HomeMy WebLinkAboutPermit Plumbing 1976-09-14n Owner
LANE COUNTY PERMIT FOR:PERIV IT NO
CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
NAIVl E ADD RESS CITY ZIP CODE PHONE
D Contractor
ADD R ESS CITY ZIP CODE
Range-- Section-Tax Lot- Code-Census Tract
Lot B lock Acreage .==--Width
DepthAccess to Property (Road Name)
NAIVIE PHO NE
O.S. Reg. +*
T
Subdivision
Existing Structures on Property:
Directions to Property - Address
STRUCTURE (# BEDROOIVIS)SO. FT VALUATION
SEWAGE DISPOSAL:
PUBLIC[] SEPTICTANK[]orHER [ ]
PLUIVIBING INSTALLED BY:
owNER[] OTHER[] NAtVr tr
BUILD ING --.
PLUIVIB ING
3% SURCHARGE
IVIOB ILE HOIVIE
WASTE DISPOSAL
PLAN REVIEW
TOTAL
WATER SUPPLY: PROPOSED I ]
EXISTING t]
PUB LIC
COIVINlUNITY NAIVIE
PRIVATE WELL
OTHER SPECIFY
.lf I
CONSTRUCTION PEBMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
IVIIN. SEPTIC TANK CAPACITY
GALS IVIIN. DRAINFIELD LIN. FT IVIAX. TRENCH D EPTH- INCHES
STAY 1OO' FROIVI ALL W EL LS
TYPE OF CONSTRUCTION GROUP- FIRE ZONE USE CLASSIF
SETBACKS FT. FROIVI CTR. OF r/W
FRONT SIDE EXT
FT. FROIVI PROP. LINE
SIDE INT REAR ZONE
AUTHORIZED SIGNATURES
lsl
ISSUANCE DATE
BLDG, PEFMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GBEEN
SANITATION - GOLDENROD
IMPORTANT
call 687-4065 to schedule all required construclion inspections. Call 687-4061 to schedule all required
septic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. standards
for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of
occupancy before being occupied.
(See Details on Reverse Side)
POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY. DEPT. OF ENVIBONMENTAL N4ANAGEN4ENT
COUBTHOUSE ANNEX, 135 EAST 6th, EUGENE, OBEGON 97401c5s -1 3
CONSTR UCTION
_#ifl MoBTLE HoME I
i:,t+1r xI
L, gAl JN
PLAN REVIEW" t
LANE COUNTY PERMIT FOR PERt\,1IT NO.
CHANGE OF OCCUPANCY [ ]
.dx*, '"rid
i,..1 ]...or4to-- L,...! t
\,
! uwner
NATVIE AoonesS'CITY ZIP CODE PHONE
tr Contractor
NAIVIE
Rang e_Sectio
CITY
Code
\Acreage
ffi
Census Tract
Width
Depth
ADD R ESS
O.S, Reg. +
t'
Tax
B lock
*. 1
,Wt
ivision Lot
Access to Property (Road Name)
Existing Structures on Property
IDirections to Property - Address:
t
UCTURE (# BEDROOIVIS)SO. FT VALUATION
S
P
BUILD ING
PLU IVIB ING
3% SURCHARGE
IVIOBILE HOIVIE-
WASTE DISPOSA
PLAi\ REVIEW
TOTAL _*,,_____ __kr:t-*
PLUN4BING INSTALLED BY:
OWNER[] OTHER[] NAIVI
WATER SUPPLY: PROPOSED t ]
EXISTING I ]
PUB LIC
COVIIVIUNITY NAIVIE
E D ISPOSAL
IC SEPTIC TANK OTH ER E
L PRIVATE WELL
OTHER-SPECIFY
CONST RUCTION PERTVI{TS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
GALS.IVIIN. DRAINFIELD LIN. FT IVIAX. TRENCH DEPT I NCHES
STAY 1OO'FROIVIALL WELLS
TYPE OF CONSTRUCTION I/'"'Ei GROUP FIRE ZON F USE CLASSIFt*
SETBACKS- FT. FROIVI CTR. OF rAtV
FRONT SIDE EXT
FT. FROIVI PROP. LINE:
SIDE INT. =--- REAR h".5'ZONE
AUTHORIZED SIGNATURES
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUN4BING _ CANARY
BUILDING _ GBEEN
SANITATION _ GOLDENROD
ISSU DATE
Call 687-4065 to schedule required conslruction inspections. Call 687-4061 lo schedule all required
septic system inspeclions. All construction shall comply with the state Buidling Code, D.E.Q. standards
IMPORTANT tor subsurtace sewage disposal and the State Plumbing Code. All buildings
occupancy belore being occupied.
(See Details on Reverse Side)
POST TH!S PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, DEPT- OF ENVIBONMENTAL MANAGEMENT
COUBTHOUSE ANNEX, 135 EAST 6th, EUGENE, OBEGON 97401
require a certificate of
,
*,tbr*
SITE INSPECTION
AppRov r o
REuanxs
DI SAPPROVED Dare I ruspecron
FOUNDATION INSPECTION
APPROVED
REuanxs
D DrsappRoveo FJ DAIE I ruspecroR
FRAM I NG
App nov e o
REltlRx s
I NSPECT I ON
D DrsrppnovEo D Darr I NSPEcToR
LATH OR SHEETROCK
Ap pnov r o
Rruanxs
I NSPECT I ON
Dr sappnovrD Dar e I NsPEcroR
FINAL INSPTCTION
Ap pRov r o
Reuanx s
Dt sappRovto Dar e I NSPEcToR
CERTIFICATE OF OCCUPANCY
Reaov ro lssuE
RruaRx s
D Nor Reaov ro lssuE D Drrr I NspEcroR
D D