HomeMy WebLinkAboutPermit Building 1973-10-05t\l
IANE COU T BUILDING PERMIT OR BIIE VlE USE APPTICATION
PERMIT TYPE - BUILDING MOBILE HOME REG. #PERMIT 4.7-1_d
OWNER MAITING ADDR
MAILING ADDRESS
PHONE
PHONE
PROPERTY LOCATION _ INCLUDE POST OFFICE
i ,i ,
PROPERTY LEGAT DESCRIPTION
I.OT-BLOCK_SUBDIV.
TWP RANGE
o_2_
,d*1,6 METES & BOUNDS
ATTACHED
YES
NO
SEC. z3cl TAX IOT CODE CENSUS TRACT
"/ /z dt' : t'15o
lpp(rclNr
NAME
AND
MAITING
ADDRESS
DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY
IEGAI. ACCESS TO PROPERTY ROAD NAMT OR
t,c-4-
PROPERTY SIZE-W DEPTH AREA
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms
STRUCTURES TO BE BUII.T THIS PERMIT
Connect to Existing Sewoge System or New
TYPE CONSTRUCTION SQ. FT
t-4\2,
rtr 3
0
VAI.UATION
3b a)72-
-Z-,t-,t--a--a,<--z.d- ed*?<-/J-oy' 0-*"*rv /a1423; //o
DISPOSAT PI.UMBING INSTATTED BY
OWNER OTHER NAME
PLANS FURNISHED
YES
PUBUC tr
BtDG.
WASTE DIS.
PI-UMBING
PI.AN REVIEW
PARK TRTR.
SEPTIC TANK
2A . f.4
OTHER
FEES WAIER SUPPTY
PUBTIC
FIXTURES
CASH !
CHECK
PERMIT
OTHER YES NO
o
3
DATE
TOTAL
NEcnoN FEE -J . t-{)
PUBTIC WATER
coNNEcnoN FEE / ,
COUNTY BUILDING & SANITATION SPECIFICATIONS
-a
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[.
DRAIN FIETD REQUIRED
tIN. FT.TRENCH WIDTH FT OR SQUARE
ZONE REAR YARDoccu PUBTICTYPE OF STRUCTURE
BLDG. SETBACKS _ FT ROM CTR.
FRONT 5 stDE rNT
Directions to Find Property:
RIGHT OF WAY
SIDEat+-
EASEMENT
USE CTASSIFICATION
r-
Form # css-tz
PTANNING
o
Dqte
REAR
I NSP.z
COPY I - OFFICE
COPY 2 - JOURNAT
COPY 3 - AUDIT
J0/2 74/so {o
,rrr,/3vE@
-/
PERMIT OR MOBIL IOME USE PERMII
LANE C {TY BUI:DING PE RMIT NO'
PHONE
MH
BUILDI NG
MAITIN (,lopnrss PHONE
inoprnrv OWNER
MA ILING
pnoprnrv
pnopenrv
TOCAT
LEGAL
loN -
DESCRI
INCTUDE
PTION _
POST
METES,
OFFICE
BOU NDS TRACTCENSUs
CODE
secrto N
neuce
APPL.
NAME
&
MAITING
ADDRESS
ixtsrtuc ON
DEPTH
LEGAL
WIDTH
ACc ESS TO
sze - rr,
AREA
New m
loNSyste
FT
m
ONLY Connect
Tvpe co
to Existing
NSTRU CTION
s [nuurt
PERM ITS BDRM
R MOB ILE nomr
ALLED
5Q
BY
FO
No. of Bedrooms
Einucru RES TO er eutu:r ruts p ERMIT
FLurtnstNc INST
OTHER:NAME
SEWAGE D ISPOSAT
PUBLIC
BUITDING
WASTE DISPOSAL
PTUMBING
PIAN REVIEW
PARK IRAILER
SEPT IC TANK OTHE
OWNER
WATER SUPPLY
F EES
(,PUBLIC tr OTHERn
SANITA
REQUIRED
rroN sprc rFlcATlo
WIDTH FT
ZONE
usr ctlsstrtclr
DRAIN FIELD
tIN. FT
OCCUPANCY
NS
TOT UNTY BU
OF WAY
ilotNo aco
,rruN. SePftC flNf CAPACITY
WITH DIST BOX: GAt.
TYPE OF STRUCTURE
BLDG. SETBACKS FT FROM CTR. OF
FRONT SIDE INT
BTDG, PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PLUilB'NG - .,4NAPY
BUILDING - GREEN
SANITATION _ GOI.DENROD
Construction to comply with unifo.rr
covering Plumbing ond sewoge dts
ii o.lr"p"'n.y before being occupied
TRENCH
OR SQ. FT
PUBLIC UTIL EASEMENT
toN
ROAD RIGHT
SIGN
SIDE EXT
ATURE - DATE
REAR DATE
AUTHORIZED
m building code qnd county regulo.bns
posol. All buildings require o cerlrttole
(See Stotement on Reverse Side)
(Posr THts pERM,r ON /r4A,N BLDG. Af S|TE)
ronu !l 655- 13
I.ANE COUNTY, BLDG. & SAN. D'V.. COURI HOUSE, EUGENE, OREGON 9740I
-
-? ./lJ,C,LOT
-_
-2ALBuilding Permit Appl ication No.
( ) Site tnspection
( ) Pre-Permit lnvest igat ion
LANE COUNTY P LANN ING DEPARTHENT NOT
ippl icab lel. Zoning 0rdinance Compl iance r)-( )(Zone
Subdivision 0rdinance iance ( ) ( )
Requ i red Access
-73 Nrtjtl E
ADD RES S
PHONE
DATE
NO YES NAI-i E Dr\TE
)
2
3
4
5
(r-
(Y-
(+--()
()
(
()
() ()
Building Site (Area, Width,
Frontage, Setback)0ther (see comments)
COH}AENTS:
EUILDING INSPECTION SECTION
6. Plans Submitted
7. Soil Stability (footings)
8. Flood Plain
9. 0ther (see Conments)
NOT
appl icable
NO YES
N
()
NA},IE
(I
,b
()
()
()
()())-tz -?>
COHHENTS:
SAN ITATION SECTION
10. Sewage Disposal
I l. Usable Area
12. lr/ater Supply
|3. 0ther (see Conrnents)
NOT NO
EEi'!_1cau te--Tl-( )
YES
N
(>{
A,
()
()
()
NAI'IE DATE
(-
((
)
,)
COH}tENTS:
TO APPL ICANT:
vou/Auilding Permit / Sife tpspection:
(n{ can be approved. to/ts/13
( ) Cannot be approved at this time as indicated on item N0.
Questions and further informa
COUNTY PLANNING DEPARTHENT"
tion on items I through 5 contact t
Quest ions and further informat ion o
above.
e ane-
n i6E5
through I l contact the Lane County Euilding and Sanitation Division.t/ill be held in this of f ice unt il you can resolve the problems indicated,
ls being returned.
Your building permit application fee is being returned under separate cur'er.
:
LANE COUNTY PLANNING DEPARTI,IENT LANE COUNTY BUILDING S SAN]TATION DIVISION
l3f 5l;1f1 lvente East, Eugerre, 0regon 97401 135 Sixt,h Avenue East, fttqenr', 0regon 97t+ot
?nou€ 3{2,.13 I I EXI . 2lt PH0NL : 142't ltt Exr. 4I I
()
()
()
M55- 'R
!g!_r-2ll!G s trE EVALUATtoN
APPL
'
CANT
T R
/U /o-3-=t3
DATE
Dote
-23
Permit No.
CURB CUT
ORDERED, thot o permit be ond is hereby issued to _
or constructing fhe following focility:for plocing, building
PERMIT
IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY
WHEREAS' the oitoched opplicotion hos been fully considered by the Boord of county com-missioners of Lone county, ond'ii is the "pi;i";;;a'1-rdg-unt of the glo;a rhor rhe soid opplicotionshoutd be sronred, ond ih"r; p"rlir;dri;-b"";;;J;;, now, rherefore, ir is hereby.
upon the right-of -woy of County Rood No Mile Posttnstrict conformi ty to the exhibits oftoched heret o, ond subiect to oll term s, conditions,ogreements,sfipulotions ond provisi,ons conloined in the o ppl icotion ond Per mit, the Rules ond Regu lotions Gov-erning Focilities to be Permitted upon County
thereto, ond ony other oppl icqble regulotions,low or ordinonce.
uql 50.190(2) ony
Speciol Provisions:
omendments
2
Drivewoy will be construcled !n occordonce with the ottoched drivewoy opprooch specifico-tions (Drowing M98-50).
Permittee will be responsible for the immediote removol of oll mud, dirt ond debris from theroodwoy.ond right of woy coused by his op"rotion, leoving the roodwoyond oreo in o neot,occeptoble condition.
BtUE - ROAD SUPERVISOR
ORANGE_BUIIDING & SANITATION DEPT
YEI.TOW _ REAI ESTATE
Rood Rights-o f-w oy, os set forth b y the Lone Mon-
Approved by Boord of County Commissioners
By
This permit is revocoble ot ony time, ond will be strictly odhered to ond no work other thon
thot specificolly mentioned obove is hereby outhorized.
This permit sholl be void unless the work herein contemploted sholl hove been completed be-
fore
Dote
l9-. Expires , 19---
lnspected ond Approved
By
WHITE _ OFFICE FILE
GREEN - RESIDENT ENGINEER
PINK - PERMITTEE
Direclor of Public Works
c98 -7 9
e.,
I
Dote Building Permir #
APPLICATION FOR FACILITY PERMIT
(Appliconr's Nome)
hereby moke opplicotion under Rules ond Regulotions Governing Focilities to be permitted UponCounty Rights-of-Woy, to construct the following focility:
Upon the right-of-woy of County Rood No.ot mile post on the
side of the rood, ormo
os shown on the exhibits which ore ottoched hereto, in strict conformity to the stotements of the
exoct noture ond omount of work to be done, ond to the description of the focilities contoined
in soid exhibits' The opplicont will be the principle owner of the focility qs constructed, or other-
wise primorily lioble ond responsible to members of the public for its proper mointenonce, repoir,
operotion ond use' The opplicont occepts oll terms, conditions, ogreements, stipulotions ond pro-
visions' in Rules ond Regulotions Governing Focilities to be Permitted Upon County Rood Rights-
of-Woy, os set forth by the Lone Monuol 50.190(2), qny omendments thereto, ond ony other op-
plicoble regulotion, low or ordinonce.
Signoture
Add ress
Zone
WHITE - OFFICE FILE
GREEN - RESIDENT ENGINEER
PINK _ PERMITTEE
c98 -78
BIUE - ROAD SUPV.
ORANGE-B[DG. & SANIT.
YEITOW - REAT ESTATE
),
No.So.E.w
To Permits Processing Noted
Dole
Noted
Director
Principol Engineer
Subdivision Engineer
Permit Engineer
Weighmoster
Phone No.
t,
LANE C ,NTY
BUTLDTNG I
BUILDING PERMIT
MHE
OR MOBI. dOME USE PERMIT
PERMIT NO.
PROPERTY OWNER MAII.ING ADDRESS PHONE
CONTRACTOR MAITING ADDRESS PHONE
PROPERTY TOCATION _ INCI,UDE POST OFFICE
PROPERTY I.EGAT DESCRIPTION _ METES, BOUNDS
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPPt.
NAME
&
MAII,ING
ADDRESS
IEGAL ACCESS TO PROPERTY
PROPERTY SIZE - FT,
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge Sysrem !New System !
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION sQ. FT, # BDRMS VALUATIoN
SEWAGE DISPOSAT
PUBUC tr SEPTTC TANK n OTHERE
PI.UMBING INSTATLED BY
OWNER E OTHER: NAME
BUITDING
WASTE DISPOSAL
PTUMBING
PI.AN REVIEW
PARK TRAITER
TOTAI.
FEES WATER SUPPTY
PUBUC tr f] OTHER
$_
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
DRAIN FIETD REQUIRED
TIN. FT TRENCH WIDTH FT OR SQ. FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT
BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT, SIDE EXT.
USE CLASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
BTDG, PERMIT _ WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PI.UMBING _ CANARY
BUITDING _ GREEN
SANITATION - GOTDENROD
Construction to comply with uniform building code ond county
covering plumbing ond sewoge disposol. All buildings require
of occuponcy before being occupied.
(See Slotement on Reverse Side)
regulotions
o certif icote
(posT THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, BIDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I
eonv # c55- t3
SLAB FLOOR
PLUMB ING GROUNTI^,ORK
Ap pnov r o
Rrul nx s
DrslppnovED Der r I Nsprcron
GAS PlPl NG GROUND,,/ORK
AP PRov E o
REala nx s
D r SAPPRovED D Dar e I ruspecron
ROUGH PLUMBING
Appnoveo Eq DrsrppRovro
Reuanxs
I Nspecr v
ROUGH GAS
Ae pRov e o
Re ltanx s
PIPING
Dr sappRovro D DrrE I Nsprcton
FINAL PLUMBING
Appnoveo K DtsrppRove, D oorr2-,t?4L
Re uanr s
I NsprcroR
FINAL GAS PIPING
Appnoveo D Dtsappaoveo D
REuenr s
Dare I NS PE croR
CERTIFICATE OF OCCUPANCY
Reaov ro lssuE
ReuaRxs
D Nor RcADY ro lssuE D Dare I xspEcroR
D o^,/L_72..2__
11,/r
LANE .--.UNTY BUITDING PERMIT OR MOB. - HOME USE PERMIT
BUTLD|NG I MH E PERMTT NO.
PROPERTY OWNER MAILING ADDRESS PHONE
CONTRACTOR MAII.ING ADDRESS PHONE
PROPERTY TOCATION _ INCTUDE POST OFFICE
PROPERTY TEGAT DESCRIPTION _METES, BOUNDS
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPPI".
NAME
&
MAITING
ADDRESS
LEGAT ACCESS TO PROPERTY
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing
TYPE CONSTRUCTION
m New m
BDRMS VALUATIONSTRUCTURES TO BE BUILT THIS PERMIT SQ. FT
SEWAGE DISPOSAT
PUBUC tr SEPTIC TANK oTHERn
PIUMBING INSTALTED BY
owNER I OTHER: NAME
$F EES WATER SUPPTY
PUBUC tr tr OTHER
BUITDING
WASTE DISPOSAL
PLUMBING
PTAN REVIEW
PARK TRAIIER
TOTAL
COUNTY BUILDING & SANITATION SPECIFICATIONS
AAIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAI..
DRAIN FIETD REQUIRED
TIN. FT TRENCH WIDTH FT.OR SQ. FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT
BI.DG. SETBACKS
FRONT
FT. FROM CTR. OF ROAD RIGHT OF WAY
SIDE INT. SIDE EXT.
USE CLASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
BI.DG. PERMIT _ WHITE
OFTICE COPY _ WHITE
COUNTY TAX - PINK
PTUMBING _ CANARY
BUILDING _ GREEN
SAN ITATION - GOI.DENROD
Construction to comply with uniform building code ond county regulotions
covering plumbing ond sewoge disposol. All buildings require o certificote
of occuponcy before being occupied.
(See Stotement on Reverse Side)
(posT THIS PERMIT ON MAIN BIDG. AT SITE)
TANE COUNTY, BIDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I
ponru #css-,3
S ITE lNSPECTION
Ap pnov r o DrsappnovEo
I
Dare I NsPEcroR
ReurRxs dar&//o-22'z
FOUNDATION I NSPECTION
Ap pRov e o
Rruraxs
Dr sappnoveo Drr E 6"-LI Nsprcton
FRAMING INSPECTION
I rspEcroRAp pnov e o
Renanx s
D r srppnovEo
LATH OR SHTETROCK INSPECTION
Ap pnov r o
Reuanx s
D Drsappnoveo V Dar r I NsPEcroR
FINAL INSPTCTION
AP PRov E D
Rruanx s
D t slppnovEo o^,21-?_-7/I NsPEc
//{-7f (a
CERTI FICATE OF OCCUPANCY
Reaov ro I ssuE I ruspecroR
RrurRx s
I
7Cr
Nor Rrrov ro lssur Drr e
-
-
a-e./62
I
F.EEG'
D o^,, //-2?'ll 0d