HomeMy WebLinkAboutPermit Temporary 1985-03-07Lane County Authori za"ttom for'
Renewal of TMH
FOR OFPICE USE ONLY
l3:*i:'i'"", ,l Ls-&s
SECTION
34 .2.3
OUT OF
700
T\CWN-SHIP
L7
RANGE
03
BIIJCK
FRCPOSED USE OF PROPERTY
[Tl nes],dential n tndustrial
fleuuric.Coinmercial
s'-rBDTvrErOMpARtrrroN (if applicable )
Nof Ann'l i enhl e
I,OTlPARCEI
1388 N. Walnut Rd., Spfld, OR 97477
C] I'iY ztPr,ocetroN- Aoonrss STREET
hed ca ortExist TMII
ffi
Centennial Blvd. to Asoen St. (to intersection with N. Walouil qa-the rieht (on N. Walnut)
DECI,ARED S VALUEDESCRIPTION OF PROPOSED WORK - BE SPECI!'IC
Renew TMH 1184-83
Exist Rainbow
i.iATER SUPPLY Proposed
Existi
# OP SToRIES
t_
# oF EI"IPLoYEES
0
= OF BEDROO}.,IS
2
726-L3Bt
TELEPHONE NUMBERO;INERtS NAIIE AND ADDRESS
Ruth Mi11ard, 13BB N. Walnut,oR 97477Spfld,
TELEPIIONE NUMBERCCNTRACTORS NAME AND OSR #
TELEPHONE NUMBER
Paul Millard, Same as above
F-F}i:IE T:O BE I4AILED TO (NAME AND ADDRESS)
I HAVE CAREFULLY EXA!.{INED THE COMpLETED APPLICATICN }'OR PERMIT, artd do hereby certify that aLl infomation hereon ls true and correct, and that t
have the following legal interest ln the property,f]or."r of record; Icontrac!.purchaser;fauthorized agent with evidence of authority attached.
I f:rther certify that any and a1I work perfomed shall be done in accordance with the Ordinancec of Lane Couty and the Laws of the State of Oregon
pertaining to the work described herein, and that No oCCUPANCY will be nade of alt strrcture without the pemission of the Building Division. I fur-
ther certify that registration with the Buil-derrs Board is in full force and effect, as required by oRS 701.055, that if exempt the basis for ex€mption
is noted hereon. and that only subcontractors ild enployees who are in compliance with ORS 701.055 wiu be used on this Project. I HAVE READ AND
CHECKED THIS APPLI.CAUON THOROUGHLY.
LI3L/85
NAME (please print)SIGNATURE DATE
Received bv Mail
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION IIAS BEEN BASED ON THE FOLLOWING CONDITIONS:
Minimum Setbacks:
rnstallation Record rssued? f, Yu" fl *"
UseLANS EXAMINAT
COM}IENTS:
Date
COM.!lENTS$
GD
DaLe
corvolENTs 86 or/I
C L,front
hewer comtrs firstuntil hardshio ceases. whi. This permit valid until 12 31
B. P. #SANITATION: s. I. #
rear
Parcel Size
interior
Lineal Eeet-
of Dra eId
Installation
Specificati
ffi pr,aNlrruc/zoNrNG:
Gallon
Tank
l,raximum D€pth
of Trenches
Zone Partition # Parcel #
G.-8€
APPROVED BY BUILDING De! oRs 456.805 DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687.4061,
I25 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR I.NSPECTION INI'ORI4ATION cL4-25 R*
I
SETBT1CXS A\D OTITER COI"DITIONS OF APPROVAL MUST BE STRICTLY OBSERVED, VIOLATION CAN RESULT IN REVO-
C,iTION OF TIIIS ?ERI'IIT, CITATIO:J UNDER PROVISIONS OF LA\*E COUI-TY'S INFRACTION OBDI:IANCE, AND,/OR OTHER
RE}IEDTES ALLOWED BY LAIi.
I,iHEN READY F'OR INSPEC?ION, CALL 687-1065. A IIINI}lU}J OF AT LEAST 24 IIOURS ADVAIiCE NO'I'ICE FOR INSPEC-
@sN:.-;'E-Ie7oIIoUinginformatIonready:perm:tnumber,jobaddre5s,tyPe
of inspeccion, when it Hill be ready, your name anC phor.e nurber, and any special Cirections to site.
BUILDING DMSION !
REQUIRED INSPECTIONS:
Foundation L.lEfSSti9n,naterials for the founda
To be made after trenches are excar/ated and forms erec!-cd and when al,l
tion are delivered on the job lrhere concrete fron a central nixing
rAterials need not be qn the -job.plant (comonly termed "transit mixed") is to be used,
2. Concrete s1a-b or under-aIoor Inspectaon: To be rnade after a1f in-!llab or under-t'Ioor building
iErvl* equiflmmtl--EonEilc, plping ressories, and other ancillary equipment itens are inplace but before any concrete is poured or floor sheathing installeC, incluCing the subfloor.
3. Framing & InsuLation Inspections: To be nade after the roof, all framing, fire blocki-ng, andblacrng are in p-Lace and alI pipes, fireplaces, chimneys, and vents are compler-e and all rough
e],ectri.cal and plumbing are approved. AIl walL insulation anc vapor barrier are in pLace.
4. Lath and/or G\?:!l Board Inspection: To be made aiter alI lathing and gypsum board, interior
ard-exterfor, 'iE-Tnllace-EilE-6ET5?e any pLastering is applied ana le:oii'gypsu board joints
and fasteners are taped and finished.
5. Final Inspection: To be made after the building is complete and before occupancy.
AEPRoVAL REQUIRED. No work shall be done on any par!- of the buitdino or structure beyond the point
indicated in each successive irspectj.on without frrst obt3jning the approvaL of the building official.Such aDproval shall be girren cnly after an inspection sha1l have been made of each successise stepin the construction as i.ndicated by each of the inspections lequired.
NoTE: AII building oermits requj-re inspections for the work aufhorized, such as buu not lj.nited to:
A. tsIock I^IaI1; To be mace after reinforcj.ng is in p1ace, but before any qrout is poured. This
iE3-prcII6i is reguired for each bond beam pour. There will be no approval until- the plumbinq
and e],ectrical inspections have been made and approved.
B. h'ood Stove: To be made after completicn of nasonri, (i-f applicable) and when installation iscompleta InstaLlatlon shaIl be in accordance with an appiovea, nationally recognized testing
agency and the manufacturer's installation instructions.
C. Mobile Home: An inspectlon is required after the mobile home is connected to an approved
sewer or septic system for setback requrrenents, blocking, footinE connection, tiedowns,skixt.ing, and plwbing connections.
i. Footings and piers to comply sith State foundation requlrenents for mobile homes or asrecomended by the nanufacEurer-
2. Mobile home mininum finish floor elevation shalt be certifi,ed when required by a flood-plai-n management Ietter.
3. Mobile home tiedowns, when required, and skirting shalL be instaLled and ready for inspec-
tj-on within at least 30 days after occupancy. Tiedowns and skirting shatl be installedper enclosure.
D. Swiming PooI: Below grade when steel is in place and before concrete i.s poured. Above grade
slen eo6l-is inscalled.
APPROVED PLANS UUST BE ON THE JOB SITE AT ALL TIMES DURrN*G WORKING HOURS. THIS PERMTT WILL EXPIRE
IF I,,;ORK DOES NOT BEGIN }]ITHIN lBO DAYS, OR IF WORK IS SUSPENDSD OR ABANDONED FOR }IORE THAN 180 DAYS.
SUSPENSION OR REVOCATION I'IAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POINT OT REOUIRED INSPECTIONS I,IILL DO SO AT THEIR OWN RISX.
SUBSURPACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
I. Permits stELl be effecti-ve for one year fron the date of issuance.
2. Upon completing Lhe construction for which a pernit has been issued, Lhe pelnit hoLder shall
notify the Lane County Department of planning and Comunit)' Development by submi.tting the
install.ation record form. The Departrent shall. inspect the corstruction co determine if it
complies with the rules contained in this divj.sion. If the construction does comply with such
rules, the Department shaLL issue a certificate of satisfactory completion to the permiti holder.
If the construct-ion does not compLy with such rules, the Departrent shall notify the permit
hol.der and shall require satlsfactory completion before issuj,ng the certificate. Failure to
meeC the requirenents for satisfactoly completion within a reasonable time constitutes a vio-
lation of ORS 454.505 to 454.745 and this rule.
Setbacks - Subsurface Sewage Disposal.
septiq tani Drainfj.erd
From: Interior property lincs 10' 10 'Edge of road right-of-way L0' L0 |
Buildinq foundation l0'
i{ells, other wate! sources 50' t00r
I
trE
TEE
anc
MAILING ADDRESS:
--CITY, STATE , ZIP:
LANO MANAGEMENT OIVISIONDepartment ol Public \A/orks
Paul Millard
1388 N. Walnut RoadSpringfield, OR 97417
BP 465-85; 17_03_34_2_3 / 7Oo
1)
2)
3)
4)
s)
6)
Person with nedical" hr
Person providing care
INFORIUATI ON PROVTDED BY THE APP LICANT
ardship R,,rh {n M,un,.t_
Pn,'l B M,.llonl
Fanily relationstrip of, the above
Resident of the priacipal dr.Ufug
Resident of the tenporary mobile hone
Signatures:Date:Pers with Hardship
Person P roviding Care
Date:,a--3t t1
r)
I,Irs2)
Name of patient
..-luiiiaro is a 56 yeal olciNature of the nediial hards
ferrrale who iras had
recurrent abdcrninal_therapy. In addition, she has had anxiety-related slzmptoms in the
3) Does this hardship necessitate that a fami ly member provide care?Please comment,:
nearby and thus I
lot so that he ntay stay near her.
W
have son
Date:12-31-86
heal
4) Physician's Signarure I 4,t,
Mailing Address:IlBO 2A,Eugene, Oregon 9740L
City, SLate, Zip:
Lane county Public Horks / Land t'tanagement' Division / 125 E' 'th Ave., Eugene oR e74O1
Telethone: 687-406I
RE: Temporary Mobile Home permit Number:Map/Tax Lot No.:
INFORMATION PROVIDED BY TI.!E PHYSICIAN OR THERAPIST
.I
fr(nodrfcr o
P.
P.
FlFtn
F]t-U
rll
f-
3)
and peptic ulcer d'isease. (2) Chronjc interm'ittent low back pain secondary to
Does this hardship necessitate that a family member provide care?- -please comment: ' No, but undue physical'exertjon'is potentjally detrimental to the
paTient.5 Qo 41fr V4,ft4
r
4) Physician's Si Date:tt-26-84
Mailing Address ! Pol*er^-ozr Tnler.n^ I [r] e .l ic_l r.g, pO
llSo PattergozrStreet ,Suite- 2ACity, State, Zipi E:r,qs,n*. (\r-g,* ezual
PATTERSON INTERNAL MEDICINE, P.C.
PHYSICIANS AND SURGEONS
1 1 60 PATTERSON STREEI
SUITE 2A
EUGENE, OREGON 97401
LAND MANAGEMENT DIVISI0N / Public Works Dept. / 1?5 E.8th Ave., Eu9. 0R 97401 (503 87 6t
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