HomeMy WebLinkAboutPermit Building 1973-10-16LANE COUN - JITDING PERMIT OR MOBILE H,.. USE PERMIT
PERMIT NO.BUTLD|NG I MHE
PROPERTY OWNER MAITING ADDRESS PHONE
CONTRACTOR MAILING ADDRESS PHONE
PROPERTY I.OCATION - INCTUDE POST OFFICE
PROPERTY TEGAI- DESCRIPTION -METES, BOUNDS
r
RANG E SECTION TAX LOT NO CODE CENSUS TRACT2A rzttu
EXISTING STRUCTURES ON PROPERTYAPPT.
NAME
&
MAIIING
ADDRESS
TEGAI- ACCESS TO PROPERTY
PROPERTY SIZE_FI.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
Connect to Existin
TYPE CONSTRUCTION
m New m
se. FT BDRMS VALUATION
SEWAGE DISPOSAL
PUBLIC tr SEPTIC IANK E oTHERn
PTUMBING INSTATI.ED BY
OWNER n OTHER: NAME
BUII.DING
WASTE DISPOSAL
PTUMBING
PTAN REVIEW
PARK TRAITER
F EES WATER SUPPTY
PUBilC tr tr oTHER
TOTAT
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAt.
DRAIN FIETD REQUIRED
LIN. FT TRENCH WIDTH FT.OR SQ. FT.
TYPE OT STRUCTURE OCCUPANCY ZONE PUBTIC UTIt. EASEMENT
BLDG. SETBACKS
FRONT
FT. FROM CTR. OF ROAD RIGHT OF WAY
SIDE INT. SIDE EXT.
USE CI.ASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
BTDG. PERMIT _ WH ITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PLUMBING _ CANARY
BUITDING _ GREEN
SANITATION _ GOTDENROD
Conslruction 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 Stotemenl on Reverse Side)
(posT THrs PERMIT ON MAIN BIDG. AT SITE)
lANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I
ronu !1 955-13
(
BU I LD ING S ITE EVALUAT ION Ja,T
/-/ 8-4,
2(7s Nr'$1E
ADDR
Buiiding Permit Appl ication No.
S i te lnspect ion
Pre-Permit lnvest igat ion
E S()
()PHONE
DATE
LANE COUNTY PLANNING DEPARTHENT NOT
Zoning 0rdinance Compl iance
(zone KU\ )
Subdivis ion 0rdinance Compl iance
Requ i red Access
Bu i ld ing S ite (lrea, Width,
Frontage, Setback)
0ther (see comments)
NO YES NA}.iE DriTE
li ab le
()/o-t /-7 <
(
(
(
(
(
2
3
4
5
)
)
)
)
COHHENTS:
EUILDlNG INSPECTION SECTION
app_l icqb,t e
YES
,1
NA},IENOTNO
((6. Plans Submitted
7 . Soi I Stab i I ity (foot ings)
8. Flood Pl a in
9. Other (see Corments)
COHHENTS:
()
)
()
(t2:to' :1"/
SANITATION SECTION
t0.
ll.
12.
t3.
Sewage Disposal
Usable Area
Water Supply
0ther (see Conments)
NOT NO YES
()
NA}'1E
aool icable-*rr-()X
a
F4
()
(
(
()
()
COI'II,IENTS:
TO APPL ICANT:
Your Building Permil / Site lnspectio
rn cated on item N0._above.
Questions and further information on items I through 5 contact the Lane-
COUNTY PLANNING DEPARTHENT" Questions and further information on itenrs 5
Lane Count Buildi and San itat ion D iv is ion.
ce until you can resolve the prob em5 cated.
( ) Your buildinq permit application fee is being returned under separat€ cL-.rr'€r.
LANE COUNTY PL^NNING DEPARTHENT LANE COUNTY BUILDING S SANITATION DIVISION
,16 Sl.xrlr lven0e East, Eugerre, 0rcgon 9740t 135 Sixth Averrue East, [rrclenr', 0regon 971+O;
Fnour 3rr2..r3il Ext. 231 pHoNl. : 1\2-tJn tXT. 4il
}{ Can be approved. /O -/5-73'( ) Cannot be approved at this time as
through l3 contact the
( ) wil I be held in this o
( ) ls being returned.
MIq-,R
DATE
()
DATE
gBra;lW *t )4/)4zL
IANE COUN
BUTLDTNG I
IIDING PERMIT
MHE
OR MOBILE H( I )SE PERMIT
PERMIT NO.
PROPER,Y OWNER MAITING ADDRESS PHONE
CONTRACTOR MAITING ADDRESS PHONE
PROPERTY TOCATION _ INCI.UDE POST OFFICE
PROPERTY LEGAI DESCRIPTION _ METES, BOUNDS
-.-,/00RANG E SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPPt.
NAME
&
MAITING
LEGAI. ACCESS TO PROPERTY
ADDRESS
PROPERTY SIZE _ FT,
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge System I New System I
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ, FT. # BDRMS VALUATION
\)
SEWAGE DISPOSAT
PUBt-tC n sEPTlc TANK
PLUMBING INSTATTED BY
F EES
OWNER OTHER: NAME
WATER SUPPTY
PUBLIC tr N OTHER
BUITDING
WASTE DISPOSAI.
PTUMBING
PTAN REVIEW
PARK TRAILER
TOTAT
co NTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
DRAIN FIETD REQUIRED
tIN. FT TRENCH WIDTH FT
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTII. EASEMENI
BTDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT. SIDE EXT.
USE CLASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
BTDG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PTUMBING _ CANARY
BUILDING _ GREEN
SANITATION _ GOLDENROD
Construction to comply with uniform building code ond
covering plumbing ond sewoge disposol. All buildings r
of occuponcy before being occupied.
(POST THIS PERfvllT ON
(See Stotement on Reverse Side)
MArN BrDG. AT SrTE)
co u nty
require
reg u lotionso certif icole
ronv *655-13
tANE COUNTY,'BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I
tt
OR SQ. FT.
-
SITE INSPECTION
AppnovEo Drsappnovro Dar e I ruserctoR
*W,-eg"v0
FOUNDATION I NSPECTION
Appnovro n DrsAPPRovEo [-1 aorr- Z'2O'?l nspecro
REua Rx
-/
FRAMI NG
Appnov r o
Re vanx
I NSPECT I
Drslppnoveo oo,,* / - 7J-D I NSPEcToR
LATH OR SHEETROCK
AppRovro
Rrunnxs
I NSPECT I ON
Dr snppcoveo Dnre I NSPEcToR
FINAL INSPECTIO
Ap pRov e o DrslppnovE, D D*,*-t/-+ (
I ruspecton
Rruanx s
CERTIFICATE OT OCCUPANCY
Rraov ro lssuE D Nor Rerov ro lssur D
ReuaRx s
Dnr e I ruspecron
2 fo6 2t-/oO
D
Zo v (*Zt
Ef, Sed()v"R
LANE COUN
BUTLDTNG []
JITDING PERMIT OR MOBITE HC
MHE
JSE PERMIT
PERMIT NO.
PROPE:TY OWNER MAILING ADDRESS PHONE
CONTRACTOR MAITING ADDRESS PHONE
PROPERTY TOCATION _ INCLUDE POST OFFICE
PROPERTY LEGAL DESCRIPTION _METES, BOUNDS
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPP[.
NAME
&
MAITING
ADDRESS
LEGAL ACCESS TO PROPERTY
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME
No. of Bedrooms
PERMITS ONLY
Connect to Existing Sewoge System f, New System f]
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION se. FT # BDRMS vALUATtoN
SEWAGE DISPOSAT
PUBIIC N SEPTIC TANK tr OTHERE
PLUMBING INSTATTED BY
OWNER E OTHER: NAlv{E
BUITDING
WASTE DISPOSAT
PTUMBING
PLAN REVIEW
PARK TRAITER
FEES WATER SUPPTY
PUBUC tr N OTHER
TOTAT
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAt.
DRAIN FIETD REQUIRED
IIN. FT TRENCH WIDTH FT oR so. FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTII. EASEMENT
BI.DG. SETBACKS
FRONT
FT. FROM CTR. OF ROAD RIGHT OF WAY
SIDE INT. SIDE EXT.
USE CLASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
BTDG. PERMIT _ WH ITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PTUMBING _ CANARY
BUITDING _ GREEN
SANITATION - GOLDENROD
Construction to comply with uniform building code ond county regulotions
covering plumbing ond sewoge disposol. All buildings require o certificoteof occuponcy before being occupied.
(See Stotement on Reverse Side)
(posT THIS pERMtT ON MAIN BrDG. AT S|TE)
LANE COUNTY, BIDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I
roav#C55-13
-
SLAB FLOOR
PLUMBING GROUNU/ORK
APPRovED E Drsappnovro
Re ttlRx s
oort /2'/f-?3 I NspectoR
L-
GAS PIPING GROUND/ORK
APPRovEo
ReuaRxs
Dr snppRovEo Dare I Hspecron
ROUGH PLUMEING
AppRoveo D DrsappnovrD D
Rruanrs
Dat e I Nspecron
ROUGH GAS PIPING
Appaovro D DrsAPPRovE, D
RrMaRx s
Darr IttspEctoR
F I NAL PLUMB I NG
AppRoveo N DrsappRovEo D o*rfuS_
Rruanx s
I HspecroR
FINAL GAS PIPING
AppRovro
RruaRr s
D r sappaovro Dare I rusprcron
CERTIFICATE OF OCCUPANCY
Reaov ro lssuE
Rrrqanxs
D Nor Reaov ro lssuE D Dore_I t.tsprcroR
*
{f3LANE COUNTY
PERMIT TYPE - BUILDING
hEDING PERMIT OR MOBILE HOM,
MOBILE HOME OSC REG. #
MAILING ADDRESS
I:E APPIICATION
PERMIT If
MAITING/e r ONE
PHONECONTRACTOR
PROPERTY I.OCATION - INCI.UDE POST OFFICE
PROPERTY I.EGAI DESCRIPTION
tOT_BTOCK_SUBDIV.
TWP RANGE
APPTICANT
NAME
AND
MAITING
ADDRESS
g /-/ a-METES & BOUNDS
ATTACHED
IF ANY
AREA
YES
NO
SEC TAX tOT cooE CENSUS TRACT
ao.< -o
IBE EXISTING ON
TEGAT ACC TO PROPERTY _NAME R
PRO SIZE_\MIDTH DEPTHPg,
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms Connecl to Existing Sewoge System tr or New System Req tr
STRUCTURES TO BE BUITT THIS PERMIT CONSTRUCTION FT S eronoorvrs vAt-uATloa{t t@z
SEWAGE DISPOSAI PIUMBING INSTATI.ED BY
PU BtIC
BIDG.
WASTE DIS.
PTUMBING
PTAN REVIEW
PARK TRI.R.
TOTAL
SEPTIC TANK
FEES WATER SUPPIY
PUBTIC
PLUMBING FEES
OTHER YES
OTHER E NAME
ISHED
NO
,TURE OF ICANT
FACITITY PERMIT
YES fl No
72t_73DATE
DATE)r'
5,QoFIXTURES
CASH ! 5sy7sp
CHECK CONNECTION FEE
PUBI.IC WATER
CONNECTION FEE
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAI.
DRAIN FIETD REQUIRED
TIN. FT. TRENCH WIDTH FI OR SQUARE FEET
C
TYPE OF STRUCTURE
B[DG, SETBACKS - FT. FROM CTR. OF ROAD RIGHT
ZONE REAR YARD
USE CIASSIFICATION
PUBtIC UTIL. EASE,\{ENT
Form # css-t2
SIDE EXT REAR
,/2--- 72I
Dole PLANNING Dqle BLDG.
Ut r-rA
FRONT SIDE INT.
I
Dote
Directions to Find Property:
COPY I - OFFICE
COPY 2-JOURNAT
COPY 3 - AUDIT
d orHER tr
$ =15, oo -
-Frcrr