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Home My WebLink AboutPermit Building 1974-01-03LANE COUNTY BUIIDING -DEPttllr OR MOBIIE HOwrt USE PERMIT BUTLDTNG I MH l_] PERMIT NO. PROPER-iY OWNER MAITING ADDRESS PHONE CON MAITING ADDRESS PHONE PERTY I.OCATION _ INC POST OFFICE PERTY LEGAT DESCR N - METES, BOUNDS RANG E SECTION CODE CENSUS TRACT 3 ,2e EXISTING STRUCTURES ON PROPERTYAPPT. NAME & MAII-ING ADDRESS TEGAT ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewoge Syslem New System TYPE CONSTRUCTION SQ. FT BDRMS VALUATION SEWAGE DISPOSAI. PUBr-rC tr SEPTTC TANK D OTHERE PLUMBING INSTALTED BY OWNER E OTHER: NAME BUITDING WASTE DISPOSAT PLUMBING PI.AN REVIEW PARK TRAITER FEES WATER PUBLIC SUPPI.Y il tr OTHER TOTAT COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIEI.D REQUIRED IIN. FT TRENCH WIDTH FT.OR SQ. FT, TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT BI.DG. SETBACKS . FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG, PERMIT _ WH ITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PLUMBING _ CANARY BUILDING _ GREEN SANITATION - GOLDENROD Construction to comply with uniform building code ond counly covering plumbing ond sewoge disposol. All buildings require of occuponcy before being occupied. (See Stotement on Reverse Side) reg u lotions o certif icote (POST THIS PERMIT ON MAIN B[DG. AT SIIE) I.ANE COUNTY, BTDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I roau f c55-13 C:E: TAX LOT NO. --1 .o $-- .'frBU I LD ING S ITE EVALUAT ION lrye r-gla@s,g/4Ax Lor- CENE''S TRACT Br.ilding Permit Applicat io^ no. i4O:{?3 4__ APPL I u6-0*,3 Nr\hE ADDR S PHONE oarc /,1 )( ( ) Site !nspection ( ) Pre-Permit lnvest igat ion L/.NE COUNTY PLANN ING DEPARTHENT NOT NO YES ({dd ({ NAI1 E Di\TE I . Zon i ng Ord i nance Comp I i ance aool icable*rr( ) 2 (Zone Subdivision 0rdinance 'R-/ ) Comp I iance ( 3. Requ i red Access 4. Building Site (Area, tridth, Frontage, Setback) 5. 0ther (see comments) () ) () () () () .z l,'&-,-. , ) CO}AHENTS: BUILDING INSPECTION SECTION NOT NO NAHE aool icable*rr-(YES ( () () 6. Pl ans Submitted 7. 'Soil Stabil ity (footings) 8. Flood Plain 9. 0ther (see Cornrnents) () w # ) () ()) CO}AHENTS: SAN ITAT ION SECT ION 10. Sewage Disposal I l. Usable Area 12. l,/ater Supply 13. 0ther (see Corrnents) NOT NO YES N E DATE aool icable*rT-( ) )) ()( () () ()) COI.1I4 ENTS TO APPL I CANT: kr() Your Building Permil / Site lnspection can be approved . /'3 -71 ry-Cannot be approved at thls time as indicated on itenl N0. above. Quest ions and f urther infornrat ion on -l ten,s I through : col'tact tt"re Lane--. C0UNTY PLANN ING DEPARTIiENT" Quest ions .rnd turther infornrat ion on iG; 5 throuq h lJ contact the Lane Cotir ,!f_e_g i I d i ry_1ircl__5an [-r at ion D i v i s ion. Wil I be held in this o{ict' unt i I yor.r can re:,olve t lre problenrs ind icatt:d. ls being returned. Your buildinq pernrit appl irat ion fee is being returned under separate c'ver ()() () LANF COTIN'I Y I'I i\NN ING DEPARTI4ENT llf Si,xtlr Avcrrue Iast, Eugerre, 0regon 97q0 I l.nrrNE 3112. lill CXl.23l l^Nt': C0UNIY til.,ltl)lNG E S/\NlTATl0N DlVlSl0N l3t Sixth Avgrrur: East, Ertt;err,', 0reqon 9740 I ,'llt)Nl:142-t1la txf. qll M55 - CANT: () ??' pAT! IANE COUNIY BUITDING PERMIT OR MOBII.E HOME USE PERMIT MH I PERMIT No.BUILDING P PERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCTUDE POST OFFICE PROPERTY TEGAL DESCRIPTION _METES, BOUNDS RANG E SECTION TAX LOT NO.CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPL. NAME & MAITING ADDRESS TEGAL ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connecl to Existin Sewo TYPE CONSTRUCTION New BDRMS VALUATIONse. FT SEWAGE DISPOSAT PUBTIC tr SEPTIC TANK tr OTHERE PTUMBING INSTALIED BY owNER n oTHER: NAME BUITDING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAITER FEES WATER SUPPTY PUBUC !tr oTHER *-------- TOTAT COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT.OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTII.. EASEMENT BTDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY rRONT SIDE INT. SIDE EXT. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG. PERMIT _ WH ITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PLUMBING _ CANARY BUITDING _ GREEN SANITATION _ GOTDENROD Construction to comply with uniform building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificqte of occuponcy before being occupied. (See Stotemenl on Reverse Side) (posT THIS PERMIT ON MAIN BIDG. AT SITE) I,ANE COUNTY, BIDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu :1 655 - 13 SITI INSPECTION AppnovEo ReuaRx s Dr sAPPRovEo Dar r lr.rsprcron FOUNDATION I NSPEC ON D rsAPPRovE o Fa Dare l-r, t "'; t .1'- lruspe cton ,- 'Ap pRov e o Rruanxs FRAM I NG App Rov r o Reuanxs I NSPECT I ON Drslppnoveo Darr I ns ee cron v LATH OR SHIITROCK AppRovro REuaRx s I NSPECT I ON Dr sappRoveo Dar e I NsPEcroR FINAL INSPECTION Ap PRov e o Rruanx s DrsnppRoveo oorr3't'71/I NSPEcToR CERTIFICATE OF OCCUPANCY Reaov ro lssuE RrulRx s DarE prrrf e(o tr flz /fu/r"41 I ruspectoR l, d D Nor Rraoy ro tssuE D IANE COUNTY BUIIDING PERMIT OR MOBILE HOMc USE PERMIT BUTLDTNG E MH tr PERMTT NO. PROPERTY OWNER MAIIING ADDRESS PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY TOCATION _ INCTUDE POST OFFICE PROPERTY TEGAT 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 Existing Sewoge Sysrem ! New System I STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ, FT. # BDRMS VALUATION SEWAGE DISPOSAL PUBTIC tr SEPTIC TANK E OTHERE PTUMBING INSTALTED BY OWNER ! OTHER: NAME FEES WATER SUPPTY PUBUC n tr oTHER BUITDING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAITER ( TOTAL COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. 8OX: GA[. DRAIN FIETD REQUIRED I,IN. FT TRENCH WIDTH FT.OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT BI.DG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BLDG. PERMIT _ WH ITE OFFICE COPY - WHITE COUNTY TAX _ PINK PIUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOTDENROD Conslruction to comply with uniform buildin covering plumbing ond sewoge disposol. Al of occuponcy before being occupied. (See Stotement on Reverse Side) (posT THIS PERMTT ON MAIN BLDG. AT SITE) LANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I code ond county regulotions buildings require o cerlificole s I ronutg55-13 $--- ft#B FLOOR PLUMBING GROUNU/ORK AppRovEo N Rruanx s D oo,r1l_ff-_b_Dr sappnovro GAS PIPING GROUND/ORK AP PRov E D Reur nx s D Drsappnovro D Dorr_I Hspecron ROUGH PLUMBING AP PRov E D REuanxs Dr sappRoveo oort/'23'2?N lrspe c ROUGH GAS PIPING Appnovro D DrsAppRovEo D REuanx s Dar r I Nsprcton FINAL PLUMBING Appnoveo /n DrsappnovED7--' Rruanxs oare f'l/-2a lruspe c FINAL GAS PIPING AppRoveD D Drsrppaoveo D Re uanx s Darr I rusprcron CERTIFICATE OF OCCUPANCY Rraov ro lssue ReuaRx s D Nor Rerov ro lssur D Dare I rspecroR | *rrrrro* ,1!*4{"'-----:------ No.v Applican Name M ailing Address Date INDIVIDUAL SEYIAGE DISPOSAL SYS 1 RECORD Installer: Complete tolr part of form to signature and rerurn iioth copies to Lane County Building Sanitation Department. S hook Other-List o oa -4Feet from Lot L er below / See instructions Signature Us e Only: sys tem Installation Conforms to Current Standards Date:2-{-7 il Pisapproved:Does Not Conform to Current Standards Ft. from well Steel I Concrete No. Compartments I Ga1. Capacity F Length Distribution Box:Yes il Nofl o I ror saa(itariany'appto.r.a, N4 J _< 60 !Bd( LT \ I I T L w tu i _l ^u I Un Baths I m Basement Yes I No PubIic /, {-Diameter DepthJ-- width Glen Dent Other Trench wj:drt. v fr sq 6 Iines J t. between thdep Remarks: Lane County Building & Sanitation Dept' Sanitarian I s r' c55-il 1 ffi I L I L I I i T I .7 /IANE COUNTY BUITDING PERMIT OR "YlfrMOBILE HOME UsE APPTICATION PERMIT TYPE - BUILDING // MOBILE HOME OSC REG. # MAITING ADDRESS MAILING ADDRESS PERMIT co PHONE PHONE PROPERTY I.OCAIION _ INC POST OFFICE PROPERTY TEGAI. DESCRIPTION LOT-BLOCK-SU8D|V. TWP RANGE /n*- -3/METES & BOUNDS ATTACHED n YES trNo SEC.TAX TOT CODE CE US TRACT*7 APPTICANT NAME AND MAITING ,ADDRESS IBE EXISTING STRUCTURES ON PROPERTY IF ANY TEGAT ACCESS TO PROPERTY _ ROAD NAME OR ,€u -n, d-^-r= PROPERTY SIZE_WIDTH DEPTH AREA FOR MOBILE HOME PERMIT ONLY Number of Bedrooms Connecl to Existing Sewoge System f or New System R"q. n STRUCTURES TO BE BUII.T THIS PERMIT TypE coNsrRuciloN se. FT. # seonooi s,zlza ( s),/644a VAI.UATIONMv-m SoL DJ /5/ /-------72= A-.a-4,-e H-7 T /7v {f ICANT S AGE DISPOSAT PI.UMBING INSTATTED BY OWNER OTH ER NAME PTANS FURNISHED YES NO RECEIVED BY FACITITY PERMIT NO PUBIIC BIDG. WASTE DIS, PI.UMBING PTAN REVIEW PARK TRIR. SEPTIC TANK OTHER D FEES WATER SUPPTY PUBTIC PTUMBING FEESa)5d OTHER OA TE _/.e 3 CASH CHECK ONNECTION FEE &4 TOTAT MIN. SEPTIC TANK CAPACITY wlTH DIST. BOX: GA[. TYPE OF STRUCTURE COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIETD REQUIRED PUBTIC WATER CONNECTION FEE tIN. FT. OCCUPANCY a TRENCH WIDTH FT. ZONE a,t - 2-> SQUARE FEET Qcs c) # e_ 5U REAR YARD USE CLASSIFICATION PUBI-IC UTIL. EASEMENT BLDG. SETBACKS - FT. FROM CTR, OF ROAD RIGHT OF WAY SIDE INT s to Find Property: BtDG.Dole PLANNING Dole Form # css-t2 SIDE EXT REAR COPY COPY COPY I _ OFFICE 2 _ JOURNAI. 3 _ AUDIT , 6"*.*;s O,f , &b4a.e qoo /. / a N-li I Dole ua*taza LANE COUNTY BUTLDTNG rX BUIIDING PERMIT OR MOBITE HOME USE PERMIT MH [] PERMTT NO. 2 3a7-73 2??7-7? PROPERTY OWNER \r/orrono, MEr- MAITING ADDRESS N. 15M t\t-zzl+e, PHONE z\tt CONTRACTOR MAITING ADDRESS PHONE PROPERTY I.OCATION - INCTUDE POST OFFICE TEGAI- DESCRIPTION -METES, BOUNDS GrRoer*way Panx Lor 5 Br-ocx ? RANGE EErroN ?lt TAX LOT NO 'ofit;q: f, lffus raoc.' ' 4lo n'*.-i:a1517o? Woprono EXISTING STRUCTU Norur %q.+,APPI.. NAME & MAITING ADDRESS tEGAt ACCESS TO PROPERTY Rouau Avrrurrr %rn PROPERTY SIZE - FT, WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge System New System se. FT BDRMS VALUATION , SEWAGE DISPOSAL PUBilC tr SEPTIC TANK n OTHERE PTUMBING INSTALTED BY OWNER E OTHER: NAME BUITDING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAITER 20-oc) ---3$50- WATER SUPPTY PUBUC Xm tr OTHER FEES TOTAT COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT OR SQ. FT. ClrcEtueD AT REeUEST oF APPLtcANT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTI[. EASEMENT BIDG, SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOI.DENROD Construclion to comply with uniform building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotement on Reverse Side) (POST THIS PERMIT ON MAIN BIDG. AT SITE) LANE COUNTY, BLDG, & SAN. DIV,, COURT HOUSE, EUGENE, OREGON 9740I ronv f c5s- t3 STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION U. B. C.Sec. lo2(o) Eveny pERMlr rssuEo By rHE Butt-orruc 0rrrcrAL UNDER THE pRovlstoNS .' oF THE Cooe snatu EXpTRE By L tMlrATroN ANo BEcoME NULL AND voto, IF THE BUILDING OR WORK AUTHORIZED BY SUCH PERMIT IS NOT COMMENCED I"/ITHIN 50 OAYS FROM THE DATE OF SUCH PERMIT, OR IF THE BUILDING OR WOR.K AUTHORIZED BY SUCH PERMIT IS SUSPENDED OR ABANDONED AT ANY TrM€ AFTER TtrE h/oRK ts coMMENcED FoR A pERtoD oF 12O oavs, BEFoRE SUCH WORK CAN 8E RECOMMENCED A NEW PERMIT SHALL BE FIRST OBTAINED so To oor -ANo THE FEE THEREFORE SHALL BE ONE-HALr THE AMOUNT RE- QUIRED FOR A NEW PERMIT FOR SUCH WORK, PROVTOED NO CHANGES HAVE BEEN MADE OR WILL BE MAOE IN THE ORIGINAL PLANS AND SPECIFICATIONS rOR SUCH \"/ORK; AND PROVIDEO FURTHER THAT SUCH SUSPENSION OR ABAND- ONMENT HAS NOT EXCEIDED ONE YEAR. r]sec. J02( e ) Txr ButLDTNG OrrrcrAL MAy, rN wRrrrNG, suspEND oR REvoKE A eERMtr lssuEo UNDER pRovtstoNS oF THts Cooe wHENEVER THE pERMtr ts tssuED rN ERROR OR ON THE BASrS OF TNCORRECT TNFORMATtOw SUpFT-raDr'OR tN '.,. VIOLATION OF ANY ORDINANCE OR REGULATION OR ANY OT THE PROVISIONS OF THIS COOE. U C. REFUND OF FEE TXE LNHE COUIITY DEPINTUCNT OT HEATTH AND SII'I I TET I ON HAV ING REQUESTEO REFUND OT FEE TO:- OF Naue Aoon Ess AppLtcATtON FOR BUILDING PERMIT DENIED, AND NO APPEAL OF SUCH DENIAL HAV ING BEEN },IADE. AppuICATION FOR BUILDING PERMIT CANCELEO. ApputcATtoN FoR BUILoING PERMIT, ovERPAYMENT' ZoNrr.tc PertrtoN. Appt-rcArloN ron REsTaURANT [.tcruse. Appu tcATtoN-ron Crnr tF IcATE nr SINITAT loN. AFpL tcAT toN roR Pneu lu t ruanv S tre lruspEcT t ot't. Fon rxE FoLLot{ I NG REASoN: AHo rxe APPL I cANT DEs I R I NG exo AuolrtNG ls REQUESTED NUMBER IN THE CASE FEE CHARGEO. Drre THAT THE FEE BE REFUNDEDT rxe DlREcrtR sr FtNANcE To RETuND THE AMouNT oF $-, ( uruoe n AtrPL I cAr loN oF AppL rcAT loN FoR BUtLDING penfirr), wx tcx ls rHE 55-029-r2 ' ' '- ' BU I LD ING S ITE EVALUAT ION /(Euilding Permit Apptication No. J3a Z-73 ( ) Site tnspection ( ) Pre-Permit lnvestigation L/iNE COUNTY PLANNING DEPARTHEN J ?/CH Rp3 s3{2.eTAX LorJ/d__.mm APPL I CANT: Nr\h E ADDR z_Q 8_g PHONE DATE T NOT NO YES Zon i ng 0rd i nance Comp I i ance (Zone& - I2. Subdivision Ordinance eomp'Tiance ( ) 3. Requ i red Access 4. Building Site (Area, u/idth, Frontage, Setback) 5. 0ther (see comments) ) aoo I icab le*rr-() ({ () ?r () (4 () vY ( () () () BUILDING INSPECTION SECTION 6. Pians Submitted 7. Soil Stability (footings) B. Flood Pl a in 9. 0ther (see Conrnents) NOT appl icable NO YES () NA}4E DATE n () ) ) () () () () () () () COHHENTS: SAN ITAT I ON SECT I ON 10. Sewage Disposal ll. Usable Area 12. l./ater Supply ]'3" 0ther (see Comments) NOT NO YES 6Et icable -()() DATE () () () () (), CO},lHENTS TO APP CANT il0l ] Your Building Permil / Site lnspection: Can be approved. Cannot be approved at this tinre as indicated on iten, N0. above. Quest ions and further infornrat ion on itenrs I through S contlEt-tfuf-Lane- C0UNTY PLANN ING DEPARTMENT. Q,uest ions .rnd turther informat ion on items 6 throuqh 3 contact t ane County 8u i ld ing or;rd 5on ltat ion -Qif l s_iqn l./ill be held in this of f icc until you can re:olve lhe problems indicated. I s be i ng retu rned. Your buildinc, pernr it appl icat ion fee is being returned under separate cur'er 0,(/j, tr1 ,0( LANT COIIN'I Y III /\NN ING DEPARTHENT I 3( 5 ir tli Averrue Ias t , Eugerre , 0r egtrn 97t+tl t l'ltoNE 3{2. llll t:Xl.21l IANF- COUNTY IJI.)lLDING 6 S/INITATION DIVISION 135 S ixt,h Avqlrur: f ast, Ert<lettt', 0r egon 9740 I l,rr0Nr'. 142-tllt txr. 4ll M55-28 T VJ NAI'1E Dr\TE CO},IHENTS: NA},lE () () () IANE COUNTY BUTLDTNG E BUILDING PERMIT OR MOBITE MHtr HOME USE PERMIT PERMIT NO. PROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY TOCATION _ INCTUDE POSI OFFICE PROPERTY LEGAT DESCRIPTION - METES, BOUNDS RANG E SECTION TAX LOT NO.CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPT. NAME & MAITING ADDRESS TEGAL ACCESS TO PROPERTY PROPERTY SIZE-FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connecl to Existi Sewo e TYPE CONSTRUCTION m New System BDRMS VALUATIONSQ. FT SEWAGE DISPOSAI- PUBTIC tr SEPTIC TANK tr oTHERn PTUMBING INSTALTED BY OWNER fl OTHER: NAME BUITDING WASTE DISPOSAT PTUMBING PtAN REVIEW PARK TRAITER TOTAT FEES WATER SUPPTY PUBUC tr N OTHER /t / -7 7 U COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIETD REQUIRED LIN. FT TRENCH WIDTH FT OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIt. EASEMENT BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CI-ASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BI,DG, PERMIT - WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PI.UMBING _ CANARY BUITDING - GREEN SANITATION _ GOI-DENROD Construclion to comply with uniform building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotement on Reverse Side) (posT THls PERMIT ON MAIN BIDG. AT SITE) LANE COUNTY, BI.DG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu t655-13 SLAB FLOOR PLUMB ING GROUND,'/ORK AppRoveo Rrlta nr s D r sappnovro D Darr I NsprcroR GAS PIPING GROUND/ORK Ap pRov r o Rsuanx s DrslppRovrD n DarE,I rusprcron ROUGH PLUMBING A PPRoV E D Rrlt a Rx s D Drsappnovro D Dare I Nspecron ROUGH GAS PIPING Ap pRov r o Reurnrs Dr sappRoveo Dar r I ruspecron FINAL PLUMBING Appnoveo D Drsappnovro D Rruanx s Dnre FINAL GAS PIPING Appnoveo D DrsappRovm D REMa Rx s Darr | ruspecron CERTIFICATE OF OCCUPANCY Renov ro lssur RruaRrs D Nor Rraov ro lssue D Dare I rsprcron I NseecroR_ LANE COUNTY BUILDING BUILDING T MH E PERMIT OR MOBIIE HOME UsE PERMIT PERMIT NO. PROPERTY OWNER MAILING ADDRESS PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION _ INCI.UDE POST OFFICE PROPERTY tEGAt DESCRIPTION -METES, BOUNDS RANG E SECTION TAX LOT NO.CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPt. NAME & MAITING ADDRESS LEGAT ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge System New System ! STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION sQ. FT. # BDRMS VALUATIoN SEWAGE DISPOSAT PUBUC tr SEPTTC TANK PTUMBING INSTAILED BY OWNER E OTHER: NAME BUITDING WASTE DISPOSAT PTUMBING PTAN REVIEW PARK TRAITER TOTAT FEES WATER SUPPIY PUBTIC ! D OTHER $_ COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOXI GA!. DRAIN FIETD REQUIRED tIN, FT TRENCH WIDTH FT OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIt. EASEMENT BI,DG. SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BTDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PI.UMBING - CANARY BUITDING - GREEN SANITATION _ GOTDENROD Conslruction to comply with uniform buildin covering plumbing ond sewoge disposol. Al of occuponcy before being occupied. code ond county regulotions buildings require o certificote s I (See Stotement on Reverse Side) (posT THrs PERMTT oN MArN BrDG. AT S!TE) TANE COUNTY, BTDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronr"r # c55-t3 oTHER! ffie",I SITE INSPECTION AppRovEo D Drsappnovro D Re uenx s Date l nspeclon FOUNDATION INSPECTION AppRovEo Rrur nx s D I SAPPRoVED Dar E I ruspecron I FRAM I NG AppRovro Reltanx s I NSPECT I ON DrsappRoveo Darr I NSPEcToR LATH OR SHEETROCK Appaoveo RruaRxs rINAL INSPECTION I NSPECT I ON Dr sappnoveo D I SAPPRovED Da Darr I NSPEcToR AP PRov E o Rruanx s I NSPEcToR CERTIFICATE OF OCCUPANCY Rraov ro lssuE Rruanx s Nor Rraov ro lssue DrrE I NsPEcroR D # I.ANE COUNTY BUITDING PERMIT OR MOBITE HOME USE APPLICATION PERMIT TYPE - BUILDIN MOBILE HOME OSC REG. # NG ADDRESS PERMIT OWNER 3 ,/l/,7 f'2bt'-= CONTRACTOR MAII.ING ADDRESS PHONE TOCATIO _ INCLUDE POST O PROPERTY tEGAt DESCRIPTION I.OT-BLOCK-SUBDIV RANGE APPTICANT NAME AND MAITING ADDRESS /-6 METES&BOUNDSIYES ATTACHED tr NO ru s3 SEC.TAX LOT 3-rs{TRACT ON PROPERTY IF ANY _ ROAD NAME OR DEPTH DESCRI ACCESS TO PROPERTY SIZE_WIDTH AREA Connect to Existing Sewoge System I or New System Req. n I FOR MOBILE HOME PERMIT ONLY Number of Bedrooms STRUCTURES TO BE BUITT THIS PERMIT / -DzztE%,-f4ffiil TYPE CONSTRUCTION SQ. FT # BEDRooMS VAI-UATIoN/2rc@ze /53ao /cgo7 SEWAGE DISPOSAT PI.UMBING INSTATIED BY PU BLIC BtDG. WASTE DIS. PTUMBING PTAN REVIEW PARK TRTR, TOTAI" Kc OTHER tr FEES WATER SUPPTY PUBTIC FE FIXTURES CASH ! 5s1ryEp CHECK CONNECTION FEE PUBTIC WATER CONNECTION FEE OTHER OWNER PERMIT PTANS FURNISHED NO OTHER NAME OF APPTICANT FACITITY PERMIT YES NO DATE -5*73 IVED DAIE/2 (-s p COUNTY BUILDING & SANITATION SPECIFICATIONS 3 MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAI. DRAIN FIETD REQUIRED TIN. FT. TRENCH WIDTH FT.OR SQUARE FEET TYPE OF STRUCTURE OCCUPANCY BLDG. SETBACKS _ FT. FROM CTR, OT ROAD RIGHT OF WAY FRONT SIDE INT SAN ITARIAN Dole PIANN Directions to Find Property: ZONE REAR YARD PUBTIC UTIL REAR 2 COPY I _ OFFICE COPY 2 _ JOURNAI COPY 3 - AUDIT Form # css- t2 SIDE EXT. Dole BLDG. INSP USE CTASSIFICATION Dot I arfu