HomeMy WebLinkAboutPermit Building 1975-08-01LANE COUNTY
BUtLDTNG Ll
BUIIDING PERMIT
MHT
OR MOBILE HOME USE PERMIT
PERMIT NO.
PROPERTY OWNER MAILING ADDRESS PHONE
CONTRACTOR MAII,ING ADDRESS PHONE
PROPERTY TOCATION _ INCTUDE POST OFFICE
PROPERTY LEGAL DESCRIPTION _ METES, BOUNDS
X LOT NO CODE CENSUS TRACTRANGESECTIONp
1
EXISTING STRUCTURES ON PROPERTY
APPT.
NAME
&
MAITING
ADDRESS
TEGAT ACCESS TO PROPERTY
J
PROPERTY SIZE _ FI
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERM IT
Connect to Existin Sewoge System New
BDRMS VALUATION
n
TYPE CONSTRUCTION SQ, FT
PTUMBING INSTATLED BYSEWAGE DISPOSAT
PUBUC tr SEPTIC TANK tr orHERn OWNER n OTHER: NAME
FEES WATER SUPPI,Y
BUITDING
WASTE DISPOSAL
PI.UMBING
PTAN REVIEW
PARK TRAITER
{
PUBUC n LI OTHER
TOTAL $---
COUNTY BUILDING & SANITATION SPECIFICAIIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[.
DRAIN FIETD REQUIRED
I.IN. FT TRENCH WIDTH FT OR SQ. FT
OCCUPANCY ZONE PUBTIC UTI[. EASEMENTTYPE OF STRUCTURE
BIDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT. SIDE EXT.
USE CLASSIFICATION
REAR
AUTHORIZEO SIGNATURE - DATE DATE
BI.DG. PERMIT - WHITE
OTFICE COPY _ WHITE
COUNTY TAX _ PINK
PTUMBING - CANARY
BUILDING _ GREEN
SANITATION _ GOTDENROD
Call 687-4065 to schedule oll required inspections. All construc'
lion sholl comply with Uniform Building Code, D.E.Q. stondords
IMPORTANT: for subsurfoce'sewoge disposol ond counly regulotions covering
plumbing. All buildings require q cerlificote of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(posT THrs PERMIT oN MAIN BLDG. AT SlrE)
LANE COUNW, DEPT. OF ENVIRONMENTAT MANAGEMENT
COURTHOUSE ANNEX, I35 EAST 6Th. EUGENE, OREGON 97,{OI
ronuf,655-13
a .'. , . -
RECORD OF APPROVAL OFiNDIVIDUAI, SEWAGE DISPOSAT SYSTEIT AND
APPROVAT TO OCCUPY RESTDENCE
ESI.ID IOI /0 t{Ue
Nom.
htryrrr, Addr...
IoilIo
Tel nrntrr Uving
Wor Sr4ply
N.orq, Lor lirr: fronr
trrrgth ot.odr o
Ioaol bngrh of ,il,
LunQn sg
SP!rc lAlql Dirrsnca from wdlE- fccr.AAotcriol
Idd liquid o
Dloarra -- - - -.-.--f.d. !.quld
Iff, D|SAOSAI HED Dirrriburion box
Dioorp from wrlt
TANE COUNTY
fi"8 Pcrmir No. /l Z */,
Bothr ----- .------,_ Eosemcnt: yer.,__.-_--,.- No , , Other
lndividuql Syrrom.. -_--_- .. Commun it/.- .. Gorb. Grinder
.,-No. of (lomportm
---------9o1. lnridc lcngrh .ft. lnrid,r widrh It
Bnts/ /Zr1_
------*-focr; Buitding Foundotion ,/: 4**
ridc-----/e h,; reor ,/A-
.fcct.
..- olher
h.
. ... feet
Iolol Gffcdiv. ob.orprio,i
fTurrt witrh---- 9/
ao in botorn of rcnchct:-_----
-------lnchcr.
feet.
r,g. fr.
lyp of fihcr morrriot,
Olpttt o, fihrr motcriol bgnooth tlb
lomorb:
Dor. of lnrpcction
rtonc---__----__._-_----t othcr -...
.-lnchcu Dcprh of filtrr over rilc
Approvodr lono CounrT Hootrh Dcportnrcnt
c-ta-oao.02 8v tirlc
r-l
,fu /.*.-/1 r 74
L
U
r-\\-/
t -1
--------___fcot. No of lincr --_
Distonce bctween lines
-3_.2-----
7'
-r/-t-u .,/
<--..tn,
a-1*-
14
Syrrrm-
!
Bur!0 tNG s rTL EVALUAT r0N
!
rc- lr l!)./ l'"
)/tz-7f
r / 8 n-P s-*ox Lor-
SUBDIVIS!ON:-J
1;f aur LD I NG pERl,t I T ApPL I cAT I ot{ No .
( ) strE tNsPEciloN
PLANNING DIVISION
Zoning 0rdinance Comp I iance: Zone
Subdivision 0rdinance Compl iance
Requi red Access
Building Site (Area, Width, Frontage)
Other (see cornments)
L0T:_ BL0CK:_
CKID BY:4&,2J947r
Setbacks TForn C |l.o{ioffia---Front Al'h
Side Exterior
Setbacks from interior lines:Side 5
APPL I CANT
DATE
A
Not
I i cable No Yes
I
2
3
4
5
-Y,YY
1-l()
()
()
()
6
()
()
()
()
COHHENTS:
BUILDING INSPECTION DIVISION NOt
7
8
9
0
Plans Submitted
Soi I Stabi I ity (footings)
Flood Plain
Other (see conments)
Aool i cabl e---Tr
(r)
(/ )
()
No Yes
1-l 8() ()
() ()CKID BY:
COMMENTS:
I'ATER POLUTION CONTROL
I l. ileets Department of Envi ronmental
Qual ity Standards.
12. Other (see comments)
COIIHENTS:
Not
le No Yesr)rI
BYDK() ())c
DATE
TO APPLICANT:
7
Your Bui I d
-$<I'can be
( ') Cannot
Quest i
COUNTY
in9 / S
aPProv
be app
ons andp5^
K4
ite lnspection:
ed.
roved at this time as indicated on item N0"Jbove.
further information on items I through 6 contact the LANE-
NG DlVlSl0N. Questions and further information on items 7
throug 2 contact the LANE COUNTY BUILDING AND SANITATION VISION.
Will be held in this of ce until you can reso ve the prob
ls being returned.
ermit li fee is b
E G E
74or135 Sixth Avenue East Eugene Oregon !
pHoNE | 687_U065
c55-28
Your buildin
LANE COUNTY PLANNING DlVlSl0N PH0NE: 587-4186
ems n cated.
r llntr ti I t
I
LANE COUNTY BUILDING
BUILDING Ll MH E
PERMIT OR MOBITE HOME USE PERMIT
PERMIT NO.
PROPERTY OWNER MAITING ADDRESS PHONE
PHONECONTRACTORMAILING ADDRESS
PROPERTY TOCATION _ INCLUDE POST OFF ICE
PROPERTY IEGAI DESCRIPTION _METES, BOUN DS
S ECTI ON TAX LOT NO CODE CENSUS TRACTRANGE
EXISTING STRUCTURES ON PROPERTY
APPt.
NAME
&
MAITING
ADDRESS
LEGAT ACCESS TO PROPERTY
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge System f,New System !
TYPE CONSTRUCTION se. FT. # BDRMS VALUATIoNSTRUCTURES TO BE BUILT THIS PERMIT
SEWAGE DISPOSAI,
SEPTIC TANK tr OTHERE
PIUMBING INSTATLED BY
OWNER n OTHER: NAI\AEPUBLTC tr
BU ILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAITER
F EES WATER SUPPTY
PUBUC tr tr OTHER
TOTAL
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAI..
DRAIN FTETD REQUIRED
I.IN. FT TRENCH WIDTH FT OR SQ. FT
TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTII-. EASEMENT
BLDG. SETBACKS
FRONT
FT. FROM CTR. OT ROAD RIGHT OF WAY
SIDE INT. SIDE EXT.
USE CI"ASSIFICATION
REAR
DATEAUTHORIZED SIGNATURE _ DATE
BI,DG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX _ PINK
PTUMBING _ CANARY
BUITDING - GREEN
SANITATION - GOTDENROD
Coll 687-4065 to schedule oll required inspeclions. All conslruc-
tion shqll comply with Uniform Building Code, D.E.Q. stondords
IMPORTANT: for subsurfoce sewoge disposol ond county regulolions covering
plumbing. All buildings require o certificote of occuponcy before
being occupied.
(See Detoils on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, DEPT. OF ENVIRONMENTAT MANAGEMENT
COURTHOUSE ANNEX, I35 EAST 6Ih, EUGENE, OREGON 9740Iroav .* 655- 13
SITE INSPECTION
AP PRov E o
ReueRxs
Dtsappnoveo Dare I nsprcroR
FOUNDATION I NSPECTION
ApeRovEo D DrsAPPRovEo
Re ttanxs O
Dat r I Nseeclon
3'7 /,
I
FRAM I NG
AppRov e o
Reuanx s
I NSPECT I ON
Drsappnoveo D TE lr.rsercron
LATH OR SHEETROCK INSPECTION
Ap pRov r o
REurnxs
D DrsappRove o Fa Dar e I NspEcron
FINAL INSPECTION
Appnov E o
Reuanrs,.nD */,L1,
,^,,rt:17 0'/bOVED I Nsprcr
J.-3i -7u %.-
CERTIFICATE OF OCCUPANCY
Rreov ro lssue
Renanx s
Nor RErov ro lssue Dare
/t o?2'?d 7/3 /d
luspecron
D
PER},IITf,/22r_
NOTE: NO PERMIT IfILL br, ISSUED TINTIL THIS APPLICATION HAS BEEN APPROVED
APPLICATION FOR:
PLAN REVIEW C}IAI{GE OF OCCUPANCY
c,$
CONSTRUCTION MOBILE
OWNER L a /Yot*"?ye t ///7r C ' €JA a' -' #c-1
Name - Address Clty / ,firn 7?/-6?irVPhone
CONTRACTOR
Name
o.s. REc. /l
Ttvp n
Subd ivis ion e.
ACCESS TO PROPERTY (Road Name)
Exlsting Structures on Property
Property Location - Address/Directions:
Address
Tax Lot
City
Code
zip Phone
(^Census Tract
Lot Block roperty Acreage tt /3 !o"ptn7 L !P Idid
for Office Use On
SEWAGE DISPOSAL
Slte Inspect lon /l
WATER STJPPLY
Well
B1dg.
Waste Dlsp.
Plumblng
Plan Reviesr
Moblle Home
12 Surcharge
Sprlng Other
Exlsting Sewage Disposal System
Publlc
Comrunity
or New System
Name of Community or lc Systen
Name
tlon
PLI]MBING:
Installed by Owner
PLUMBING
Other
3of Fixtures Water
Conoection
FACILITY PERMIT
YES
Date
>-tion 2-
SHED
/-f-a
TOTAL
Min. Septlc Tank Capacl
CHECK
Dtalnfield ired - Lineal Feet
Signature of
Fee Recelved
Maxlmum
Type of Construction Fire Zone Use Classificalion
Bldg S - from Center of Road Right of Way:
" frrt. -Z(S Rear RA,
PIANNING:DATE:
css- r2 COI'NTY DEPARTMENT OF EIWIRONMENTAL
DATE:
E*l
SANITATION:
l---l
DATE: BUILDING:
,l fl^'MANAGEMENT
rv I