HomeMy WebLinkAboutPermit Signage 1973-06-18IANE COUNTY BUITDING PERMIT OR MOBILE HOME USE APPIICATION
,,4
PERMIT TYPE _ BUILDING
TOCATION - I
MOBILE HOME IOSC REG.#
IING ADDRESS
PERMTT #Q-
PHONE
PHONEMAITI-e
PROPERTY TEGAT DESCRIPIION
TOT_BTOCK-SUBDIV.
METES & BOUNDS !!€rsATTACHEp Dla.,ro
TWP RANGE sEc.CODE3L
TAX rOT #&Jaa ,/7<
CENSUS TRACT3o.-3ao
D RIBE EXISTI
TEGAT ACC
CTU ON PROPERTY IF ANY
PERTY NAME OR
DEPTH
APPTICANT
NAME
AND
MAITING
ADDRESS
SIZE_WIDTH AREATzro /
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms Connecl to Existing Sewoge Sysrem I or New System Req. Esrnu onooms vALuATloN
aa
f,
SEWAGE DISPOSAT PTUMBING INSTAI.TED BY
PUBUC tr
BtDG.
WASTE DIS.
PTUMBING
PI.AN REVIEW
PARK TRLR.
TANK OTHER
FEES WATER. SUPPTY
PUBTIC
PTUMB FEES
-
FIXTURES
cAsH n
CHECK
OWNER
PI.ANS FURNISHED
NO
OTHER NAME
APPI-ICANT
FACITITY PERMIT
OTHER YES
DAIE
3 "oO
/,
FEE
PUBTIC WATER
CONNECTION FEE
COUNTY BUILDING & SANITATION SPECIFICATIO
DRAIN FIETD REQUIRED
tIN. FT. TRENCH WIDTH FT
/-73TOTAT
MIN. SEPTIC TANK CAPACITY
WIIH DIST. BOX: GAL.OR SQUARE FEET
.a
/ilsTA LL 5 tda Farz Da*cilzd.-s
TYPE OF STRUCTURE OCCUPANCY ZONE REAR YARD PUBTIC UTIT. EASEMENTq-u )-L C- ?-'
USE CTASSIFICATION
Form # css-t2
,6
Dole
BIDG. SETBACKS - TT. IROM CTR, OF ROAD RIGHT OF WAY' .\' l,.r
FRONI SIDE INT. SIDE EXT.REAR
Dote BLDG. lNING
Directions to Find Property:
COPY I _ OFFICE
COP'( 2 - JOURNAT
COPY 3 - AUDIT
4Z:s/z/,
-
r
IANE COUNTY
BUTLDTNG r
BUILDING PERMIT OR MOBILE HOME USE PERMIT
MH E PERMIT NO.
PROPERTY OWNER MAILING ADDRESS PHONE
CONTRACTOR MAIIING ADDRESS PHONE
PROPERTY LOCATION _ INCIUDE POST OFFICE
PROPERTY tEGAt DESCRIPTION - METES, BOUNDS
RANG E SECTION
4
TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPPT.
NAME
&
MAII,ING
ADDRESS
LEGAI. ACCESS TO PROPERTY
PROPERTY SIZE - FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connect to Existing Sewoge System ! New System I
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ. FT. # BDRMS VALUATION
SEWAGE DISPOSAT
PUBUC tr SEPTTC TANK -OTHERE
PI.UMBING INSTATTED BY
OWNER f] OTHER: NAME
BUILDING
WASTE DISPOSAL
PLUMBING
PI-AN REVIEW
PARK TRAIIER
F EES WATER SUPPLY
PUBUC n tr OTHER
TOTAL
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAI..
DRAIN FIEI,D REQUIRED
TIN. FT TRENCH WIDTH FT,OR SQ. FT,
TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIt. EASEMENT
BIDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT. SIDE EXT.
USE CTASSIFICATION
REAR
DATE
BLDG. PERMIT _ WHITE
OFFICE COPY - WHITE
COUNTY TAX _ PINK
PTUMBING _ CANARY
BUII.DING _ GREEN
SANITATION _ GOTDENROD
Construclion to comply with unif orm building code ond
covering plumbing ond sewoge disposol. All buildings rof occuponcy before being occupied.
(See Stotement on Reverse Side)
county regulolions
require o certificote
(POsT THIS pERMtT ON MAIN BLDG. AT SITE)
I.ANE COUNTY, BLDG. & SAN, DIV., COURT HOUSE, EUGENE, OREGON 9740I
FoRM f C55-13
AUTHORIZED SIGNATURE _ DATE
(>{
BU I LD I NG S ITE EVALUAT I ON
{i c
Building Permit Appl icat ion No.,/,// O -73
S ite lnspect ion
Pre-Permit lnvest igat ion
r^JZ^ @ssy'. U,., rex wr 3fu)a LCENSU. I'RACT.-t---
Z--r4,rdAPPL I CANT -77/ e-
NAI"IE
ADD
)
()PHONE
DATE /- -./O
LANE COUNTY PLANNING DEPARTHENT NOT
I . Zon ing 0rd inance Comp I i ance
aool icable*rl-(
)(zone c:-'-:_.)
Subdivision 0rdinance Compl iance
Requ i red Access
NO YES NAI'iE DATE
()'
(tr
(+'-(r-
(3 a 3
2
?
()
()
()
()
()
()
4. Bu ild ing S ite (Area, Width,
5. other (ru" "o[,]:ll:i"'
setback)
(
()
COH}4ENTS
BUILDING INSPECTION SECTION NOT NO
EEE'I icable -
YES
{r )() (6, Plans Submitted
7, Soil Stabil ity (footings)
8. Flood Pl a in
9. 0ther (see Corrnents)
COHHENTS:
T
()
()
() ()
()
()
s9
SAN ITAT ION SECTION
10.
il.
12.
t3.
Sewage Disposal
Usable Area
UJater Supply
0ther (see Comments)
aool icable-Tr-( ) (
NOT NO YES NAI"IE
()
()
()
il
#
()
)
)
)
)
COHI1ENTS:
TO APPL ICANT:
Yo,ur Building Permil / Site lnspect,ion:
tt'') Can be app roved. '' . ,,, .'
( ) Cannot be approved at this time aS indicated on item N0.
(
(
(
above.
Questions and further information on items I through 5 contact t 6Il€-
COUNTY PLANN ING DEPARTMENT. Quest ions and further informat ion on items 5
through l3 contact the l-ane Count Buildi and Sanitation Division.
Will be held in this of ce unt you can resolve the pro ems ind i cated.
ls being returned.
Your building permit appl ication fee is being returned under separate cuver.
L/\NT COUNTY PLANNING DEPARTI'IENT
l't\ 5 ixt h l\rente Liast, Euqene, 0reqon 97401
l'lhlNl : {lr?*llll lX1. ?'il
LANE COUNTY EUILDING E SANITATION DIVISION
135 Sixth Avenue East, Eugene, 0r-egon 97401
Pt1ONt-: 342- l3l I EXT. 4l I
NA},IE DATE
F2L
DATE
LANE COUN,
BUILDING E
BUITDING PERMIT OR MOBITE HC" .E UsE PERMIT
MH E PERMTT NO.
PROPERTY OWNER MAILING ADDRESS PHONE
CONTRACTOR MAITING ADDRESS PHONE
PROPERTY LOCATION _ INCTUDE POST OFFICE
PROPERTY I.EGAL DESCRIPTION _ METES, BOUNDS
RANG E SECTI ON TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPPL.
NAME
&
MAILING
ADDRESS
TEGAL ACCESS TO PROPERTY
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connecl to Existi Sewoge System ! New
TYPE CONSTRUCTION SQ. FT BDRMS VALUATION
m
STRUCTURES TO BE B ILT THIS PERMIT
SEWAGE DISPOSAT
PUBUC tr SEPTTC TANK n OTHERD
PTUMBING INSTALTED BY
OWNER - OTHER: NAME
BU II.DING
WASTE DISPOSAI-
PTUMBING
PtAN REVIEW
PARK TRAILER
TOTAT
FEES WATER SUPPTY
PUBUC D tr OTHER
COUNTY BUILDING & SANITATION SPECIFICAIIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[.
DRAIN FIETD REQUIRED
I-IN. FT TRENCH WIDTH FT,OR SQ. FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTII.. EASEMENT
BIDG. SETBACKS
FRONT
FT. FROM CTR. OF ROAD RIGHT OF WAY
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 unif orm 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 THIS PERMTT ON MAIN BrDG. AT S!TE)
TANE COUNTY, BTDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I
ronu = 655-13
E!ErF.rFlr.E
-
-
S I Tt I NSPECTI ON
Ap pnov E o
RruaRx s
D t snppnoveo Dare I ruspecron
FOUNDATION INSPECTION
AppRovro
REuaRxs
D r sappRovEo Drrr I ruserctoR
FRAMING INSPECTION
AppRov r o
Re uanx s
Drsappnoveo Drr e I NsPEcroR
LATH OR SHTETROCK
Ap pRov r o
Rruanx s
I NSPECT I ON
Dr sappRoveo Ir.rspecToR
FINAL INSPECTION ilAp pRov e o
RrttaRx s
d Dt SAPPRovED Darr l^ Zt, 73 ,*rr..ro"
CERTIFICATE OF OCCUPANCY
REaov ro I ssuE
REuanx s
n
D Dore-
D Nor Re aov ro lssue D Dore_lnsercron_