HomeMy WebLinkAboutBuilding Building 1976-07-28n Owner
LANE COUNTY PERMIT FOR PERIVIIT NO
CONSTRUCTION [ ] MOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
NAIVIE ADD R ESS C ITY ZIP CODE PHON E
n Contractor
NAIVIE ADD R ESS C ITY ZIP CODE
Census Tract
PHONE
O.S. Reg. +
Twp- Range-- Section C f ax
e,-l;3'N #s(
Subdivision Lot B lock
Access to Property (Road Name)
Code
Acreage Width
Depth
Existing Structures on Property
Directions to Property Add
STRUCTU R E (# BED ROOIVIS)SO. FT VALUATION
SEWAGE DISPOSAL:
PUBLIC [ ] SEPTICTANK [ ] OTHER [ ]
PLUIVIBI NG INSTALLED BY:
OWNER[] OTHER[] NAI\4 tr
BUILDING
PLU IVIB ING
3% SURCHARGE
IVIOBILE HOTVIE-
WASTE DISPOSAL
PLAN REVIEW
TOTAL
PUB LIC
COIVIIVIUNITY - NAIVIE
PRIVATE WELL
OTHER-SPECIFY
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
IVIIN. SEPTIC TANK CAPACITY
GALS MIN. DRAINFIELD-LIN. FT MAX. TRENCH DEPTH I NCH ES
TYPE OF CONSTRUCTION G ROUP FIRE ZONE USE CLASSIF
SETBACKS FT. FROIVI CTR. OF rA,A/
FRONT SIDE EXT
FT. FROIVI PROP. LINE
SIDE INT REAB
-
ZONE-
AUTHORIZED SIGNATURES
lsl
ISSUANCE DATE
BLDG. PERlvllT - WHITE
OFFICE COPY - WHITE
COUNTY TAX _ PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION _ GOLDENROD
IMPORTANT
Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required
septic system inspections. All construction shall comply with the State Buidling Code, O.E.O. standards
foi subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate o,
occupancy belore being occupied.
(See Details on Beverse Side)
POST THIS PERMIT ON MAIN BLDG. AT SITE
LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT
COUBTHOUSE ANNEX. 135 EAST 6th, EUGENE, OREGON 97401
c55-13
WATER SUPPLY: PROPOSED t 1
EXISTING I ]
STAY 1OO'FROI\4 ALL WELLS
Btr L0l S ITE tt,CxBUILf-iNG PERHIT APPLICATION NO
stTE tNSPECTIoN
PLANNING DIVISION
l. Zoning 0rdinance Cornpl iance:
2, Subdivision Ordinance Compl ia
3. Requi red Access
4. Bui lding Site (Area, }Jidth, F
5 " Other (see cornrnents )
CO}{}.IENTS:
Not
Aool i cabl ei.z:"W()
rontage) ( )()
11 ^03s2SUBD IV, JN:
APPL I CANT
T
DATE
TAX LOT
()
li44 zrgil,,zGNofl()
()
()
()
5
CKID BY:
Setbacks-Frorn clT-oT
Front
.T-
t)
S
Setbacks frorn interior I ines:
Side
Rear
)
)
)
(
(
(
(
A
BUILDING INSPECTION DIVISION
7. Plans Submitted
8. Soi I Stabi I I ty (footings)
9, Flood Plain
O. Other (see conrnents)
Not
I icable No YesE()
()
()
r)()
()
())
)
(
(
(CKID BY:
COHMENTS:
},ATER POLUT ION CONTROL Not
Appl icable
ll. l{eets Department of Environmental
Qual ity Standards.
'12. 0ther (see comments)
No Yesr) TT
DATE
COilHENTS:
(
BYcKr 0() ()()
)
TO APPLICANT:
U
Your Bui lding / Site lnsPection:
(VCan be approved"(-) Cannot be approved at this time as indicated on item N0" . ,,above
l" Questions and further information on items I through 5 contact the LANE-)u couNTy PLANNINc Dlvlsl0N" Questions and further information on items 7t\through l2 contact the
( ) bri I I be held in this of( ) !s being returned.
LANE COUNTY BUILDING AND SANITATTON DIVIS
ce unt i you can reso ve the prob4
c55-28
A
Your bui ldin
ems
ON
cated.
rmi t a I i cation fee i s
135 Sixth Avenue East Eugene 0regon 97401
PH0NE: 687-t+065
LANE C0UNTY PLANNING DlVlSt0N PH0NE: 587-4186
. - /f/{'z G
PLAN}I ING DIVI5ION AgI ION I'TNUINE:( , NO( ,, Al',r',LrUAll
w
I
11,5-7 (pnnurt il
NOTE: NO PERMIT W[I,L BE ISSIIED IINTIL THIS APPLIC,A1'..;N HAS BEEN APPROVED
APPLICATION FOR:
CONSTRUCTION C}TAi{GE OF OCCUPA}ICY
OWNER t?
Name ess City one
o.s. REG. #
r-P
*0. fl *or"-J-r..tion Tax Lot Code Census Tract
Subdivlsion Lot Block P roperty Acr
ACCESS TO PROPERTY (Road ti WAua
Existing Structures on Property:
Property Location - Address/Directions3 ,{L
Below for Offlce Use
SEWAGE D
Site Inspec tlon /l
Valuatlon
WATER S
Well
FEES:
'Yy Spring
B1dg.
Plumblng
3Z Surcharge
Waste Dlsp.
Plan Review
Moblle Hone
TOTAL
Mln. Septlc Tank Capacity_
0ther
PLUMBING:
lnsta11ed by
PLUMBING FEES:
CASH
Drainf
Sewage
Connection
PLANS I'URNISHED
TIZ--YEs
Signature of
Fee Received By:
- Lineal Feet
Ilater
Connection
FACILITY PERMIT
YES
Date
Exlsting Sewage Disposal System
Public
of Community or Publlc System
Namen.60
ll of
NO/7-<T- F%icnucr
74
Maxlmum
Type of Construc Fire Zone Use Classiflcat
c55-12 LANE COT]NTY DEPARI},IENT ENVIRONMENTAL
DA
Bldg Setbacks - from Center of Road Righr of Way:
Front dn side rnr.{Side *6fr---r'"-
DATE:,TION:DATE:
MoBTLE HoME n PLAN REVTEW f--]
<t
(
LANE COUNTY PERMIT FOR;PERI\,11T NO
coNSrRUCrloN t I lvloBllE HolvlE t I PLAN REVTEW t I cHANGe or occ?ffiv f l
n Owner
D Contractor
NAIVIE A ESS=*IP CODE NE
O.S. Reg. +
Jwp- Range- Sectio
Subd ivision Lot
ZIP CODE
7'
Tax Lot- Code- Census Tract
B lock Acreage Width
Depth
NAI\4 E ADD R ESS CITY PHO NE
Access to Property (Road Name)
Existing Structures on Property:
Directions to Property - Address
STRUCTU R E ( # BED ROOIVIS)SO. FT VALUATION
SEWAGE D ISPOSAL PLUIVIBING INSTALLED BY:
OWNER[] OTHER[] NAIVIPUBLIC [ ] SEPTICTANK tl orHER[]F
BUILD ING
PLUTUB ING
3% SURCHARGE_-
IVIOB ILE HOIVIE
WASTE DISPOSAL
PLAN REVIEW
TOTAL
WATER SUPPLY: PROPOSED t ]
EXISTING t]
PUB LIC
COIVIVIUNITY - NAIVE
1.,t
G
d
?
7
9
PRIVATE WELL
OTHER SPECIEY
CONSTRUGTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
IVIIN. SEPTIC TANK CAPACITY:
GALS.- IVIIN. DRAINFIELD-LIN. FT IVIAX. TR ENCH D EPTH I NCH ES
STAY 1OO'FROIVI ALL WELLS
TYPE OF CONSTRUCTION GROUP FIRE ZON E USE CLASSIF
SETBACKS - FT. FROIVI CTR. OF rAfl FT. FROIVI PROP. LINE
SIDE INTFRONT 1_ srDE EXr REAR ZON E
AUTHOBIZED SIGNATURES
/s/
ISSUANCE DATE
BLDG, PERI".4IT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANAFIY
BUILDING - GREEN
SANITAIION - GOLDENFOD
IMPORTANT
Call 687-4065 to schedule all required construction inspections. Call 687-406.1 to schedule all required
septic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. standardsfor subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of:
occupancy before being occupied.
(See Details on Reverse Side)
POST THIS PERMIT ON MAIN BLDG. AT SITE
LANE COUNTY, DEPT. OF ENVIRONIvIENTAL MANAGEMENT
COUBTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
3
d
I
d
c55-13
/
SITE INSPECTION
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FOUNDATION I NSPECTION
AppRoveo
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I rusprcton
FRAMTNG INSPECTION
APPRovED ru- DtsrPPnove o
Re lteRx s
D DorrJ *?-?- ZJ I NSPEcToR
LATH OR SHEETROCK I NSPECT I ON
D r sappRovEo Dar E I NspecronAp pnov r o
RrxlRx s
F I NAL I NSPECT ION
D o^r, ?- Jy'-fl,Rl.NSPECTORAp pRov E o
Reuanx s
D r slppRoveo
CERTIFICATE OF OCCUPANCY
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fa Nor Rraov ro lssur D Drrr I NS PEcroR
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& DrsappnovEo 7J D*, ,/'Y?-ryT