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HomeMy WebLinkAboutPermit Building 1983-06-106e- r-\Z 6D!'-t- 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 ,clblw tr a ( , 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 c t4-zs k" cor.ty PLAI'INING & COI'S'IUNITY DTYELOT'' T ACTIVITY INFORMATION SH EET INCOMPLEIE FOR}4S I',ILL BE REJICTTD! @ COMPLETE THIS SECTION. I {Rrnes *. L6rrtrs $rr4ts c. PERSON MAKING RTQUES 6t]r21ae Nom e4zz UaerFf ISB- MAILIN6 ADDRESS Sr< t q4 r rE Ub ARfuQA,l 1t\fl IP CODECtrTYSTATE 7 72b' 33'i5ffi 740- qqsS HOME TELEPHONE # 74{, - {{.S Imrill.SS TELEPHONE-? HOI'I-E TELEPilONE # I (IF DTFFERENT Tn 3 naae B FArleEL NIJrvlBEFI (fronr tax maps i r Departnrent of Assessment and Taxation or from tax sta:ement)( REQUTR.Ep INFoRI4ATIoN) 11 c3 _A-ss T0hINSHIP RANGE SECTi0N oo 50o TAX IOT(S) 0R PARCTL # ZONING T0m'smF ffi mm0N ffi ZONIRG TWfiSETP' M-NGE. SEETIO'N ffi mria6- " ACREST0uL CONTIGU0US PR0PERTY IN sAl4E 0I.INERSHIP: 4 SUBDIVISION ( if appl icab'le)axAN( €<T S LOT 5OO BLOCK 5 RTQUEST (state exactly what you plan to do) e'qlLD 28O + ADp trro{ , -,. 6 DIRECTIONS TO SITE:6 Or.t ** FOR STAFF USE ONLY ** ZONE/LAND USE: BYt -. DATE: - ,, TIME IN:-. 0UT:- NUF'IBER DATE { aJ1 { -TAIIING ADDRESS SrRturorrer-s 6wr;a* q7*?7 CITY . STATT ZIP CODE N6RTT{. 2o {},* 80, a D€c( Fr l3r-r,entXrtILP r I I I I 37' a"'$ $t F l&ri!r/i ffi Ip lr )l* rl 1 jl?' 'r JI "t- S€y, Dertt{rt((5 *.*+-?4-.+.*a**.*4?t I l+" J IL ,t \u tro -i L.2 + fir'' I : a i Irfl ,l tc,rd e.rr31{Uftrrll q{ 16,r *nQffi* rg' ,s 'nervf V67'rc rwnshp 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 -- Ntu, PPAI& F,ciL! *..\'"}€) ,...1e3 ,u b f-r )l !r ADD rrr "\ $outr. I a;' e + { L -tl I 1 t)l-r, .E lnstaller' {Trtle as shown on DEO [cense] Telephone License No lding ComPanY USE BLACK INK ONLY FOR INSTALLER'S USE:Trench Dept 3 fi.Gravel Depth Below Tir- 6" Tank Capa Manufacturer From Drainfield - Total Length of Lines 75'v Date-- Measured Distance from Well to Tan COMPLETE THE FOLLOWING IF A PUMP WAS USED ON THIS INSTALLATION: I (installer's name)----- certify that a {Mfg)-(Model No. )-Pump l and Mercury Float Switch (Mfg. and No.)-have been installed with this sewage installation(Signature of Licenw) lnstalled BY Owner- ol Owner Signat FOR SANITARIAN'S USE ONLY: Date- i ourc 6/et/83 stem Approved D System Disapproved [l Needs Correction COMMENTSicant's Name & Address ;oo{.RII{x.lsE/Pr-ElLIC SERVICE BUILDIIIG t25 E. 8TH AVE. ETJGENE, ORECC{ gtt|ot i System Ca tem Corrected Da Da INSTALLATION BECORD & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the Counttlsanitarian, thiscertificate is evrdence as per ORS 454.665 of satisfactory completion of a subsurface sewage disposal system at the above locatiof . al./day Signatu RETI..TN THIS FORM I1CI EEEARTTENT O,F Pr-Ar$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 t L c55-73 ,.E-rNEtpEETtoN FrEo,lJtFrE., Phone 6A7-4OCi5 FoFl APPFIoVAL INSPECTOR