HomeMy WebLinkAboutPermit Building 1973-07-18IANE COUNTY
BUTLDTNG I
BUITDING PERMIT
MHE
OR MOBILE HOME USE PERMIT
PERMIT NO.
PHONE
PROPERTY MAILING ADDRESS
CONTRACTOR MAIIING ADDRESS PHONE
PROPERTY TOCATION _ INC[UDE POST OFFICE
PROPERTY LEGAT DESCRIPTION _ METES, BOUNDS
SECTION TAX LOT NO CODE CENSUS TRACTRANG E
EXISTING STRUCTURES ON PROPERTY
LEGAI. ACCESS TO PROPERTY
PROPERTY SIZE - FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge Syste
TYPE CONSTRUCTION se. FT. # BDRMS VALUATIoNSTRUCTURES TO BE BUILT THIS PERMIT
SEWAGE DISPOSAT
PUBLIC N SEPTIC TANK N oTHERn
PI.UMBING INSTATIED BY
OWNER fl OTHER: NAME
FEES WATER SUPPLY
BUITDING
WASTE DISPOSAL
PTUMBING
PI.AN REVIEW
PARK IRAIIER
PUBUC n N OTHER
TOTAL
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
DRAIN FIETD REQUIRED
I.IN. FT TRENCH WIDTH FT OR SQ. FT
TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTII-. EASEMENT
BLDG. SETBACKS
FRONT
FT. FROM CTR. OF ROAD RIGHT OF WAY
SIDE INT. SIDE EXT.
USE CTASSIFICATION
REAR
AUTHORIZED SIGNATURE - DATE DATE
BLDG. PERMIT - WHITE
OFFICE COPY _ WHITE
COUNTY TAX - PINK
PI.UMBING _ CANARY
BUILDING _ GREEN
SANITATION _ GOTDENROD
Construction to comply with uniform building code ond counly regulotions
covering plumbing ond sewoge disposol. All buildings require o certificote
of occuponcy before being occupied.
(See Stotement on Reverse Side)
(posT THts pERMtT oN MAIN BIDG. AT S|TE)
TANE COUNTY, B[DG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I
FoRM = C55- 13
APP[.
NAME
&
MAII.ING
ADDRESS
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JUL 13 1973
LAf{E COUNTY HEALTH
/'.42 (-o,P/a--t(- ,5-Z X-/BU ILD ING S ITE EVALUAT IT T7- z-z
-c N US
APPL I CANT:
Nr\l1E
ADDR ES S
l'
n 8u ilCing permit Appl icar ion No.
( ) S ite tnspect ion
( ) Pre-Permit lnvest igat ion
PHONE
DATE
LANE COUNTY PLANN I NG DEPARTHENT NOT
Requ i red Access
Building Site (Area, |ridth,
Frontage, Setback)
0ther (see comments)
Zon i ns 0 rd inance comp I i ance *i5*,1
subdivisiono.o,"jill"ffil" () ()
NO YES NAI.1E Dr\TE
2
(+-
(L-
(L-
)
(
3
4
5
()
()
()
()
)
COHII1ENTS:
BUILDING INSPECTION SECT!ON
5. Plans Submitted
7. So i I Stab i I ity (foot ings)
8. Flood Pla in
9, 0ther (see Conments)
NOT NO
E66't icaule -
(
YES NA},IE
()
)
()
I(
,\
)
()(
() ()?-/?-7)
COHHENTS:
SANITATION SECTION NOT NO YES NA}IE DATE
app I icab_!e10. Sewage Disposal
I l. Usable Area
12. I'Jater Supp I y
13. 0ther (see Corrnents)
(
(()
)
()
)
()
()
(Aq
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)
COH}lENTS
TO APPL ICANT:
Your Building Permit / Site lnspeclion:
Pi 8il":; ;:';;::t"F"P,n,T(# ",
(
(
(
indicated on item N0.above.
Questions and further information on items I through 5 contact the Lane-
COUNTY PLANNING DEPARTMENT" Questions and further information on ,ffi 5
Lane Count Buildin and San i tat ion D iv is ion.
ce until you can resolve the prob ems cated.
Your buildinq permit appl icat ion fee is being returned under separate cur'er.
through l3 contact the
Wil I be held in this o
ls being returned.
LANE COUNTY PL^NNING DEPARTI.IENT
I 35 5 Ir lh Aven0e Eas t , Eugerre, 0regon 971+01
fnoNE 3f 2.- ll l l Ex l . 23t
LANE COUNTY BU I LD ING 6 S^N ITAT ION D I V IS ION
135 Sixth Avsrrue East, Etrrlent', 0regon 971+0 I
PH0NI" : 142-t 5ll txT. 4I I
Mqq- r9
(// * - =--s
(
DATE
)
TANE COUNTY BUITDING PERMIT OR MOBILE HOME UsE PERMIT
BUTLDTNG I MH E PERMTT NO.
PROPERTY O}VNER MAILING ADDRESS PHONE
CONTRACTOR MAII.ING ADDRESS PHONE
PROPERTY LOCATION _ INCI.UDE POST OFFICE
PROPERTY I-EGAL DESCRIPTION _ METES, BOUNDS
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPP[.
NAME
&
MAILING
ADDRESS
TEGAL ACCESS TO PROPERTY
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connecl to Existing Sewoge Sysrem f] New System I
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION se. FT. # BDRMS vALUATtoN
SEWAGE DISPOSAT
PUBTIC tr SEPTIC TANK tr oTHERn
PLUMBING INSTALIED BY
OWNER E OTHERT NAlv{E
BU ITDING
WASTE DISPOSAL
PTUMBING
PI.AN REVIEW
PARK TRAILER
TOTAL
F EES WATER SUPPI-Y
PUBLIC E tr OTHER
$_-'-
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAT.
DRAIN FIETD REQUIRED
TIN. FT TRENCH WIDTH FT.OR SQ, FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT
BTDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT, SIDE EXT.
USE CLASSIFICATION
REAR
AUTHORIZED SIGNATURE - DATE DATE
BLDG. PERMIT - WH ITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PIUMBING _ CANARY
BUILDING - GREEN
SANITATION - GOTDENROD
Construclion to comply with uniform building code ond counly reguldtions
covering plumbing ond sewoge disposol. All buildings require o certificote
of occuponcy before being occupied.
(See Stotement on Reverse Side)
(posT THIS pERMrr ON MAIN BLDG. AT SITE)
TANE COUNTY, B[DG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I
FoRM =c55-13
nL_/
SITE INSPECTION
Ap pRov r o
Rruanx s
DrsappRoveo Darr I rusprctoR
FOUNDATION I NSPECTION
AppRovto
Rrua nx s
Dr sappnovro Dare I Nspecron
FRAM I NG
Ap paov e o
RrulRx s
I NSPECT I ON
l_a Drsappnoveo D DArE l rspecron
LATH OR SHEETROCK INSPECTION
Ap pRov r o
RexaRx s
D DrsappRovE o f-a Dare I NseEcton
FINAL INSPECTION
Ap pnov r o
Rrunaxs
rt DrsrppRovEo D Dare 7-2/'lJ I rusprcron
CERTIFICATE OF OCCUPANCY
REaov ro lssuE
Re t.taRx s
D Nor Re aov ro lssue D Dore_lruseecroR_
/7tu73 2€/ 0 3
\-:
a
LANE COlr,rfY BUIIDING PERMIT OR MOBITE rdME USE APPIICATION
ACC TO
PERMIT TYPE _ BUILDING
OWNER
TION _ INCTUDE
PROPERTY T ,t DESCRIPTION
toT -_ SUBDIV.
NAME
AND
,rtAltlNG
ADDRESS
MOBILE HOME IOSC REG.#
MAILING ADDRESS
MAITING ADDRESS
PERMIT 3 - "73
PHONE
PHONE
METES&BOUNDSNYES
AT]ACHED NO
CENSUS TRACT
-ldZ
TAX r.oT #CODE &a -a-a e
DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY
I
NAME OR
SIZE_WIDTH DEPTH AREA
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms
TO BE BUITT PERMIT
Connect to Existi
TYPE CONSTRUCTION
m
SQ. FT.
or New System Req. E
BEDROOMS VATUATION
/-6
*21-a-4-,*
SEWAGE DISPOSAT
PUBTIC SEPTIC TANK OTHER tr
FEES WATER SUPPTY
PTUMBING INSTAI.LED BY
OWNER OTHER NAME
PTANS FURNISHED FACITITY PERMITB[DG.
WASTE DIS.
PI.UMBING
PLAN REVIEW
PARK TRIR.
TOTAI. -
PUBTIC OTHER NO
RE OF APPI-ICANT
IVED BY
PUBI.IC
IT
CONN
YES NOE
CASH
CHECK
DATE
DATEJ-fr
5 a'.a FEE
SEWER
CONN]
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[.
DRAIN FIEI-D REQUIRED
TIN. FT. TRENCH WIDTH FT OR SQUARE FEET4n;
TYPE OF SIRUCTURE
BIDG. SETBACKS _ FT. FROM CIR. OF ROAD RIGHT O20t4-
OCCUPANCY
DA
ZONE REAR YARD
USE CLASSIFICATION
PUBLIC UTIT. EASEMENT
Form $ g55-12
PTANNING
EXT
'- / 7.- ?7 Dole
FRONT .S- stDE tNT. 5-
AR
Directions to Find Property:
e*x ,'u€- 1 /
Dole BLDG.
COPY I - OFFICE
COPY 2-JOURNAL
COPY 3 - AUDIT
/3 4/- 7s
COUNTY BUILDING & SANITATION SPECIFICATIONS