HomeMy WebLinkAboutPermit Building 1976-09-13n Owner
LANE COUNTY PERMIT FOR PERIVIIT NO
CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
CITY ZIP CODENA I\4 E ADD R ESS PHONE
D Contractor
NAIVIE
O.S. Reg. +r
Tw
Subd ivision
Access to Property (Road Name)
Range-- Section 3 tax Lot
Lot
-
B lock
ADD R ESS CITY IP CODE PHONE
Code Census Tract
Acreage Width
Depth
Existing Structures on Property:
Directions to Property - Address
STRUCTURE (# BEDROOIVIS)VALUATION
SEWAGE DISPOSAL:
PUBLIC [ ] SEPTICTANK [ ] OTHER I ]
PLUMBING INSTALLED BY:
OWNER[ ] OTHER[ ] NAM tr
BUILD ING
PLUIVIB ING
WATER SUPPLY: PROPOSED t ]
EXISTING I]
PUB LIC
COMIIVIUNITY NAIVIE
3% SURCHARG E
MOBILE HOIVIE
WASTE DISPOSAL
PLAN REVIEW
TOTAL
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
IVIIN. SEPTIC TANK CAPACITY
GALS MIN. DRAINFIELD-LIN. FT MAX. TRENCH DEPTH I NCH ES
STAY 1OO' FROIVI ALL WELLS
TYPE OF CONSTRUCTION G ROUP FIRE ZON tr USE CLASSIF
SETBACKS FT. FROIVI CTR. OF rAfl
FRONT SIDE EXT
FT. FROIVI PROP. LINE:
SIDE INT.
-
REAR ZONE
AUTHORIZED SIGNATURES
lsl
ISSUANCE DATE
BLDG. PERMIT _ WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUIMBING - CANABY
BUILDING - GREEN
SANITATION _ GOTDENBOD
IMPORTANT
POST THIS PERMIT ON MAIN BLDG. AT SITE
LANE COUNTY. DEPT, OF ENVIBONMENTAL MANAGEMENT
COUFTHOUSE ANNEX, 135 EAST 6Ih, EUGENE. OBEGON 97401
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, D.E.Q. stanilardsfor subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of
occupancy belore being occupied.
(See Details on Reverse Side)
c55 -1 3
SO. FT.
PRIVATE WELL
OTHER . SPECIFY:
Bu r L_0 !I{G- S I T.L EVI}UAT r 0N
() BUILDING PERIIT APPLICATTON NO.
( ) stTE tNSPECTtoN
'-tt:--grgfi;
L0T:_ BLOCK:_
CK.D BY:
SUBDIVISION:
APPL I
DATE
PLANNING DIVISION
l" Zoning Ordinance Conpliance: Zone
2. Subdliirion Ordinance Compl iance
3. Required Access4. Bui ldlng Si te (Area, Width, Frontage)
5. 0ther (see conrnents)
Not
{ppllcaL!e NoY s
Setbacks rom r
Front
Side Exterior
Setbacks from inter or nesISide
Rear
COHilENTS:
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AT ION#
BUILDING INSPECTION DIVISION NOt
Yesw()
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7
8
9
0
Aool i cabl e----rr
i,\
No
Plans Submitted
Soi I Stabi I I ty (footi ngs)
Flood Plain
0ther (see comnrents)CKID BY:
COMHENTS:
},ATER POLUT ION CONTROL Not
Appl i cabl e No YesTTI l. l{eets Department of Envi ronmental
Qual ity Standards.
l2 , Other (see cornments )
()1-l
() ()()CKIO BY:t ?(
DATE
COHHENTS:
TO APPLICANT:
Your-Building / Site lnsPection:
Qr{C." be approved.q.l*?y'() Cannot be approved at this t ime as indicated on item N0
ce unt i you can reso vet Pr
e LAN
I ems
above.
SL Questions and further informa tion on items I through 5 contact t
c PLANNING DI S 0N. Qu estions and further information on items 7
t rou9 2 contact t e NE COUNTY BUILD NG AND SAN ON DIVIST
Lrill be held in this of
ls being returned.
c55-28
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()
Your buildin
135 Sixth Avenue East Eugene 0regon !/
pHoNE. 0Al-4065
uAHe COUIITY PLANN tNG D !V IS ION PHONE : 587
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LANE COUNTY PERMIT FC..
CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
I Owner
NAI\4E ADDRESS CITY ZIP CODE PHONE
D Contractor
NAIVIE ADD R ESS
O.S. Reg. +
Twp- Range- Section-Tax Lo
CITY ZIP CODE
Census Tract
PHONE
t Code
Subdivision Lot- Block Acreage Width
DepthAccess to Property (Road Name)
Existing Structures on Property:
Directions to Property - Address
STRUCTU R E (# BEDROOIVIS)SO. FT VALUATION
SEWAGE DISPOSAL:
PUBLIC [ ] SEPTICTANK [ ] OTHER [ ]
PLUIVIBING INSTALLED BY:
OWNER[]OTHER[] NAIVI E
BUILDING WATER SUPPLY: PROPOSED t ]
EXISTING t]
PUB LIC
COIVIN/UN ITY . NAIVIE
WASTE DISPOSAL
PLAN REVIEW
TOTAL
PRIVATE WELL
OTHER . SPECIFY
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATI ONS
IVIIN. SEPTI C TAN K CAPACITY
JALS tVIIN. DRAINFI ELD- LIN. FT IVIAX. TRENCH DEPT I NCH ES
STAY 1OO , FROIVI ALL WELLS
: OF CONSTRUCTION GROUP FIRE ZONE-- USE CLASSIF
SIDE EXT
FT. FROIVI PROP. LINE:
SIDE INT.
-
REAR ZONE
]D SIGNATURES ISSUANCE DATE
IMPORTANT
(POST THIS PERM!T ON MAI N BLDG. AT SITE
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, D.E.O. standards
ioi suUdurtace sewage disposal and lhe State Plumbing Code. All buildings require a certificate of
occupancy before being occupied.
(See Details on Reverse Side)
- WHITE
WHITE
DINK
\ARY
:N
LDENROD
LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OHEGON 97401
PERMIT NO.
PLUIVIB ING
3% SURCHARGE_-
IVIOB ILE HOIVIE
KS- FT. FROIVI CTR. OF r/W:
SITE INSPECTION
Ap pnov e o
Rruanxs
Dr sAPPRovEo Dar e I ruspecron
FOUNDATION INSPECTION
Ap pRov r o
REua nx s
DTSAPPRovED Darr I rusercroR
FRAMING INSPECTION
Appnov e o
Reuanx s
Dr slpenoveo Drr r I NSPEcToR
LATH OR SHEETROCK INSPECTION
Ap pRov e o
RruaRr s
I rsprcron
FINAL INSPECTION
AppRovro
Reuanxs
DrslppRoveo ,*,/-vl-4 (
I NSPEcToR
CERTIFICATE OF OCCUPANCY
Reaov ro lssue
Rruanx s
D Nor Reaoy ro lssur D Dare lruspe
e^
te
z
D
n Drsappnove a f--7 Dore_
PERMTT +A8726
CONSTRUCTION
NO PERMIT \--L BE ISSI,ED TINTIL THIS APPLIC'AI-JN HAS BEEN APPROVED
APPLICATION FOR:
MOBILE HOME PI.A.N REVIEW CTIAI\IGE OF OCCUPANCY
OWNER le L
Name Address
6Z 5e ol
Clty
eSS rJ 5
Address
Sectlon A rct / /f,oo ?*3
Lot Block Acreage
2 - 2J r,fCONTRACTORo
o.s. REG. tt / 20 70
Twp.
Subdivls
ACCESS TO PROPERTY (Road Name)e
ExisEing Structures on ProperEy:
Census Tract
I1Iid th_Depth_
k
Property Location - Address/Directlons o51- Sn
e Use
Sq. Ft.
Exlsting Sewage Dlsposal System Z or New System Requlred
Public
Conmunlty Name of Community or Public Systen
1on
SEWAGE DISPOSAL:
Slte Inspect 1on /l
cro
oo
WATER
Well "y Spring 0ther
FEES:PLIJMBING:
Installed by Owner
PLT]MBING FEES:
,D 0 Other Name
Bldg.
Plunblng
3Z Surcharge
Waste Dlsp.
Plan Revieqr
Moblle llooe
// of Flxtures Sewage
Connectlon
Water
Conoection
PI-A,NS PURNISHED
YES NO
FACILITY PERMIT
TOTAL 77.-7r
CASH
CHECK LSignature of Appllcant:G**t-
Fee Recelved urrfur""", VT3- 7/
Mln. Septlc Tank Capaclty Drainfield Required - Lineal Feet Maxlmum thDep
Type of Construc Fire ^o. -$ u"e Classlfication
Bldg Setbacks - from Center
Front 40' srde rnr
of Road,URtgh,t of Way:
. b side Exterio
cs5- l2 I-A.NE COT]NTY DEPARIMENT OF EIVVIRONMENTAL MANAGEMENT
Zone
DATE:PIANNING:DATE:SANITATI,ON:DA
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