HomeMy WebLinkAboutPermit Mechanical 1982-10-27:6l!'--
COI{PLETE
CONSTT- JCTION/PLACEM ENi
PERM IT
THIS BLOCK PLEASE USE BLACK INK AND PRINT.
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FCR c,r:lCC LrSLt ONL Y
Plan Checli Info SheetAP. TTIOI.i .le:UBD
'pdesidentiar
I commerciaJ.
I rndustrial
! trrirric
P d
ting
WATER SUPPLY7r*w foP
Tffiry7
that registration uith the Builder's Board is in fuLl force and effect as requirod b)'OP'S 70].055, Lhat if cxerrPt ttre L)asj
hercon, and that only subcontractors and employees who are in conpliance wj.t-h oRs 70t.055 will be usod on this !'roject-
APPLICATION THOROUGHLY
TUiI(!.1 ease
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LY EXAMINDD TIIE COMPLETED APPLICATION }'OR PE , and do lrcrcL,T 'r'11 i f )' Lhri a-l 1 ilrfr)rmrt-iolr ircr'"rrr
certj.fy that
to the work
ilI h th ord olratccs Lano C and rhaandworkdrformeshaldonebeanpe
of Brrthe ldibeofnadeanstructurat hout Lhe :;Srmr onde scr heibed TNre and haL OCCUPANCYNO WI pe trg
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Divisron. I furtll.r ir':rfi'
is for ex€'ml,ti.,II is n()t, d
.rnd a()rr.r.t,lIr.l I flrrl
n PLANNING ZONING:Zont jrar."i tion q Parcel :
lnterior
i'arcel Srze
rl,lrl amum Sc k!t",
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Ccmre nt
tr FLOODPLAIN:In flood hazard area?f]*" fl ves see d sheet
Date:
Date:
Date:fl nunar,ADDRESS ING : (;R1D COOR.DINATL N
tr SANITATION: s. r. #B. P. #
Insrallation
Specifications:
Gal 1on
Tank
Lineal Feet
of Drainfield
lnstailatior, Record rssucd? f v.t fl w"
Maximunr Depth
of Trerrches
Coments:
PLANS EXAMINATION:
Coments
;_'p. 5N crrri, R3 _ 'rse F j.repl ace f,nsel. t
FOR PEBMIT **DENIm**r Requests for additional- information slrcwing
afe net, and appropriate information suppl-iedr no refund.W02-02.83
CONSTRUCTION AUTHORIZED BY THIS PERMIT
cripti Sq. Ft.
Fixed Feel
Unit Cost
Floodp n Fee
Sub
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Fees
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AL PEE
FEES PAID
Date:
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TOTAL VALUATI
PERI.{IT APPROVED BY BUILDING OFFICI.\L/I)ESIGTIE;E (;ET' OI1S 456.8C5
By
l DATE
I.ANE COUNTY DEPART!.TENT OF PLAIINING & COI'I}IUNITY DEVEI'PMENT / I25 EAST EIGHTH AVENUE, EUGENE, OREGON 974OL
SEE RBVERSB FOR INSPECTION INFORMATION
-_--
iz*,i."@
f t*o coplcs of Plans
!r'wo Copies of Piot Pians
[)techan:.cai Checklrst
! r,r -*u..; nc checr:1i s1:
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Pee
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATION OF THIS PERMIT,CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOI,IED BY LAl.l.
I,IHEN READY FoR INSPECTIoN CALL 687-4065. A MINIMUM OF AT LEA5T 24 HOUR ADVANCE NOTICE FoR INSPECTION REQUEST MUST BEGIVEN. Have the following information ready: Permit number, job address, type of inspection, when it *il'l Ue ready,your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED IIISPECTIONS
l) FoUNDATI0N INSPECTIoN: To be made after trenches are excavated and forms erected and when al.l materials for the foundationare delivered on the job. Where concrete from a central mixing plant (commonly termed "transit mixed") is to be used,materials need not be on the Job.
2) C0NqRFTE SLA9 0R UNDER-FIOOR INSPECTION: To be made after all in-slab or under-floor- building service equipment,conduit, piping accessories and other anciilary equipment items are in place but before any c5ncrete is ioui^edor floor sheathing installed, including the subfloor.
3) FB$MIryG & ITiULAII0N INSPECTI0NS: To be made after the roof, alt framing, fire blocking and bracing are in place andall-pipes, fireplaces and tlinrneys and vents are complete and al'l rough electrical and [1umbing are"approved. A1Iwall insulation and vapor barrier are in p1ace.
4) LATH AND/OR GYPSUM B0ARD IIISPECTI0N: To be made after ail lathing and
or before gypsum board joinls and
gypsum board, interior and exterior,-.is in place
fasteners are taped and flnished
5) FINAL INSPECTION:To be made after the building is complete and belfore occupancy
APPR0VAL REQUIRED. No work shall be done on any pant of the building or structure beyond the point indicated in eachsuccessive inspection without first obtaining the approval of the building official. Such approval shall be given onlyafter an inspection shall have been made'of each successive step in the construction as inditited by each of ifre inspeltions
requi red.
N0TE: A11 building permits require inspections for the work authorized, such as but not limited to:
A. BLOCK I^JALL: To be made after reinforcing is in p1ace, but before any grout is poured. This inspection isrequired for each bond beam pour. There will be no approval until the plumbing and electrical inspections
have been made and approved.
B' td00D ST0VE: To be made after completion of masonry (if appljcable) and when installatjon is comolete.
Installation shall be in accordance with an approved nationally recognized testrng agency arrd the manu-
facturer's installation instructions.
C. ttOgtLf HOl4f, An inspection is required after the mobile home is connected to an approved sewer or septic
system for: setback requirements, b'locking, footing connection, tiedowns, skirting, and p'lumbing
connecti ons.
(l) Footings and piers to comply with State foundation requirements for mobile homes or as recommended
by the manufacturer.(2) Mobile home minimum finish floor elevation shall be certified when required by a floodplain
management I etter.(3) l4obile home tiedowns, when required, and skirting shall be installed and ready for inspection
within at'least 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure.
D. SWIMMING P00L: Below grade when steel is in place and before concrete is poured. Above grade when pool
is instalIed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING I,IORKING HOURS. THIS PERMIT WILL EXPIRE IF I,IORK DOES NOT BEGIN
WITHIN ]8O DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN ]8O DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PERMIT I,JAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS I,IILL DO SO AT HIS OI,IN RISK
SUBSURFACE AND ALTERNATIVE SEHAGE DISPOSAL SYSTEMS
(r )
(2)
Permits shall be effective for one year from the date of issuance.
Upon completing the construction for which a permit has been issued the permit holder sha11 notify the
Department by submitting the installation record form. The Department shall inspect the construction to
determine if it complies with the rules contained in this division. If the construction does comply with
such rules, the Department shall issue a certificate of satisfactory complet'ion.to the permit holder. If the
construction does not comply with such rules, the Department shall notify the perm'it holder and shall require
satisfactory conrpletion before issuing the certificate. Failure to meet the requirements for satisfactory
completion witfrin a reasonable time constitutes a violation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewaqe Disposal
From Interior property lines
Edge of road right-of-way
Building foundation
l.lel'ls, other water sources
Seotic Tank Drainfie'ld
-m]_--_-lT.I--'10'
5',
50'
t0'
l0'
r 00'
CANCELLATION/REFUND AUTHORIZAT -\ PERMIT /I 8Z--)
NA}IE (PLEASE PRINT)
ADDRESS
APPLICANT (
REASON FOR CANCELLING T (oR APPLTCATTON)
SIGNATURE DATE
FEES PAID FOR WASTE DISPOSAL SYSTEMS (SITE INSPECTIONS AND/OR APPLICATIONS TO INSTALL THE SEPTIC
TANK AND DRAINFIELD) ARE ORDINARILY NONREFUNDABLE. SOME REFUND MAY BE ON THE BUILDING, PLANNING,
OR PLI'MBING PORTIONS ACCORDING TO THE AMOUNT OF THE PERMIT/APPLICATION PROCESSED.
AUTHORIZATION FOR POSSIBLE REFUM:'
SIGNATURE
TO DEPARTMENT OF FINANCE
BUILDING PERMIT REFUND
STATE SURCHARGE REFUND
SEPTIC DISPOSAL REFUND
SITE INSPECTION REFUND
LAND USE APPLICATIONS
PLAN AMENDMENTS
PRE-APPLICATIONS
RECORDINC FEES
PARTITIONS
COPIES & ORDINANCES
$
TOTAL AI"IOUNT REFUNDED
PLEASE MAKE CHECK PAYABLE TO:
Z BUILDING PERMIT FEE $
z MOBILE HOME FEE $
Z PLWBING PERMIT FEE $
Z PLAN CHECK FEE $
MINUS $25.00 FOR PROCESSING FEE
TOTAL AMOUNT TO BE REFUNDED
Z STATE SURCHARGE FEE $
Z SEPTIC DISPOSAL FEE $
Z SITE INSPECTION FEE $
Z LAND USE APPLI. $
% PPA OR NPA (PLN AMD)$
Z PRE-APPLICATIONS $
% RECORDING FEES $
Z PARTITIONS $
Z COPIES & ORDINANCES
$o
$
DATE L-
24-08-74/ACCT 4212olpnOc 041 Recelpt /l
24-08-74/AC?T 42l24lpnoC 041 Receipt /l
24-08-74lA1CT 42133lpRoc 043 Receipt /l
24-08-74/ACCT 42L34lpROc 043 Receipt //
24-08-74/ACCT 42150/pnoC 035 Recelp tll
24-08-74/ACCT 42t50/pnoc 013 Receipt i/
24-08-74/ ACCT 46202lpnoC 034 Receip tll
24-08-74/ AC?T 462l0/pnoc 035 Receip tll
24-08-741 A]CT 46202lpRoc 035 Recelpr #
24-08-74/ACCT 44419/pnoc 034 Receipt #
$
$
$
$
$
$
$
$
$
NAME
ADDRESS
DEPARTMENT OF PLANNING & COMMUNITY DEVELOPMENT
COURTHOUSE/PUBLIC SERVICE BUILDING
125 EAST 8TH AVENUE, EUGENE, OREGON 97407
lt*tSI
lane countyHOLID SLIP fi!'
-
APPLICATION # t(d.,,lt' -
LOCAT I ON z./,llr/l
NAME
ADDRESS
ZIP CODE
The above appf ication is being held for the following reasons:
l, Fltd ptq/E 7,1/t6,<TS SHezt
(lrtTgX /lgtltrr ApJ,,Nrtt iD r
/?d /-t -s/t*= 11 .
( l.,v 9 f,ht/. , /'/ f/dN)
S-u €rt/r rl U- tL,. t' { ri ti: /-/ )Y e3, %u,n, ( /J r/clt
7fr8 ///t,Ftlf / j
ry't;^oD r 72 BE
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&zl-tZd'<--'
-ffi lTfurr.z'7 (J7 ?-#/'1
OFFICE HOURS
This appl ication wi I I be held unti'l
above has not been furnished by tha
If the jnformation required'c(
t te your a plip cati on w'i I I be cancel I ed .
Building fees paid for permits cancelled under these circumstances will be proratedaccording to the work that has taken place as of the date of cjncellatjon.
BUILDING & SANITATION / ENVIRONMTNTAL MANAGEMENT DEPARTMENT
125 East Bth Avenue / Public Serv'ice Building / Eugene, Oregon 97401 I (503)687-4061
lone county
PLANNING & C0MMUNITY DEVEL0PI"-r'lT
ACTIVITY INFORMATION SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS t,,lILL BE REJECTED!
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MUIING-TDDRESS-
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BUSINESS TEIEPHONE # HOME- TELEPHONE #
t/trq - 7b1a
L HOME TELEPHONE #
2 PROPERTY ADDRESS
( IF DIFFERENT
3 rvrae B PAFIeEL NUMBEn
( REQUTREp rNF0RI4ATr0N)
(from tax maps in Department of Assessment and Taxationor from tax statement)
MINSF-IF R,INGE SMTION ZON I NG
Mu,_NSE-IF MNGE SECNON W ZON I NG
MINSHTP MNGE SECTMN ffi ZON I NG
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:ACRES
4 SUBDIVISI0N (if applicable)LOT BLOCK
5 REQUEST (state exact'ly what you plan to do)
6 DIRECTIONS TO SITE:
5
FOR STAFF USE ONLY **
ZONE/LAND USE:
NUMBER
DATE
-{F(r',
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BY:
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DATE:--_ TIME IN:_ OUT:_
bota, t Kevrn (-0n,,
UPERSON MAKING REQU$ST
5or',v\a{;?)L nP- nq77
u C I\TY STATE ZIP CODE
/l8tb
TAX LOT(S) OR PARCEL #