrethod of at.tachment of fire dampers to construction
as wel'l as size and gauge of material s (if app'licable).
At.L PLANS StlALL Si-10'!,J
l. Name and address of property owner.2. ltlarne and address of the person who prepared the plans3. The scale on al 1 drawings.4, An'accurate deset"ifiblon of the building use.
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il55-83
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HOI,ID SLrP'
tL2b7q4)
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lane county
APPLICATION #
LOCATION
NAME
ADDRESS
The nrinimum requirenrents for "exterior envelope" construction (Re: Section 5303, lSZflState Bldg. C
Requirements) require "double glazing" or openings equipped with storm windows having a "U" factor
'i ess when the ratio oi' bui iciing c,penings io extei ior wal I a, s. ,s le,s Lirail i7i.1.
al to or exceeds 17% of the vrall area, heat loss calculations are
trl gatiet,t W *tE,B^q
E
The above app'lication is being held for the following reasons:
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z. ?€o(toe ?oil$DrcfioN PU'N O? N/- ft(pL-11fi{ tNcugg
w(flry ftsu,+,rt AcD h.e$T'lo l{lon} ' '
D?axt-'TBlxAllNq @o
h fov--fi4€f<r?E^1gaQf,.,Auil^ h qp ar?-.? tgkt@-
When the area of openings is equ
equations 53-l & 53-2, Section 5
conforms to Chapter 53 of the l9
I nd'i cate type, 'locati on and amou
Area of exterior walls - sq. ft.
303
Percentage of openings to exterior walls.
Codes, or a statement saying that your build, tstQ State Bldg.
B1dg. Codes prepar ed by a registered 0regon architect or engineert{
nts of insulation.------- PILL-
of openings - sq. ft
ode Minimum
of 0.70 or
required, per
ing
H
JAa++?.!? to V$acxg,. A.u- WtxrVattt + w6e- 5r* d yruf-flA) '
-x/.If the jnformation required
i cati on wi I I be cancel I ed.
Irfr5 clppt tgclLtoft 1 il De hetd unti I
above has not been furnished by that ate your appl
Building fees paid for perm.its cancelled under these circumstances wjll be proratedaccording to the work that has taken place as of the date oi ijnceflation.1 Tffiffuo froVp wttrTzequrReo;-s€e FanbrurL
:::;m:l!r::.!:r:iir*i:-1vi f,.iJ ^ c:.:t:r.E.E _!!1:!,r!-i?-----r.r=:!iEE!E:-
4^l"n
Iw0ffim S-rc)I
-rHE FOLLCWING IN[:ORI\4,A1-!ON !5 REQtJtRED TO ''
APPLy FOf.l A 5l0\/E P[:R I'Vlll-:
L
M .I
COPV
a 100pY
of the nialiufacture!"'s installation instructiorrs.
of the floor plan anr.l elcvlltions;
:,"i
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li
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a. lndicato all clcarancos to rvalts uncl vrirrclou/s.
b. Nonconlbustible rnaterials to [:e usetl lor the lrearth
lor reduced clearanccs to walls.
c. The mcdel nanlc or nurnLrer of ttrc stovc.
d. The chimney ti'lanufacturer.
e. Details ol tlte conlbustion;.rir duct itrrcl clperrirrg.
and
NO PERMIT WII-L BE PROCESS[:L), UN[.ESS ALL THE
REQUIRET] INFORMi\]'ION IS SUI3MITTED.
lane county
HOLID SLIP m!r\-
APPLiCATION #LC23H4)
LOCAT I ON
L=
NAME
ADDRESS
.NIT*
+ itl;a
/LNltrtl(rrtj
Kf cr.t{ ltrfr\,1\tff)
??ovtoe Yod$r;*froN YI-NJ oF Ptw t1t7rrloxl tvru)frry
%tX t ry f:ou,nrtAllo nJ A a) AdEAIT-'rO hffi tflAfJ'
T)?Ap((- 7 p1xil r ffi tze{tr'o .
The minimum requ'lrements for "extepior envelope" construction.(Re: Section 5303, 1975 State
n.i"ird*"rir)-Jiqri."'idouble 9lazin9" or openings equipped with storm windows having a "U"
tedi wnen ttri "atio of buildin{ openings to exterior wall area is less than li%.
Bldg. Code Mlnimurn
factor of 0.70 or
The above application js bejng held for the follow'ing reasons:
llhen the area of equal to or exceeds 17% of the wall area, heat loss calculations are required' per
equat ions 53-l &on 5303, .l976 State Bldg. Codes' or a staternent say i ng that your building
conf orms 3 of the 1976 Bldg. Codes prepared by a req istered 0regon arc hitect or engineer
Indicate on and amounts of insula tion.
h r*ak n}+)a
openi ngs i s
53-2, Secti
to Chapter 5
type,'locati
Area of exterior walls - sq. ft
Percentage of openings to exterior walls.
-frR#a of
J.
openings - sq. ft.
.*xJqo tpo@\v w Nriltuln 1 3@? 3tz?8 dJ Y6llL
ld until If the jnformation required
cation will be cancelled.above has not been furnished by that a your appl i
Building fees paid for permits cancelled under these circumstances will be prorated
according to the work that has taken place as of the date of cancellation.
4, T,w,ffr, a0vE rep{v\rT vequ(Rr:D-*w mrytfsnrt
BUILDING & SANITATION / ENVIRONMENTAL MANAGEMENT DEPARTMTNT
125 East Bth Avenue / Public Servjce Building / Eugene, Oregon 97401 / (503)687-4061
I I P CUIJE
I
1
t2
l4
t6
11
20
22
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32
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,+i:'i:'!.. i ,;iri.lT i.jrilf-l{i , i4*i:i i,liri.li: ,'illiltj ?i.i :i:.i i-.Ut:i:i i-.*iJi:. ?i; , i::L!l:'!:N[ , iii;:
T!.r1 {?(:}:1'J"i't:+531}t} :il-jiiirli:v ;;:,r.ri-iii:r;i-!inLii:.:} i::';:tl:Ll''.' :,ii'iii $iJ.:iiTj:'Li!'+ i.-ij'i ::;.",i)
! i (: i:' ii +=1 iJ ii :i 5: rr -r; ii + tri i-l ',-i ,\j i T li '3 i:i ': ht i-l .:i:
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r::i:. ;:rili{ l l. ':' tji.li,j"i r."iil} i:,!iit .}ij . i {i i:qii?ii:j'r!::' i::.:'.ii.:i-ii.::i:i iriil:i:ii:;:1!:il"J+rY ;i;14 i;'" :i+ I I :li]
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51
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r.LS}.I L:HHCH T:EI:
.i i:i j; -7' :. ioiri :--: i ,. | ::, '.lii.
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lane countyHOLID SIIP
APPLICATION #
LOCATION
NAME
ADDRESS
ZIP CODE
The above appl'ication is being held for the follow.ing reasons:
Area of exterior walls - sq. ft. tgl Z- Ft Area of openings _ sq. ft at
The minimum requirements for "exterjo. unr.l:!:l,construction. (Re:.section 5303, Wfirrur" Bldg. code MinimumRequirements) require-"double otiii'r;;' o.'opunings equipped wiih ston, windovrs norinq a ,,u,,factor of 0.70 orIess when the ratio of buildini .p..i.gr'tJ e*teiio. ,or1-u.ui-i's less than 17"i.
When the area of openlequa'li'ns si-r-a
""i.ii,ji,.#J;ffiiiil,:ili,.f.Ji:,':ilr,ii:::ffrj,l;;j::,il:j,J:rr.ruii:iri""'' ,"conforms to Chapter 5iIndicate type, locatic
Percenrage of openings to exterior *ullr. Z-7,7 To
N:,?Y^Ya bawT+ilwalq wsTtq weNvF,,-Fq. 7q0€a e+au_ (H bb oi exir,,,q"?ww 4atcro?E ffi9zt4__4)\/"4ry. .
*,%refnItalq
t>oJi,q
SIGNATME--DATE
OFFICE HOURS PH()NE
be held until If the information required
n'ished by that-Iate Vour application wjll be cancelled.
Building fees paid for permits cancelled under these circumstances will be proratedaccording to the work that has taken place as of the date of cancellation
BUTLDING & SANITATION / ENVIRONMTNTAL MANAGTMENT DEPARTMENT
125 East 8th Avenue / Public Service Building / Eugene, Oregon 97401 I (503)587-4061
Th'is application will
above has not been fur
ANCELLATION/REFUND AUTHORI ZATII,.,Permi t #
Name (please print)
Address
Applicant() 0wner()
Reason for cancelling permit
Contractor ( )
Si gnature Date
Fees paid for waste disposal systems (site inspections and/or applications to install the
septic tank and drainfield) are ordinarily nonrefundable. Some refund may be made on the
building and plumbing portions according to the amount of the permit processed.
CONSTRUCTION PERMITS & INSPECTIONS
Authorization for possible refund:
(0FFrcE usE oNLY)
o/
lo
ol
ol
lo
o/
Building permit fee
Mobile home fee
Plumbing permit fee
Plan check fee
State surcharge fee
TOTAL AMOUNT
Date
$
$
$o/
$
$
$
Septic disposal system
Site inspection fee
TOTAL AMOUNT
Date
o/
lo
lo
$
$
$
Building permit refund $
Septic disp. syst refund $
Site inspection refund
TOTAL TO BE REFUNDED
$
$
PLEASE MAKE CHECK PAYABLE TO:
Name
24-08-24 /Acct 46960/Pr"og 021
24-A8-25/Acct 42:I33"/Prog 0l 1
24-08-25 / Acct 42134/ Pi'og 012
Recei pt #
Receipt #
Recei pt #
Address
S i gnature Date
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE/PUBLIC SERVICE BUILDING
I25 EAST 8TH AVENUE, EUGENE, OREGON 97401
c74-L79
Si gnature
WATER POLLUTION CONTROL
Authorization for poss'ible refund:
Si gnature
TO: DEPARTMENT OF FINANCE
lane countyflOLID SLIP 6t!r--!7
AI'PI ICATION II - -_-
I.OCAT I ON
NAME
ADDRESS
F-Lll'a;q rq
-----7_--
ZIP CODE
The a application is being held for the following reasons:
Ctlull-1 w @ kraf 'breezau-tY' e q€,,Ah Et xt^ow) .
tf 2o, (PtUtOW
EYJq*q AAA
sWLTtotJWyav*l/,9Ot,Y" EY\E&tot- u&L P
cbrfrt?ucT{aj .
n *arce zxeta+ tt)u5'
litAT SUNL1- Tp.e loptilapr.)
tr WrattW t'l$u$f*Iu0run fcLt#,qt
4AL/y4& 4 fVw@16,u$t1
,?E \[a",sytan ff Att- Vcota'>
'Ttte wtuwo \tMut[1, *LWr 9*n
foa rJtsr Tvzu?1GD P4 ,lE*
rt 1 W
/V
I E DA T E
RvRltRguE gy Rppott{tNnlr oNLy (ru0 wRLr=tNs)
This application will be held unti ' ll- {i.,.*? .
687-406r ( )R-
If the'information required
above has not been furnjshed by that date your application will be cancelled.
RETURN THIS SLIP t^IITH THE ABOVE REQUESTED INFORMATION.
BUILDING & SANiTATION / PLANNING & COMMUNITY DEVELOPMENT DEPARTMENT
125 East Bth Avenue / Public Service Building / Eugene, 0regon 97401 / (503)687-ni5.1
6
4
AI
(r'
il
!.
l n
t plr
Nalne (
"[l*CANCELLATiON/ REFUND AUTHORi ZAT
ile
Con ctor ( )
Permi t
p1 ease pr int )
4ddress
Applicantld Owner ( )
Reason for cancelling permit
Si gnature Date
Fees pa'id for waste
septic tank and drai
bu'ilding and Plumbin
disposal systems (site'inspec-tions and/or app'lications to install the
;i;tiAj u"6-ordinirily noni^efundable. Some refund may be.made on the
g portions according io the amount of the permit processed.
CONSTRUCTION PERMITS & INSPECTIONS
ONL
Bui I di ng perrni t fee
Mobile home fee
Pl umb'ing permi t fee
Plan check fee
State surcharge fee
OFF I
Authorization for Possible refu
1ao?o JbzY
n{s* {"t'
o/b
q
-c.:* %
too ?a %
$
$
$
$
$
B*-r-
TOTAL AMOUNT
Date
$a-
S'ignature
llIATE R POLLUTION CONTROL
Authorizat'ion for poss'ible refund:Septic disposal sYstem
Site inspection fee
TOTAL AMOUNT
Date
ol
to
/o
$
$
$
Si gnature
TO: DEPARTME NT OF FINANCE 4J/j<( /rr;t
?4-08=24 lAcct 4€96,01H1., Recei Pt"ttffi' ry# ('
{
/#",' ; {{io7_
#/2'/
#
?4-08-25/Acct 42.l 34/ Pi'og 0l 2 Rece'i pt #
-
Date
Bu'i I d i nq Permi t ref und -
i{ {'tl t' t{''{p'.K { t . } 6 {i{{
Site insPection refund
TOTAL TO BE REFUNDED
$
67i lL
DEPARTMENT OF ENVIRONMENTAL MANAGEMENI
COURTHOUSE/PUBLIC SERVICE BUILDING
I25 EAST 8TH AVENUE, EUGENE, OREGON 9740I
$
$
PLEASE MAKE CHE Y TO:
Name
Address
Si gnature ->
c74-L79
-'--
.,,P qlnlso
DEPARTIiENT OF ENVIRONI4EI'ITAL IlANAGEI.lENT
PSB, I25 EAST BTH AVENUE
EUGENT, OREGON 9740I
lEt AV€Ci ty a)
Appl ication #
t+Assigned NumbersJob Address
Township, Range, Secti
Subdivision RA
Appl ication for
Structures now
k
Proposed use of proper Residential /7 Conmercial /_/Industrial /-/ Public
Affidavit: I,Nilre -(a+utrree),
hereby certify that this information is true and accurate.
on the pro pe r ty
ty: /-/
If this application is for a
Lane County Code Chapter l0 (zoning) and for no other purpose
owner of record con trac t pu rc ha ser ;
@n agricultural building it will be used for purposes allowed by the State Building Code and
ve the following 1ega1 interest in the property:
an exclusive option to purchase;
.Iha
lessee;-lX-durv authori zed to aiT-To'r the owner,'ls le s
S i gna ture/Add res s
Te1 ephone
When pennit is notify: / / Applicant
Owner
Contrac tor
Contractor's OSR#
If Commercial: # of stories
Residential: ; of bedrooms
SI test holes ready
or
/_/ Contractor
P1 umbing by
# of employees _# of uni
Da te
z1
SDS:Existing, BP
Phone
Phone
#
Fee Sq. Ft. or
# of Sites
/_-/ Proposed, SI #
Unit
Cos t ValuationCodeQescri pt i on Fee
/0 Tota I Va l uati on : $
Plumbing fixtures at $
Sewer/water conn. at $
471 State surcharge
Plans check fee
Change of 0ccupancy
$
each
each
s
I
/:/Check #
Received by
Water Supply
Proposed _
Year Instal I ed
Su btotal
TOTAL
t
$
$
$
Existing _
PERMIT PROCESSING Zone
Minimum setbacks, t,
Part. #Parcel #Parcel Si ze
aL, side rearint
Comments
To be typed on permit
By Da te
ft. of drainfield; max. depth of tqenches:
WATER POLLUTION CONTROL
Instal I atjon specif ications gal. tank;
To be on permit
Di ons site
/_/IF0 Pl ans to
pl cpat
/^7.uec
/ / Pla^n1nq
/_/ Public Works
/ / Llevatron
-/_ / Address
/_/ Facl|litj'Permit
/ / Enutronmental Heallh
CP&l set( s )hPC '.---.- set(s)
I
I
I
t"r,
/ t nta
Da te
Requ i red
Hold Slip
to PCC
Da te
Compl eted
Date to
PCC
;(
(,L
(zip))(* I
t7o.I
)lCt
t
$
(
Terephone 6.?7- {aZl sy oate 7/J.t/?o
Approved Disapproved Date Inspector
I
2
3
4
5
Site Inspection
Foundation Inspection
Framing Inspection
Lath or Sheetrock InsPection
Final Inspection
Slab Floor, Plumbing Groundwork
Gas P'iping Groundwork
Rough Plumbing
Rough Gas Piping
Final Plumbing
Fi nal Gas Pi p'ing
t-OC)
-{o
=
6.
7.
8.
9.
.l0.
ll.
Remarks:
EmF
=-{
iE
12. Certificate of 0ccupancy:
ready to issue;
-
not readY; date;i nspector.
INSPECTION RECORD
TRS#-o DATE ISSUED:PERMIT#
MEN
C;SIDE I NTERI OR
I
F T REAR
NG
approved4lL _D
ON
ate Correcti on Date Insp ector
PLUMBING GRoUNDII0RK I NSP ECTI ON
Approved Date Correcti on Date Inspector
UNDERSIAT PLBG.fI /UNDE RFLR PLBG. N I NSPECTI ON
Approved Da te Correction Date I nsp ector
IApproved Date Correcti on Date Inspe ctor
ROUGFTI-UM-TIIruE
ApprovedlQL_)
(TOP ouT)INSP ION
Correcti onDaZ-Date I nspe ctor
FRAMING INSPECTION
Approved zqL Date lz-L'87 lCorrection Date I nspe ctor
ROUGH MECHANICALApproved Date Comection_l Date i nspec tor
INSNTA-IITN / VAPOR BARRI ER INSPECTION
Approved 4hK Date lz-9- 81 /Correcti on Date Inspe ctor
LATH / GYPSUM BOARD INSP ECTION
Approved-Da te Correcti on Date Inspector
FINAL MECHANiCALTApproved Date
srovE nCorrection Date=----_InsPe ctor
FTNAT-PIUMBINFI N SPECTi
Approved_4foL _Da rc /-24-?1/correction Date Ins pecto
FINAL INSPECTION BUI ING ETIMOBI LE H0ME n lAG PLACEMENT fI
Approved /zz Da te Correcti on Date I nsp
IF CCU
Ft7 4-t97
Approved l_Date
ector
Insp.Approved Date-InsP.
LANT COUNTY INSPECTION RECORD
arfu
4 o l,'r2{'1,4=j t,zr-+: ?n77'n ' Pl'8S
cvTi't5 ryryS6-= <32
Zzql-K = tTOo
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Qil'n"ni. ii H"ia ini"tila uj, tt,-''"nniiii".i.' ri
""il-t.,.t iI;' i,;;;itIn the back and thc sidcs, a 0. I02-inch-rhi"k ri.,,li L,,iii" ir',it-tached to the heartl.r pan- An ash dtrnrp is p16r,itlt.tl it, ih.t ,i1r1ri"*i-
mate centcr of thc hearth rvith an asli y,rri rrrr<l.r th<r ir.,,,.tt"-'ltl,,
runit can be supplied rvith threc lcgt or i tlirp,,zoiil,rl ir,*" "i-ij.ojii_inch-thick stccl. Witlr eithcr the lr.gs or tirc Ir:rso, tlui lr<.trtir isI inches above the floor. jlhc ffr.trpluic o1>cnirrg i, iir.,iaa"a iriiii'.trvo-picce mctal rncsh scrccn rvlriclr ricti ,rs ir'sptik ,I,,iiiJ.
--" i
The minimunr clearance. to coml>trstiblc rurrtcriuls anrl sizc ofthe hcarth cxtcusion arc shourr irr'l'ablc No. Il of tliis rt.port.
. 'I'hc overall height of thc fircplace arrd its chirnncy shall riot bc
lcss than 12 fcct nor grcttcr tltarr 00 [ct:t.
rr.r,rv r\v, / r,_,1/v.r.
K. Athcna AFWilt)u: The Atrrr-'na AFw3gu is n sotid-fuer-burn-i,g frcc,st.rrrlirrg. (i.'place stove dcsigrrcd f,rr "urii"i i"stutraiii,lilre
;xff i:l'Xlf.::ui;i,'l;:tltl'i:l;::l:"tt3x,,,ll,Ilf; i.i;:l#i"*f;shicld att.chcrl tr-r thc outer casing o"ioi.- Uu"[, ,po"J- f i."f,away. witlrin .tlrc fire chrrnrber there-is u u.rttte-oi'o.iozi""ri+iii"[stct.l.'l'his balllc is suncnd I inch from ii,"'ori"i.oring. The outerc:rsirrg. a,d balllc are atto..heJ- to- a_'ii.0on-i*i.tii"t-'"ri.;i' h;;lipan which rests Z inc'cs from the !";i;; i-;;il;i";i"i;d:"ti;Ircarth puu is t.vcr.rr rvith -I-inch-trtici higiiic;pcratrrre minerarIibcr i.sulatiorr . rrrl l -irrch- rhic[,"li""to.y'il;t"ri;]. i'h;' ;iil;;nrat('rial is slrippcd in bags for on-sitc iiri"fi"ti.,
-;Iil:irH"irilltili:,-t;i*:r'il"?,,r,":d:;r,"il:rr,,fi Ffi :,#irT
conn('ctor pi1>cs arc frrrnished rvirh each unit. Th;'-i;;i;"il't?-sigrrcd for qsc with a tr,{ajestic-Mo&il:St, 9_;;"hAid;;.'iirL"jI*v-lreut u,pli;rrrcc crrimney. a trtoaci aPs-u irriil,liiir,ii', ilp,iii:.irvitlr tlrr: rmit for att,chment to the chimney'-c6i,rrector. Minimum
9lc1l1qce to combustible rvalls and heaiti "it""-ri* size are shownin 'l'abkr No- II.
r,..:;,X;:i['s'i;:"]r'rl]1.$""!::LYL'",'"liixft 1?li,'_,,,ffi l*]tixstallutiorr, i.c., rvitl the h"arth ofi;;i"g;";rli;l ; ll,;.;;Uii.Thc rrnit is similar in corrst.rction ti ii-," p..ri"o,;i; icsci#;Atlrc,u .AIrW3gU firc,lace. .t'hc Nrr,(,sri;- Ai,3-ii ptri" .i,ilia-- iIrr:tluirt'd [o.complt.tc ilrc irrstall,,tion.'iii;;,",;;
"lararrcc to com-b.rrstiblc *'rrlls aritl sizc of the h;*rai, "*i;;,;i;;;;ii;;;r" f"tf"No. II.
The installed leight of the .ffreplace and chimney shall be arninimum of 12 fcct-arrd o ,nuli*u'ni oi St'i".t."'
^ \l- Jupitcr llf \V3()U: 'this. is a -frcestanding so!id-fucl_burninofire;rl*cc -stove. It h;rs u corrical h.on.tof-o.o5a-;;i.tiriiiiJ""',iiiiliil5tr,t, st.r.l r:rrrrrrr't,t.rl t,r :r,3U.-i,ch-d1,,,,r..,t,"-,i_i,iii;-i;;,;; l,;;;tili;;;[,rlrrir,rtt'tl lltu. ().oi]-irrch-tlrick
""i,i-iiiii"a:typ"'slic"l.'t.r,e ov".rlllr*igli.t of tht: rrrrit is 43'i.inchcs. spac.icr i{"rii"ii"r-"L""r"'ir,"lr.a.rth. pa,.is a 0-().'10-i'ch-thick srecafi;;;ti, ufrt.r;fri;i ;.;;;;";;trritlr l-irclr-(lritk Irirh-rtrnpt..rrurc ;i;.;,,f 'ni;.;',.^lirlirir"ri",ili r'l-irrclr-tlrir.k rc[ritct.r i. ,.atciiirl-l:Lc i.:i.,i"ir.::'riit";iri ;r::;;p;;; tirr l,ugs for o^-sitc i',rt,ril,rtion. Tf,;1,;:;1iii;;i, n,,l,,nt, ro a 0.0lil_i,ch-1hick str:cl brst. 'l'hrcc holc-s nr" rri,i"l.i"J"i; il,;il";;"'i;,attaching t. thc floor. within the rr";4"*i-;i;;Iu".i t""trr" rr""iirtpan is a 0.034-irrch-thick srcel bnlile which l; ";il;i,riii; ;;;;:i: :lalrr cr*rnrcl. 'l'he Iir.rl,,ee opening i. ]"""ri"i ii;h ;"tT",j;i;;;mctal mcslr scr,.v'n wliich r.ti m oipir('il;;.
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m 1 CCIPY ol tlrc rrtatiuf actrrrer's irrst:rtlirtiorr inslructions.
iot the floor ;rlari alrt.! elev;ltions;OOPVxt
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TIJE FOLI,OWING lN[-ORI\.4ATION tS; i([:(]UtRED TO,:r,:,
' :' : : ; , App1y ;-op. ,{ sl o\/E t,l:Rlvil r: -,,i,i'
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a. lndicate all clearances tcl v,rnlts and v,lirrclows.
b.'Noncombustible tnaterials to be usetJ f<lr the llearllr and
for reduced clsarances to walls.
c. Tho model tlanlo or rrrur.rhcr ol t!rc stovo.
d. Ttre chimnoy ntarrufacturer.
e. Details of the conrbustion air rluct iincl operring.
ItNO PERMIT WI[.t t]E I'RO(-I-55[-[), IJNI-[.55' ALI- I'HE
REQL]IRED II\I--ORN{AI XON I5; SI.JIIIVIX I-ED.
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