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HomeMy WebLinkAboutPermit Mechanical 1982-03-22mV -7 CON STK:' CT ION/PLAC E M EN' "PERMTT 3_/A COI{PLETE THIS BLOCK. PLEASE USE BLACK INK AND PRINT. FOR OFFICE USE ONLY TOWNSHIPt7 ov A,4Z M SUBDIVISION//PARTITION (if applicable)LOT,/PARCEL BLOCK LOCATION ADDRESS Nr. zl5r-d,ztPO PROPOSED USE OF PROPERTY ffiesidential [-l commercial I rndustrial flrruric Ct-t tx* f OF BEDROOMS3 UF STORIES I #oF W}I.ER SUPPLY,TKtq*t,t 01 E Proposedffr.xisting TELEPHONE NUMBER 5W-',ffiru- uFilEffiIGF=--*5aqb4 DI ONS '{ I IIAVE CARETULLY EXA_I4INED THE COMPLETED APPLICATION FOR PERMIT, and do hcrcrby ':crtifi that all inforration hercon is true and corre.t ar).i I furt]rcr certify that any and aII work lrerforred shal1 be done in accordance with Lhe ordirarccs of Lane County and the LaBs of thc stat-e of Ore,)]rr !,,-'rtaining to the work described herein, and thaL No oCCUpANcy will be made of any structure without the permission of the Buildirrg Division. r furth.r (.rlrfy that registration wlth the Builder's Eoard is in fu11 force and effect as requ.irc,f by ORS 701.055, that if exenpt the basis for exemPtiorr is not'd hereon, and lhat only APPLICATION THOROUGHLI subcontractors and employees who are in compli th oRs 701.055 will b.e used on this project' I HAVE READ AND cllECruD THIS t t l-'l or,r"t ffontrrrt", fl eeentNAMEDAIE tr PLANNIN ZONING 3 zone Partition #Parcel #. interior I arcel Srze-- trllru.mw Setbacks: CL,front_CL, .rd.. .re ar CoIrutrents: I f'frOOOpf,ef U 3 rn flood hazard area? fl nunal ADDRESSTNG' cRrD cooRDrNArE tr SAIiITATION: s. r. + (*"! ves, see attaclred sheet EN Date: Date I Date: B. P. #rnstallation Record lssucd? ! v.= fl lr" Maximun Depth of arenches Insca 1 Iation Gal 1on Tank Lineal Feet of DrainfieldSpeci fications : Co[unents Date: d PLANS EXAMINATION: rype 5U ",o,n R- 4 Use Coments: Date:tu?- L2:81- CONSTRUCTION AUTI{ORIZED BY THIS PERMIT Des Sq. Ft - t l't tia,-A- Fixed Fee,/ Unit Cost Floodplain Fee S Subsurface Fees I Bui J-dlng Fee $ Sewer/Storm Drai.n/Water $ Plumbing Fixtures $ Mechanical $ Plans Check Fee S State Surcharge $ TOTAL FEE $ q halll-wzr,rfP .J o FEES PA By: Date: Check flcasrrrBY: TOTAL VALUATION S A-n >8L DATE LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEIT,IENT / 125 EAST EIGHTH AVENUE, EUGENE, OREGON 9740L C74-I94 SEE REVERSE iip,:^:ii'"4:/)-8? fl rro Copics of Pl-ans flrwo Copies of Plot Plans f] l,techanical Checklist felu*Ui.,g Checklist Ie:-an Check rnfo Sheet T tr -fT V\oP-?+= PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.805(I)) 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, ANDIOR OTHER REMEDIES ALLOWED BY LAH. I,IHEN READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST MUST BE GIVEN. Have the following information ready: Permit number, job address, type of inspection, when it will be ready, your name and phone number, and any special directions to site. BUILDING DIVISION: REQUIRED IIISPECTIONS l) FOUNoATION INSPECTI0N: To be made after trenches are excavated and forms erected and when all materials for the foundation,ffiob.Whereconcretefromacentra.lmixingp1ant(common1ytermed..transitmjxed..)istobeused, materials need not be on the Job. ?)C0NCRETE SLAB 0R UNDER-FL00R INSPECTION: To be made after all in-slab or under-floor building service equipnent' ary equipnent items are' il p'lace but before any concrete is poured subfl oor. 3) FRAMING & INSULATIoN INSPECTIoNS: To be made after the roof, a'l'l framing, fire blocking and bracing are in p' sandventSarecomp.leteanda.llroughe1ectrica.landp1umb.ingareapproved. wall insulation and vapor barrier are in p1ace.. 4)LATH AND/oR GYPSUM BoARD INSPECTIoN: To be made after all lathing and gypsum board, interior and exterior, is in place orbeforegypsumboardjointsandfastenerSaretapedandfinished. (1) (2) SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS Permits shall be effective for one year from the date of issuance. Upon completing the construction for which a permit has been issued the permit holder sha1l notify.the Dbpartmeht by iubmitting the installation recbrd form. The Department shall inspect the construction to determine ii it compliei,with theirules contarlned i4 this division. If the construction does comply vtith such ru'les, the Department shall issue.a certificate of satisfactory completion to the permit ho'lder. If the constrqction does not comply with guch-t"ules, the Department_shal1'notify the permit holder and shall require satisfdctory completion. befbre'jssuing the certifigate. Failure to meet the requilements for qatisfactory comp'letion,within a rea'sonable time constitutes a violation of ORS 454.605 to 454;745 and this rule. conduit, piping accessories and other ancill or floor sheathing instal Ied, including the From:Interior property lines Edge of road right-of-way Building foundation l.lells, other water sources 'lace and An 5)FINAL INSPECTI0N: To be nlade after the buj_lding is complete and before occupancy. APPR0VAL REQUIRED. No work shall be done on any part of the building or structure beyond the point indicated in each successive inspection without first obtaining the approval of the bui'lding official. Such approval shall be given on'ly after an inspection sha1l have been made of each successive step in the construction as indicated by each of the inspections requ i red. N0TE: A11 building permits require inspections for the work authorized, such as but not limited to: A. BLOCK l,lALL: To be made after reinforcing is in p1ace, but before any grout is poured. This inspection is required for each bond beam pour. There will be no approval until the plumbing and electrical inspections have been made and approved. B. l,I00D ST0VE: To be made after completion of masonry (if applicable) and when'installation is comolete. Insta]lation shall be in accordance with an approved nationally recognized testrng agency arrd the manu- facturer's instal lation'instructions. C. I40BILE H0ME: An inspection'is required afttir.tlr€'mobile home is connected to an approved sewer or septic' system for: setback requirements, blocking, footing connection, tiedov{ns, skirting, and plumbing connect i ons . (f) Footings and piers to comply lvith State foundation requirements for mobile homes or as recommended by the manufacturer.(2) Mobile home minimum finish floor elevation shall be certified when required by a floodplain management letter.(3) l4obile home tiedowns, when required, and skirting shall be installed and ready folinspection within at ieast 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure. D. S}IIMMING P00L: Below grade when steel is in place and bef,ore concrete is poured. Above grade when pool is installed. APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT tlJILL EXPIRE IF WORK DOES NOT BEGIN }IITHIN I8O DAYS, OR IF I,IORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERTIIT t^lAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION. ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS I,JILL DO SO AT HIS OI,IN RISK Sept'ic Tank Dra'i nf iel d -T0''-10. 'I 0' 5', 50' l0' I0' I 00' TRS, lane county TL l({3-ru,1 ,-*zrzg z_ADDRESS n2 PTUMBING/MECHANICAL tQ e1 <T 1ng SS or At 6t!'.t- CHECKTIST APPLI CANT INFORIVIATION : OI 1 t OI.^ln Cont. OSR# 1p PLIIMBING CONTRACIOR ! Ves Firm Address E No D s"rr MEGIANICAL CONTRACTOR fi VCs Firm Address ont. OSR#ufl uo fl serr directions to site PLTJMBING OFFICIAT USE ONLY App1i. / Permit # Type of Fixture Ntmber of Each Fee On Each Total Sink $ s.oo vato 1n 5. 00 Tub (with or without shower)5. 00 Shower, separate 5.00 to 1 5. 00 Dishwasher 5.00rs. 00 Washing Machine 5.00 5.00 s. 00 Sewer--1st 50ft 15.00 10. 00 Water Service--1st 100 ft.15. 00 each additional 100 ft.10. 00 Storm t 100 ft.15.00 each additi-onal 100 ft.10. 00 Special Waste Connection s.00 Sewage and Sump Pr-unp ei ector 5.00 Wate 10.00 Other (specify) SIIB-TOTAI (Minimum $10. 00) TOTAL FEE MEGIANICAL I certify tha accordance wi Revised Statu unless l t th all p appl s Chp I umbi ng work wi] I be done i n icable provisions of Oregon appl i cabl e ,a liurnber of Each Fee on Each TotalType of Equipment $ 10.00Mechanical Permit Base Fee BFurnaceto 116r\$ 6.00 Furnace over 7. 50 Clothes Dryer Vent 3. 00 tent1on 3. 00 4.50Ranse Hood with }Gchanical Exhaust , 6. 0L)Wood Stove Air Conditioner Only 6. 00 t 6.00 6.00Floor Furnace Gas Piping System 1 to 4 Outlets Per Outlet .50 Other I 'specify) S[D.TOTAL TOTAL FEE Signa "u s. 447 & 693 and out@""*i t issued by I I - lry WateT C Water t e, Fl oor Dra n t nno 100 t a Itlobi 1e um) lane county PLANNING & COMMUNITY DEVELOPMFilIT ACT IVITY INFORMATIC^J SHEET ilv.-, COI4PLETE THIS SECTION.FORMS WILL BE REJECTED: o PERSON PROPERTY OMJER MAII,ING ADDiTESS MAILING ADDRESS CITY STATE ZIP CODE CITY STATE ZIP CODE HOME 'TELEPHONE NUMBER I-IOME TELEPHONE NUMBER @ TAX MAP/PROPERTY DESCRIPTION NUMBER (from tax maps in Dcpartment of Assessment & Taxation or from tax statement) llap & Parcel Number: ..- Tax Lot(s): Township Range Scction I out of rL Tax Map & Parcel Number of Adjoining Property in Same Ownership Tax Lot (s) : T""/"s] 'rrp Ra"S" Se.tio" I uone I unkno*n #By Partition f-- BLOCK I,OT @ neeunst (urier describe inforrnation THIS SECTION FOR CONSTRUCTION APPLICATIONS ORP E SEE *NOTE BELOW **FOR STAFF USE ONLY** NUI,IBNR: DATE t-: Fln F:ltrTIME INITIATED: CTIECKED BY: ATTACHED EXHIBITS @ TorAL coNTrcuous PRoPERTY rN SAME oWNERSHTP: @ NUMESN OE STRUCTURES ON PROPERTY: StANdATd hOMC- Modular home RV in use as residence- Garage_ ShoP- @ otunn EASEMENTS ovER PRoPERTY' - @ eeuornc PERMrrs oN PRoPERTY: acres O pneseut usg oF PRoPERTY: @ nrne DrsrRrcr: widrh -.-- @ enoenRrv ADDRESS: @ warrn DrsrRrcr: Mobile home_ storaqe_ Barn Private Road Nane Road Easement *of U sers @ accrss To PRoPERTY: Public Road Name I erot Plans (2) ! constr. Plans (2) flsite rran Dcopy of Tax MaP !oth."- SCREENING VERTFICATIO'}I : By: Date Time In: Out:_ I accept f] Reject Routed tot-- *NOTE: ATTACH A COPY OF iEl-uep ; SHorrr EXrsrrllG STRUCTURXS AND TAX LOTS IN YOT1R OWNERSHIP. OB- TAIN TAX MAP IN SELF HELP AREA OF A & T.9,/81- REV (OVER) BUW ffi @ SUeorvrSrOu (if applicabre): qzo COI{PLETE THIS SECTION TOR I,AND @ rnoeosno usE oF PRoPERTY rN DETATL: CONSTRUCTION APPLICATIONS .**FOR STAFF USE Oi!:iY** ZONE D USE By: Date: @ aurr-orltc REQUESTS Contractor's #(for mobile home setuP also) Time fn._ Otlt:.-=-- f] accept I neject f] nlanning Application l-lConstructj-on Permit APP. fl rnformation only Zoning: Comp. Plan Designation:- SANITATION: By: Date: Time In:-- Out:_ ! accept I neject ! constr. Permit Issue f site Evaluation rssue PERI'IIT ISSUED (SAME DAY ONLY): Permit # By Date: Directions to Si-te: l-l agri-cultural: use Check the type of Permit requested: Iowe1ling: f]uew Inepracement [eaditional; Iaaaition Ialteration; fl uodular Home fl uoui-re Home - Mode1 Year- nnv Istandard construction; fl n:."n check only n commercial: Use Floor Area i n oth.r": Use Floor Area @ uuuenn oF BEDRooMS NUMBER OF STORIES @ sailrrarroN REeUESTS : fl site evaluation for SDS feasibility I llew system installation I nepair/replacement ! alteration,/re location l-l cn..rg. of use - How? Time In:_ Out:--- f Hoox to exi-stJ-ng ADDITIONAL INFOR]I4ATTON : ZVZS Xhrc LANE COUNTY INSPECTION K''ORD NUMB E PH NE7 SET_BNETTEOIIREMENTS #PLUMBING FIXTURES^ ' ct,*!tor IntERtoR RrRR"1, FRONT I^JORK AUTHORIZED BY PERMIT DIRECTIONS TO SITE SITE ADDRESS PERMIT NUMBER N UN T N NSP ON OR MOBILE HOMEApproved_ Correcti on Di sapproved_Da te I ns pector I S ECT I ON CONCRETE SLAB / UNDER-FLOOR INSPECTION Approved Correctjon_ Disapproved-Date Inspector UTDEtrTLA-B IP I-uI'Ig I NG GROU N DI^JO RK I NS P ECT I ON ,Approved Correcti on Di sapproved--Date I nsp ector ROUGH PLUI'{BING INSPECTIONApproved Correcti on Di sapproved-]Date I nspector FRAMiNG INSPECTIONApproved Correction Disapproved Date--Insp ector I_NSTTION / VAPOR BARRIER INSPECTI N Approved Correcti on -D'isapproved IDate i ns pec tor IATH- / GYPSUM BOARD INSPECTI Approved - Correction Disapproved Date Inspector FINAL PLUMBiNG INSPECTI ON Approved_ correcti on_ Di sapproved Date _l nspector.-- F I NAL bJASTE D I SPOSAL SY ST EM I NSPECTI ON Approved Correction Dj sapproved Date Inspector FINAl INSPECTION BUILDING proved u/ C orrecti MOBILE HOME n D'isapproved e Ins pec tor CERTIFICATE OF OCCUPANCY Approved__-._Correcti on Di sapprove TEMPORARY CERTIFICA TE OF OCCUP AN CY Inspector Form C74-L97 d Date LJ I] 1