HomeMy WebLinkAboutPermit Building 1982-06-09@
CO}IPLETE TIIIS BLOCK. PLEASE USE BLACK INK AI'JD PRINT.
a (\l :i: :- I a i. ,Lr s I i:::_Y
Ap:rIicrt.j.o
Pernit !
!rro Copics of Plans
f Tro Coo j c:s of Plor P1,ans
Iltcchanica] CncckLrst
I I,l umbj nc Ciiec):I j-st
^ftftf=dry-
I)1an Checii lnfo Sheet
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E4esidentiat
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Proposed
Exi sting
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TI]LL;
trn
I IIAVE CAREFULLY EXA-I.II
certify that any and all
TilE COMPLETED APPLICATIOI,I FOR PERMIT, and do hcrctry ,rcrt-ifi. thot all inforFation he!4rn i,i true n
work performed. shall be done in accordaDce with the Ordirrrtccs of Lane Coulrt.y and tl)e La?s of thr. S!Jl-
Z
fu,,",
I conrr"c:or
!;gort
a'rd I f urtlr,,
I Orr:.f)n I,cr Lainin.,
to the work described herein, and that.NO OCCUPANCY vill be made of any structur. without the pernission of the Buildir)g Division. I furthar c(rtif)
Lhat regisLration vith the Builder's Board is in full force and effcct as required by ORS 701,055, that if exempt the basis for.ixcnf'tion is not.:d
hereon, and th3t only subcontractors and enployees who are in compliance sith ORS 701.055 will be used on this Project. I HArrE READ AllD CllECruD THIS
THOROUGITLY Rrsge euto
L, ZtS*6'.-
NAME (I)Ieasc print)
tr PLANNING ZONING:Zone Parcel ,rru€6'XfrB'
,",' \5'Q(lt--'l'lir)rmum sctbacks, c",
f.'o.,. .QN t",E-
Part-it.ion f,
side
Parcef I
interior "'4
'X3,a,aluii:.---rL}'
Z
kAiic'
As
f tpP
tr FLOODPLAIN:In ,flooC hazard area?ff"" '[ ves
RURAL ADDRESSING: cRrD cooRnrr,Arr:
SANITATION:rlfiQaz rnstalLatiorr Record rssued? [ Yu" ! Ho
!1ax1mun Depth
see attacired sheeE.
E
Date:
Date:D
x B. P
Insae]lation Gal 1on
Tank
Lineal Feet'
of DrainfieLd o{TSpecifications:
Come n ts
Date:g PLANS EXAMINATION:rrn" 5 l,/ , Group---JL\--- use t-AT<?rrrT-
Corments
7.-(
scription
CO}ISTRUCTION AUTHORIZED BY THIS PER}IIT
Floodplain Fee $
Subsurface Fees S
Building Fee S
Sgwer/Storm Drain,/l'Iater $
funrumbing Fixtures s
Mechanical S
Plans Check Fee S
State Surcharge S
Fixed
Unit4
. Fee/,"&-v7-=-
-ry$-52-Z
TOTAL FEE
FEES PAID BY:
TOTAL VALUATION $
Date:
PER,MIT APPROVED BY BUILDING OFFICIAL,/DESIGNEE 456
LANE COUNTY DEPAP.T!,1ENT OF PLA}iIIING & COM}IUNITY DEVEIOPMENT,/ I25 EAST EIGHTH AVENUE'
SEE REVERSE FOR INSPECTION INFORMATION
s
^i-
DATE
GENE, OREGON 97
"1
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CONSTE "CTION/PLACEN,IENI
.
: PERM Ir V\4 QrP
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By:
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COI\IPLETE THIS BLOCK. PLEASE USE I]LACI( I}JI( Ai']D PRINT.
SltlP
Api,licatio
I,ernit t
[] f '*"o Co!-,rcs of I)l ans d
!';'ur,, Cc;rr t::: cf l,ioi pla:rs
f] ::c-'r-'i:a:, I c:r I Cireckir s t:
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L'I
I IIAV' CAREFULLY EXAM
I,lan Ch(lcir In:o Sheet
7"lt l.I
fJ t:.cusrrial
Ll , uDI,-c
I Proposed
I rzi s"-ing
zzz
TllE cOMpLETEo APPLICAI'ION t'(rt PnRHtT, and do hcri:trT , crLifi, that all infornitron lrer4rn t:i lrr!: ,1
'.trLtFt
LLL,
on
,[d I furt
certlfy that any and all york pcrforrcd. shall be dono ln acqordance vith thi: orditrancctr of Lane County and thc l,axs of th(: stll
to the work dcscribed herein, and that'ilo OCCUPA:iCY vll1 be made o! any structure uithout. thc pcrnission of the Building Divisi
t Orettrn l.qrtairin t
I furth4r c(frtil'
thlt registration yith the Buildcr,s Board is in full force and eff.rct as required by o8-s 701.055, that if cxempt the basis for exent'tion i.i not.id
hereon, and thsf only subcontrac[ols and enployecs uho are in cor,pfiance uith oRs ?OI.O55 wj.11 be usad on this projcct. t HAr,rE READ AlrD CllECfxD Tl{Is
ii.j^ t.Q'.t.t7 .-,a{a(,DbWH,a,ahr{:i.;li
Os
cutl
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d<xr"t'td
6.- 7-trk fl conirac'-or
. D. re I igcntNAlr.ti: (please pri.nt)
D PLANNING ZONING 2 zone 4.&o ^J,"r., "ido .F)
Ct.-t. *-i- '
i.nteri.or -'dIlinimum bctbacks, CL, ftbn
""r"rt ,rr"€6 tXE3'
,.,, \5'e(E*'
W--{
tr PLOODPLAIN:
,RURAL ADDRESSING: GRID c00RDlN^'rii
rn fto*'hazard'uru"r fr no ! ves
Da
see attached sheet. Date
E).ltr
d SAIIITATION: s. r. I r /{oa I Date
nstallatiorr Record Issu".d? [ tur I f.:;
llaximw Depth
ol Tle
Date:
lnsta 11 atlon
Specifications r
Gal lon
Tank
Lineal feet.
of Drainficld
g PLANS EXAMINATION: ryPe 5 V , "'o*--$--
Commerits:
(
scription
Pixed
Unit ,
4,
Fce/"w
CONSTRUCTION .AUTHORIZED BY THIS PERMIT
Floodplain Fee $
Subsurface Fees $
Building Fee $
Sj'*erlstorm Drain,/ttatcr $
Vfu&"unrbins t'ixtuies $
Flechanical $
Plans Check Fee $
State Surcharge S
TOTAL TTEE $
FEES FN.ID EY:
Bl":
*-v7'#-''
I L
.{56 I
$]:lj REVNR.Hf:;.TN$Pfl CTION INT'OBJ,IATION
D.qTI
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lF'
coNSt-',ucTioN/P[_ACEIvIE] ,
PEI?N{ iT v\q e,*-L.\ Y
(r
pf.csidcn t- i a1
fl connercial
TltoRol)GilLY.t
ParrrEton fi Parcel { - -
/{2
f
CorNIrents,
u""_ fAT(tr7fLT
,r-\
LANE COUNTY INSPECTION RECORD
OhJNER'S NAME P HONE ER
Di NS SIC E
PERMiT NUMBERSITE ADDRESS
NG/
Approved
N
Correcti on
E LE E T
D i sapproved_Da te 7- 27-_84.nsp ector
CONCRETE SLAB / UNDER-FLOOR INSPECTIONApproved Correction__Disapproved Date I nspector
UNDER SLAB / PLUMBING GROUNDl,jORK INSPECTIONApproved Correcti on D'i sapproved Date I nspector
ROUGH PLUI'1BING INSPECTIONApproved Correction Di sapproved_Da te I nspector
FRAMiNG iNSP
Approved
2
INS
Approved
TION
Correcti on---.Di sapp roved Da te
N N
Correcti on Di sapproved Date
I nspector
I ns pec tor Li1^/e th-/
tl re++
U
LATHT GYPSUM BOARD INSPECTION
Approved _ Correction Disapproved _ Date I nspector
FINAL PLUMBING INSPECTIONApproved Correct'ion- Disapproved Date I nspector
FINAL bIASTE DISPOSAL SYSTEM INSPECTION
Approved Correctjon Djsapproved Date Inspector
INAL INSPE T N BUILD
Approved
B LEH
Correction i sapp roved Wlnspector--e
E
CERTIFICATE OF OCCUPANCY
Approved
TEMPORARY CERTIFICATE OF OCCUPANCYDate--_---Inspector--
Form C74-197
Correcti on Di sapproved I
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Pernlt #
Permlt /i
Perml t#
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Pernlt #
Permlt
Pernlt
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For
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Subdivision
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Islot Plan For
For For
For For
Block
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c74-L50
Vlcinlty Map N
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lane county
HOTID StIP
APPLrcATron + ?E f____-?_& __
LOcATlon .A_8-ln ._U!1'!_A ___l42Af_
U[t\ti_ou_ _!, _R\SSEE_u_w .___ NAME
,-8 r.t_. _\'JtLL _ _ l4AJ ADDRESS
sPKuf,o F-Le-!=D --t - OK-- l1r7,lr1r1
The above application is being held for the fol'lowing reasons
O NEED sKeTcH frt^ooe.er-nu) o t ts xtsr tN(2 HousE
SHo,.^r11.y6 AN5 poo3. {- r-r.r}NDo\L) OPeNlN6S ON \aALt-
ADtRceUT- To NErt-l Prcorose} cA3,FcXS, AL5o lt.rDlcNTe
Rootr 6t;Le AND ilLe OF Z:.YTeRroK OPer*rr$GS FKaiA
Tflos6 6oolA$ A5 weLL As U SA6e crc7chcV, Beotroou er<)
3F CoNuEuTror.lAu F RAA^ED ooF (trre) ls U6€p \^rrTH
Jr.cr RArveR.s oP?osr uG Ne
R\Dr e / Ce\r-reR. R.ATE p \^ttLL SeAK AT
/6 + FeeT F Ka^^ eAU
w Auu) BE cAv 5e T R€
I5 lrt rl" u'/cetr-rpG T
a,lt trULtu96 0Ne
R 1' -tustDe oF E xlSTlr.rc
s PA lJ o F ?.Xb FAFI6 R.'
FT€R5 \.,$ t L L HAv€ TO Be
7oY1 tro R Yo uR rtDDlrraPAu z.t/Fo\oF yruE6(ercu J_ JVLt gZ
DAT-E-7
BRAceD trFol't 6xtsr tN(= '''e'rALt- z
?reAs6 veKrF\,l T,tr HrP RAFr€R/Rtvce To Be
t0+ F€eT oRl ^5 s*lav..t$ oN YovK PRAwiuG
t
687-4061
PHONE HOU RS
This appiication wi1 be hetd unti1^ 4{/6AIT If the information required
above has not been furnished by that date your app'lication will be cancelled.
RETURN'THIS SLIP t,lITH THE ABOVE REQUESTED INFORMATION.
BUILDING & SANITATION / PLANNING & COMMUNITY DEVELOPMENT DEPARTMENT
125 East 8th Avenue / Public Service Bui'lding / Eugene, 0regon 97401 / (503)687-4051
nvjlLaLlr sY APPoTNTMENT 0
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