HomeMy WebLinkAboutPermit Building 1975-07-14TANE COUNTT-UITDING PERMTT OR MOBITE HOi - USE PERMIT
BUILDING [II;.. MH E PERMIT NO.
owt.tER MAILING PHONEADDRESSI Rrcxurxo SpR r xcr r suo Ongeon
CONTRACTOR MAITING ADDRESS PHONE
S aue
PROPERTY LOCATION _ INCLUDE POST OFFICE
Jrsprn Roro to Rtcxuero
PROPERTY IEGAI. DESCRIPTION _ METES, BOUNDS
Lor I Br-ocr J
i
RANG E SECTION TAX LOT NO,CODE CENSUS TRACT,4./ # bffi
f{rtr- rAr F. BeHxrrr
EXISTING STRUCTURES ON PROPERTYAPPt.
NAME
&
MAITING
ADDRESS
39h1
I.EGAT ACCESS TO PROPERTY
R t cxltno R l cxl lruo SrRtEr
SpR r xor trrD 0aeeoir
PROPERTY SIZE - FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connecl to Existi
TYPE CO UCTION
3o8 I 5.3o
m New
BDR MS VALUATIONSTRUCTURES TO BE BUILT THIS PERMIT
Penurr ro BUTLD EARAeE
SQ. FT
gi 63a.1+o
SEWAGE DISPOSAI
PUBTIC - SEPTIC TANK tr OTHERE
PLUMBING INSTAIIED BY
OWNER n OTHER: NAME
BUILDING
WASTE DISPOSAT
PTUMBING
PI.AN REVIEW
PARK TRAITER
TOTAL
lfsuncxrnoe
$ FEES
$
WATER SUPPTY
PUBUC !N OTHER
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
DRAIN FIEI.D REQUIRED
I.IN. FT TRENCH WIDTH FT,OR SQ. FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTII,. EASEMENT
BI.DG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION
FRONT SIDE INT. SIDE EXT.REAR 5
/s/ ,t.
AUTHORIZED SIGNATURE _ DATE
Snoox/aexrrARtAN t /r\/t>
DATE
BLDG. PERMIT - WHITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PLUMBING _ CANARY
BUITDING _ GREEN
SANITATION _ GOTDENROD
Coll 687-4065 to schedule oll required inspections. All construc'
tion sholl comply wilh Uniform Building Code, D.E.Q. slondords
Ii PORTANT: for subsurfoce sewoge disposol ond counly regulolions covering
plumbing. All buildings require o certificote of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(POsT THIS PERlvllT ON MAIN B[DG. AT SIrE)
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURIHOUSE ANNEX, I35 EAST 6th, EUGENE, OREGON 9740I
ronu * 655-13
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PTRMIT ISSUED TO:
Nome__lcug F.;,-,:r; I l
, l!
Moilingoddress-.- i'L5 'l 5tr:t'- ?','i'J
lr ,toller's nomL. ('. ,')
I rilding pcrmit number
I ropcrty oddress
Tolo! number: Living units tl- Bedrooms J - B,ths / go:cme;ti ycs No
woter supply by: Public sysrem L/ lndrviduol system conrmunrry r;stcnr
Septic tonl: Distonce lrom well Fcet. Motcriol, c,!c.- No of corrrporttlrcnr,,
Totol liquid copocity 7:C, 9ot. tnsidc tength ,?' !/ ii-r;r,.J. *,.f ,n ;
Diometer- - t ,' ' lt. Liquid dcpth / '/' ./ // ,t.
Tile disposol lield: Distribution bor? Ycs i; No Orhcr
Lenglh eoch line l'. - /'rt It. Drstoncc f r,rrn
Torol length ., > i f r. wcil
Width ol trench .] lt. Neorc.,t
lr
i, , r
Totol squore lootogc
Distonce between lines
Type of lilter moteriot . glsysl .(,'t 7
Depth of lilter moteriol over tile .')
SftTCX tSec inltructronr,
(/\
./ ;!.. tt Lot lrnc. ['r;nt !,rlr. -. i'i.,r
Foundutron l, . r
Dt'pth ol l'll,:r nrrrt,t.rr,jl l.rr, rrr, lrl,
7o
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S,9nolur.
lunclron so?isior lr,rrly, ond rs thr r,.l .r r;1, :. r, J l1
LA\t ar.),.'.
FOR USI OT SAIJITA'(IAN. ONLY
Syrtem opporcntly rrll P yill not
Remorks:
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(!o",4i 7-
7
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i..et
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!t 5UrI TO lN0taati r.ioRIHtFLr [r,it.'Tr,'.
'.. .lil i! \i.f...1',i
l,rrrrr^tr a\
ILOING SITE EVALUATION \S
11=5-19
SUBDIVISI,,{:/rr T 18 -o?- sO64,lTAX lOr :!l!]
u.fi, LD r NG
'ERH
r r AppL I cAT t 0N No .
( ) srrE rNsPEcrroN
PLANNING DIVISION
l. Zoning Ordinance Cornpliance: Zone
2. Subdivision 0rdinance Compl iance
3. Requi red Access
4. Bui lding Site (Area, }Jidth, Front
5. 0ther (see cornments )
CK. D
6 Setbacks rorn
Front
. S i de F-"tef iOf .
Setbacks from interior I ines:
LOT:BLOCK:
APPL I CANT
DATE
Not
Aool icablePci-rr()
()
ase) ( )()
4
Nor)
)
es
(
(
(
((Side
Rear
COI{MENTS:
PLANNTNG DIVISION ACTION PENDING:( T N0( )APPLICATIo N#
BUILDING INSPE cT!0N DlvlsloN
Plans Submitted
Soil Stabil ity (footings)
Flood Plain
0ther (see corrments)
Not
7
8
9
0
Aool icable
()
()
()
YesNor)()
()
()
TT()
()
()-)--CKI D BY
COHMENTS:
I'ATER POLUTION CONTROL
I l. ileets Department of Envi ronmental
Qual ity Standards.
12. 0ther (see cornments)
Not
li le Nor)YesrT
() ()CKID BY 7r
DATE
COI.IHENTS:
TO APPLICANT:
,ndbw
Building / Site lnsPection:
Can be approved.
Cannot be aPProved at t
Questions and further i
his time as indicated on item N0.
nformation on items I through 5 con
Questions and further informati
above.
tact the LANE-
on on items 7
t rough 2 conta
NG DIVISI
ct the LANE BUILDING AND SANI OND tvl
ce unt you can reso Pr I emsvet( ) utill be hetd in this of
( ) ls being returned.
c55-28
Your bui ldin
n
N
ca ted.
ermi t I i cation fee s etn
NTAL E
135 Sixth Avenue East Eugene Oregon
PHoNE. eu-4o65
LANE COUNTY PLANNING DIVISION PHONE:
97401
687-4186
n
I
I
)
NOTE: NO PERMIT WILI E ISSI]ED I]NTIL TIIIS APPLICATIOI
APPLICATION FOR:
CONSTRUCTION MOBILE TIOME PLAN REVIEW
PERMTT +/?x- ){
A,S BEEN APPROVED
/,Ji il i Artt tr I39,.tN r Tf 3ci +t R.cllla,vc SPtr D. '? 7 +77 7*7-fitr
Address City zlP Phone
CONTRACTOR
Name Address
o.s. REG. /l
*r. /f *n""-! L-s""t.on o 6 r^*
,"ou;"l" if,Vl*r.,!",. n"r 4
Code Census Tract
B1 o.xE---Jroperty Acreage tlidchfi/oepthJ$3:V
ACCESS TO PROPERfi (Ro L trilD sn
Existing StrucEures on Property:l/o u, 5 *-
property Locarion - Address/DLrectrolst 3r 4 l R ; C /l t A .{ p SfFD. J* < Ptrg fe.O.
Below for Offlce Usez-n--?
S
SEWAGE DISPOSAL:
Slte Inspectlon #
WATER SIJPPLY
Well Spring Other r;x
Exlstlng Sewage Disposal Systern * or New systen Requlred f-l
Public
ComunLty Name of Conmunity or Pub11c Systen 2fu
FEES:
Bldg.
Waste Dlsp.
Pluobing
Plan Revlew
Moblle lloue
1Z Surcharge
PLUMBING:
InsEalled by Owner
PLIIMBING FEES:
---
0ther Name
of Fixtures Sewage
Connection
Water
Connection
PLANS FURNISHED FACILIfi PERUIT,17 [Xcasn .E'us YES EZI-no
nate: Z-Q-?- zS-
NO
TOTAI
Mln. Septlc Tank Capaci
/ 7, :-CHECK Signature of
Fee Recelved By
Dralnfleld..Required - Lineal Maxlmum Depth
css-12 LANE COI.]NTY OF ENVIRONI'{ENTAL MANAGM{ENT
Group Flre Zone Use ClassiflcaElon LTypeof Construction
Bldg Setbacks - from Center of Road Right of Way
,roo. 4c) | slde rnr Rear 5 ?or"-EA-
DATE:DATE:BUILDING:DATE:
- /c
/5
'+o S o. 3e 77 -( e Fi- a,*t P;c g ta^ro /# 4 t, s t
O,{3a
/- ao
.[
a UIANE COUNT'I
BU ILDING I
ITDING PERMIT OR MOBITE HOA
'MH T
USE PERMIT
PERMIT NO.
PROPERTY OWNER MAII.ING ADDRESS PHONE
CONTRACTOR MAILING ADDRESS PHONE
PROPERTY TOCATION - INCI.UDE POST OFFICE
PROPERTY TEGAL DESCRIPTION _ METES, BOUNDS
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPPt.
NAME
&
MAITING
ADDRESS
TEGAT ACCESS TO PROPERTY
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existi Sewo e
TYPE CONSTRUCTION
New
STRUCTURES TO BE BUILT THIS PERMITt SQ. FT BDRMS VALU ATI ON
SEWAGE DISPOSAT
PUBI.IC N SEPTIC TANK N OTHERE
PTUMBING INSTALTED BY
OWNER n OTHER! NAME
r),,*
BUITDING
WASTE DISPOSAI.
PTUMBING
PI.AN REVIEW
PARK TRAITER
FEES WATER SUPPTY
PUBUC tr tr OTHER
I
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: G,A[.
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIEI,D REQUIRED
LIN. FT TRENCH WIDTH FT OR SQ. FT
TYPE OF STRUCTURE OCCUPANCY ZONE PUB[IC UTIL. EASEMENT
\
BLDG. SETBACKS
FRONT
FT. FROM CTR. OF ROAD RIGHT OF WAY
SIDE INT. SIDE EXT.
USE CLASSIFICATION
REAR
F
AUTHORIZED SIGNATURE - DATE DATE
$
BLDG. PERMIT _ WH ITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PTUMBING - CANARY
BUILDING _ GREEN
SANITATION _ GOTDENROD
Coll 687-4065 to schedule oll required inspeclions. All construc- 1
lion sholl comply with Uniform Building Code, D.E.Q. stondords-.1
IMPORTANT: for subsurfoce sewoge disposol ond counly regulqlions coveringr Jplumbing. All buildings require o cerlificole of occuPoncy before\!\
being occupied
Detoirs q"n Re.verse side)
(POsT TH|S PERMIT ON MAIN BIDG. AT SIIE)
IANE COUNW, DEPT. OI ENVIRONAAENTAT ATANAGEMENT
COURTHOUSE ANNEX, I35 EAST 5Th, EUGENE, OREGON 9740I
ronu -- 655 - 13
-
tE-
s
SITE INSPECTION
Ap pnov r o
Reuenrs
D r srppRovro Dare I nsprcron
FOUNDATION INSPECTION
AppRoveo
Rsua nx s
D Drsaepnovrl D Dare I ruspecron
FRAMI NG
AppRov e o
Re uaRx s
I NSPECT ION
D Drsappnoveo D DarE I Nsprcron
LATH OR SHEETROCK
Ae eRov E o
RExanxs
I NSPECT I ON
DrsnppRoveo Drr r I rsercton
FINAL INSPECTION
AppRov Eo D r s appnovEo
Reuaax s
CERTIFICATE OF OCCUPANCY
Reeov ro lssuE
Rruanx s
D Nor Rerov ro lssuE D
Dar E I ruspectoR
3 7t//
Dare I Hspecron
,
\ri,
DATE:a)
TO:,LL'ITA BAPP ElI I
ADDI{ESS:
1P3 t r4r rE LD*Oa, ? 7q77
SuBJECT: Buildins Permi t * t}3k2{
r'rap: lE-- OL:Q[-rax Lot ti t-q!i^tl{.o&?3ttf ao0 to ttrLl,erstTrAn,tr,
Th'is letLer is to inform you that an inspectjon has been made at the above-s'ite, whic.h indicated thc structure and/or bujlding authorized by building
permilu # Wg-E.as not built.
Therefore, since no construction was begun within lB0 days the above noted
pemit is nuil and void. Before any construction may start a new permit
must be applied for and jssued.
If you have any questions regarding your permit cancellation, p'lease feel
free to call our of,fice.
>A Ss,"Q
JOHN S. SMEtD, Bu'i I di ng Off i ci a1
Buildjng & Sanitation Divjsion
JSS/ J bW lel ec 9o'LT-iei )'P\ LAI^B
A9 PorED oo)"fctr,i A-?-gi*
>42
tSo\oz-
Springfield Utility B o ard
INSPECTION FORM
q l\ -r L{-gtlACCOUNT NO.AUDIT DATE
INSPECTION DATE TET)2s t we/D) 3OlNSpEcrr oN No.INSPECTED BY
REINSPECTION DATE-TIME-INSPECTION NO.-INSPECTED BY
cusromen's NAME OWNERS NAME 4
ADDRESS ADDRE SS
ZIP CODE
8335.1&11!l(r-B
(
USINE
HO NE
SS
STATE-zIP coDE
owruen's PHONE _
NO. OF UnrrS )LOW INCOME BUILDING TYPE ALL MEASURES coMpLETED_-cHEcK To o/c
KWH SAVED
PREVIOUS INSTALLED MEASURES PREVIOUS REIM. TO CUSTOMER IAQ SUBTOTAL
MEASURE AR EA KWH CO ST RE I MBURSEMENT
6 uro*, *,,uro*,/s-20
fr PATIO/FRENCH DOORS 4oh 4oo
;.WALL INSULATION aeb /of
;. CE lL I NG INSULATION
R.ADOEO2A zsral ,/f23
)M9R TNSULATToN /24y'WEATHERSTRI P
DOORS / WIN DOWS
CAU LK I NG
SEAL DUCTS
DUCT WRAP
C LOCK THERMOSTATE
OTHER
TOTA L
COMMENTS:
TOTAL REIMBURSEMENT
/23-e{DAT E
INSTALLED MEASURES APPROVED
FOR REIMBURSEMENT BY
zo
lii
.,,
'*4