HomeMy WebLinkAboutPermit Building 1976-07-22PERMTT # lf
NOTE: N0 PERMIT IfILr, ,lE ISSUED llNTIt THIS APPLIC,ATIOi\ .rAs BEEN APPRoVED
APPLICATION FOR:
CONSTRUCTlON PLAN REVIEW CTIAI{GE OF OCCUPANCY
o*r* Joe C Ober*oo// /6i7f/r?d r Gqqene V72b/ 7-za 7a6A.
Name Addres s cjlxy - V zip Phone
CONTRACTOR er e// r ,-7 7 tn A/m00 Eu c
Name Address City zip
3 section J&t /',J rax r,ot Tdaa /-*sCode Census Tract
6Z
Phone
o. s. REG. /l
ACCESS T0 PROPERTY (Road Name)
Existing Structures on Property C re y'e- S
erry Acrease I.I idth/Q-Deptt -2!!_S-
/rofruo{)el
,v &-
au A e
Property Location - Address/Directlons:
e Use
SEWAGE DISPOSAT:
Slte Inspec tion //
WATER SUPPLY:
I^Ie11 Spring Other
/
Ft
Sys r=or New System Required
Name of Community or Public System
0
Water
Connection
PLANS FURNISHED FACILITY PERMIT
YES YES
Signature of Appl
Fee Received Date
Valuation
"/-r.spo
Publie
Coomunity
Existing S el^7age
PLI]MBING:
Installed by Owner
PLUMBING FEES:
ll ot
4/ao
,a?,72
BIdg.
Plumblng
3Z Surcharge
waste Disp.
Plan Review
Mobile Home
TOTAL
Ff cesn
CHECI(
Mln. S tlc Tank Drainfield Requ ired - Lineal Feet Maximum
Type of Constructi Fire Zone Use Classificatlon
Bldg
Fron
PIANNING:
Setbacks - from Center of Road Right of Way:
e Int.{Slde Exterior 1/ { rc^,-v
DATE:SANITATION:DATE:fi TE:BUlLDING:
css-12 LANE COI]NTY DEPARTMENT OF ENVIRONMEN MANAGM,IENT
Zone
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, 72-
NO
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LANE COUNTY PERMIT FOR PERIVIT NO
CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
NAI\{E ADD R ESS CITY ZIP CODE PHONE
D Contractor
NAIVIE
O.S. Reg. +r
Twp- Range- Sectio
Subd ivision Lot
Tax Lot- Code
B lock Acreage
ADD R ESS CITY ZIP CODE
Census Tract
f,
Access to Property (Road Name)
Width
Depth
Existing Structures on Property:
Directions to Property - Address
STR UCTUR E ( # B ED ROOIV4S)SO. FT VALUATION
SEWAGE DISPOSAL:
PUBLIC [ ] SEPTICTANK [ ] OTHER [ ]
PLUIVIBI NG INSTALLED BY:
OWNER[] OTHER[] NAIVI tr
BUILDING
PLUIVIB ING
3% SURCHARGE
IVIOBILE HOIVIE-
WASTE DISPOSAL
PLAN REVIEW
TOTA L
WATEB SUPPLY: PROPOSED I ]
EXISTING t]
PUB LIC
COMMUNITY.NAME
PRIVATE WELL
OTHER.SPECIFY
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATION S
MIN. SEPTIC TANK CAPACITY
GALS MIN. DRAINFIELD-LIN. FT IVIAX. TRENCH DEPT I NCHES
STA Y 1OO' FROIVIALL WELLS
TYPE OF CONSTRUCTION GROUP FIRE ZON USE CLASSIFF
SETBACKS- FT. FROIVI CTR. OF rArV
FRONT SIDE EXT
FT. FROIVI PROP. LINE:
SIDE INT.
-
REAR
AUTHORIZED SIGNATURES
/sl
ISSUANCE DATE
BLDG, PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GBEEN
SANITATION - GOLDENFOD
IMPORTANT
(POST THIS PERMIT ON MAIN BLDG. AT SITE
LANE COUNTY, DEPT. OF ENVIBONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
Call 687-4065 to schedule all required construclion inspections. Call 687-4061 to schedule all requiredseptic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. stanbardsfor subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of
occupancy before beinq occupied.
(See Details on Reverse Side)
c55-t 3
ZONE=.-
o3 s 'o//lo, wr 96 dnBULOING SI E T ION
BU I LD ING PERI,I I T APPL I CAT ION NO.
( ) srrE tNsPEcrloN
PLANNING DIVISION
5"2*
t77o -7L
T
SUBD I V I uN:x
DATE
Not
I icable No Yes
:-B
CKID BY:UPt /f9ry4!/ ZdsetbacksffiFront 4 ,f
-
APPL I CANT
, t.I 2.' 3.
4.; 5.
Zoning 0rdinance Comp I iance: Zone
Subdivislon 0rdinance Compl iance
r)m
ilLd
6
Requi red Accessguilding Site (Area, Width, Frontage)
0ther (see conments)
Side Exterior { {Setbacks from interior lines:side g
Rear AZ-
(
(
)
)
)
)
CO},I}tENTS:P,A
PLANN I NG IVIS
BUILOING INSPECTION DIVISION
7. Plans Submitted8. Soi I Stabi I lty (footings)
9. Flood PlainO. 0ther (see corments)
COHI,IENTS:
sA
Not
I icable YNor)()
()
()
()
()
()
(
(
(CKID BY:)?.a ,J
},ATER POLUT ION CONTROL
I I . l{eets Department of Envi ronmental
Qual ity Standards.12, Other (see cornments)
Not
Appl icablg> No Yes7Tr) rT
() ()()cK'D BY I Af^(&-t "-)o
-)6UDATE
COH},IENTS:
TO APPLICANT:
U
^b
Youy Building / Site lnspection:
Llf can be approved.( ) Cannot be approved at this time as indicated on item N0. above.
Questions and further information on items I through 6 contact the LANE-
CoUNTY PLANNTNG DIVIS!0N. Questions and further information on iteilf7
t h rough I2 contact the LANE COUNTY BUILDING AND SANITATION OIVISION.ffi'I (
(
)
)
Will be held in this office un-tll you can resolve the problems
ls being returned.
c55-28
Your bui ldin
i nd i cated.
rmi t I ication f sbe
AL
135 Sixth Avenue East Eugene 0regon 97401
pHoNE. 0Al_4065
LANE C0UNTY PLANNING DlvlSl0N PHONE: 587-4185
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LANE COUNTY PERMIT FOR:PERt\4IT NO
CONSTRUCTION [ ] N1OBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
NAME ADD R ESS CITY ZIP CODE PHONE
D Contractor
NAME
Tax Lot- Code
B lock
CITY
Acreage
-
ADD RESS ZIP CODE
Census Tract
PHONE
O.S. Reg. +t
Tw Range- Section
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:
OWNER[] OTHER[] NAIVI E
BUILDING
PLUMBING
3% SURCHARGE_--
MOBILE HOME
WASTE DISPOSAL
PLAN REVIEW
TOT.AL
WATER SUPPLY: PROPOSED t ]
EXISTING t]
PUB LIC
COMTVIUNITY-NAIVIE
PRIVATE WELL
OTHER-SPECIFY
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLL UTION CONTROL SPECIFICATIONS
IVIIN. SEPTIC TANK CAPACITY
GALS.IVIIN. D RAINFI ELD- LIN. FT MAX. TRENCH DEPT I NCH ES
TYPE OF CONSTRUCTION-- GROUP FIRE ZON F USE CLASSIF
SETBACKS- FT. FROIVI CTR. OF rAV
FRONT SIDE EXT
FT. FROI\4 PBOP. LINE
SIDE INT R EAR ZONE
AUTHORIZED SIGNATURES ISSUANCE DATE
lsl
BLDG. PEBMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX _ PINK
PLUMBING _ CANARY
BUILDING _ GBEEN
SANITATION _ GOLDENHOD
IMPORTANT
(POST THIS PERM IT ON MAIN BLDG. AT SITE)
LANE COUNTY, DEPT, OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
Calt 687-4065 to schedule all required construction rnspections. Call 687-4061 to schedule all required
*ptii iy.tu- inspections. All construction shall comply with the State Buidling Code, D.E.O. standards
ioisuO6urtace sewage disposal and the State Plumbing Code. All buildings require a certificate of
occupancy before being occuPied.
(See Details on Reverse Side)
Subd ivision Lot
-
t
t
t
t
STAY 1OO' FROIVI ALL WELLS
SITE INSPECTION
AppRovED
RruaRx s
Dt sappRoveo Date I xs pr cron
FOUNDATION INSPECTION
Appnovro Dar r I ruspecron
Rr urnx s 6 *:r ar
FRAMING INSPECTION
__z_AppRovro & DtsAPPRovEo
Reuenx s
Dar r /- tA- )/txsetcroav
LATH OR SHEETROCK INSPECTION
AppnovEo D DTsAPPRovE o Fl Dore_
Re urnxs hZ;zt-C*
I rusprcron
rINAL INSPECTION
Ap pRov E o
ReMeax s
d DrslppRovto I ruspecron
CERTIFICATE OF OCCUPANCY
Reaov ro I ssue
ReuaRx s
Nor Reaov ro I ssue Drr e I t.lspecroR
tf0Ar ??
d.//q fr"*
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D
D DrsAPPRovEo fa
D oorrr/- ,/7-72 )
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