HomeMy WebLinkAboutPermit Building 1989-07-31 (2)Job tacation:
Ic,s Iot il1-0s-73-tAaaeaaore MaP il
Subdiuieion
A-mer:
Phone:Address:
Qo.,atnnq_,\r)
Describe l,lork5{
ValueDate of Applieatian
l*,n'
lart,ldditian
RenoCel
tll.. RESIDEI{TlAL" spFrNGFrEr-D
APPLICAT.
225 North Sth Street
Sprtngfield, Oregon 97477
Building Divisio.n
7 26-37 53
t/PERMTT
Date:
ont rac tor
Ceneral
P lurnb
I.lechanica
t rica
clanIilec E rrv13Sup
0R !.t)wD
fno,r,rBui
It ia tha
the e
!ding
SITE INSPECTION:
ecaoat6ilt
forna.
nnd.e ard apptoued.
FIPEPLACE:,r-;;i;G
To be
prior to aet
t card ia
shall renain
after
uP of
holder to aee that aLL inapectione are nade at the pro?er tine, that ecch cddreas i's readabi'e
Located at the frcnt of the property.
on the Building Site at aLL tines.
PRocgDUPE FoR INSPEOI1N rysQUESr:CALL 7:
iAq,,6stcA-ffi-fiennou uiLL be ready fon
--iLL be rmde the sane dcy, requeete ncde
UNDERSLAB PLUMBING. ELECTRICAL &
MECltLllICAL: To be nnde before any
GFTiaotered.
fT roormc ,g F)UNDATT2N: lo be rmde
ld dt;;=;"".A """ *catated attd
forne a.re erected, but Pnior to
WurinS ccncrete.
Q uvosncnouNo pzuvBtttc. sstPn, .vltw'
I /\l DRAIilAGE: To be nflde Prlor to !LL-
Lir4 trenchee.
UIIDERFLOOR PLUI,IBING E MECI]ANI9AL :
of
floor ineulation or decking.
7F1 posr AND BEAM: To be nade priot' to
| /'l ffiiiTGiGllof floon iwulation or
decking.
f-fl ROUGII PLUIIBITIC, ELECARICAL & MECH:
I /'l antcat: No uork ie to be couePed
" GrTT-theae inspectiona have been
INSI]T.ATION /VAPOR BARRIER IIISPECTION :
@atl insulaticn ed
tcquired uapor barriera axe in pla,ce
bui be|ore qtA hth, gyPou)n boaYC or
rnLL couerinil i,e applied, and before
oty inaulation is concealed.
r,-7 DRYWALL INSPECAION: Tc be tmde
| / l;FaZn@tfia in ptace,
" but prtor to cnY taPing.
of inspeclictr
befcre 7:00 c:t
Sanitaty aaset capped at propertg line
Septic turk pwped ard filted vith gra:sel
Final - l{hen abcoe i,tans are eanpleted
and uhen denolition ie conplete or atruc-
ture noted otd pretrlsea cleaneC up-
Btocking otd Set-:tP
Plmbtng connectione '- aa)el and, uaier
Electrical Cotnection' Blocking' aet-up
and plunbing connections rruet be appror;ed
before requbati.ng eL eclt'ical inspection
Acceesory Building
26-3769 (tecorder) state gour City
Contractors or Anners nane and plone
deaignated job number,iob a&beas' tYPe
P.equeets receitedinspection,nwnbet,.
aftet 7:00 on uvill be nnde the nett wtki-ng day.
lour City Deaigr,ated Job Nunber Io
MAS)NRI: Steel location, bond
ffiiigrouting or verticale in
accordorce DLth U.B.c. Section
2415,
HOODS?oVE:
&*7TAA.
After installatton ie
w
n
CURB & APPRCAC\I 4!PON: After forms
A,e erei;[Tut ;r7or to Pouring
concrete.
SIDEWALK & DRIWVAY: For aLL con-
;;;tei"u6,r{ril; atreet risht-
of-,xy', to be made after aLL exca-
oating canplete & forn wnk & sub'
base ttptenial in Plzce.
Final - After
etc. are canP"
pcrchee, ekirting, decks,
teted.Pnior to plccirq
and before framing
faaing
inepec-
tion.
FRA|'IING: ttust be requeated after
approoal of rough plwrbing' electri-
aL E neclanical. ALL roofing
braoing E chimeya, etc. nast be
: conpleted. No r,tork ie to be con-
, eecled until this inapectton lae
'been mde anC approoed.
?ENCE: hrhen conplete -- ProoiCejEE or mortable aectiona through
P.U.E.
K S*t.+l^"'t"
FITIAL PLUMBII,IG
FINAL MECIIANICAL
FINAL ELECTRICAL
r /
a
m
TAI,L MANIICL*S AND CLEANOUTS NUS? BE ACCESSIBLD, AD,IUSTIIENI TO BE I'L4DE AT NO COST TO CITY Pege 1 of 2
-.--ALL project conditiona, such ae the installation of st,eet treee, conplatton-of the
required l""d;;;;p;4,'-L*., mtst be aatisficd before the BUTLDTN? P|NAL can be requested'
/1^ F1NAL BUTLDTN7: the Einal Buitdi.ng rnepection mtat be requeated alter the Final Pltnbing
W Electnical, otd Nechanical fnepeetiona latsa been nade and approued.
OLAR ACCESS REQ.--z-Bedroons
L-CO G+
€;*F,7eP
I HAW CAREFIILLy EXA\4INED the completed application fo-r permit' and do
herebu certifu ttnt atl-|t|o-otton hereoi ie true and correct, attC f
'iir'r77.,""r-Z'nriliiy- ti"t ony oh aLL uork penf-orned ahall be done in accor-
a""Lii*iti th|"OrdinaicZe- of the city of 'Springfield,
'td
th-e laae of tha
SiTi Zt U"gin- pertdining io the uo-rk Ceebribcd herein, dnd tlldt N0 OCCU-
pAiCy ,hU b"e ,rade of ang" etructw,e uitlaut permieaion of the Sutlding Di-
uieion. I furthen "-"niiig tit oily con_trac'tore otd etployeea uko are in
canpliance'ritn ons ?o1.bss uiLL be uaed on thia proiect
JOB NO,
IDT IYPE
fr nterior
R49=ry
,
P,
tat Facea -
-- Fees --
Corner
Panlundle
Cul-de-aac
tnt Sq. Etg.
7 of Lot Cooerage
! of Storiee
Total Height
TopograPhY
x ValueTTEI'I SQ. F?G
58 l3lor"t\4[04I'bin q r1ss01-
aa?nac 5ro
Carport
H\I )\ o.t1trfi,,,(x+t()Acceaaofu
Zras-74tTOTAL VALUE
Date Paid:n :31- Bq- 6qnno"i.pt l, 14
signed' ad t Oft )
Building Volue & Permit
This permit ia gnanted on the erPres! cotd.ition tfu,t :\", eaidr-eonsLrucLion
"n ff', fn all rLapeeti,- conform'to the 0rdinance edopted 6iy the Ci.ty 2f
ip:,tiiftiti, hlllual.ng' til.uii"g cydinanc-e, regulaL-i,rts the ccnstttcticn
;"d ":;; of Lui.Ldinge,"*rd ^iy be"euapend'ed or rbuokec at ctry Lime upon vic-
ta.tion of any prcoieiona of eaid ondinancea'
tzA
ITotal Clnrgea
Buitding Pemrit
State
S.D.C. 1.5 t
NO FgE CHARGE Plumbing Permit
Ilo De?Eon ahall conattwct, inetall, alter ot clunge -cny nel.cr ezisting
'""t"irt'a1"""tr
"i;;;o;"r;;r; in uhoie or in part, inleas euch pereon is the
i;;;i-;."2'"r;;";Vz;21;; p\'",t;"*'" Li"nn"L, e'xcept that a pe"son nav do
plhi&i "ort, to propn*ty-"Liin- i, oumed, Leaaed o'r opetated by the appli-
cant.
Ftbtt*es
Reailential AU"tnl
Sani Seuen
e€,
/4>
2A
Plwnbi.ng Pernit s2
State
t
Electricol Permit
trhere State tas requit'ea ttlat the electrical uork be done by an glectrical
Ciiti""lir, the elictrLlcai pintion of t'his -pernit etlall rot be valic wttil
the Label -haa
been aigned Ay tne Electrical Contractor'
Neu/Eztend Circuita
Seniee +
cz>
t
NC ECD CIIARGE Mechonicol Permit
,
Eshanet Hoo,1
Vent F@t a-*
Permtt fsaunrce
Neclnnicel Pertt O-5s
a
-. ENCROACEI4ENT --
Securi t
Stonage
Maintenance
Pemnit
:/f-saCutbcu!
2o-52Sida,nlk 2O /
A-arLbFence
LabeL
.2a-?6
Mobile llone
TOTAL AMOUNT NUE:.7a
Total I
Eigned
4.t{-)
/7- 6a
7z?. eo
/v-,?
A v
7<. aollcodstoue
i.;cap t,1.. RESIDENTIAL..
225 North ,rt ,,ronf""o'
N/PERMIT
Springfield, 1regon 97477
Building Diuision
7 26-37 53
SPHINGFIEI.D-
It i8 the reeponaibi-LilU of-tte penrit lpller to see that aLL inopectiona ate nad,e at the ptopet tine, that ecch aditeas is req4abietr*:-W at?ee-t, and that the-pentrit_oatd ia_ Located at the frcnt of the property.rBui!-ding Diuiciot approu'ed pl.an slull yemain on thi i"l,iii"fi- siie at aLL tines.
PROCSDUPE. FOR INSPETION R9QUES?:CALL 7
ne-quested and ahen you oiLL be ready fot,uill be nade the eane dcg, requeste-mZd.e
A,snere nctne and phone
the nett wrking day.
Date:
26-376 9 ( reconder ) state yout Citg designated job nr,onber, job aC<fuess,type of inspecticninspection,Conttactors ot,number, Requeets receitea befxe 7:00 s'taftet 7:00 an uiLL be nade
Iour City Desigr,ated Job Ntnber fs:a qo 7br)
,Iob Location:{r QS {Attf'V?)
Iat Iot #Aesesaors Map fl
Subdioieion:
Asner:
Add.ress:Phone:
ci
Descz"Lbe llotk:t--t
Value
lon
Date of
Bob M
Addition
Renodel
trac lxplres Phone
General
Plurnbin
trica
ectr:clanS
I'lobi Hcnes
Blocking atd, Set-up
Pltnbing connectione -- slrer. otd. uater
Electrical Connection - Bloeking, set-up
and plunbing connections mtst bb apprct;-ed
before requeeting eleclri :al inspee)io;t
Aeceesorg BuiLding
' pcrches, skirting, decks,
Leted.
Final - Afteretc. ate comp
Page 1 of 2
SITE INSPECTION: Io be rmde aftereseauation, but prior tc set up of
IO"mg.
UNDERSLAB PLUMBING, ELFCTRICAL &aMnnnlWng
uork ie eooet'ed.
POOTIN} & F)INDA?ICN: Io be nadeafter trenches a?e eceauated and
forns_ ate erected, but prior topouting ccncrete.
,l
To be nnd.e priot to inetallation offloor ineul,ation on decking.
P9ST AND BEAM: ?o be made priot toinetall,aticn of floor iroulation or
deeking.
ROUGH PLAIIBITIC. ELECYRICAL & MECH-ANICAL:MffilTthese inspeetione hanse been
made atd. appnoueC.
FIPEPL!,CE: Ption to placirg facinanrc.te?ials attd before froning in"pnZ-tLon.
TNSVLATION/VA9OR BARRTER I\\SpECTION :
To be made after aLL insulaticn and
t,equired oapor ban'iers are in plaee
but before any Lath, g7peun boatC ontxLL couening is applied, at.d beforeoty inoulation is concealed.
!.:owD IiICS
Scniloty eeaer eapped at property Line
Septic totk p;tnped and filled urith gra;sel
DRYWALL INSPECTI)N: Tc be nadeafter aLL d.rywall is in plaee,
but ptiot, to cng taping.
MAS2NRI: Steel Location, bond
beons, grouting or uerticals in
accotdotee uith U.B.C. Section
24L5.
WOODSTO"'E:
@npCTA.
Aftet, installation is
Final - l{hen abcue itens are ccrnpleted
and uhen Cqtolition is conplete or atrur-tw,e norted and. pranrtses cleaneC up.
CURB & APPRCACH APPON:ate-iiecieaEii pioi to
eoncrete.
Aftet forns, pourirtg
SfDEilALK & DRIVEIIAI: pot all con-
cr-ete paoittg uithin etreet right-of-,xy, to be nade after aLL Zxea-oating conplete & forn uoz,k & eub-
base rruterial in place.
FRAI.,IINC: litust be requeoted afterapprooal of rough pZwr,bing, eleetri_eal & mechanical. ALL noofingbtaeing A- chinmeye, etc. nuet beconpLeted' llo ucnk is to be eon_'-cecled until this inepectton las'been nade anC approoeZ
!!NcE:gatee
I{hen conplete -- prouiCe
or mozlable eectione through
P,U.E.
FTUAL PLUMBIIIG
EINAL MECHANICAL
FINAL ELECTRICAL
ALL proiect conditions, such aa the installation of stteet trees, co:tpleiiot: of therequined Landsccpir-g' etc. ' tmtst be eatisfied be|ori ttze BUilDii'G FrinL ean be requested..
?rNAL BaTLDTNG: The Pinal BuildittT- Inepection mtet be requested alter the |inal pltnbing
\J Eleetrical, anc aeehanicil i;;p;;;,i7""s iaxe t"ni-rof,n'irra approued.
*ALL MANH1LES AND cLEANours t'tusr BE AccESsrBLE, ADarusnnvr ro BE IL4DE AT No cosr ro cr?)'
cc
u-trL I DRIINAGE: To be nade prior to fil-Lirq trenches.
I
JOB NO.SOLAR ACCESS REQ,-G*
CrottZone:
L-CO
Bedrooms
Iot Sq. Ftg.
/, cf Lct Ccoercge
LOT ?YPE
fnterior
Lot Faces -
P.L House
I of Stot"tes
Total Height
lopography
Corner
Panhandle
C'uL-de-sac
Lace
toDe
-- Pees --
rrru , Frc x Va ue Building Vqlue & Permit
This penfi
L, in
LA gnanted on the exp?e89 cotdi-tion tlwt the said conettwetion'by the city of
the ccnsttucticnstnI1I respects,
ineluding
conforn to the }rdinanee adopted
'.LatingSpringfieLd,the Zoning CYdinance f'egu
ord use of bui
of aily
Ldings, and may be
pncoisione of said
suspended or y,et;okeC at cn!time upon DLC-
Lation Ov'dinanees
TOTAL VALUE
DC
s. D. c.1<6
Bui,Ldt.ng Pernrtt
Date Paid:
State Receipt fl
Total Chargea Signed:
NL)I'EE CIIAR(;E Plumbing Perrnit
No Dereon shall consttttct, instal!, altet or clnnge -any ned-cr ecisti.ng -';ir;br;'"";' d"iilZiZ "iit*, in uhoie or in part' i"1""-:-:-"o-h-p-erson is the
'tZJil_' p"ou"n""on o7" o ,1"t1i pi"^i"r,i LicersZ, eicept that a pe"son nay do
plwnbing uot'k to p"opnltg-"iiii-i" o'*nd, LeZsed or operated by the appli-
cant.
Fictutes
RestdentiaL (1 bath)
Seuer
Plunb:.ng Pernit
State Su'ehange
Iotal
Nau/Esterd Cit't ttits
Electrico I Permit
Whel,e State La r,eqlit,es th,at the electr,ical uonk be done by an Eleotrical
Contractor,, the electrlilc"lf,o"L1o"-o7 thts-per^'tt etla,Ll not be oaliC until
lie Label'las been signed ly the Elecbrical conttacto"'
Seto:'ee
t
Stcte
?otal
NC t;,L CIIARCE Mechq nicol Permit
,s
bhanat HooC
Vent Fot
't'lcodstooe
Perm['! Issuanee
l,leclnr.icel Permtt
TNCROACHMENT --
Secaritu DePosit
Sto"age
l,hintenance
Petwtt
Cvtbeut
Sidasalk
LL
Nobile Hone
Date'Pf,an Eoaninez'
rHAwIAREEULLyEOAMINEDtheeompletedaoplicationforperlnit'anddo
het'eby certify th";";L:i-;"i"rryyibn t'enniii is true attl cbrrect' and r
fwther cet'tify that any oit otl uonk perforned stnll be done in accot-
d";;;;"rth' ti'n" onaii,ii'n,*irli" iti Li sp'ti1"tfi*;rX!.ry r:#',frf ,:r1:t-r State of ltegon pertaining to the utork Cr
pt_Ncy tlil:- be nnde ";-;:;'
"i;";i"."" *rt7"7l- pirnission of the Buitdins DL-
ttision. r further eertify the-t -only oonliit'to"" and enplcyeee uho ote in
;;;1.i;"";'rttt, ons-iot"ois "t'tt be- ueed on thie pnoieet
?otaL
T7TAL AM)UNT DIl:*
te
&"Vp L/ (-s 6> s R^+
89813 Sprague Road . Eugene,
(s03) 343_8796
)\-4..\
BLOOMER'S NURSERY
Oregon 97401
To >id i -iJ(l-,'87
Address
City
INVOICE
,-jL,i7 5?II i'Eir frJbil)y,\ JPo LZ
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5
t7-03-33-14 Tax Lot 00904
675 Rayner Avenue
PETITION FOR ANNEXATION AND CONSENT
TO ANNEXATION
To: City of Springfield, Lane County, Oregon.
The Petitionerr Edward A and Arlene S. porth
petitions,
1.
outsi de th
consents, and represents as follows:
Real Property:The undersigneO Petitioner(s) owns real property locatede Ci ty I 'imi ts , but located within the adopted Urban Growth Boundary
depicted in the Eugene-Springfield Metropolitan Area General Plan, here'in referred toas the Property and more particularly described'in Exhibit "A", attached hereto and
made a part hereof.
2.
Petitioner(s)
Consent
and ORS
Irrevocable Petiti on and Consent to Conti uous Annexati on:
ere v rrevoca ype t ons an consents to cont 9uOuS annex
The
ofthe Property to the City of Springfield pursuant to ORS 222.170. Petitioner(s)petitions, consents and agrees that the City Council in'its sole discretion, now orat any time hereafter, ffidJ adopt a resolution'initiating contiguous annexation under
ORS 222.170 and ORS 199.490 (2) or any other state statute, a proceeding to annex the
Property to the City. The Pet'itioner(s) consents to inc'lud'ing in such proceeding anyother property the City Counc'il may direct or wh'ich the owner(s) have petitioned and
consented to the annexation.
th at th'i s
oRs 199.490
at'i on
Petiti on and(t)(o) & (c)
Peti ti oner'( s ) understands, consents, and agrees
may be used by the C'ity to meet the requirements of
lee.4e0 (3)(b) & (c).
Pet,itioner(s) also irrevocably authorizes the City to present this Petitionand Consent to the Lane County Local Government Boundany Commission to init'iate any
minor boundary change under ORS 199.490 (1) as an interim measure to pnovide service
to the Property prior to its annexation to the City.
In consideration for this Petition and Consent Agreement, the C'ity agreesthat the Petitioner(s) Propenty may receive municipal senvices from the City and
Petitioner(s) may undertake the development of the Property in accordance with the
Springfield Development Code and other applicable City p1ans, policies and standards
and w'ith the requirements of Lane County.
3. Binding on Successors: Petjtioner(s) agree that Petitioner(s) and
Petiti oner(s) heirs and successors 'in interest 'in the Property shall be bound by this
Petition for Annexation and Consent to Annexation which shall run with the Property,
and that noti ce of thi s document wi I I be recorded by the C'ity 'in the deeds and
records for Lane County. A copy of the not'ice has been executed by the Petitioner(s)
and is presented herewith to the City.
4. New Use: Petitioner(s) must obta'in C'ity's approva'l for any new use, changeof use, ffins'ification of use of the Property. The C'ity will grant approval of
the use if it 'is in compl'rance with the Springfield Development Code and other
applicab'le p'lans, pol icies, and standards as interpreted by the C'ity.
t
5. Cost of Serv'i ce i n the Event Annexati on Deni ed : If an admi ni strati veagency or court of competent jurisdiction determinei tnat the Property or part of it
may not be annexed to the City or that the City may provide no serv'ice to theProperty or the part, the City may retain all consideration theretofore paid to the
Cit,y for serving the Property and may collect in addit'ion thereto whatever additional
considerat'ions are due the City fon services the City has pnovided pnior to thedeterminatjon that the Property may not be annexed to the City or the City may not
provi de servi ces to i t.
6. No Limitation on Fi rst Amendment Rights: Althou gh this Petition for(s), and may be usedAnnexat i on and Consent to Annexation@ Petitionerfor the purposes for which Petitioner(s) has agreed, nothing herein shall be
construed as limiting or inf ringing upon Pet'it'ioner(s)' right to speak out, comment
upon, or present arguments regardi ng the advi saoi I i ty of proceedi ng with the
annexation proceeding. It is specifical ly understood by Petitioner(s) ttrat in
executing this Agreement, d Situation may arise wherein Pet'itioner(s) may be opposedto the annexation and would have all rights under the First Amendment to articulatethat opposition but the Petition and Consent of Petitioner(s) as contained hereinwill be used for the purposes herein descrrbed by City in order to achieve and
demonstrate compliance with ORS 199.490.
7 Provision of Services:In execut'ing this Petition and Consent'it is
speci f i cal ly understood that any annexation sha l'l be contingent in its appl ication to
any particular annexat,ion request upon the annexing City, within a logical and
reasonable time, to provide key urban facilities and serv'ices,'including, where
appl'icable, sanitary sewers, solid waste management, water serv'rce, fire protection,police protect,ion, panks and recreat'ion programs, plectrical service, land use
controls, communication facilities, publ'ic schools on a district-r^ride basis (in other
words, not necessarily within wa1king distance of all students served), paved streets
with adequate provision for storm water run-off and pedestrian travel.
the
the
8. Application: The C'ity shall not levy assessments, taxes or fees against
consei'tTn3-6--T-ndowner not app li ed to properti es of s'imi lar character throughoutrest of the City.
rh
DATED th i s day of 19
oner
oner
ACCEPTANCE BY CITY:
The City of Springfield hereby accepts Pet'itioner(s) Petition for Annexation and
Consent to Annexat'ion and by this acceptance acknowledges this as an Agreement
meeting the requirements of Lane County Code 10.183-05 through -55.
ve opment rector
the City offiipat corporation of
ref erred to as "C'ity " , on the 4f day of
Porth , herei nafter referred to aE
into an agreement governing an annExEtion to theTax Lot _lf-03-33-14 - Assessor's Map 00904
. NOTICE OF AGREEMENT
NOTICE IS GIVEN THAT Edward A. porrh
N TNESS t,lHEREOF
675 Rayner Avenue
and Arlene S.
t,one r S , and
e Stat of Oregon, hereinafter
19 F1 , entered
idencified asreap ro pe rty
i s attached as Exhtbir "A" and incorpora re erence herei n.
a legal description of which
, the parties hereto have set their hand and seal this ,/
The use and development of the above property is governed by the terms andconditions of the agreement signed by the parties. The agreement is fi led in thecentral files of the City, to which reference is hereby made for all matters andthings therein contained. This Agreement is binding on the PeUitioner(s)'heirs,
assigns and successors in interest in the property.
I
day of Ie 87.
--iF-
By %4
d--'Vf
Dat e
Byr ve opmen e
D c
By:.
r
STATE OF OREGON
County of Lane
ss.
0n
not a ry
,lbTiffi-day of
the sa'i
thi s ,1
pe
g_ff_, before me, the undersigned,
rsonal ly appeared the 'wi thin named
known to me to be the the
a cou an a 6S
and
nt ca ind v ua s escri be herei n and who executed the same freely and
vol untari ly.
IN TESTIM0NY WHERE0F, I nave hereunto set my hand and seal the day and year last
above written
a
My Commission Expi resl- /-843
)
)
)
/'ar 87ezaaSmruo ue:D uGD
La,ne County Authori zattot:r for'FOR OFPICE USE ONLY
wApplication/
Permit *
RANGE2 CTION
appJ,icable I,OT,PAF.CEI BLOCK
PRCPOSED USE OP PROPERTY
Fl Residential I r.,d,rntri.l
f]euu:.i"Commercial
IO}J ZIPI,OCA CITY
,Y ON
. BE SPECIFICDESCRIPLD VALUE
S or s
VZr/ 1 Proposedisting
S NAME AND ADDRESS TELEPHONE NUMBER
CONTRACTORI S AND TELEPHONE NWBER
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't
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idlng
as cor(ecC
and
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and that I
Oregon
I fur-
AND
I HAVE CAREFULLY EXAMINED aHE COIIPLETED APPLICATIOII l'OR PERMIT, arrd ,lo hcre):,v certify that all infomati
have the following Legal interest in the property,f]or.". of record; f]ccnlra,,t. furchaser;Iauthorized
I f:rther certify that any and all work perfomed shal1 be done in accordaitr:r: wilh thr: ordlnances of Lane
pertaining to the wolk described herein, and that NO OCCUPdNCY will be made of ari strtlcture without the
ther ceru.fy that registration with the Builder's Board is in fulI force and effect, as required by oRs 7ot
i.s noted hereon. and that only subcontractols ad emp),oyees who are in compliance with ORS 701.055 will be
CHECKED THIS APPIICATION THOROUGITLY.
NAME (please print)
READ THIS SECTION CAREFULLY, YOUR AUTHORIZATION I{AS BEEN BASED ON TIIE FOLLOWING
COI'OIENTS:
ParceI Sir"_
Date:
Installation Record Issued? f] v"" I n"
Maximun DepthLineal Feet
of Trenches /o^l* R,l
Date:
COM}IENTS:
rear
.t
teq.3 t)
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DaLe
tr
tr PLANS EXAMINATION:
front
of Dra infiq 1d
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SANITATIONT s. I. *
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COM}lENTS
calLon
Tank
P.
IInstallation
Specifications:
ct, uid.- interior,
fl pmuuruc,zzoNrNG:
Minimum setbacks, "",
zone- Partition #- Parcel #.
BY BUILDING OFFICIAL,/DESIGNEE cer ORS 456 DATF
COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT D]VISION, 687.4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION cL4-25 R*
'1UWi\5Hl P/7 lAx Lo'r', J lou'i' oF
AA?D y'
=\\
SETB.\CXS AND OTSER CC:iDITIO\S OF APPROI,/AL T1UST BE STRICTLY OBSERTIED. VIOLATION CAN RESULT IN REVO-
CnTION OF ?riIS pE:11.11T, CIT;T1C:; UND:R PITOVISIO).1S Oi LAI.,E COUjTY'.1 INFRACTION ORDINAT'CE, AND,/OR OTHER
RE)IEDIES ALLOWED AY LAd.
hHEN READY FoR INSPICTIoN, CAL:687_.1055. A YINI}1U}1 OF.1T LE;\ST 24 I1OURS ADVAIiCE NOTICE FOR INSPEC-
T uE cJViN- rr:lr6-EhE--iollowing informarion .eedy: permit number, lob address, type
of inspecEion, when it wrlI be ready, your name end phonc number, and any special Cirections to site-
BUlLDING DIVISION:
REQUIRED II.SPECTIONS :
I- Foundation Inspectlon: To be made after trenchei are
mate!ia1s Ior the founCation are.iel.ivered on the lobpl,ant (comonly termed ''transit mixed") is to be used
2. Concrete Slab or Under-aloor Inspection; To be maie after alf in-slab or under-floor building
sEi-vi* equipm*t, co:urrc, prpm.l ressorres, and other ancillary equipment items are in
pl-ace but betore any concrete is poured or floor sheathitg installeC, ancluding the subfloor..
l. Framing & Insulatiol lnspections: To be made after the roof, aIl framing, fire blocking, and
blacing are in:rl-ace and all cipes, fireplaces, ciimneys, anC vents ale complete and aII rough
electrical and plunbing are approved. Al-l wall rnsulation anC vapor barrier are 1n place.
Lath and/or cypsum BoarC Inspection: To be made ar-ter a1I lathing and qypsum board, interior
and exterior, is in pLace bul before any plastering i.s appiied and beiore gypsw board joj.nts
and fasteners are taped and finished.
Final Inspection: To be made after the building is conplete and before occupancy.
APPROVAL REQUIRED. I.Jo work shall be done on any part of the building ox Structure beyond the point
-indicated in each success-ive inspection without first obtainang the apploval of the building off:cia1
Such approval shaLL be given cnly aft€jr an inspection shalL have been maCe of each successj-ve step
in the consLruction as indi.cated by each of the inspecticns.required.
NOTE: AII building permits require inspections for the work authorized, such as but not limi-ted to:
A. Block I,laIL: To be made af+.9r reinforcing is in ?Lace, but before any grout is poured. This
Ini-pectl6i is required for each bond beam pour. There will be no approval until the plumbi.nq
and electrical inspections have been made and approved-
B. hrcod Slove: To be made after completion of nasonrv (if applicabLe) and when installation is
com-pIet4 lnstallatlon shall be in accordance ej.ti an approved, national-ly recognized testing
agency and the manuiacturerrs installation j-nstructions.
excavated and forms erected and when a11 -
i{here concrete from a central nixinq
materials need not be on the iob.
c Mobil-e Home: An inspection is required after the mobile home is connected to an approved
sewer or septic system for setback requirements, blocking, footing connection, tiedowns,skirt-ing. and plwbing connections.
1. Footings and piers to comply with State foundation requirements for mobi-1e homes or asrecomended by the manufacturer.
2. Mobile home minimum finish floor elevation shal1 be certified when required by a flood-plain managenent Ietter.
3. MobiIe home tiedowns, when requi-red, and skirting shaLl be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns aod skirting shall be installedper enclosure.
D. swiming Po_o1: Below grade when steel is j-n place ano before concrete is poured. Above graderhen poo) is insraIIcC.
APPROVED PLANS ltusf BE ON THE JOB SITE AT ALL TIMES DURTNG r^IORKING HOURS. THIS PERIIIT WILL EXPTREIF h'ORK DOES NOT BEGIN WITH]N 1BO DAYS, OR IP I,IOR( IS SUSPENDED OR ABANDONED FOR I1ORE THAN IBO DAYS.
SUSPENSION OR REVOCATION i,1AY OCCUR IF ?HIS PERI,IIT WAS ISSUED ON THE BASIS OF INCOMPIETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POII,IT OI REQUIRED Itr\SPECTIONS i{ILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEIdAGE DISPOSAL SYSTEMS:
t. Permits sha1l. be effectrve for one year fron the date of issuance.
2. Upon completing the construction for which a pernit has been issued, the permit holder shaltnotify the Lane County Department of PIannj-ng and Comunity Development by submitting theinstallation recoxd iorm. The Department sha1l inspect the construction to determine if itcomPlies with the rules contai-ned in this division. If the construction does comply with suchruIes, the Department sha1l issue a certificate of satisfactory completion to the p;rmitiholder.If the construction.ioes not comply with such rufes, the Departsent shalL notify the permitholder and shal"1 requrre satisfactory comDletion before issuing the ccrtificat;. Failure tomeet the requirements for satisfactory completron uithin a reasonable time constitutes a vio-lation of ORS 454.605 to 45q.745 and this ruIe.
S-glblSkr - Subrurfrcc S.rd- DrrposdI
Septic Tank Drainfield
lnLerior prcpert./ llics
ECAe of road r1.;itt-of-way
Burldrng foundation
irel]s, othcr water sources
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