HomeMy WebLinkAboutPermit Building 1984-11-086e
til 1
Lane County Authori za'tion for'
1)l"
r,OR OFPTCE USE ONLY
Two Copies of Plans
Three Copies of Plot Plans
Mech,/Plumbing Checklist
Legal Interest Document
Ief.rr Check ]nfo Sheet
Applica
Permit
TIWNSHIP
t6 3 Z,LSECTION TAX LOT OUT OF
if u"
I,OCATION PROPOSED USE OP
n neside-ntial
Commercial
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[-l rnaustrial
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DECI.AREDltu?S VALUE
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= OF BEDROOMS/m!-# OE STORIES '
On!,
# gr/eMproynes /
hrvrunOnLu.Proposed
Exi s ting
ADDBESS
€.P/4S NAME AND Ii TELEPHONE NUMBER7/A _f?,7,>
S NAME AND TELEPHONE NT]I4BER
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TELEPHONE NWBER
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have the following legal interest in the property,[o*..r of record; !contractI f:rther certify that any ed alL work perfomed shau be done in accordance with the ordinances of Iane cowty and the Laws of the state of oregon
pertaining to the work described herein, and that NO oCCUPANCY wiLl be made of ay structure without the pemission of the Building Division. I fur-
ther certify that registration with the Builderts Board is in full force and effect as requLred by oRs 701.055, that if exempt the basis for exempti
is noted hereon, and that only subcontractors ild employees who are in conpliance with ORS 7OI.O55 will be used on this project- I HAVE nEAD AND
CHECKED THIS APPLICAIION THOROUGHLY
F,/', *l I(please
certi fy that a]'rlnf omti.on hereon is true and correct, and that I
purchaser;ffi*,o.ir"a agent with evidence of authority attached.
I HAVE CAREFULLY EXAT4INED THE COI'IPLETED APPLICATION EOR PER.FIIT, and do
o rtl
YOUR AUTHORIZATTON HAS BEEN BASED ON THE FOLLOWING CONDITIONS:
Date:
rnstallation Record Issued? [ r"" ! N"
Ga110n
Specifications 3 _ Tank
Date:
V- 11
Date:
,%"
z
Use
s'4ii
s. r. #B. P. *
*r- /{rro*S EXA.I"IINATION:
COMT1ENTS
COMI1ENTS:
READ THIS SECTION CAREFULLY
I planurwc,zzoNrNG: zone
Minimrm Setbacks; CL, fro.,t
Parcel *
interior
H6ll:slsrq,
Installation Maximum Depth
of Trenches
Partiti,on fl
c",
"id.
ParceI size
,"^, &'
Lineal Feet
of Prainfield
TOTAL VALUATIoN $CONSTRUCTION AUTHORIZED BY THIS PERMIT
_ Description
etrrwnou-Ata
Sq. Ft.
Fixed Feer/
Unit Cost
Floodplain Fee $
Subsurface Fees $
Building Eee $
t'1ech,/Plmbg Fee S
Pr ans Check Fee $
state Surcharge $
DEQ Surcharge $
ToTAL FEE SS
() u"
u -8-gy
PERMIT APPROVED BY BUILDING OFF (per oRs 456.805 -------5{rE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687.4061,
125 EASTSTH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORI4ATION
c t4-zs
i?are-4
RANGE
i420
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATTON CAN RESULT IN REVO-
CATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER
REMEDIES ALLOWED BY LAW.
WHEN READY FOR INSPECTION, CALL 687-4065. A MINTMUM OF AT LEAST 24 HOURS ADVANCE NOTICE FOR INSPEC-
@N Have the fo1 lowing information ready: pbrrhit nul.nber, job address, type
of inspection, when it will be ready, your name and phone number, and any special directions to site.
BUILDING DIVISION
REQUIRED INSPECTIONS:
1. Foundation Inspection: To be made after trenches are excavated and forms erected and when allmaterials for the foundation are delivered on the job. Where concrete from a central mixingplant (commonly termed "transit mixed") is to be used, materials need not be on the job.
2. Concrete SIab or Under-Floor Inspection: To be made after all in-sl-ab or under-floor buildingEeiilce equipmentT-conEuIt, plpIng accessories, and other ancillary equipment items are inplace but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framing & Insul-ation Inspections: To be made after the roof, all frarning, fire blocking, andbracing are in place and all pipes, fireplaces, chimneys, and vents are complete and aII roughelectrical and plumbing are approved. AII wall insulation and vapor barrier are in place.
4. Lath and/or.cypsum Board Inspection: To be maale after all lathing and qypsum board, i.nterior
ana exterl5r-js inlTace-Eut EEfor-e any plastering is apptied and before gypsum board joints
and fasteners are taped and finished.
5. Final Inspection: To be maale after the building is complete and before occupancy.
APPROVAL REQUIRED. No work shall be done on any part of the buildj-ng or Structure beyond the point
indicated in each successive inspection without first obtaining the approval of the building official.
Such approval shall be given only after an inspection shall have been made of each successive stepin the construction as indicated by each of the inspections required.
NOTE: A1I building permits require inspections for the work authorized, such as but not limited to:.
A. Block WaIl: To be made after reinforcing is in place, but before any grout is poured. This
InspecElon is required 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 iscomplete' fnstallation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturerrs installation instructions.
C. Mobile Home: An inspection is required after the mobile home is connected to an approved
sewer or septic system for setback requirements, blocking, footing connection, tiedowns,skirting, and plumbing connections.
I. Footings and piers to comply with State foundation requirements for mobile homes or as
recommendeil by the manufacturer.
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-plain management letter.
3. Mobj-le home tj-edowns, when required, and skirting sha)-l be installed and ready for inspec-tion within at least 30 days after occupancy. Tiedowns and ski-rting shaII be installedper enclosure.
D. Swimming Pool: Below grade when steel is in place and before concrete is poured. Above grade
when pool is instafled.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WTLL EXPTRE
IF WORK DOES NOT BEGIN WITHIN IBO DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IE THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFOR}4ATION.
ANYONE PROCEEDING PAST THE POINT OF REOUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISX.
SUBSURFACE' AND AI,TERNATIVE SEWAGE DTSPOSAL SYSTEMS:
Permits shall be effective for one year from the date of issuance.
Upon completing the construction for which a permit has been issueil, the permit holder shaIlnot,ify the Lane County Depa{trent of Planning and Community Development by submitting theinstallation record. form. The Department shal1 inspect the construction to determine if itcomplies with the rr.rles contained in this division. If the construction does comply with suchrules, the Department shall issue a certificate of sati-sfactory completion to the permitlholder.If the construction does not comply with such rules, the Department shal1 notify the permiEholder and shal1 require satisfactory completion before issuing the certificate. Pailure tomeet the requirements for satisfactory completion within a reasonable time constitutes a vio-lation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewage Disposal
Septic Tank
r0r
10r
5t
50'
Drainfield
I
2
Interior property lines
Edge of road right-of-way
Bui-1ding foundation!,leI1s, other water sources
Prom:10 !
10r
10!
100 r
lane county
ACTIVITY INFORMATION SH EET @COMPLETI THIS SECTION. INCOMPLITI FORMS t^JILL I]I RLJTCTIDI
I t1a.*,rL4lJ
EST PROPERT
MAILING ADDRESS MAILING ADDRESS
5Y5 - 4744
CITY STATE ZIP CODE
m HOME TELEPHONE # B E HOME PHONE
2 PROPERTY ADDRES
( IF DIFFERENT F
S/2
E S
3 rvlar, I PAFIEEL NUMBEFI (from tax map6 in Department of Assessment and Taxation
( REQUTREp rNF0RI4ATr0N)or from tax statement)/gz
TOWNSHIP RANGE
7-(
SEETMN
OO
q b)fi 4
rbwruSlrlP n-n-rlGr STeil0n rAx LOr(s) O-R--PIR[EL 7 Z0NII[6-
MWN-SFTF RANGE SETTION W ZON I NG
TOTAL CONTIGUOUS PROPERTY iN SAME OWNERSHIP:ACRES
4 SUBDIVISI0N ('if appl icable)LOT BLOCK
5RE ST (state exactly what you lan to do)
a
b_
6 DI RIC ONS TO SITE
** FOR STAFF USE oNLY **
DATE:_ TIME IN:_ 0UT:_
NUMBER
DATE
-i7t/,
ZONE/LAND USE +
BY:
LAND MANAGEMENT DIVISION / 125 E. Bth AVE.. EUGENE, OR 9740I / 687-4061
LN
$L2
TO
tlater District
School District
--,[lntater Pol I uti on Con trol F'ire Distr.ict
_Land Di v'i si',:, Section
_Reg i ona I P.l a' r,i ng
_Pl anni ng P.e:errch
--.._-Zon i ng Enfor.-in,ent
Environnrental Health
_Soils Data
_Fl ood Management
{TransPortation Pl anni ng
Assessment & Taxation
_Parks Djvlsion
Lane Rea'l Es ta te Di v .
__Lane Publ ic Safety
_Lane Publ 'ic Lands
__-Lane Legal Counsel
___llousing & Comm. Dev.
Lane Extensi on Servi ce
Lane Transit D'istrict
Lane Reg. Ai r Pol . Auth.
_Boundary Commissjon
Port of Siuslaw
aPran DePt
_City
-El^lEB
of
__N.l,l. Natural Gas
_Pacific N.ll. Bell
_Pacific N.t^J. Power
--Tri-Agency
Dog Control
LCDC
oate--a/Q-:/-: €!-
_Slate Fore';try -
St.ite HighwaY Di'ii sicn
State Env'iron. irr-;a 1 i [;
State Dept. of L inds
__ _Stctt.e Fish & Ganie
_State Geol. & iulirleral -ndus
State Veteri nari an
Dunes Nat'l Rec. Area
Siuslaw Nat'l Forest
--1^lillamette
Nat' I Fores:
_Bureau of Land i"igmt.
Soil Conservation Service
Corps of Engineers
Fed. Av'iati on Authori tlr
Fed. Conrnun'ications Coi:m
0the r
6sz-.36{7
.__ Neighborhood Group_0ther
Fronr:
LANE COUNTY LA.IID MANAGEI'IENT DIVISION.l25 East 8th Avenue, Eugene, 0regon 97401
Phone: 687-406.]
A request for land use action,
received by the Planning D'ivis
to Land l4anagement Di vi si on bY
as described on Data Surnmary and attached schematjc naS :een
future develoPme
a
nt
ddition to adverse imPacts on
ion. If signi/2- /z-ficant jmpact'is evjdent, please sen0 ccnfienis-e{
Specific concerns of your agency shoul
genera I I i vabi 1 i ty of the area and 'i ts
For additional information, contact
DATA SUMI"IARY: Journal No.P+2730 -8
Appl i cant
P rope rty Address /37 So, ? ^d
d be addressed 'in
Zone District
Lot si ze
Map
Tax Lot
O oo6
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