HomeMy WebLinkAboutPermit Mechanical 1982-08-17@ CoNSTRL ]TION /PIECEM
PERM IT
COMPLETE THIS BLOCK. PLEASE USE BLACK INK AND PRINT It't
PLANNING ZONING:Parlition f Parcel ii
interior
"rr"., a.r. NA
Cl.lrlrmum Sct-oacks: L
Zone
, frcnt L, slde re al:
FOF. OFI'ICE
t3
Residenti ai
[-l commercial
5 VALUE
H I
P
t n
P
P
t
l
f,rndustrral
flrutric
Applicati
Permit li
Irwo copics of Pfans
f]rro Copies of Piot Pians
f,ttechanicai CheckI j st
! llumbino Cliecl:lj-st
PIan Checii lnfo Sheet
WATEK SUPPLY2-xt*td f! eroposecr
I nxisting
foF; oF stoRt
I
f oF BEDRooMS--n
IIEE^I
r%:ffifI
TO SITE
certify that any and all sork performed shall be done in accordancc wi th the ()rdiua:lcos of Lane Courrty and the !,ai{s cf f Lr" s'.'lc rt', ''-tt'''t )li }' I I I rr
Z 9.4
an
APPLlCATION on
{I
)
.-, "*;O;,,. ,,,,,1.1)'.'r i,,,r I r,''l-..-t;;tir,, tt .,t' {y),r,.^u
structure without the permission of the Builditrg Divrslon' I f Irth)l '' r {yto the work described herein, and that No oCCUPANCY will be made of any
as requircd by ORS TOl.055, that if exL'mpt thc basis for 'rx('mlt-j(rr:L' Ir')t-'dLhat.registration with the Builder's Board is in ful] force and effect
this project. I HAVE REI'\D AllD CIIE(,/-llD TI]Iuith oRS 701.055 will be usedand employees whohcreon, and that only
f] ;o,,t."Ah,.
! eg.,r,tNAME (please pr
I f'f,OOOpf,afUl rn f]ood hazard area? I ro f] v.r, see attached sheer
Coments:
lnstallation
Specifications I
Comments :
cRrD CooRDTNATE N
Date:
Date:
Date:fl nunar, AppRESSTNG:
I samrtATroN: s. ]
E
ff B. P. #lnstallation Record lssuud? f v." I l"
Maximwr Depth
of Trerichesl
Ga1 Ion
Tank
Lineal feet
of Drainfiel-d
Date:
fflFr,aus EXAMTNATToN:kJ @.Use t^]daD sT)v€Type
coments' 9 TOU e 9T L
U,I'Date U
cript j-on
CONSTRUCTION AUTHORIZED BY THIS PERMIT
Eixed Feel
Unit Cost
Floodplain Fee
Subsurface Fees
Building Fee
Sewer/Storm Drain/Water
Plumbing Fixtures
Mechanical
Plans Check Fee
State Surcharge
TOTAL F'EE
FEES PATD
Sq. Ft
+
$
$
S
$
$
TOTAL VALUATION $
PERMIT APPROVED BY BUILDING OPF
By
$
I casrr
YLfqAJ,H"..'
\Rs-aEZ.Eoslill
e
IANE COUN?Y DEPARTI4ENT OF PLA\INING & COMMUNITY DEVEIIPMENT / 125 EAST EIGHTH AVENUE, EUGENE,
SEE REVERSE FOR INSPECTION INFORMATTON
D}ITE
ck
9740L
-\\-_-/
ENTth
)
T
tr
T
tr
I
SETBAOKS AND OTHER CONDITIONS 0F APPR0VALlfsr sr STRICTLY oBSERVED. vI0LATIoN caru nEsdlr rN REVocATrr 0F THis prRMrr,
CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDiNANCE, AND/OR OTHER REMEDIES ALLOWED BY LAi;.
l'r'rFN READY FoR INSPECTI0N CALL 687-4065. A MINIMUM 0F AT LEAST 24 H0UR ADVANCE NoTICE FoR INSPECTI0N REQUEST MUST BEGMN. Have the foilowing information ready:. Permit number, job address, type of inspection, when it *irl O" read1.,your name and phone number, and any special directions to site.
BUILDING DIVISION:
BlqurgED iltsPEcTroNS
and forms erected and when a'll materi'als for the f,oundationplant (commonly termed "transit mixed") is to be used,
f) F0UNDATI0N INSPECTI0N:' To be made after trenches are excavated
are delivered on the job. ,f.lhere concrete'frorn a central mixing
materials need not be on the Job.
Setbacks - Subsurfrace Sewaqe Disposal
Septic lqnK
2) C0NCRETE SLAB 0R UNDER-FLO0R INSPECTI0N: To be made after atl in-slab or under-floor building seivice equipment,conduit, piping accessories and other ancillary equipment items are in place but before any concnebe is pouredor floor sheathing instai'led, including the subfloor
3) FB4MING & INSULATI0N INSPECTI0NS: To be made after the roef, all framing, fire blocking and braci;,r: ,:-e in place aridall pipes, fireplaces and chimneys and vents are complete and alI rough electrical and plumbing ar,.: at:proved. Allwall insulation and vapor barrier are in p1ace.
4) LATH AND/IR GYPSUM BoARD INSPECTIoN: To be made after all lathing and gypsum board, interiorand exterior, is'in place
but befor,r any plastering is applied or before gypsum board joints and fastenbrs are taped and finished.
5). FINAL INSPECTIoN: To be made after the building is complete an! before occu_pancy.
APPROVAL REQUIRED. No work shall be done on any part of the building or structure beyond the point indicated in each
successive inspection without first obtai.ning the approval of'the build'ing official,l Such approJal shall be given onlyafter an inspection shall have been made of each successive step in the construction as indicated by each of the inspectionsrequired. r :,
NOTE: All building permits require inspections for the work iuihorized, suth as but not lim'ited to:
A. BL0CK WALL: To be made after reinforcing is in p1ace, but before any grout is poured. This inspect'ion is
required for each bond beam pour. There will be no approval until the plumbing and electrical inspections
have been made and approved.
B. w00D STOVE: To be made after completion of masonry (if applicpble) and when insta1lation is comolete.
Installation shall be in accordance with an approved nationally recognized testrng agency arrd the manu-
facturer's installation instructions.
C. I40BILE H0ME: An inspection is required after the rnobi]e home is connected to an approved sewer or septic
system for: setback requirements, blocking, footing connection, tiedowns, skirting, and plumbing
connecti ons,
(l) Footings and piers to comply with State foundation requirements.for mobile homes or as recommended
by the manufacturer.
{?-) Mobile home minimum finish floor elevation shall be certified when required by a floodplain
management I etter.(3) l4obile home tiedowns, when required, and skirttng shall be installed and ready for inspection
within at least 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure.
D" Sl,JIMMii'lG P00L: Below grade when steel is in place and before concrete is poured. Above grade when pool
is installed.
APP?OVED PLANS I'4UST BE ON THE JOB SITE AT ALL TIMES DURING I,IORKING HOURS. THIS PERMIT I'IILL EXPIRE IF I'IORK DOES NOT BEGIN
I,]i] Ti, .. ] DAYS, OR IF I,IORK IS SUSPENDED OR ABANDONED FOR MORE THAN 'I80 DAYS' SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PLR;i1T UIAS ISSUED 0N rHE BASIS 0F INCOIIPLETE 0R ERR0NE0US INFORMATION.
AN'/ONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS I'JILL DO SO AT HIS OI^IN RISK
SUBSURFACE AND ALTERNATIVE SEWAGE 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 PeTi! holder shall notify-the
oipi.i*eirt by subm.itting the initallation recbrd form. The Department shall inspect the construction to
aelermine ifit compliei with the rules contained in this diviiion. If the construction does comply vt'ith
such rules, the Department shall issue a certificate of satisfactory colpletion to.the permit holder' If the
construction aoes not-Comptv wlth such rules, the Department shal'l notify the pirmit holder and shal'l require
iitittiiioiv ionrptetion-uEtirre issuing the certificate. Failure to meet the requirements for satisfactorv
iompietion *itnii, a reasonaOle time c6nst'itutes a vio'lation of ORS 454.605 to 454.745 and this rule'
From:t0'
t0'
5'
50'
Interior property f ines
Edge of road right-of-waY
Building foundation
Wells, other water sources
Drai nfield
-To-t-'l 0'
l0'
'l 00'
---/
)5)-Zb hne counry0)LANNING & COMMUNITY DEVELOPMEI
ACTIVITY INFORMATION SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
I t,f-tt t-
E I
c I
LIN SS I
J V 7
I
ffi
2 PROPERTY ADDRESS
lAlo'5fr t? I
HOME TELEPHONE #BUSINESS TELEPHONE #
E
fiL-t-aog 7 A"{e' &$,q '
HOME TELEPHONE #
I
( IF DIFFE RENT FROM MAILING ADDRESS)
3 rvrap 6i PAneEL NUMBEFI
( REQUTREp rNF0Rr,lATr0N)
(from tax maps in Department of Assessment and Taxationor from tax statement)
*#*m ffi1 )blmTAxLoW ZON I NG
MINSFIF RANGE SETTI.oII M ZONING
MilNSF]P RAME SETTION M ZON I NG
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION ( if appl icable)
5 REQUEST (state exactly what you plan to do)
.+l*.^e-.
ACRES
LOT BLOCK
,
6 DIRECTIONS TO SITE:l*.*f?ot -
** FOR STAFF USE ONLY **
ZONE/LAND USE:
NUMBER
DATE
-{F
U1
I
BY:
--
DATE:- TIME IN: OUT:
i
t I STATE ZIP CODE
I
e CONSTRU( .-ION/PLACEMENT
PERMIT
USE BLACK INK AND PRINT.
FOP. OFiICf, USL] O\LY
ili|^ii i'"\'laj - +i_,,
!rwo coPies df t'Ians
!r:wo CoPies of Plot Pl-ans
Ilaechanical Checklrst
Ielumbing Chec]:Iist
Pfan Check lnfo Sheet
]O}lPLETE THIS
Hf I)
BLOCK PLEASE
s
't4
1,.
tr PLANNING ZONING:Zone Partition *- Parcel +-
C, -; AL i-nterior
Parcel Slze
rearC
Dlirrj-mum sctbacks: -1, front or{
O
f,rnCust-ria1
flruuri"
()
I-l commercial
Residential
S VALUE
ProPosed
Ex j- s+-ingSUPPLY
r.tuTEL
)(-,t=)
FOR
'ERMIT,iii accordancc
fi
CARE
v
ldirrg
f
i,,iLr,r. .1nd a()rtr'.t I'r'l I f1'r
oi't., lt,r-^' r,'r'r ;'r'"rnfornlticl ltcrn'ln,rcrt: if)'thah alland do hcr.'lr/
I.'ULLY EXAJ.IINIiD TIIN COMPLETED APPLICATION n,,
iila.ces of Lane'1]r'onty alld lho LailsIIwith the Ord fJ'rformed shall be done Division' r furthcr r:t rany and alL work Pc iljthout the Pcmission of the BuicertifY that be mde of any structure sis for cxtlmf'ti(rrl r!'n:)!:''drhar No occuPANCY willdescrj-bed herej'n, and ORS 7C1.055, that if ex€nPt the bato the work and effect as requ'ircd bY I HA\/E P€llD A}{D CIIEC-T.ED TI]TSr's Board is in full forcewith the Builde 055 will be used on this Projec!that registration in compliance with oRS 701and emploYees who arehereon, and that only subcontractors tuA'PL TCA'IION THOROUGHLY.rc *,ar1 .U,t11f1{ (r*l ",u)o
NAME (Please
\tf
fl ," I v.=, see attactred sheet
Comlents:
Lrrscal- lation
Specifications:
ri *f
I f'f,OOOpf,af W i In rf ood hazard area?
fJ nunar, ADDRESSTNG: GR,D cooRDrNArL
tr SP,NITATION:rnstarlation Record lssued? [ vtt f] no
Maximur DePttl
of Treriches
E
Date:
Date:
Date:
B. P. +
Gal ]on
Tank
Lineal Feet
of Drairrficld
Cornments:
Date:
f! pr.eNs EXAMINATION: rype Group-Use
Coments '1r
VT (trt,
CONSTRUCT ION AUTHORIZED BY TH]S PERMIT
Description Sq. Ft
Fixed Fee,/
Unit Cost
Floodplain Fee
Subsurface Fees
Building Fee
Sewer,/Storm Drain,/water
Plumbing Fixtures
Mechanical
Plans Check Fee
state Surcharge
TOTAL FEE
$
$
e
c
frrrt
$
$
$
$
i"Tl
TOTAL VALUATION $
APPROVED BY BU
FEES PAID BY:
By:
I cnecx I casr,
7;r .#t
ILDING OFFICIAL/DESIGNT:E oRs 456.805 I DATE
OF PLA\INING & CO}I}IUNITY
SBE REVERSE F'OR
pnveurPl,lcNt ,/ 125 EAST EIGHTH AVENUE, EUGENE, OFEGON 9']4OLIANE
INSPECTION INFORMATION
?Ai
I rt'I
t ,:,
.t
tl)
)r,
lt
{
il
n
T
-a--
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATICi.; ()F THiS PERMiT,
CITATIoN UNDER PR0VISI0NS 0F LANE C0UNTY',S TNFRACTToN oRDTNANCE, AND/oR oTHER REMEDTES ALLoHED By LAri. :.
l,r'rEN READY FoR INSPECTIoN CALL 687-4065. A MINIMUM 0F AT LEAST 24 HoUR ADVANCE NoTICE FoR INSPECTI0N REQUEST MUST BEGIVEN. Have the following information ready:. permit numbery job address, type of inspection, when .it *itt oe ready,your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED I TISPECTI ONS
'r)
2)SLAB ER-To be made after all in-sl
F0UNDATION INSPECTI0N: To be made after trenches are excavated and forms erected and when all materials for the foundation@ol.wnere-i";;;;i"-;;;i-..ni.ui-,i,.ingpru,t(corrrmon.lytermed,,transitmixed,,)istobeused,materials need not be on the Job.
con p n9 accessor esaor floor sheatfiing installed, in clu
er anciliary equipment items areding the subf'loor.
ab or under-floor bui'lding servicein place but before any c6ncrete io equi pment,
s poured
3)
4) LATH AND GYPSUM
ut rrr aly p AS ng s app ed
Setbacks - Subs Sewaqe Disposal
From Interior property 1 ines
Edge of road right-of-way
-8+i l d ingJoundation
lrlells, other water sources
To be made after all lathing and gypsum board, interior and exterior, is in placeor before gypsum board joinls ana-?lsieneri are taped and finished.
'.il,:I.ffi:.lI':I,l[.I.lftl]]IiiUl,3;"IlIi.:],:fl,;,i;3,l;.Il:.,.i[i,Jlol,.ii,.,o
5) FINAL INSP ECTION:To be made after the building is complete and before occupancy.
APPR0VAL REQUIRED' No work shall be done on any part of the building or structure beyond the point indicated in eachsuccessive inspection without rirst ouiiining-i"l,e"apirorui"ot"it..ouiraing-oiii.iirl' such.approva.r shar.r be g.iven onlyafter an inspection shall have oeen maie or Eu.n-rrii.rrir""rtJp in the.onit"riiiin as indicated by each of the inspectionsrequi red.
N0TE: A11 building permits require inspections for the work authorized, such as but not limited to:A' BL0CK WALL: To be made after reinforcing is-in place, but before_any grout is poured. This inspection is;ff:'[::rt;:03':loo:;i.:;![.ro"' There-wirr u"'no-upp.ov"i untir-tie'piumuins'ana-eiectriiai'iispectioni
B' t^l00D srOvE: To be made after completion of masonrv (if applicabre) and when installation is comolete.instal lation shall be in accordance with an approved'nationatit.;;"s;;.J';";i;;;';;;;;y oi,d'ih. ,unr-facturer's instal lation instructions.
c' I40BILE HoME: An inspection is requ'ired after the mobile home is connected to an approved sewer or septicsystem for: setback requirements, blocking, footing connection, ii;Jil;, stirtinbi inJ-pirruirgconnecti ons .
(1) Footings and piers to comply with State foundation requirements for mobi'le homes or as recommendedby the manufacturer.(2) Mobi'le home minimum fjnish floor elevation shall be certified when required by a floodplainmanagement letter.(3) l4obile home tiedowns, when required, and skirting shal'l be installed and read.y for inspectionwithin at least 30 days after occupancy. Tiedowis and skirting-striir-ue irtiiri.i p.i'in.torr.".
D. SWIMMING P00L: Below grade when steel is in place and before concrete is poured. Above grade when poolis instal led.
APPAOVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING I^JORKING HOURS. THIS PERMIT WILL EXPIRE IF l/lORK DOES NOT BEGIN!'iii.tlt .,.:l qAIl'_0B IF |,I0RK Is SUSPENDED 0R ABANDoNED FoR MoRE THAN t80 DAys. suspENsroN 0R REVocATToN MAy occuR rF THrsPERIIIT l.lAS ISSUED ON THE BASIS OF INCOMPLETE ON TNNOIITOUS TI{TONI,INTIOT,I.
ANYONE PRoCEEDING PAST THE PoINT 0F REQUIRED INSPECTI0NS I,,IILL D0 S0 AT HIS ot{N RISK
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
(t )
(?)
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 shall notify theDepartment by submitting the installation record form. The Department sirall inspect the construciion todetermine if it complies with the rules contained in this division. If the construction does comply withsuch rules, the Department shall issue a certificate of satisfactory completion to the permit holbei. If theconstruction does not comply with such rules, the Department shall irotify the permit hoider ana snil requiresatisfactory.conrpletion before issuing the certificate. Failure to meet the requirements for satisfactorycompletion within a reasonable time constitutes a violation of ORS 454.605 lo 454,745 and this rule.
Septic Tank Drainfield
-Tdr-l0'
'I 0'
5!
50'
'10'
10,
I 00'
7
-
l^\t
LANE COUNTY INSPECTION RECURD
PH ONE N EROi^lNT.R'5 NAI{t
N N
E
ET BACK REQUIR NTEME
C1
S
SIDE
#P ING FIXTURES
FRO T I NTERI OR REAR
K Y PERMIT
D CT ONS TO SITE
/ffi/(
PERMIT N
FOOTiNG / FOUNDATION INSPECTION MOBiLE HOME SET UP IN SPECT I ON
Approved Correcti on Di sapproved_Date Inspector
CONCRETE SLAB / UNDER-FLOOR INSPECTI ON
Approved Correcti on- Di sapproved-l Da te I nsp ec tor
UNDER SLAB / PLUMBING GRO NDWORK INSPECTIO
Approved Correcti on Di sapproved Date I nspector
NOU-CIT T I- UI'18 I NG I NS P E CT I ONApproved Correcti on Di sapproved-lDate I nspector
FN.AMTTI NSPECTION
Approved Correcti on Di sapproved--Date i nspector
T-I$UIATIO[\|-7 VAPOR BARRIER I PECTION
Approved Correct'ion-Di sapproved Date I nsp ector
YP
Approved Correction DisaPProved Da te I nspector
NII'IAI- PI.UMBING INSPECT ION
Approved Correction- D'isapproved Date I nspector
FTNAL WASTE DISPOS
Approved Correctjon D pproved Datersa
AL SYSTEM I NSPECTiON
I nspector
FI ECT DIN MOB L E
Ap r0ve Correcti on pp roved
qf
CER T
Approved
e Ins ector
I 0F0CY
Form C74-197
Correct'ion Di sapproved Da te
P
2
TI
/
'17Lru,t ;{,+L (fu
\
1"/.
Fb't