HomeMy WebLinkAboutPermit Building 1980-07-16*6 747 DEPARTI'iENT OF ENVIRONI4ENTAL I,IANAGEMENT'-
PSB, I25 EAST BTH AVENUE
EUGENE, OREGON 9740I
Job Address
Appl ication for
Structures now on the property
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Affjdavi t: I ,
iit s.*,i.-.**Uu:t*.i
/_-/ I:I#l#.*Sf$.l:lii /_/ i#S"1,l$*,,:i
hereby certify that this information is true and accurate.
Code and
perty:
purchase;
If this applir
Lane Coqgty C,
L/ owner
duly ,
cation is for an agricu ra td t will be used for purposes allowed by the State Building
ode Chapter l0 (zoning) and for no purpose. I have the following legal interest in the pro
of record;con tra c t pu rc ha ser ;I essee;holder of an exclusive option to
authorized to act the owner, who is knowTe-dgeabl e o th sa lication.
'ing i
other
S i gnature/Address
Tei ephone
When permit is ready notify: ! Applicant
orrrner lTr- fru BESWENA e,2
or
er /_7 Contractor
Date
(zip)
Con trac tor (zip)
Phonc
Phone
Contractor's 0SR#P1 umbing by f1A
If Commerciai
Residential:
# of employees
--
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::::::r::::i:::t:t:::::i" r - J*r**-
i$S$.iii.;' /] Existins, BP #
! Proposed, SI #SI test holes ready
iiiFE€:i:i
SIuliEn"*
$
$
$
Tota'l Va.l uati on $$
at
at
$each
each
$
t_t
/:/:i:f ,ilf, fi ii:ii.iiiiiiii
:r:fihdfi#:i:i:#
b $
Su btota'l
TOTAL 16.
$Received by 4% State surcharge
Plans check fee
Change of 0ccupancy
$
Water Supply $
$Proposed _
Year Installed
Exi sti ng _
t
PERMIT PROCESSING
Minimum setbacks:
Comments
Zone
t, front
Part. #
t, side
Parcel #Parcel Si
i nt.thrJ ; rear
To be typed on permit
By Da te
CP&l Ty
To be typed on permi t
Group Fire Zone Use Classification u
By Da te
PhoneFor plans information call a ln tor )
tions to siteD
/-/ sr Plans to CP& I
t^iPC
set
set
Da te
Requ i red
I ip
PCC
Da te Date to
PCC,I/cpat
/VwPc
/l Planning
a/ Publ ic tJorks
//Elevatio^ trt^
/7 Address
/-/ Facil i ty Permi t
/_/ envtronmental Health
Comol eted7/z'
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I
c74-L7l
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Va l uati on Fee
W
on
INSPECTION RECORD
Approved Disapproved Date Inspector f-OC)
-{
O
=
l. Site Inspection
2. Foundation Inspection
3. Fram'ing Inspecti on
4. Lath or Sheetrock Inspection
5. Final Inspection
6.
7.
8.
9.
't0.
il.
Remarks:
Slab Floor, Plumbing Groundwork
Gas Piping Groundwork
Rough Pl umb'ing
Rough Gas P'ipi ng
Fi nal P1 umb'ing
F'inal Gas Pi pi ng
Em
=-l
+
12.Cert'if i cate of Oceu+agV :
ready to isiu6i not readY' date;i nspector.
W
POST THIS PERMIT ON MAIN BUILDING AT SITE
CONSTRUCTION PERMIT # LC 1930-80
JOB ADDRESS: 2460 North 20th Street, Springfield, 0regon
TRS, TL: L7-03-24.4.3, 1601
SUBDIVISION: N/A
C0NSTRUCTI0N APPR0VED BY THIS PERMIT: Deck (covered) - l4x2Z feet - 308 square
feet.
CONDITIONS 0F APPROVAL: Minimum structural setbacks: from center Iine of
road, front, 50 feet; side interior property lines, 15 feet; rear property
line, 20 feet.
PERMITTEE: Jean Beiswenger
DATE ISSUED: July 28, 1980 BY: Hans Ettlin/Carol Dyal
DIRECTI0NS T0 SITE: North 19th to end; right onto Yolanda to Ranch Market
Drive. Right onto 20th. Second house on right.
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Plclt Plan
Job Location (Add
Permit #
Perml-t
Perlqit
For Pernlt #
Permit
Permit
Fo.,
ForFor
For For
Subdivision
Lot
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Block
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3
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5
Sjte InsPectiort
Founda t'i on I ns pec t i on
Frarni ng Inspccti on
Lath or Sheetrock lnspection
Final Inspcction
Slab Floor, Plumbing Gt'oundwork
[las Pi pi ng Groundvrork
liougtr P1 urnb i ng
Rough Gas Piping
Final Pl urnbing
Final Gas Piping
i NSPICT I ON RECORD
Approverl Disapproved Date Inspectcr
rt6.
7.
B.
9.
10.
il.
Renrarks:
i
trI
)2. Certificate of 0ccupancy:
ready to i ssue;
--.-
not ready; -----_--- date;
d
inspector.
hre county
LANE COUNI{ BUILIDING [,'EBMIT
POST THIS PTRMIT ON MAIN BUILDING NT
.SiTE
CONSTRUCTION PTRI-IIT # LC 1930.80
s!
JOB ADDRLSS: 2460 North 20th Street, Springfield, Oregon
TRs, TLS rt -03-24.4.3, 160I
S(BDIViS I0l'l: N/A
C0NSTRUCTI0N APPR0VED BY THIS PERI'IIT: Deck (covered) - 14x22 feet - 308 squarefeet.
C0NDITI0NS 0F APPR0VAL: l4inimum structural setbacks: from center line ofroad, front, 50 feet; side interior property lines, 15 feet; rear propertyline, 20 feet.
PERHITTEE: Jean Beiswenger
DATE ISSUED: July 28, 1980 BY: Hans EttlinlCarol Dyal
DIRECTI0NS T0 SITE: l,lorth 19th to end; right onto Yolanda to Ranch MarketDrive. Right onto ?Oth. Secord house on right.
l,lP 28305-5E-2
*********************
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION
CAN RESULT IN REVOCATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S
INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOI,JED BY LAI^I.
WHEN READY FOR INSPECTI0N (see attached) call 687-4065. Have the fo'llowing
information ready: Permjt number, job address, type of inspection, when'it will
be ready, your name and phone number, and any special directions to site.
0THER QUESTI0NS? Call 687-4394.
ENVIHOI'JMEN IAL MANA(;T MEN I DIPARTMENT
125 EAST 8IH AV$NUE / EUGENE, OREGON 97401
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LANE C0LINTY DEFl' Et'lV l"!f,T AE:CEIF'T + 1?30S0 SATE Q716.--a
AFFLICANT I]EI.SIdENGER, JHAN ADDft ?4&* N " :101'H, SFFD. , NREGNH
TL+ t 703244301601 SUtttlIV l-0T BLK
NEI,J BL.D6 TYFT L'SE R NCI BDRFI.S OS NO UNITS OOi Nfi "TTilRIES NT} FI.D6S OO1 -CODE AFPL NO Afi I$N SESCRIPTIOH SQ F]' UNTT I]T]ST VAI.UATIOH TEH EAYS
r{P pECH ( CSVERHIT ) 30* ;5.70 I { 3?
BF.
BF.
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BF.BF LC t ?3080 F:AAA I { 39 1 ?, O0
Fl-. N0. FIXTLiHHS : N0. CIINNECT|]RS : 5 ^ 00 HACH :=
I.IECH }'{Ef,I{ANIIAL. I3EE
SUft STATE SURUHARGI: 4?. 0.48
FCH F'LAN CHHCH TEIi sOX 6 ^ SO
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EST. COI.IF.LETION DATE *?T5IIS
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Subdivision
Lot
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PIcrt Irlan
Job Locatloa (Add
Permit ii
Permit
Permit
For Permit #
Permit
Pernlt /l
For
For For
For For
NoPrLt
Block
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DICTATING INSTRUCTIONS
CONSTRUCTION PERMIT # I
JOB ADDRESS: 2
TRS, TL: 3
SUBDIVISION: 4
CONSTRUCTION APPROVED BY THIS PERMIT: 5
C0NDITIONS 0F APPR0VAL: 6
PERI4ITTEE: 7
DATE ISSUED: B BY: 9
t^JP 28305-5E-2
**** ** ********* ***** **** ** ********** *** ****** ****** * ****** ** **** * * *** **** ***)k* ****** *
di ctati ngThi s i s 24-08-?5, Program 0l I , extension
a bu'ilding permi-f [or bui 1 di ng perrn'its) on l{ord Processing Form
,
#N!0i-5E2,with 4
copi es.These are final copies to be sing1e-spaced. I will need them bY
morn'ing, afternoon. I will come and p'ick up. Please call when rea dy.
ust eave message.Note: Please type all numbers 'in numerical , unless otherwise
,
Vari abl e
Vari abl e
Vari abl e
Vari abl e
Lcaplta1 C space /%o hypen B0 (Al1 caps TMH or MH)I
2
3
4
Capi ta1g/-*
I1 hyphen O) hypen
(lf none, just say N/A) If s
A-4 period 4 ,"
3
riod comma space /6o /
o, give sub name, Lot, Block. 44*
Variable 5 : Go to nglgt or application.
Variable 6 : Go to ndTE5-or applicatjon.
Variable 7: Applicant'?Name ,W I
Variable B : (Day after d'ictation date) 1ll-S
Variable 9 : Plan Checker/Sanitarian/Permjt Processing Clerk (You
names, and not all names are necessary, see notes).
fPirections to site, colont End of oerm'i t.
e./
NEf permit. Start over.
NOTES:
Variable 5:
must sav "sIash" betweenFElc>
Vari abl e 6: Text:
WPC: (Repeat below if applicable, plus text, if appljcable).
Subsurface sewage disposal system'installat'ion specificatjons colon
tank semi-colon- feet of drainfield semi-colon max'imum dept
sem'i-colon ----period. Keep drainfield at least l0' from all
h of trenches
foundati ons
ga'l1on
and
noted.
property lines comma and .l00'from all water sources period. Keep septic tank atleast 5'from build'ing foundation comma l0'from all property lines comma 50,fromall water sources comma and l0'from edge of right-of-way perioa.
Paragraph (written comments)
Paragraph
Pla : M'inimum structural setbacks colon from centerl'ine of road comma front comma
semi-colon side'interjor pro perty lines comma / S sem'i-colon rearproperty'i ne comma aro s-)-peiioo emi -co I on or ,peri od ( s i de exTeffiF comma from centerl i neof road comma
Paragraph (wri tten comments )
Paragraph Directions to site colon
End of permit.
NOTES AND SUGGESTIONS:
Vari able 2
Vari abl e 5:
Variable 6
Variable 7:
Variable 9:
If on a new SFD please look at addressing's copy of new address. If
on a septic installat'ion on1y, there usually is not an address, just a
road name. Spell out unusual road names.
Spe11 out SDS (subsurface sewage disposal system) don't abbreviate.
SOmetimes there 'is not room on the appf icat'ion for the construction and
the septic so the clerks write it down by the fees so be sure to look to
see jf the permit is for septic also. Always hypen and put the square footageof the structure(s).
Prepare this before djctation. Sometimes jt varies, such as the septicjnstructions (not always the regular format) and the setback requirements(not always in order). Always say paragraph betleen different texts.
Spe11 unusual names.
These names will differ due to who js jnvolved. One permit may be all
3 names and one permit may be just 2 names. For septic only put the
sanitarjan slash clerk, bu'ilding only put p'lan checker slash clerk.
Spe11 nantes jf unusual (l'4cGuckin, Cruickshank, We'iderhold, etc.)
Speak clearly and say s as'in Sam and f as in Frank for those type ofters that sound like other letters.
Always say comma or period if there is one; also parenthesis.If you make an error please see Dictation Instructions sheet
BE PREPARED. Have al1 applicable notes ready. You do not have tote down everything you are going to say, on sheet just write "see app".
(a )let
(b)
(c)
(d)
wri
Suggesti ons :
Just be sure you have the papers in order to dictate from.
Job Address
Township, Range, Section, Tax Lot
Subdivision
DEPARTI]ENT OF ENVIRONI4ENTAL IlANAGEMENT -
PSB, I25 EAST BTH AVENUE
EUGENE, OREGON 9740I
City
frE
Lane Countvy'6wi',e
duly
\k^)Appl ication #
Assi Numbers*
Lot
-==--
Block _
Appl ication for
Structures now on the property
Proposed use of property: /7 Residential /J Conrmercial /_J Industrial /-/ public
hereby certify that this information is true and accurate
p ea setion is for an a gricul tural bu lding it wiil be used for purposes allowed by the State Building Code andCode Chapter 10 (zoning) and for no other purpose. I have the followi ng legal i nterest in the property:r of record
Aff i davi t: I ,
If this appl ica
; contract pu
to act for the owner
rc ha s er;I essee holder of an exclusive option to purchase;, who is RnowlEIgeaUle of-Tn-is appl ication
S i g na ture,/Add res s
Te1 ephone or
When permit is ready notify / / Appl icant /_/ }wner /7 Contractor
au tho ri zed
Da te
Owner
Con trac tor
z1
(zip)
Phone
Phone
Contractor's 0SR#Plumbing by
DO NOT I^]RITE B IHIS LINE
If Commercial: # of stories
Residentia'l: # of bedrooms
SI test holes ready
# of employees # of units
SDS: I Existing, Bp #
17 Proposed, SI #
Fee
Code
Sq . Ft.
of Si
Unit
Cost
0r
Descr ti
ar
Val uation Fee
b
$
$
Total Val uation: $
P1 umbi ng fi xtures at $
Sewer/water conn. at $
4% State surcharge
Plans check fee
Change of Occupancy
$
eac h
each
$
/_/ Casn
Rece i ved
/_/Check #
$
Subtota l
TOTAL r5.
b
$
tJater Supply
Propos ed Existing _
$
Year Instal led $
PERMIT PR0CESSING Zone
Minimum setbacks t, f"on
Part. #Parcel #Parcel Size('L, side int. ltxt/; rearJ
Comments
To be typed on permit
By Da te
ft. of drainfield; max. depth of trenches
WATER POLLUTION CONTROL
Instal lation specifications :gal. tank
To be typed on permit
Te ephone
Di tions to site
/-/ sr
r-/"'CP&1
/-/ .y{Pc
/_/ Planning
/-/ Publjc Horks
/ / Llevatrcn
/_ / Address
Pl ans to \EL
set(s )
Da te
Requ i red
Da te
Compl eted
Date to
PCC
CP&I
I,'/PC
lip
PCC
/tf n/a
1-/ Faci I i ty Permi t
/-/ Environmental Heal th
Da te
Clvr
4
2 2
L
IE
r1 ArlPho/b
I tn
/
Qv
lt\tl )
lt
r-<
\)
1. Site InsPection
2. Foundation InsPection
3. Framing InsPection
4. Lath or Sheetrock InsPection
5. Final InsPect'ion
INSPECTION RECORD
Approved Disapproved Date Inspector a-OC)
-{
O
=
6.
7.
8.
9.
.l0.
ll.
Remarks:
Slab Floor, Plumbing Groundwork
Gas Piping Groundwork
Rough P1 umbi ng
Rough Gas PiP'ing
F'inal Plumbing
Final Gas Piping
EmF
=-{+
12, Cert'ificate of 0ccuPancY:
ready to issue;
-
not readY; date;i nspector.