HomeMy WebLinkAboutPermit Building 1985-12-066llr-.-
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. FOR OF'PICE USE ONLY
ApplicatiPermit #
IDM;SHIP
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SJBDIVISION/PARTITION (if applicable)I,OTIPAi?.CEL
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BLOCK
PROPOSED USE OT PROPERTY
ftesiaentiar nrnaustrial
I e,ruri-"Commercial
CITY ZLP
,ION OF DECI"ARED S VALUE
# OF EI'IPf'CryEES,Z/D€I^JA''ER SUPPLY P roposed
NAME AND ADDRESS
{-T,ELEPHONE NUMBER4ff,-fa/fzI
have
1S
, and th* }lo OCCUPANCY will be nade of ail str{cture
md enployees who are in
CHECKED THIS
fomati1n hereonon t and correct thatand I
agent
of Statethe oofLanetheandLawsCowty
the pemission of the Building Division. f fur-
with the Builder rs Board is in full force and effect
done in accordal)ce with the
r;
701.055, that if exenpt the basj.s for
AND
arrd tlo hereLy certify
; f contra.,t. prrrchase
be used on this project. I HAVE
fl pmrwrxc/ZoNrNG:
77ry
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on Record rssued? fl vu" fl u"
Maximurn Depth
of Trenches
Use
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re ar
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Id
COM.NIENTS
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Parcel size
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caIlon
sDecifications: Tank
cold\lENTS
/2/at?Z.arrb
Date:
Insta
PLANS EXAM]NATION:
COMI'IENTS:
interior 1f I
partition # Parcel *
c .-L, srde
zonu iQ/7
rront L/O /Minj.murn Setbacks, "",
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BUILDING OFFIC Der ORS 456.805 1))DATE
NTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EASTSTH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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READ THIS SECTION CAREF'ULLY.
SETBNCKS AND OTIIER CCIiDITIO!]S OF APPROVAL:{UST BE STRICTLY OBSERVED. \'IOLATION CAN RESULT IN REVO-
C.:'?ION OF lllIS PaRMIT, CIT,-{TIO:i UNDsR PROVISIONS OF LAN"E.:(]U\TY':; INFRACTION OBDII;.\NCE, AND,/OR OTIIER
REi!]EDIES ALLOWID BY LAW.
wHEN RE.\DY FOR Il,lsPICTION, CALL 687-11065. A UINI]1U11 OF AT LEiiST 24 IIOURS ADVAiICE NOTICE FOR INSPEC-
ffir:*.'-la]rrthefoILowinginfornationready:Fcrmitnumber,jobaddres5,type
of inspecLion, when it wilt be ready, your name and phonc nunber, and any special. directions to site.
BUILDING DMSION r
REQUI RE D I:.S PECTI ONS
L. Foundation II:!SSE9!, To be made after trenches are excavated and forms et'ected and uhen aII
ni;Ee;l;Is for- tire foundation are delivered on the job- I{here concrete flon a central mixing
pLant (comonly termed "transit mrxed") is to be used, materials need no! be on the job.
2. Concrete Slab or ljnder-aloor InsDecLion: To be made after all in-slab or under-floor bui].ding
EEivIre eliJ-rpmmt, cxciLnt, pf[ing rcrcssor1es, and other ancillary equipment items are in
place but betore any concrete is poured or floor sheathing lnstaIIed, including the subfloor.
3. Framing & Insulation Inspectibns: To be made after thd roof, all framing, fire blocking, and
bracing are in p-Iace anci a1I pipes, filepIaces, chimneys, and vents are complete and alI rough
e.lectrical and plumbing are approved. Al1 waLl, insulation and vapor barrier are in p]ace.
4. Lath and,/or qllM Board Inspection: To be made after all lathing and qypsum board, i.nterior
and exaerior, is in place but before any plastering is applied and before gypsm board joints
and fasteners a_re taped and finished.
5. Final Inspection: To be made after the buil-ding is complete and before occupancy.
APPROVAL REQUIRED. No work shall be done on any part of Lhe building or Structure.beyond the poinL
indicated in each successive rnspection without first obtaining the approval of the building official
Such approval shaII be. given cnly after an inspection shall have been nade of each successive step
in the construction as indicated by each of the inspections required.
NoTE! A11 buifding permj.ts require j.nspections for Lhe qork authorized, such as but noc limitea to;
A. Block I"laII: To be made after reinforcing is in pl-ace, but before any grout is poured. This
ii'-pecEi6n is required for each bond beam pour. There uil1 be no approval untj,I lhe plmbing
and electricaL inspections have been made and approved.
B. lJood stove: To be made after completion of masonrv (if applicable) and when installation is
@Ielt Installation shalt be in accordance with an approved, natj.onally recognized LesLing
agency and the manufacturerrs installation instructions.
C. I'lobile Home: An j.nspection is required after the mobile home is connected to an approved
EEilrei-Feptic system fo! setback requirements, blocking, footinE Gonnection, tie-downs.skirting, and plwbrng connections.
Poot.ings and pj.ers to comply with Stale foundation requrrements for nobile hones or asrecomended by the manufacturer.
l,lobile hone mj-nimum finish fl-oor elevation shaLl- be certified when required by a flood-plain management l"etter.
tion wiLhin at' Ieast 30 days afLer occupancy. Tiedowns and skir tinq shall be insla
ready for inspec-.IIedenclosure
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING !'ORKING HOURS. THIS PERMIT WILL EXPIREIF T4ORK DOES NOT BEGIN WITHIN lBO DAYS, OR IF VJORK IS SUSPENDED OR ABANDONED FOR'FIORE THAN'180 DAYS.susPENsroN oR REVOCATTON I4AY OCCUR rF THrS PERMTT WAS fSSUED ON THE BASTS. OE..INCOMPLETE OR ERRONEOUS
-INFORMATION.
ANYONE PROCEEDTNG PAST THE POINT OT REQUIRED INSPECTIONS WILL DO SO AT THEIR.OWN RISK.
SUBSURFACE AND ALTERNATIVE SEI{AGE DI S POSAL
I
2
3
I. Permits shall be effective for
2. Upon completing the construct
complies with the rules c
Fron:
the Cate of issuance.
.uobile home tiedowns, when required, and skirting shall be installed and
notify the Lane County De
installation record form,
par tren
ln!ules, the Department shatl issue"b..
If the construction does not comply
holder and shall require satisfacto
meet the requirements for satisfact.o
lation of ORS 454.605 to 454.745 and
Setbacks - Subsurface Sewage DiSposaL
Iiterior propert;, Iines
ECge of road rlght-of-way
Burl<iinq foundation
lie1Is,. other Hater' source.s -
t has been issued, Lhe pernit holder shallty Development by submitling theconstruction to determine if it1n
h
ry completion
t
10'I0l
10,
t0 gjr
truction does comp),y with suchtion to the permi ti holderthe pernit
Failure to
not i fy
f tery completioii'rithis rule -
Sept.i.c Taok
l0'
10,
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Dra i
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Above gradeg*-ls-.ili-rir
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NAME(PLEASE PRI
APPLTCANT ( )owNER ( )
REASON FOR CANCELLTNG PERMIT (OR APPLICATION)
CANCELLATION/REFUNDAUTHORIZATION PERMIT u
CoNTRACTOR( )
ADDRESS
SIGNATURE
FEES pAtD FOR WASTE DTSPOSAL SYSTEMS (S!TE TNSPECTIONS AND/OR APPLTCATTONS TO INSTALL THE
SEPTIC TANK AND DRAINFIELD) ARE ORDINARILY NONREFUNDABLE. SOME REFUND MAY BE ON THE
BUILDING, PLANNING, OR PLUMBING PORTIONS ACCORDING TO THE AMOUNT OF THE PERMIT/APPLICATION
PROCESSED.
FEES PA]D
\
Flood Plain Fee
Building Permit Fee
Mobile Home Fee
Plumbing Permit Fee
Mechanical Fee
Plan Check Fee
State Surcharge Fee
Septic Disposal Fee
Site lnspection Fee
DEQ Surcharge
Land Use Application
Planning Director
Recording Fees
Partitions
Copies & Ordinances
Surveyors
Minus $25. for Processing Fee $
TOTAL AMOUNT TO BE REFUNDED $
o/o
oh
%
o/o
%
%
$
$
$
$
$
$
$
$
$
SIGNATURE
TO DEPARTMENT OF FINANCE:
Building Permit Refund $
State Surcharge Refund $
Septic Disposal Refund $
Site lnspection Refund $
Land Use Applications $
Planning Director $
Recording Fees $Partitions $
Copies & Ordinances $Surveyors $
TOTAL AMOUNT REFUNDED $
2A-1 7-88/Acct. 421201 P rog. 060 Recei pt
1 7-88/Acct. 42124lProg. 060 Rece i pt
1 7-88/Acct. 42133lProg. 060 Rece i pt
1 7-88/Acct. 42134lProg. 060 Rece
1 7-88/Acct. 421 5Ol P rog. 060 Recei pt
1 7-88/Acct. 462021 P rog. 060 Rece i pt
tA-
-24-1
7-88/Acct. 4621 0/Prog. 060
1 7-88/Acct. 4847 4l P rog. 060 Rece i
17-88/Acct. M4l9lProg. 060 Receipt4A
-25-06-74lAcct.
44451 I P rog. 01 0 Rece i
PLEASE MAKE CHECK PAYABLE TO:
NAME
ADDRESS
LAND MANAGEMENT DIV|S|ON / Public Works Department I 125 E.8th Ave., Eugene, OR 97401 (503)687-4061
,/hne cor.rnty
AC ^ rVITY INFORMATIOTT SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
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),.L A,p. fZaz/ -cfiY TTATT- -I[ MDEgfumr(/Q?7_ra/r 7 n -r u/ '-'96 -
BUSINESS TELEPHONE # HOME TELEPHONE #BIJSIIIE-SS_TETEPEONEI HOME TELEPHONE #
2 PROPERTY ADDRESS
( TF DTFFERENT TnO
3 rvrarr Gi PAFIeEL NuMBEn
( REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
tJ, d'"?" b frI" ly _og _a6:1/-
TOI'INSH IP RANGE SECTION
{ueaTAl torft OR-PARCEIT mNING
MuINSE-IP RANGE SEET-IOII
TOilNSEIP MNGE SEETI.ON
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
ffi ZON I NG
W ZONTNF_
ACRES
O ,rrr^ON (if appl icable)LOT BLOCK
5 REQUEST (s:tate exactly what you plan to do)
6 DIRECTIONS TO SITE
** FOR STAFF USE ONLY **
BY:
-
DATE: TIME IN: OUT:
NUMBER
DATE
-l7
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LAND MANAGEMENT DIVISION / 125 E. Bth AVE., L-UGENE, OR 97401 / 687-4061
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ZONE/LAND USE:
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lane ccunty
ACTIVI-rY INFORMATION SI-,EET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
6Tl'
-
I
PERSON MAKiNG REQUEST PROPERTY OINER
MAILING ADDRESS MAILING ADDRESS
DE C iTY STATE Z IP-T-ODE
ffi
2 PROPERTY ADDRESS
HOME TELEPHONE #BUSINESS TELEPHONE #HOME TELEPHONE #
(IF DIFFERENT FRO
3 rvlap 6i rrAFrcEL NIJMBEFI
( REQUTRE! TNFoRMATT0N)
(from tax maps in Department of Assessment and Taxationor from tax statement)
TOINSH]F"R;ANGE SEETMN M ZON I NG
MINSH-IP RANGE SECTToN ffi ZONING
MTNSFTF RANGE SETTMN
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
W ZON I NG
4 SUBDIVISI0N ( if appl icable)
ACRES
LOT BLOCK
5 REQUEST (state exactly what you plan to do)
6 DIRECTIONS TO SITE
ZONE/LAND USE:
** FOR STAFF USE ONLY **
TIME I N OUT:_
NUMBER
DATE
-+Flr1
-{
DATE:BY:
LAND MANAGEMENT DiVISION / 125 E. Bth AVE., L-UGENE, OR 9740I / 687-406I
UOI,D SL:P bne county
APPLICATION #
LOCAT I ON
NAME
3 ? r,r'f,*l;L- r#ADDRESS
7/7
The Lane County Bujlding and Sanjtation Divis'ion cannot proceed w'ith processing
your appf icatjon because:
tr Incomplete application (items deficient).
P sed number of bedrooms
appl i
in dwe 11ing.
Address and/or directions to cation site
provable plot plan (see attachment).
N ot'i f i cati on of date
Verification of existing s
Two test holes (2'x4'
of existing sewage d'i
dra'infields.
u Other:
ired (see a chment) .
x5 ' deep ) req u'i r pansion or repair
sposal system in ea of the proposed
test hol es
i"
yste\n requ
will be ready
2
3 tr
L4
4
i/
144/
/t
, n t'\ ---'
lC ,f:11 L
S I GNATURE DATE
t4 -mrl"u'^ (rffgi- 3 from to
PHONE
If no response has been received in regards to this matter
the appl ication wil I be den'ied.
//- r fa
BUILDING & SANITATION PROGRAM / LAND MANAGEMENT DIVISION
CourthouEe-Public Servjce Bui.lding / .|25 Eas.t 8th Ave. / Eugene, 0R 9740] / (503)687-4061
){6rs'ft
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OFFICE HOURS
t
Mt^{ORANDUM lane county6l!r-.-7
TO
FROM
SUBJ ECT DATE /(-rq-ff
tr Al /,;/, _zU
*ft'irJ, A ,*fu
,*il *r"{ tr @t-t- ;*'7A*
ND AUTHORI; ]ON PERMIT #Ly'6 d- y{
NAME (PLEASE PRI ,l n -r^rnro /8 -o2 -o1"./ /. 6 y4tr
ADDRESS 3? /C P
APPLTCANT ( )owr.ren (4 ooNTRACTOR( )
REASON FOR CANCELLTNG PERMIT(OR APPLICATION)
SIGNATURE DATE
FEES pAtD FOR WASTE DTSPOSAL SYSTEMS (SITE TNSPECTTONS AND/OR APPLIGATIONS TO INSTALL THE
SEPTIC TANK AND DRAINFIELD) ARE ORDINARILY NONREFUNDABLE. SOME REFUND MAY BE ON THE
BUILDING, PLANN!NG, OR PLUMBING PORTIONS ACCORDING TO THE AMOUNT OF THE PERMIT/APPLICATION
PROCESSED.
FEES PAID % REFUND
Flood Plain Fee
Building Permit Fee
Mobile Home Fee
Plumbing Permit Fee
Mechanical Fee
Plan Check Fee
State Surcharge Fee
Septic Disposal Fee
Site lnspection Fee
DEQ Surcharge
%
o/o
%
%
o/o
%
%
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
$
o/o
%
o/o
Land Use Application
Planning Director
Recording Fees
Partitions
Copies & Ordinances
Surveyors
Minus $25. for Processing Fee $
TOTAL AMOUNT TO BE REFUNDED $
SIGNATURE
TO DEPARTMENT OF FINANCE:
Building Permit Refund $
State Surcharge Refund $
Septic Disposal Refund $
Site lnspection Refund $
Land Use Applications $
Planning Director $
Recording Fees $Partitions $
Copies & Ordinances $Surveyors $
TOTALAMOUNT REFUNDED $
.A 1 7-88/Acct. 42120lProg. 060 Receipt
1 7-88/Acct. 42124lProg. 060 Receipt#-
1 7-88/Acct. 42133lProg. 060 Recei.A
1 7-88/Acct. 4213/ll P r og. 060 Rece i pt
Otl 1 7-88/Acct. 42150lProg. 060 Receipt
-24-1
7-88/Acct. 462O21 P r os. 060 Recei
1 7-88/Acct. 4621 0lProg. 060 Receipt#.-
1 7-88/Acct. 4847 4lProg. 060 Receipt#-----
4A
2n-
1 7-88/Acct. 44419/Prog. 060 Recei
--25-06-74lAcct.
44451 I P r og. 01 0 Rece i pt
PLEASE MAKE CHECK PAYABLE TO:
NAME
ADDRESS
LAND MANAGEMENT DtVtStON / Pubtic Works Department I 125 E. 8th Ave., Eugene, OR 97401 (503) 687'4061
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L Coun fort
PERI4IT APPROVED BY BUILDING OFPICIAL,/DESIGNEE (DeT ORS 456.805(I)) DATE
LANE COUNTY DEPARTMENTOF PUBLIC WORKS LAND MANAGEMENT DIVISION,687.4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
QIatt DE,\/E1pQE' I'np TNTqDFa'rFTOr\I T\IErnpMArlaTnN
rlD
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POR OFFICE USE ONLY
on/Applicati
Permit #
I]WNSHIP
/?
**"'
/,*
S'JBDIVISIDN/PARTITION (if applj.cable)LOT//PAi?.CEL
---)
BLOCK
FRCPOSED USE OF PROPERTY
fte"ia"r,ti"r Irndustrial
[-l commerciat n euuric
t-r I i'Y ZLP
7./
STRUCTURES CUFI-ENT{,Y c1r-Vd,z,,
DECI,ARED S VALUE
OF WA?ER _l
ProoosedItxisting
TELEPHONE NUMBER-;;::-"- "-"--"
IELEPHONE NUMBER4fffa/r
L
pertai,ning to lhe work described herein. and that xO OCCUPANCY will be nade of arri' structure
ther certify that registrat.ion with the Builder's Board is in full force and effect
I TIAVE CAREFULLY EXAM
r'7-fsis rcted hereon, and that ud enployees who are in
CHECKED THIS APPLICATION
of the Sta te Ore 9onf:rther
thehave owner recordof rac t.con t rresinte1nttheprrrchaselegalfollowi.ng Prope !that alland work shal 1d donebe accor da:)ceIN tllw1 Fts.,certify any pe rf or-ire
infolTation hereon i and correct, and that I
agent
of Lane Cowty and the
701.055, that j.f exempt the basj.s for exempti
AND
COMPLETED APPLICATION !-OR PERMIT, arrd rlo hereLy certify
the pemission of the Building Division. f fur-
be used on this projec!. I HAVE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION IiAS BEEN BASED ON THE FOLLOWING CONDITIONS!
I pr,euurnc/zoNrNG: zon aQa{ partition #-
?r)77ry
tr->7 -*P
Maximum DepthInstallation
Speci fications of Trenches
Date
PLANS EXAMINATION:
COM}IENTS:
Date
rear
L
colr.[lENTs
t
tur--
t
Record rssued? fl v." I x"SANITATION3 s. I. #P. *
ie ld
Parcel SizeParcel #
Minimum Setbacks:
co|!\1ENTS
Use
GAIION
Tank
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of
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n/{.l//C,.&A
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