HomeMy WebLinkAboutPermit Building 1984-09-17l($-p,
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ESCRIPTION OF PRAPOSED
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WORK - BE SPECIT'IC
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VALUE
(o oAt -= OF BEDR,OOI,IS # or sroRrEs
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# OF EMPLoYEES -/WATER Proposed
isting
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AND
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TELEPHONE NUMBER
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I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICAUON FOR PERMIT. and do hereby
I f:rther certify that any and all work perfomed shal1 be done in accordalce withpertain.ing to the work described herein, and that NO OCCUPANCY will be nade of any
ther certj.fy that regj-stration with the Builderrs Board is in ful1 force and effect as recl
NAI'I8
,:, , Lify that alljdfmatior,
purchaser i ffirno, i""d ugurt
ad employees who are in
afra$Crnltr(a
contract
'Ellttan
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hereon is true and correct, and that I
ave the following 1e9al" interest in the property:owner of record;with evj-dence of authority attachedthe ordinances of Lane Cowty and the Laws of the State of Oregon
structure the Fem.ission of the Building Division. f fur-
by ORS 701.055, that if exempt the basis for exempt_iis noEed hereon. and that only subcontractors compliance with 055 will on thls project. I READ ANDTHIS APPLICATION THOROUGHLY
s.
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATTON I{AS BEEN BASED ON THE FOLLOWTNG CONDITIONS!
Date:
Specifications:
CO}OIENTS:
COMI1ENTS:
-tljate:
/ffio*rrorror,/ \ ,"**r..t."
/-?Groupt1-^/Use Gn RAGE
re ar
,9QxParcel Size
B. P. *
PLANS EXAMINATION: Type
Iv."[r"
COM}1ENTS:
Installation Record fssued?s. r. *
caIlon
Tank
Lineal Peet
of Drainfield
Dare: 7-,ff'
I plauuruc,zZoNrNG:
l,linimrntr Setbacks , "r,
Maximw Depth
of Trenches
FOR OFFICE USE ONLY
fhree Copies of plot plans
Mech,/PIumbing Checklist
Legal Interest Document
Plan Check Info Sheet
ofP NSTwo
Applica
Permi
TOTAL VALUATION $CONSTRUCTION AUTHORIZED BY THIS PERMIT
Fixed Fee/
Sq . Ft.UnitDescription
N
?";,
Floodplain Fee
Subsurface fees
s
$
$
$
)
C
$
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t= Q.-t 7- 94
PERMIT APPROVED BY BUILDING OFFIC oRs
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 6874061,
125 EASTSTH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
DATE
il
c t4-zs
nda rl CITY ZIP
n 02ct
STREET
OL
9'r,Y,sini/u fQ S l/Q
f,neside_ntia1
[-l commercial
[-l rndrr= t.iur
[-l e,uri"
PROPOSED USE OF
0/€J t .
/r
3 Vt^'Vs v7
PJITI'IIT TO BE I',IAILED TO (NAI4E AND ADDRESS)I I'ELLPHUN!; NUI"IBUR
Partition Parcel *
1d Eee -=
,Wffi
Fee
Fee
surcharie*
TOTAL FEE
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED' VIOLATION CAN RESULT IN REVO-
cATIoN oP THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND,/OR OTHER
REMED]ES ALLOWED BY LAW.
WHEN READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 2
G1 ave bllowing informat ion ready
of inspection, when it wiII be readY,
BUILDING DIVISION:
REQUIRED INSPECTIONS:
your nErme and phone number,
I
4 HOURS ADVANCE NOTICE FOR INSPEC-
: permit number, job addreis, tYPe
and any special dj.rections to sj-te.
Foundation Inspection: To be made after trenches are excavated and forms erected and when all
*ffitffi;dationaredeIiveredonthejob.whereconcretefromacentraImixing
;i;;t-i;il""fy- i"rr"d "transit mixed") is to be u-ed, materials need not be on the job.
To be made after at1 in-s1ab or under-fIoor -building2. Concr ete Slab or Under-Floor sories, and other anciIlarY equipment items are inservce, conAnit, p or floor sheathing installed,includj-ng the subfloor.placd but before any concrete is Poured
3. Framing & Insulation Inlpegliolsr T9.be made after the roof, a11 framing, fire blocking, and
6r"cffi6 are-lnllace ffi-aT-I pipes, fireplaces, chimneys, and vents are complete and all rough
electrical ana ptumUing are. appiovea. AII wall insulation and vapor barrier are in place.
4. Lath and/or Gypsum Board lnspection: To be made after aII lathing and gypsum board, i-nterior- a;a-e"t"rior;-is inlTface-EuE-EeTore any plastering is applied and before gypsurn board joints
and fasteners are taped and finished.
5. Final Inspection: To be made after the building is complete and before occupancy.
APPROVAL REOUIRED. No work shall be done on any part of the building or Structure beyond the point
j.ndicated in each successive inspection without first obtaining the approval of the building official.
Such approval shal1 be given only after an inspection shall have been made of each successive step
in the construction as indicated by each of the inspections required.
NOTE: All building permits require inspections for the work authorized, such as but not limited to:
A. Block WaIl: To be made after rej-nforcing is in place, but before any grout is poured. This
Ln-s-pecEloi- is requiled for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
B. wood Stove: To be made after completion of masonry (if applicable) and when installation is
conrpfete- Inst.allation shatl be 1n accordance with an approved, nationally recognized testing
agency and the manufacturerts installation instructions.
C. Mobile Home; An inspection is required after the mobile home is connected to an approved
seh'er or septic system for setback requirements, blocking, footing connection, tiedowns,
skirting, and plumbing connections.
1. Footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufacturer.
2. Mobile home minimum finish floor elevation shal1 be certified when required by a flood-
plain management letter.
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least,30 days ifter occupancy. Tiedowns and skirting shal1 be installed
per enclosure.
D. Swimming pool: Below grade when steel is in place and before concrete is poured. Above grade
wE6-po6I-Ts installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TTMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN I8O DAYS, OR IF WORK IS SUSPENDED OR ABANDONED POR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERI{IT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEBDING PAST THE POINT OF REOUIRED TNSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURTACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
1 Permits shall be effective for one year from the date of issuance.
Upon completj.ng the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installation record form, The Department shall inspect the construction to determine if it
complies with the rules contained in this division. If the construction does comply with. such
ru1es, the Department shalI issue a certificate of satisfactory completion to the permitlholder.
If the construction does not comply with such ru1es, the Depart$ent shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. Faj-Iure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
Iation of ORS 454.505 to 454.745 and this rule.
Setbacks - Subsurface Sewage Disposal
Septic Tank Drainfiefd
Prom: Interior property lines I0 I 10 t
Edge of road right-of-way 10 I I0 I
Building foundation 5 i 10 !
Wells, other water sources 50r 1001
insoection:4,iPlngia{ces
)
Builders o Remodelers . Real Estate
23 Oakway Mall. tugene. Oregon 97401 .345-4347
To Lane County Building Department
Lane County Court House
Eugrene, ore. 97401
I{e refer to application for building permit, applied for on
September 10th 1,984, for work to be performed upon property
located, at:
2888 Yolanda Street, Springfield, OR.
Owner: Harold and Ri.ta Gi1lis, salne address.
As per request - herewith is ownerrs approval of said work
(which is to demolish old and build a nev garage building)
to be performed upon named property:
ELLISON &
e
We have entered into contract with ELLISON & PLATZ CONSTRUCTfON
coplPAlitY to demolish our old garage building and to build a new
gar in the sarne location at the above address.
ELLISON
E? PUAIZ
CONSTRUCTION
s!., *r/*-Lo--rrrn
co.
Dated
SIGNED
HaroI 1lis
Rita 1is
TRS#DATE ISSUED:1
OR REAR
PERMIT
ER
I
SDS APPRO\fAL REQUIRED
#
L C1FRONT
DI
S ITE
I
Approved K lDut" __ta:!:El-/ C o r r e c
PECT
io n Date Insp ector &D
PLUMBING GROUNDI^IORK INSPECTIApproved Date /Comection Date-Inspe ctor
UNDERSLAB PLBG. fI /UNDERFLR PLBG. D INSPECTI
Approved Da te Comect'ion Date I nsp ector
tnurn TNSPECTToNApproved Date Correcti on Date Inspector
PECTION
Approved_Date Correcti on Date I nspe ctor
FRAMING INSPECTION
Approved ,,/ Date /l-7f-8+ lCorrection Date "WI nspecto
mApproved Date Comecti on Date Inspe ctor
INSULATION / VAPOR BARRIER INSPECTI ON
Approved Date Correction IDate I nsp ector
LATH / GYPSUM BOARD INSPECTIONApproved Date Correcti on Date Inspector
FiNAL MECHANICALEApproved Date
/H00D srovEn
Correct'ion Date Insp ector
FINAL PLUMBING INSPECTIONApproved lDate Correcti on Date Ins pe ctor
App
N
roved ll-28-8e /Correcti on DateDate Inspe ctor
MNCYtr IORARY CERTIFICATE OF OCCUPANCY D
Approved I
y174-t97
Date Insp.Approved Date Insp --
LANE COUNIY INSPECIION RE(:ORD
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PERMIT #
TRS/TL#
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NAME (PLEASE PRINT)
ADDRESS
AppLrcANT ( ) 0WNER ( ) CoNTRACT0R ( )
REASON FOR CANCELLING PERMIT (OR APPLICATION)
S IGNATURE DATE
FEES PAID FOR WASTE DISPOSAL SYSTEMS (SITE INSPECTIONS AND/OR APPLICATIONS TO INSTALL THE
SEPTIC TANK AND DRAINFIELD) ARE ORDINARILY NONREFUNDABLE. SOME REFUND MAY BE ON THE
BUILDING, PLANNING, OR PLUMBING PORTIONS ACCORDING TO THE AMOUNT OF THE PERMIT/APPLICATION
PROCESSED.
lo Flood Plain Fee
Building Permit Fee
Mob'ile Home Fee
Plumbing Permit Fee
Mechanical Fee
Plan Check Fee
State Surcharge Fee
o/
o/
/o
$
$
$
ol
/o
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ol
lo
$
$/o
$ollo
$ol
$/o
F5
-'-'61lo
Septic Disposal Fee
Site Inspection Fee
DEQ Surcharge
Land Use Applicatjon
Planning Director
Recording Fees
Partftions
Copies & 0rdinances
Surveyors
Minus $25. for Processing Fee
TOTAL AMOUNT TO BE REFUNDED
DATE
$
ol
o/
$
$
/o
/o
S I GNATURE
TO DEPARTMENT OF FINANCE:
Building Permit Refund
State Surcharge Refund
Septjc Disposal Refund
Site Inspection Refund
Land Use Applications
Planning Director
Recording Fees
Parti ti ons
Copies & Ordinances
Surveyors
TOTAL AMOUNT REFUNDED
PLEASE MAKE CHECK PAYABLE TO:
24-17 -88/ Acct.
4-l 7-BBlAcct
4-l 7-88lAcct
-l 7-BB/Acct
-24-17-88lAcct.4-l 7-88/Acct.
-l 7-88lAcct.
4-l 7-88/Acct.
4-l 7-88lAcct.
5-06-74/ Acct.
$
42120/Prog.060
42124/Prog. 060
421331Pro9.060
42134/Prog.060
42150/Prog. 060
46202/Prog. 060
46210/Prog. 060
48474/Prog. 060
44419/Prog. 060
44451 /Prog. 0..l0
$
$
$ta
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NAME
ADDRESS
LAND MANAGEMENT DIVISISN / Prrblic works Dept. / 125 E. 8th Ave., Eug. 0R 9740'l (503)687-4061
IANCELLATI ON/ REFUND AUTHORI ZAT I I
/
I ./
FEES PAID % REFUND
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