HomeMy WebLinkAboutPermit Mechanical 1986-10-21lane Co ty Authorization for -J,T7 ./-,e 'l,ke Z,act g:!:;f";,=ffi-f_tra-
I-2-a PROPOSED USE OF PROPERTY
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CITYS?REET ZIP
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IC\4ORK
Proposedisting
SUPPLYOF
NUMBER
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OitNER S AND ADDRESS
TELEPHONE NUMBERIS NAME AND
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DATEtl't,/r-{9-
&,.''shall bef!rthe
thatandandtruecorrectreonheainf oira tiontithathereL),t1o ce fyITPERMandLICATIAPP!-oRONCOI4PI,ETEDTHEEXAMlNEDCAREFULLYIIAVEI zea t.authori a9enco!uprrrchase rrecordaTthetrestnproperty Stathe ofleinteLawstheof OregonfollowingtheIegaICouandhaverdolltanceLanetyofthr:thaccol dailcedonerf omed fur-alIand work UA on IPethatofBuitheanyronldingcertifywaureoutrhtireofpes t-r uche1lnadear,-1wrthaandNOtOCCUPANCYherein forbas isdeworkcribed exemptionthethetothatexenptifrtaininguadoRs70peASffectbyanforcereqrrtfulla5anlderBoardsANDrhBuitheREADIHAVELrationthonect1Sregthatusedbeprojrthece rLify 701oRs 055waanceth1nwhoconpliareedemployee
'r7<.4/
j.s noted hereon, and that only subcontractors
CHECKED THIS APPLICATION THOROUGHLY'
rnstallation *u/ota rssued? fl v"= [ N"
Lineal Feet
of Drainf ie Id
Date:
o-Date
zb
Date
Use
}(
tr SANITATION:
front
PLAN S EXA.}4INATION
Minimum
COIA1ENTS
72
C L,s idecL,Setba
B. P. *s. r. f
YOUR AUTHORIZATION I]AS BEEN BASED ON THE FOLLOWING CONDITIONS:
CO}I}1ENTS
rearinterior
COMIIENTS:
READ THIS SECTION CAREFULLY '
Maximum DePth
of TrenchesInstallation Gallon
Specifications: Tank
partition *- Parcel *- Parce1 size
l-1 pr,axrlrnc/ZoNrNG :
LY PC
/o -z/- ea
PEruTt APPROVED BY BUILDING orrtcrel,/pestclren (per oRS 456.805
DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DI
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INI'ORMATION
DATE
vlsloN, 687-4061,
LANE COUNTY
C L4-.25 R8+
RURAL
D
(,to\lo
u
[-ood StoYe Per]rit Application
A PERMIT CANNOT BE APPROVED UNTIL A COPY OT THT MANUFACTURER'S
INSTALLATION INSTRUCTIONS IS SUBMITTED
* NAME T-,/ll PHON E
* ADDRESS FOR INSTALLATION rty 4iL I
I
* NAl,lE 0F MANUFACTURER edh MODE
ORS #
llrild/U ,t/r4 I
I
I
I
I
I
It,
* INSTALLER a.7;L
CIRCLE THE SKETCH I4OST
CLOSELY RESEMBLING YOUR PROPOSALCONSTRUCTIONI
* A. The unit is listed or: flul
B. The floor protection is
)t-
I
1
11flrcao no*rer (name)
inches thick. (t{aterial )
C. The wa'lI protection wilI be: (Material)
* 0. Type of chimney:tr Factory $turon", (lined? W", fl^")
L_ _ _t- --.' rL_-L-
0ther ,I
sht. mtl
DIMENSIONS: ('in i nches )
I. Side of unit to protected wall_(unprotected wall_)
2. Rear of unit to protected wall_ (unprotected wa'll )
3; Floor protection at side of unit_ at rear _in front __
4. Length of wall protection at rear of unit-at side
5. Height of wall protectiorr_
5. Edge of wall prot,ection to nearest door or window
7. Air space between wall protectlon and wa)l_
8. Diameter of chimney and stove pipe(ve nt connector)
NOTES:
(l) Outside combustion air is reortired for all fuel burning installations. A 7 Sq. inch (min. area)c'losable vent loc
ated within 24" of the fireplace or appliance on the floor or base of a wa]l.(2) A c.opy of the approved manuiacturer's installatlon instructlons must be on Job site at ttre time*flnspection. In-
_ spectlon cannot be rBde with out these instructlons. , ,' . . i i(3) The 'Approved'plan/appltcation shall be kept on the Job slte for'use at the time of inspection.--(t) Hot all unltr are appiioved for corner lnstallatlons or reduced clearances with wall protection. (Refer to manufac-turer's llstlnq. )(5) If masonry chimney is to be used, it must be lined (Required by Law) IxlstlnEllges must.:5e approved.by-inspector
_ ,riol.tq use. Y-ou musr jroy'idF ac&ss for the insoector _ i
;,
(t)
1r. lll;!l::.jri:;:
is to be installed, verif:catron ot wall header'location rn relationshio rto breast of fireplace
' tll iitiiliil-iniiri?"i"e not.pemitted tn factory-buttt or prefaDrtcit€d-mtal "ol clearancp figep,laces,-unless
speclflcally tested and llsted.(a) fireplaie l'nserts a.e not pemitted in masonry flreplaces wlth exlstlng hert form type mtal flreboxes unlessspeclflcrlly tested and llsted,(9) Unlftted units shall be lnstalled ln rccord with the State Mechanlcal Code, utllizing the materlals and clearances
set forth ln Ch.pter 5.
c-74-32 APPROVED AS NOTED
By
Dale ,/{:) - o( L)\-L) ,
PERMIT #
E. rype 9f stove pipe. : , J-lFactory flzosu (or heavier) salv
( venE connector,I
t-r-
,.1,
r1-
r:t
LIl.llr
r:l
Lr
L,tl
--[l
--f I--E/-1
l_
t-_
3'
l-
t-r
IF YOUR INSTALLATION DIFFERS
FROM THESE EXAMPLES OR IF THE
INSTALLATION IS A FIREPLACE
INSERT, PROVIDE A PLAN AND
ELEVATION DRAWING ttllTH DIMEN
SIONS OF YOUR PROPOSAI.
I
LAND MANAGEMENT DIV. / PUBLIC II0RKS DEPT. / 125 E. 8th Ave Eus. 0R 97401 (s03)687-4061
\
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u
/c)l(PEC-fioL)FoRE lilgrAll /L tusEKr-
33sA-AG
COMPLETE THIS SECTION.
A IIVITY INFORMATT _-N SHEET
INCOMPLETE FORMS I^JILL BE REJECT @ED!
pd.Ja So fu d N-f A
E
&A^rJ,
I tP {7 {p,(,,?a
2 PROPERTY ADDRE
( IF DIFFERENT
SS
3 rvlep s PAFICEL NUMBEFI
r NFORMAT r 0N )
(from tax.maps in Department of Assessmeor from tax statemeht)
03 Cyj) 7aa o
RANGE SETMN @
(RE IR nt and Taxation
frf\/7
MTNSH]F
ING
MTNSFTP MN_GE SEeTIor.r TAX LOT(s)on pnneEl-7 Z6NlIi-e---
M]iNSF-IP RANGE sEermN
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
@ mNlxc--
ACRES
4 SUBDIVISI0N (if appt icab'te)LOT BLOCK
5 REQUEST (state exacily what you plan to do)
lt e 4(r< ./
(
rl Se P,
6 DIRECTIONS TO SITE:A o€eil 8B,d €d, I 8/a e
r]6 d* .(t vfq p N
** FOR STAFF USE ONLY **t7
a#rw//o ilSe on l.rl-* S,d
ZONE/LAND USE:
14-33
LAND MANAGEMENT DIVISIoN / \25 E. 8th AVE., EUGENE, 0R 97401 / 687-4061 /,
I
Tvlt>u?@
TRS#77-03-2 4.3.3 3000 DATE iSSUED:10- 2 1 -86 PrRr,tir#3358-s€,
E
EDWARD V. JOHNSON N 745 7248
TRA 4 ZP N
U IRE #P FISIDEI NTER I OR
FIRE PLACE INSERT
REAR
PE SDS APPROVAI, REQUIRED
Di i\iTE
North of Hayden Brid ge Road, one block, turn left to Harvest Lane,
Yol anda on ri ght.
CTJ1 D
1484 Yolanda Ave., S pri ngfi e1 d
Ti NG NDATI
Approved Date Correction Date
LE INSP
I nspector
PLUMB I NG GROUNDI.IOR K INSPECTIONApproved Date Correcti on Da te Insp ector
UNDE RSLAB PLBG. f,l DERFLR PL I NSPECTi OIN
App roved Date Correcti on Da te Ins pector
OTHER INSPECTIONApproved Date Correcti on Date I n s pector
GHP ING TOP
App roved Date Correct"ion Da te
T INSPE
Inspe ctor
rove d__d_Date lC>24-gL /Correctjon lDa te Ins pe ctor
App roved Date /f
=^
-ft tcomect'ion Date I ns pector
iNSULATION / V R BA.RRIER INSPE CTION
Correcti on DateApproved Date I n spe ctor
LATH / GYPSUM BOARD INSPECTIONApproved Date Correcti on Da te inspector
p roved
D STOVE []
Oate 1O *O-#t Correction Da te Ins pe ctor
FiNAL PLUMBING INSPECTIApproved Date Correcti on Date Inspector
FiNAL 1NSPECTI0N BUILDING n /l40BlLE H0ME D /AG PLACEMENT D
Approved Date /Correct'ion Date Inspector
CERTIFl 0t PANC
Approved Date
I1i4'197
f,
lnsp Approved-Date Insp.
,S NAME PHONE
FRONT