HomeMy WebLinkAboutPermit Building 1983-06-106e-
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Lane C,---rnty Authori za,tion ttz
FOR OFFICE USE ONLY
Applicatio
Permit *
Two Copies of Plans
Three Copies of Plot P1ans
Mech/Plumbing Checklist
Legal Interest Document
Plan Check Info Sheet
P FANGE 03 .a<
LOT,L
l,ocAT ADDRESS PROP05ED
d'*".
l-l e,uri.
USE OF PROPERTY
idential Industrial
Commercial
-BEOF PROPOSED PECIF IC
Existing
posedOF
tlruO;\NER S NAME AND
I f:rther certj-fy that any and aI1 work perfomed shalL be done in accordance with the Ordinances of Lane Cowty and the traws of the State of Oregon
rtaining Eo the work described herei-n, and that NO OCCUPANCY wilL be made of any stxucture without the pemission of the Building Division. f fur-
ther certify that registratlon with the Builderrs Board is in fufl force and effect as required by ORS 701.055, that if exempt the basis for excmptiorl
.is noted hereon, and that only su.bconlractors ed enployees who are in conpliance with ORS 7o1.055 will be used on this project- I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY.
rcE GG;;fi.j-"t,SIGNATURE
i Nnneg fr4 kuri;
I P,AVE CARXEUILY EXAMINED THE
the following legal interest
L is true and correct, and that I
evidence of authority attached.
TED APPLrcATroUlon peRurr,
property: ffin", of record
and do c rti athat tionnforma reonheherebyfy
tcontrac auth zeorl d thwlanthpurchaserTagenttr
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION HAS BEEN BASED ON THE EOLLOWING CONDITIONS:
I pr.asNrNc,/ZoNrNG:
fl nr-oonpr,eru:In flood hazard area?
r 47-64
Ins tallation
COTl.IlENTS:
COM}IENTS:
Date:
No
NoYes
Tank
AA
cL, f.o.t
SANITATION: S- 1. #B. P
"--ntlL ?s,Spec ifications:
Installation Record Issued?
Zone
trlinimm Setbacks:
CO}L\IENTS:
Parcel Size
rear
Partition #Parcel #
Date :
Date:
;S.", "...of Drainfield
tf Maximw Depth
of Trenches
c .-L, srde _--
FTrnterJ.or _)
TOTAL VALUATION $CONSTRUCTION AUTHORIZED BY THIS PERMIT
Oddrt-1ffi10"""
D q. Ft.5f,n'
Fixed Fee/Floodplain Fee $
Subsurface Fees $
Building Eee $
ilech/Plmbg Fee $
Pr ans Check Fee $
State Surcharge $
DEQ Surcharge S
TOTAL FEE SS
PERMIT APPROVED BY BUILDING OFF r ORS
I,ANE COUNTY DEPARTMENT OF PLANNING & COMMUNfTY DEVELOPMENT / 125 EAST EIGHTH AVENUE, EUGENE,
SEE REVERSE FOR INSPECTION INFORMATION
9740L
/ l',rjLll.PrFJNE NU!1tsr;R
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tr
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(
,
Ivu=, SEE ATTACHED SHEET.
Ww)gt6-
6,/2+42-
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATTON CAN RESULT IN REVO-CATION OP THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTT6N 9RDINANCE, AND,/9R 6THERREMEDIES ALLOWED BY LAW.
WHEN READY POR TNSPECTION
TroN REQUESTS [rUsr eE GrvENof inspection, when it will
Framing o
bracing a.
electrica
CALL 687-4065. A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE FOR INSPEC-. Eave-ih-e-Eolrowing information ri:ady: permiL number, lou .aa.";=l-avp"be ready, your name and phone number, and any speciar diiections to'siie.
BUfLDING DIVISION:
REQUIRED INSPECTIONS
Poundation rnspection: To be made after trenches are excavated and forms erected and when aLlmaterials for the foundation are delivered on the job. where concrete from a central mixingplant (commonly termed "transit mixed.") is to be u!ed, materj-als need not be on the job.
Concrete slab or ungtl:rfeer rnspection: To be made after aIl in-s1ab or under-f1oor buildingsErvTce equT-pment, conauit, pipig accessories, and other ancillary equipment items are inplace but before any concrete is poured or floor sheathing installld,-intluding the subfloor.
I
2
fnsulalion ll!_pegtionsr To be made after the roof, aIl framing, fire blocking, andre in pl-ace ana=T1-plpes, -f ireplaces, chimn.ys, ..ril vents are iomplete and a1i rough1 and plumbing are approved. AlI wall j-nsulation and vapor barrier are in p1ace.
SUBSURFACE AND ALTERNAT]VE ,SEWAGE DISPOSAL SYSTEMS;
-, -_:____-;1. Permits shall be eftebtive for one year from \he date of issuance.
3
4. Lath anvor Gypsum Bo$d rnspection: To be made after all lathing and gypsum board, inLeriorand exterlorl-ls in-pface-Eut-EeEore any plastering is applied.rri b"for" gypsum board joj-ntsand fasteners are taped and finished.
5. Final Inspecti-on: To be made after the buildj-ng is complete and before occupancy.
APPROVAL REQUTRED. No work sha1l be done on any part of the building or structure beyond the pointindicated in each successi.ve inspection without first obtaining the approval of the building oifici.I.Such approval shall be given only after an inspection shalf have been-made of each successive stepin the construction as indicated by each of the inspections required.
NOTE: A11 building permits require inspections for the work authorized, such as but not 1imited to:
A. Block WaI1: To be made after reinforcing is in place, but before any grout is poured. ThisIi-s-pectTo-n is required for each bond beari pour. There witl be no approval until the plumbingand electrical- inspections have been made and approved.
B. Wood Stove: To be made after completion of masonry (if applicable) and when installation isconrpfete- Installation shalI be ln accordance witir an appioved, nationally recognized testj-ngagency and the manufacturerrs installation instructions.
C. Mobile Home: An inspection is reguired after the mobile home is connected to an approvedse\,{er or septic system for setback requirements, blocking, footing connection, tj-edowns,skirting, and plumbing connections.
1. -Pootings and piers to comply with State foundation requirements for mobile homes or asrecommended by the manufacturer-
2. Mobile home mj-nimum finish floor elevation shall be certified when required by a flood-plain management letter.
3. Mobile home tiedowns, when required, and. skirting shaIl be installed and ready for inspec-tion within at least 30 days after occupancy. Tiedowns and skirting shalI be instal-Ied
^ar ^h^ 1r-- -..,*osure.
D. Swj-mming Pool: Below grade when steel is in place and before concrete is poured. Above gradewhen pool-fs installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURTNG WORK]NG HOURS. THIS PERMTT WILL EXPIREIF WORK DOES NOT BEGIN WITHIN 1BO DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENS]ON OR REVOCATION I'IAY OCCUR IF TI'IIS PERMIT WAS ]SSUED ON THE BAS]S OF INCOMPLETE OR ERRONEOUS
]NFOR}4ATION.
ANYONE PROCEEDING PAST THE POINT OT REQUIRED ]NSPECTIONS WILL DO SO AT THETR OWN RISK.
2 Upon completing the construction for which a permit has been issued, lhe permit holder shallnotify the Lane County Departrent of Planning q,nd Cqnnuniqy Develolrne!t.by submttti.ng'.theinstallh.tion record forrn. The Departrent shall inspect thb construetion to determine if itcomplies with the.,rules contained in this division. If the construction does comply with suchruIes, the Department shail i-ssue a certifi-cate of satisfactory completion to the permitiholder.If the construction does not conply with such rules, the Department shalI notify the permitholder and shall- require satisfactory completion before issuing the certificate. Pailure tomeet the requirements for satisfactory completion within a reasonable time constitutes a vio-lation of ORS 454.605 Lo 454.745 and this rule.
Setbacks - Subsurfgce Sewage_ Di.sposaI
Septic Tank Drai-nfield
From: Interior property lines 10 ' 10 t
Edge of road right-of-way 10 t 10 !
Building foundation 5 t 10 !
Wells, other water sources 50' 100t
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PLAI'INING & COI'S'IUNITY DTYELOT'' T
ACTIVITY INFORMATION SH EET
INCOMPLEIE FOR}4S I',ILL BE REJICTTD!
@
COMPLETE THIS SECTION.
I {Rrnes *. L6rrtrs $rr4ts c.
PERSON MAKING RTQUES
6t]r21ae Nom e4zz UaerFf ISB- MAILIN6 ADDRESS
Sr< t q4 r rE Ub ARfuQA,l 1t\fl
IP CODECtrTYSTATE 7
72b' 33'i5ffi 740- qqsS
HOME TELEPHONE #
74{, - {{.S Imrill.SS TELEPHONE-? HOI'I-E TELEPilONE #
I
(IF DTFFERENT Tn
3 naae B FArleEL NIJrvlBEFI (fronr tax maps i r Departnrent of Assessment and Taxation
or from tax sta:ement)( REQUTR.Ep INFoRI4ATIoN)
11 c3 _A-ss
T0hINSHIP RANGE SECTi0N
oo 50o
TAX IOT(S) 0R PARCTL # ZONING
T0m'smF ffi mm0N ffi ZONIRG
TWfiSETP' M-NGE. SEETIO'N ffi mria6-
" ACREST0uL CONTIGU0US PR0PERTY IN sAl4E 0I.INERSHIP:
4 SUBDIVISION ( if appl icab'le)axAN( €<T S LOT 5OO BLOCK
5 RTQUEST (state exactly what you plan to do) e'qlLD 28O + ADp trro{ , -,.
6 DIRECTIONS TO SITE:6
Or.t
** FOR STAFF USE ONLY **
ZONE/LAND USE:
BYt
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DATE: - ,, TIME IN:-. 0UT:-
NUF'IBER
DATE
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CITY . STATT ZIP CODE
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LACK INKb5 Secrion 24,3,5 Tax Lot :tt
form c55-11
YICINITY MAP MUST B
l7
ETNBI
RangePermit No.
Standard S System n. (Specify Trype)
24A: Nonnt tsLystem E Alternative
APe.r,aa/Job Location (Street Add SPPNGf
Subdivision / Partition #E'5'ffrrZ5 Parcel 3 LouS.- Block 2
DETAIL SYSTEM PLOT PLAN AS CONSTRUCTEI'
llD{.'37 'Scale / "= 3A'
Sbot
Exrrtgg
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lnstaller' {Trtle as shown on DEO [cense]
Telephone
License No
lding ComPanY
USE BLACK INK ONLY
FOR INSTALLER'S USE:Trench Dept 3 fi.Gravel Depth Below Tir- 6"
Tank Capa Manufacturer
From Drainfield - Total Length of Lines 75'v
Date--
Measured Distance from Well to Tan
COMPLETE THE FOLLOWING IF A PUMP WAS USED ON THIS INSTALLATION:
I (installer's name)----- certify that a {Mfg)-(Model No. )-Pump l
and Mercury Float Switch (Mfg. and No.)-have been installed with this sewage installation(Signature of Licenw)
lnstalled BY Owner-
ol Owner
Signat
FOR SANITARIAN'S USE ONLY:
Date- i
ourc 6/et/83 stem Approved D System Disapproved [l Needs Correction
COMMENTSicant's Name & Address
;oo{.RII{x.lsE/Pr-ElLIC SERVICE BUILDIIIG t25 E. 8TH AVE. ETJGENE, ORECC{ gtt|ot
i
System Ca
tem Corrected Da
Da
INSTALLATION BECORD & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the Counttlsanitarian, thiscertificate is
evrdence as per ORS 454.665 of satisfactory completion of a subsurface sewage disposal system at the above locatiof .
al./day Signatu
RETI..TN THIS FORM I1CI EEEARTTENT O,F Pr-Ar$ilNG AtrD @nIi{lI{TTy DEVELOPIENT
Javaes
*rri[t COU N TION - Rrc0ltu]Y INSPE
DA"I"I I SSUED:PIRMIT#
I
ER'S NAME
N
S
C
ETBACT REQUIRE
FRONT
ENTSMr
L
# PLUMBING FIX ES
L SIDE
I
INTERIOR h5<REAR TJ I C ui.6
PL
-lNS-PECt-lbN --
,.orrection Da te _lnsp ector
SITE
/ F0uN
Approved Ol- _Date
App roved Da te I nspector
,NDERSLAB PLBG. fl /IJNDEtr PLI]ON
Date I nspectorApprovedDatelorrecti on
SLAB INSPECTION
Approved___Date-_--- -Correct j on--__*.-Da te-_,-*-.-* - ---l nsp ector
NO'U-ET PLUMBING (TOP
Approved-_--._Date
0ui)--t-ttSPrcr tou
Correcti on Date I nspe ctor
FRAMIN CT
roved Date
Approved .-Date_
Correcti on Date
Correcti on_*_Date
nspec tor
Ins pe ctor
SU T N R
ApprovedlQ[L -t
Date
PECTI ON
/ Correc t i on -..---*_Da te- ---_* -,*I n spe ctor
LATH / GYPSUM BOARD INSPECTI ON
A p oved Date i,orrecti on-.-__*-Date
{:orrec I j on Da te
I nspec tor
L MEC Ni Ltl
Approved **___-Date- =-*_
IO Eil
Inspector
r-mf-F,L' iIiETm Tri$r cTiTl'i --_-
Aoproved __.Date_ -_*_
FINAL INSPECTION BUI LD i N.G ir Lf-Ho'l'lr n "7hc [LmtilENTfr -
Approved @f _, Da te l-?:- b.-_ t lt '.orrecti Da te
CtRTIFICT\TE 0F OceiFnl',icYfl -- -
-*TEli{p0trAli1
,/l
- _-1*.- _w /t40'
orrec ti on Da te I nspector
I nspector
Approved___,Dat .,-Insir -.-_-._Approved-*------.Date Insp.
iRS# \?-s3-.>u*3,
P LmTKEmIiDImf -it{SFL fT t o [-
lXrue couNTY, oREGr-' I
DEPT. OF ENVIRONMENTA
JOB ADDRESS z
ANAGEMENT
CGIFIFIECTIGIN NGITICE
CONSTRUCTION PERMITS
A INSPECTION DIV.
DATE
TO
NOTE
BLDG. PERN,4IT
zY
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c55-73 ,.E-rNEtpEETtoN FrEo,lJtFrE.,
Phone 6A7-4OCi5 FoFl APPFIoVAL INSPECTOR