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Home My WebLink AboutPermit Building 1973-02-127/VA) ls -.,rZz-*.- LANE COUNTY B )IKG-PERMIT OR fz-4ezz--4,,"-&,gzzr*/2.'224a$ MOBITE HOME . APPTICATION PROPERTY PROPERTY TEGAT DESCRIPTION toT-Br.ocK-suBDtv. TWP RANGE PERMIT TYPE _ BUILDING POST OFFICE MOBILE HOME osc REG. # J TING ADDRESS MAILING PERMIT 7s *73 PHONE PHONE METES&BOUNDSNYES ATTACHED NO CE ?1I 5T- SEC.TAX tOT CODE/7 O? APPTICANT NAME AND MAITING ADDRESS DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY TEGAT PROPERTY _ ROAD NAME OR PROPERTY ZE_WIDTH DEPTH AREA FOR MOBILE HOME PERMIT ONLY Number of Bedrooms TO SEWAGE DISPOSAI PUBTIC THIS PERMIT SEPTIC TANK Connect to Existi TYPE OTHER PI-UMBING INSTAI.TED BY OWNER OTHER NAME FURN ISH ED NO or New System R"q. E BEDROOMS VATUATION .' tITY YES NO DATE m SQ. FT2tu ,) OTHER B[DG. WASTE DIS. PtUrv{BING PTAN REVIEW PARK TRTR. TOTAT 3 6 F EES CASH ! CHECK WATER SUPPLY PUBTIC PIUMBI iH 2-( - DATE2-6 - 3-z COUNTY BUILDING & SANITATION SPECIFICATIONS FEE *?'v fr DRAIN FIETD REQUIREDAAIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. TYPE OT STRUCTURE 'UO I.IN. FT NE OR SQUARE FEET REAR YARD USE CTASSIFICATION ?> PUBTIC UTIT. EASEMENTtt BIDG. SETBACKS - FT. TROM CTR. OF ROAD RIGHT OF WAY Form # cls-tz SIDE EXT.REAR (/ NGDqle Dole BLDG. INSP, IRONT SIDE INT. Directions to Find Properly: Dote coPY I - OFHCE COP\ 2-JOURNAT COPY 3 _ AUDIT // y',s PUBTIC WATER CONNECTION FEE ,/, , TRENCH WIDTH FT. , "1 -t LANE COUNTY 'IIIDING PERMIT OR MOBILE HOM BUTLDTNGE _ MHE ,5E PERMIT PERMIT NO, PROPERTY OWNER MAILING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY I.OCATION - INCTUDE POST OFFICE PROPERTY LEGAI DESCRIPTION -METES, BOUNDS RANG E SECTION ,Ll ,l ,fr I 7-.Cl LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY APPT. NAiTE & MAITING ADDRESS TEGAT ACCESS TO PROPERTY PROPERTY SIZE-FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connecl to Existing Sewoge Sysrem ! New System ! STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION sq. FT. # BDRMS VALUATION SEWAGE DISPOSAT PUBI.IC D SEPTIC TANK tr oTHERn PLU'iABING INSTALTED BY OWNER E OTHER: NAI\IE BUITDING WASTE DISPOSAT PTUMBING PtAN REVIEW PARK TRAIIER $rEES WATER SUPPTY PUBr.rC tr tr OTHER TOTAI. COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIETD REQUIRED tIN. FT TRENCH WIDTH FT.OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT BLDG. SETBACKS TT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BLDG. PERMIT - WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PI,UMBING _ CANARY BUITDING _ GREEN SANITATION - GOTDENROD Conslruction to comply wilh uniform building code ond counly regulolions covering plumbing ond sewoge disposol. All buildings require o certificole of occuponcy before being occupied. (See Stotemenl on Reverse Side) (POST THIS PERMIT ON MAIN BIDG. AT SITE) IANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu 1* 655- 13 $- K7 - l'2 t,/ ch-:. APPL I NAHE ADDRESS /-4 N BU LCI.I NG 5 ITE EVALUAT ION Building Permit App I icat ion No./ 73 - 7S ( ) Site lnspection ( ) Pre-Permit lnvest igat ion PHONE DATE LANE COUNTY PLANNING DEPARTI.,IENT NOT NO YES DATE a-p'p't icab le -r)())ffI . Zon ing 0rd in "'""i::"'.frL, 2. Subdivision Ordinance Compl iance 3, Requ i red Access \ () () () () ( () ()4. Bu ild ing S ite (Area, l,/idth, 5. other (ru" .ol,l::I3i"' setback) CO}l},IENTS: ( ) ) BUILDlNG INSPECTION SECTION 6, Plans Submitted 7. Soil Stability (footings) 8. Flood Pl a in 9. 0ther (see Comments) aool icable ,N () NOT YESNO () () () () k) ,'{' ttl NA}IE DATE q ()()7-/ 7'rV COII1}4ENTS: SAN ITAT ION SECT ION 10. Sewage Disposal I l. Usable Area 12. Water Supply 13. 0ther (see Cornments) NOT YES vd g) () NO () () NA}IE DATE aool icable*rT-( () () / )) CO}4}4ENTS: TO APPL ICANT: Y our !ui vY c"n lding Permit / Site lnspectio be approved. 2- /2- 7' ()Cannot be approved at this time as indicated on item N0. Questions and further information on items I th rough 5 contact COUNTY PLANN ING DEPARTMENT through l3 contact the Lan above. ane- Questions and further information on iEiE Ge Coun Buildi and Sanitat ion Division. t () ) Will be held in this o ice unti you can resolve t pro ems I cated.f (ls being returned.()Your building permit application fee is being returned under separate cover. LANE COUNTY PLANNTNG DEPART}IENT 135 Sixth Aven0e East, Eugene, 0regon 97401 PHONE: 342-l3l I EXT. 231 LANE COUNTY BUILDING S SANITATION DIVISION 135 Sixth Avenue East, Eugene, Oregon 9l4}l PH0NE: 342-t3ll EXT. 4l I M55-28 tr NA/{ E ,? a T Date Ito. PERM IT IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY WHEREAS, the attached application has been fully considered by the Board of County Commissioners of Lane County, and it is the opinion and ,judgment of the Boardthat the said application should be granted, and that a permit should be issued, now, therefore, it is hereby ORDERED, that a permit be and is hereby issued to and constructing of the following facility: for the placing, building upon the right-of-way of County Road No. . in strict conformity to the exhibitsattached thereto, and subject to all terms, conditions, agreements, stipuiations and pro.visions contained in the application and permit, the Rules and Regulations GoverningFacilities to be Permitted upon County Road Rights-of-Way, dated March 31, 1g60 and any amendments thereto, and any other applicable regulation, law or ordinance. Special Provisions: completed before , 19 -. Expires This permit is revocable at any time, and will be strictty adhered to and no work other than that specifically mentioned above is hereby authorized. This permit shall be void unless the work herein contemplated shall have been ,19 Inspected and Approved Approved by Board of Commissioners By By- WHITE , OFFICE FILE GREEN . RESIDENT ENGINEER Director of Public Works PINK . PERMITTEE ORANGE - BUILDING & SANITATION DEPT BLUE . ROAD SUPERVISOR YELLOW . SURVEYOR c98 52 Date ---- Date APPLItrATION FOR FAtrILITY PERMIT IN THE BOARD OF COUNTY SOMMISSIC,NERS OF IJ\NE COUNTY Your applicant, ' hereby rnakes application under Rules and Regulations Governing Facilities to be Per- mitted Upon Gounty Road Rights-of-Way, to construct the following facility: Upon the right-of-way of County Road No., at the folloruing location as shown on the exhibits which are attached hereto, in strict conformity to the state- ments of the exact nature and amount of work to be done, and to the description of the facilities contained in said exhibits. Your applicant will be the beneficial owner of the facility as constructed, or otherwise primarily liable and responsible to members of the public for its proper maintenance, repair, operation and use. Your applicant accepts all terms, conditions, agreements, stipulations and provisions, in Rules and Regulations Gorerning Facilities to be Permitted Upon County Road Rights-of-Way, dated March 31, 1960, and any amendments thereto, and arty other applicable regulation, law or ordinance. Signature WHITE . OFFICE FILE GREEN . RESIOENT ENGINEER PINl( . PERMITTEE BLUE. ROAD SUPERVISOR ORANGE . BUILOING AND SANITATION OEPT YELLOW . SURVEYOR Address Phone No. J IANE COUNT }UIIDING PERMIT OR MOBILE HC BUTLDTNG E MH n USE PERMIT PERMIT NO. !.ROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCTUDE POST OFFICE PROPERTY TEGAT DESCRIPTION _ METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY APPI. NAME & MAITING ADDRESS LEGAL ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewoge SYstem TYPE CONSTRUCTION SQ. FT New BDRMS VALUATION SEWAGE DISPOSAL PUBUC tr SEPTIC TANK tr oTHERn PLUMBING INSTATTED BY OWNER I OTHER: NAME BU ITDING WASTE DISPOSAI. PTUMBING PTAN REVIEW PARK TRAITER TOTAT F EES WATER SUPPLY PUBUC tr N OTHER q $-__- COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIETD REQUIRED tIN. FT TPENCH WIDTH FT.OR SQ. FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIt. EASEMENT BLDG. SETBACKS FT. FROM CTR, OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BLDG. PERMIT _ WH ITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PLUMBING _ CANARY BUILDING _ GREEN SANITATION _ GOLDENROD Construction to comply with uniform building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificote of occuponcy before being occupied. (See Stotemenl on Reverse Side) (posT THrs pERMtr oN MAIN BLDG. AT S|TE) I.ANE COUNTY, BTDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronu ii 6 55 - 13 S I TE I NSPTCT IONI,. Appnovro RruaRxs DrsappRovro Dar r I rusprctoR %&b'-2/'ts7d FOUNDATION INSPECTION APPRovED Rruanx s Dr sappRovrD n oorrZ_=-/'7C_ truspe c FRAMING INSPECTION AppRoveo Rruanx s D r sappnoveo oartJ -;j -'? .4 I Nsprcro 'V B,7t- LATH OR SHEETROCK INSPECTION Appnov t o Ret'taRxs Dr srppRovro DarE I Nsercton rINAL INSPECTION Ap pRov e o Reuenxs D Dr snppRovEo -r.) o^r, {-Z^,fi/J NS P E CTOR 7 ,n CERTIFICATE OF OCCUPANCY Reaov ro I ssuE Reuaex s I HsprcroR F*4 fla- I ao/7e'7a o& ffa R TLf rt' D Nor Reaov ro lssue D DarE IANE COUNT' BUTLDTNG [-r UIIDING PERMIT OR MOBITE HOI MHN USE PERMIT PERMIT NO. PKOPERTY OWNER MAILING ADDRESS PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY TOCATION _ INCLUDE POST OFFICE PROPERTY I.EGAT DESCRIPTION -METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY APP[. NArvtE & l{AruNG ADDRESS LEGAL ACCESS TO PROPERTY PROPERTY SIZE - FT, WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge TYPE CONSTRUCTION New SQ. FT BDRMS VALUATION tr STRUCTURES TO BE BUILT THIS PERMIT SEWAGE DISPOSAL PUBLIC N SEPTIC TANK tr oTHERn PLUMBING INSTAI.LED BY OWNER E OTHER, NAlvlE BUITDING WASIE DISPOSAI PTUMBING PIAN REVIEW PARK TRAII.ER F EES WATER SUFPTY PUBUC tr tr OTHER TOTAI. COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. DRAIN FIETD REQUIRED TIN. FT TRENCH WIDTH FT OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTIt. EASEMENT BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CLASSIFICATION REAR AUTHORIZED SIGNATURE _ DATE DATE BIDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUITDING - GREEN SANITATION - GOTDENROD Conslruction to comply with uniform building code ond county regulotions covering plumbing ond sewoge disposol. All buildings require o certificole of occuponcy before being occupied. (See Stotemenl on Reverse Side) (posT TH|S PERMIT ON MAIN BLDG. AT SlrE) I.ANE COUNTY, B!DG. & SAN. DIV., COURI HOUSE, EUGENE, OREGON 9740I ronn If 655- 13 , SLAB FLOOR PLUMBING GROUND/ORK APPRovED ffi Drsappnovro Darr j 4o-7?I rs pe cron 9- Reurnxs GAS PIPING GROUND/ORK Ap pnov e o ReuaRx s D DrsApPRovEo D Dare I Nspecron ROUGH PLUMBING Appnoveo M Drsappnoveo D DArE Rrua nx s ?-,+/-2, Ir.rsprc ROUGH GAS PIPING APPRovEo D Drsappnovm D Rruanr s Dare I nspecron FINAL PLUMBING AeeRoveo K DrsappRoveo D oorr-fj._?)3__ Rr urnr s I NspEcroR FINAL GAS PIPING AppRov eo Reuanx s D r sappRoveo Darr Ir'rspEctoR CERTIFICATE OF OCCUPANCY Rraov ro lssur Rgua Rr s Nor REaov ro lssur Dare I Hsprcron ,o-4i D D INDIVIDUAI SEVIAGE DISPOSAL SYSTEM RECORD Installer: Complete top part form to signature and return both gopiu. to Lane County Building Sanitation Department. ss V iewnount Other-List 173-73 ler s Name No.L .v c Bectrooms \, Baths / Basement Yes fl NoR UnitsI Ft. from well Steel I Concrete No. Compartments r.ength widrh Diameter Depth GaI. Capaclty l6t T Distribution Box:Yes No fI Other D s on- tion / 0 Lot Line below tppli Name M ailing Address s-Pt.er 2I 3. 4. 5. 6. Mel f rd Feet24tl N. l5th rr fieldr 0r. Trench widrh ...,Total soJrt.between tt.<y'J-o'lrir,"" fl- rit\el lF tvpe/Lt ,( Fillerabove Ske See instructions oate rJ Signature For Sanitarian Use OnIY:trn Disapproved : Does Not Conform to Current Standards Approved: System Installation Conforms to Current Standards 73 E (d' ?0 I lt ,(2 v)hoyff* ?otio ln II I illf:fnn r ^ .l 73 Ifl'IE {.;UUNI} HMTIH UflII Remarks: Lane County Building & Sanitation Dept' Date tarian's c55-il Water Sl Public I +.-,gt 'f I I