HomeMy WebLinkAboutPermit Building 1981-10-06to/t69!'
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CON STRU C..'.oN/ PLAC E M E NT
PERM IT
CO}IPLETE THIS BLOCK. PLEASE USE BLACK INK AND PRINT.
POR OFFICE USH ONLY
?Z*,ii,,M
!:rwo Copies of Plans
flrwo Copies of Plot Plans
f]laechan ical Checkl-ist
I i,J-umbing Checklist
f]etan Check rnfo Sheet
SECTIONror{NsHrP
/ 7
FANGE
SUBDIVISION//PARTI?ION (if applicable)LOTIPARCEL BLOCK
x2/qY ztP7 PROPOSED USI] ClF PROPERTY
'ffisidenti.at
[-'l commercial
Irndustrial
f,ruttic
7 :7 WATER opossting
NUMBER
f%se4z
certify that any and all work pe!formed shall be done in accordance with the Ordiiaxc.)s of Lanc Cotrnty and the Lails of thc Si-.ri:e of are.J.)i) J,,trL.rjt)if.lto the work described herein, and that NO OCCUPANCY will be made of any struclur-6 without the permission of the Bui.lding Division. f furrjher crri_rfy
that.registration with the Builder's Board is in full force and effect as requ.ired by ORS 7O1,055, hhat if exempt the basis for.rxemlrtiorr is rroL.:d
hereon, and that only subcontractors and employees who are in compliance with ORS 701,055 will be used on this project. I HAI,E R-EAD AIJD CtiECy.ED THIS
APPLlCATION THOROUGHLY.
SIGNATURE
:H;
DATENAME (p.lease print)
[-l ornet
E&r.."..o.
f 49..t
I pr,anmrucrzZoNrNG:
ivltni-mum Setbacks: CL
Zone Partition #
L, srd(-
Parce 1
interior
Parcel Size
re ar
tr IN
n RURAL ADDRESSING: CRID COORDINATE N
fl sarlrrArroN:
In flood hazard .r..: Hlto l-l y"=. see attacrled sheer,LJ'""Date:
Date:
Da
rnstallati.on Record rssued? ! v"= [ n"
Maximunr Depth
of Trelclies
E
s. r. #B.P.#
Insta Ilation
Specifications:
Coments
Gal-Ion
Tank
Lineal Feet
of Drainfield
TDate:
re!48 EXAMINATION ,, *r" 6\J Group____.tu,L_Use YtT
Coments:
Date:
Descri
TOTAL VALUATION $
PERMIT APPROVED sy surl,otNc orFrc
CONSTRUCTION AUTHORIZED BY THIS P ER.TTIT
Fixetl Fee/
Unit Cost
f'loodplain Fee $
Subsurface Fees $
Building Fee $
Sewer/Storm Drain/Water S
Plumbing Fixtures $
Mechanical $
Plans Check Fee S
State Surcharge S
TOTAL FEE
PEES PATD BY:
Byt
Date
Sq. Ft
/
IALIDESIGNEE (per oRs 56.80 r))
$
10,6 4l
LANE COUNTY DEPARTMENT OF ENVTRONMENTAL MANAGEMENT /125 EAST ETGHTH AVENUE
DATE
oREGON 97407c74-L94 SEE REVERSE
EUGENE
)
Il
T
-v374-
SETBACKS AND 0THER CONDITIONS 0F APPRT.,vAL MUST BE STRICTLY 0BSERVED. VIOLATION Crt,q RESULT IN REVoCATIoN 0F THIS pERMId'
cITATIoN.UNDER PRoVISIoNS 0F LANE CoUNTY'S INFRACTIoN 0RDINANCE, ANDIOR oTHER REMEDIES ALLOT,,IED By LAI.I.
WHEN READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTIOGMN. Have the following information ready: Permit numberr job address, type of inspection, whenyour name and phone number, and any special directions to site.
BUILDING DIVISION:
N REQUEST MUST BEit wilI be ready,
3)
REQUIRED INSPECT IONS
f) F0UNDATI-0N INSPECTI0N: To be made after trenches are excavated and forms erected and when all materials for the foundation
are delivered on the iob. Where concrete from a central mixing plant (conrmonly termed "transit mixed") 'is to be used,
materials need not be on the Job.
2) CoNCRETE SLAB 0R UNDER-FL00R INSPECTIoN: To be made after all in-slab or under-floor building service equipment,
conduit, piping accessories and other ancillary equipment items are in place but before any concrete is poured
or floor sheath'ing instal'led, including the subfloor
FRAiTJNG &INSULATI0N INSPECTI0NS: To be made after the roof, all framing, fire blocking and bracing are in place and
are complete and al'l rough electrical and plumbing are approved. Ai1all pip'ds, fireplaces and chimneys and ventswall 'rlsulation and vapor barrier are in place.
4) LATH AND/0R GYI'SUM B0ARD INSPECTI0N: To be made after a'|1 lathing and gypsum board, interior and exterior, is in place
but before any plastering is applied or before gypsum board joints and fasteners are taped and fin'ished.
5)FINAL INSPECTION:To be made after the building is complete and before occupancy.
APPR0VAL REQUIRED. No work shalll 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 building official. Such approval sha'll be given onlyafter an inspection shal l have been made of each srrccessi've step in the construction as tndicated by each of the inspections
requi red.
NOTE: A1i building permits require inspections for the work authorized, such as but not limited to:
A. BLOCK WALL: 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. td00D STOVE: To be made after completion of masonry (if applicable) and when insta'llation is comDlete.
Installation shall be in accordance with an approved nationally recognized testtng agency and the manu-
facturer' s instal lation instructions.
C. i'|OBILE HoME: An inspection is required after the mobile home is connected to an approvgd 1ew91 or septic
system for: setback requirements, block'ing, footing connection, tiedowns, skirting, and plumbing
connecti ons.
(f ) Footings and piers to comply with State foundation requirements for mobi'le homes or as recommended
by the manufacturer(2) Mobi'le home minimum finish floor elevation shall be certified when required by a floodplain
management letter.(3) Mobiie home tiedowns, when required, and skirting shal'l be installed and ready forinspection
within at least 30 days after occupancy. T'iedowns and skirting shalI be installed per enc'losure.
D. SWIMMING P00L: Below grade when steel is in place and before 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 WILL EXPIRE IF I'IORK DOES NOT BEGIN
WITHiN I8O DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN]8O DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PERMIT hIAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT HIS Ot,lN RISK
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
(r )
(2)
Permits shall be effective for one year from the date of issuance.
Upon completing the construction for which a permit has been_issued the PeIT'il holder sha11 notify.the
otpi.i*"ht by iubmitting the installation recbrd form. The Department shall inspect the construction to
O.i"rrin. if"it compliei with.the rules contained.in this divisiort., If tfre construction does comply vtith
such rouleg. the Depirtment s,nalllssue a certifjiate of satisfactory completion.to the permit holder. If the
I";iti^iiti".-Ao.i-hpt iomply yrith such rules, the Department shall notify the permit holder and shall require
iitiiraii6"v iompr"ii'oo oLr-ore isiuing the cer:t'ificate,.i Failure to meet.the requirements forisatisfactory
iorpi"iion'ritfrih a reasonable time c6nstitutes a violation of ORS 454.605 lo 454,745 and this ru'le.
Setbacks - Subsurface Sewaqe Disposal
From
Septic Tank Drainfield
-T6]-Interior property lines
Edge of road right-of-waY
Bui1ding foundation
Wells, other water sources
'10'
t0'
5',
50'
l0'
l0'
I 00'
LANE COUNTY, OREGON
DEPT. OF ENVIRONMENTAL MAN
-
(
AGI,/IENT
CclFIFlECTIclN NGITICE
CONSTRUCTION PERMITS
Er INSPECTION DlV.
6
JOB ADDRESS 1g DATE
TO
NOTE
BLDG. PERIVIT
w
2
Z o
3 L
c5s-7t tE-lNsPEcrloN FlEoLrtFlE.,
Phone EiEl7-4CtEis FoFl APPEIoVAL I N S PECTOR
/
/
lane county
Environmental Management
ACTIV*.'Y 1NFORMATJON HEET 6l\,\7
Y
o e'l Cons l ida c PROPnttY OtntleR
PERSON I'IAKING REQUEST
2497 N. 34th Street
2610 W. 5th ITETi.TUC ADDRES
MAILING ADDRESS
Sj
7 47 -7095
ZIP CODE
STATE ZIP CODE
484-9888 HOME TE LEPHONE NUMBER
irour tnr.nPHonr NUMBER
BI]SINESS INi-EPTTONS NUMBER
in Department- of Assessment & Taxation or from tax scatement):
I o.rt of TL + BY Partition il-.'------_-
@ tax MAP,/PRoPERTY DEScRTP'rroN NUMBER (from tax maps
!{aP & Parcel Number' *knIF *"* +*#
Tax MaP & parcel Number of Adioining Property in same ownership:
fi""htp
tr
Range
None
Sect ion
Tax Lot(s):
! u.,k.,orn
BLOCK: LOT
@ SunorvrsroN (if aPPlicable):
Build p erml t for fire damage rest ora tion on
@ neQUeSf (briefLy describe information needed):
COMPLETE THIS SECTION.INCOMPLETE FORIIS WILL BE REJECTED:
COMPLETE THIS SECTION FOR LAND ,USEI
PROPOSALS SEE *NOTE BELOW.
**FOR STAFF USE ONLY**
CONS'TRUCTION APPLICATIONS OR
NU},1BtrR:
DATE:
TIME INIT]ATED:
--
CHECKED BY:
ATTACHED EXHIBITS:
Hfrln
'Jtr
O TorAL coNTrcuous PRoPERTY rN SAME oWNERSHTP:
@ NuMsnn oF STRUCTURES oN PRoPERTY: Standard home x Mobile home-
Modul.ar home RV in use as residence- Storage-
Garage x shoP- Barn-
Other (spocify)
@ pRopsntY ADDRESS
@ pnrsuxt usE oF PRoPERTY:
Private Road Name
Road Easement
@ nrnu DrsrRrcr
acres
OR
widrh
inefield
@ accsss To PRoPERTY: Public Road Name NorEh 34th Street
477eet. SPr2497 N. 34th Str
Single familY dwelling
Spri ield
@ orgsn EASEI.IENTS oVER PRoPERTY:
@ nenorxc PERIrrrs oN PRoPERTY:
#of
USETS
O warrn Drsrirrcrr Rainbow
fl erot Plans (2)
I constr. Plans (2)
I sit" er.r,
Dcopy of Tax MaP
f]otrrer-.-_--
SCREENING VERIFICIlTION
By:
Date:
Time In:Out:
I accept I Reject
Routed to:
*NOTE: ATTACH A COPY OF
TAX MAP; SHOW EXISTING
STRUCTURES AND TAX LOTS
IN YOUR OhTNERSI.IIP. OR-
TAIN TAX I4AP IN SELF
HELP AR-EA OI.' A & T.9/81 REV (OVER)
rps -
COMPLETE THTS SECTTON FOR USE OR CONSTRUCTION **FOR STAFF USE ONLY**
ZONEILAND USE:
Byt
Dat.e:
Time f n:=-- Jr.rt:----.-
! accept f neject
! nlanning Apolication
! Construction permit App.
[-l rnformation only
Zoning
Comp. .Plan Designation:
SAN]TATTON:
By:
Date:
Time fn:-=- Out:
! accept I neiect
I Constr. permit Issue
f] site Evaluation rssue
PERMIT I$!!9 (SAME DAY oNLY):
Permit #
By:
Date:
Time In Out:
@ enoeoseD usg oF pRopERry rN DETATL:ingle fS
@ aurlorrvG REeuESrs:
Contractorrs #
EXCEL CONSOLIDATED , INC
7 /8237 46 3 Expires:
dwel line
7/(for mobile home setup atso)
x
Directions to Site:
Check the type of permit requested:
Dwelling: Iuew [|neplacement
I aaaition I alteration;
IModular Home f]uouir" Home _ Model
fl*u !standard construction;
Iefun Check only
n comrnercial: Use
fl agricultural: use
fl otn.r", use Floor Area
I adaitional;
Year
llcr,.r,g" of use -.How?
@ uuuarn oF BEDRooMs j
@ sanrrarroN REeuESrs:
I Site evaluation for SDS feasibility
I Uew system installation
I Repair/replacement
I atteration/re location
Inoof to existing
ADDITIONAL INFORIiIATTON: COSt fOr rCS
NUMBER OF SToRIES .I
toration: 58.000 00
Floor Area t
/1 - 0Z'/7,3 Z 723tJ
LANE COUNTY INSPECTION RECORD
I NTERI OR REAR
PH
FI S
B
E FRO T
/.- /-/,
OO
S
SIDE
xK
I'l RK E
h
D
DIREC'IIONS TO S IJE/r
SITE ADDRESS PERMIT NUMBER
/ FOUN N NSPECT I MOBILE HT
rove d Correctjon DisaPP roved Date
ET UP INSPE ON
App Insp ector
CONCRETE SLAB / UNDE - FLO OR INSPECTION
Approved Correction- Disapproved Date I nspector
UNDER S,LAB / PLUMBING
,Appro verrl Correc t i
ROUNDWORK INSP
on Di sappr
ECT I ON
oved__Date I nspector
ITOUGH PLUMBING INSPECTI N
Approvr:d Correctjon Disapproved-Date I ns pec tor
FRAMI ION
Correc ti onApprov,ed Di sa ro Date I nspector
N
Approv,ed Correc ti onr_D'isapproved Date /O - /:-3/ InspectorL
rrection Disapproved-DatekZ,ZZ&-InspectorYPSUM 90A,/ co
LATH / G
Appro ved
RD INS ECT I ON
FINAL PLUMBING INSPECTI
Appr'oved_ Correct'ion- Di sapproved Da te I nspector
rII'IAI_ WASTE DISPOSAL SY TEM INSPECTION
Aprproved Correction Djsapproved Date Insp ector
I L N ECT NB NG
Correcti on D'isa pprovedApproved I nspector
CERTIFICATE OF OCCUPANCY
Approved--'__Correct j on Di sapproved_---Date
MPORARY CERTIFICA E OF OCCUPANCY
-___I ns pec tor-_-
Forn C74-L97
t
/a
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