HomeMy WebLinkAboutPermit Building 1976-05-19PERI\4IT NO
C6{STNUCTION t ] IVIOBILE HOIVIE [ ] PLAN REVIEW t ] CHANGE OF OCCUPANCY t ]
Itn Owner
NA ADD R ESS CIT DE PHONE
n Contractor
NAN/ E
O.S. Reg. +
Twp- Range-- Section
Subdivision Lot
Tax Lot- Code
B lock Acreage
ADD R ESS CITY ZIP
Width
Depth
PHONEE
Census Tract
Access to Property (Road Name)
Existing Structures on Property:
Directions to Property - Address
STRUCTURE (# BEDROOTVIS)SO. FT VALUATION
SEWAGE DISPOSAL:
PUBLIC [ ] SEPTICTANK [ ] OTHER [ ]
PLUN/]BING INSTALLED BY:
owNER[] OTHER[] NAM E
BUILDING
PLU I\18ING
3% SURCHARGE
IVIOBILE HOIVIE
WASTE DISPOSAL
PLAN REVIEW
TOTAL
WATER SUPPLY: PROPOSED I ]
EXISTING t]
PUB LIC
COIVIIVIUN ITY - NATVIE
PR IVATE WE LL
OTHER SPECIFY
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
IVIIN SEPTIC TANK CAPACITY
GALS.IVIIN. DRAINFIELD-LIN. FT IVIAX. TRENCH DEPT I NCH ES
STAY 1OO' FROIVI ALL W ELLS
TYPE OF CONSTRUCTION G ROUP FIRE ZON E USE CLASSIF
SETBACKS FT. FROIVI CTR. OF rAV
FRONT SIDE EXT
FT. FROIV] PROP. LINE
SIDE INT REAR
-
ZONE-
AUTHORIZED SIGNATURES
/sl
ISSUANCE DATE
BLDG, PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUN4BING - CANAFY
BUILDING - GREEN
SANITATION - GOLDENBOD
IMPORTANT
POST THIS PERMIT ON MAIN BLDG. AT SITE
LANE COUNTY, DEPT. OF ENVIBONL4ENTAL l,/ANAGEI,/4ENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OBEGON 97401
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
foi sub6urface sewage disposal and the State Plumbing Code. All buildings require a certificate of
occupancy before being occupied.
(See Details on Reverse Side)
c5s -l 3
LANE COUNTY PERMIT FOR:
BUILOIN SITE EVALUATION ]S'" | # l*,#;, Xrura&anx,or;56,ay{B{ILDrNG pERr,ilT AppL lcATloN No" ,?'" " ' ',-LOT: BLOCK:
( ) s rrE .r NSPECT t oN
PLANNING DIVISION
APPL I CANT
DATE
Not
le No YesTIW 6.()(!4ll8() ()
)
)
)
CKID
Setbacks omc
Front
Side Exterior
Setbacks from inter
Side
Rear
-4 {-/B-76
I
2
3
4
5
Zoning 0rdinance Comp I iance: Zone
Subdivision Ordinance Compl iance lERequi red Access
Building Site (Area, Width, Frontage
0ther (see cornments)
)nes:or<_a_w
COHMENTS:
Fm[N-IN6-D| v ts tm-IefmN-PEl{D mG a Y
BUILDING INSPECTION DIVISION
7. Plans Submitted
8. Soi I Stabi I I ty (foot i ngs)
9. Flood Plain
O. 0ther (see conrnents)
rT APPL r CAT r
Not
Aool i cabl e
ir IT() ()
() ()
)
)
)CKI D BY:
COHIENTS:
WATER POLUTION CONTROL NOt
I | . l{eets Department of Envi ronmental
Qual ity Standards.
12. 0ther (see cornments)
Aool icable-"-TV-r) TfNo Yes
(./CK'0 BY , M f/, r/z
DATE
CO}IMENTS:
() ()
TO APPLICANT:
,#
Your,}d()
Building / Site lnsPection:
Can be approved"
Cannot be aPProved at this t ime as indicated on item N0
Questions and further informa tion on items I through 6 contact the LANE-
c0 PLAN 0lvlsl0N Qu estions and further information on items 7
t rou 2 contact the LANE BUILDING AND SAN ON DI 0N.T.
abov
{r
Will be held in this of
ls being returned.
ce unt you can reso vet
c55-28
Your buildin
ems
s
i cated.
rmit I ica ion fee is bein
AL E
135 Sixth Avenue East Eugene 0regon
'H,NE.
597-4065
LANE COUNTY PLANNING DIVISION PHONE:
97401
687-4t 86
I
i
n Owner
PERIVIIT NO
CO;\STRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
NA I\{ E ADD RESS CITY ZIP CODE PHONE
D Contractor
NAME ADD B ESS
O.S. Reg. +
Twp- Range- Section-Tax Lot-_-- Code
Subd ivision B lock
CITY
Acreage
ZIP CODE
Census Tract
PHON E
Lot
Access to Property (Road Name)
Width
Depth
Existing Structures on Property:
Directions to Property - Address
STRUCTURE (# BEDROOIVIS)SO. FT VALUATION
SEWAGE DISPOSAL:
PUBLIC[] SEPTICTANK[]OTHER [ ]
PLUMBING INSTALLED BY:
OWNERT] OTHER[] NAIVI E
BUILD ING
PLUTVIB ING
3% SURCHARGE
IVIOB ILE HOIVIE
WASTE DISPOSAL
PLAN REVIEW
TOTAL
WATER SUPPLY: PROPOSED t ]
EXISTING t ]
PUB LIC
COIVIIVIUNITY . NAIVIE
PRIVATE WELL
OTHER.SPECIFY
CONSTRUCTION PERMITS & lNSPECTIONS A ND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
GALS MIN. DRAINFIELD-LIN. FT IVIAX. TRENCH DEPTH I NCH ES
STAY 1OO' FROTVI ALL WELLS
TYPE OF CONSTRUCTION GROUP F IR E ZONE USE CLASSIF
SETBACKS - FT. FROM CTR. OF rAN
FRONT SIDE EXT
FT. FROIVI PROP. LINE
SIDE INT R EAR ZONE
ISSUANCE DATEAUTHORIZED SIGNATURES
lsl
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION _ GOLDETBOD
IMPOBTANT
POST THIS PERMIT O N MAIN BLDG. AT SITE
LANE COUNTY, DEPT. OF ENVIBONMENTAL MANAGEMENT
COUBTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
call 687-4065 to schedule all required construction inspections. call 687-4061 to schedule all required
."piii-.v.i", in.pl"ii*". Att Co-nstruction shall comply with the State Buidling Code, D E.Q. standards
ioisuo6urtace sdwage Oisposai ano tre Strt" PtumOing Code. All buildings require a certificate of
mcupancy bef ore bei-ng occupied.
(See Details on Reverse Side)
LANE COUNTY PERMIT FOR:
D DrsAPPRovEo D Dare I Hseecron
SITE INSPECTION
Ap pRov r o
RruaRx s
FOUNDATION I NSPECTION
Appnovro
Reur nx s
D DrsAPPRovEo F7 DArE
FRAMI NG
A ppRov e o
Reuanx s
I NSPECT I O
Dr snppnoveo
I Nsprcton
\
o^r, 7-?'7O I NSPEc
LATH OR SHEETROCK INSPECTION
Ap pRov E o
Reulnx s
ffi Dr sappnoveo Dar e I rseEcton
FINAL INSPECTION
AP PRov E o
Ret'tanx s
I SAPPROVEO DarE I NSPEcToR
CERTIFICATE OT OCCUPANCY
Rraov ro I ssue
RruaRx s
D Nor Reeov ro lssue D
to)n te07
Dnre I NS PE croR
D
p
\y*!__tt?€SV/
NOTE: NO PERMIT WI, 3E ISST]ED TTNTIL THIS APPLICATIO" HAS BEEN APPROVED
APPLICATION FOR:
CONSTRUCTION
R.'J
Name
clr Aen l6o7 S
Address
co /€
,q/€ €u,
City Phone
6 $aCONTRACTOR
Name
o.s. REc. //
Twp.Section
subdivtsion 9 n{N0', 7: c"tl
ACCESS TO PROPERIY (Road Nane)
Existing Structures on ProPertY
Property Location - Address/DirectLons:.
Le
Below
I
SEI,IAGE
Site Inspec tlon /l
WATER SUPPLY:
Well Sprlng Other
ess
Lot
City ZLP Phone
A2:4-h,
Lot :a Block
I le t/€_
'/
Ft
Existing
PLUI,IBING:
lnstalled by Owner
PLII,IBING FEES:
ll ot
=rT
Name of communi
/doff,-
ty or Publrc syste' efu"
tem
FEES:
Bldg.
Pluobing
3Z Surcharge
Waste Dlsp.
Plan Review
Mob11e Home
36rc
n7-
o Name
Sewage
Connection
FURNISHED
Water
Connection
FACILITY PERM]T
YES
TOTAL
Min. Septlc Tank CaPaci
CASH
CHECK
Drainfleld Required - Llneal Peet
YES
ture of Applicant:
Recelved ayi-f.'L-tC rzt- Date
Maxlmum
f a> -a2
Fire Zone Use ClasslficationTypeof Construction
Bldg
Front
Setbacks - from Cent *.:g-"* 'rll] u*..'r.,-/Z//f :X"^r/
\
S- t3=16
I.ANE COT,NTY DEPARIMENT oF EI\TIRoNMENTAL
Zote RA
DATE:DATE:r.t7
cs5- l2
Census
t
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