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HomeMy WebLinkAboutPermit Building 1976-07-23PERIVIIT NO CONSTRUCTION I ] IVIOBILE HOME [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] ZIP CODE n Owner NAIVIE ADDRESS CITY PHONE n Contractor NAIVIE ADD RESS O.S. Reg. + Twp- Range- Section-Tax Lo CITY ZIP CODE Census Tract PHONE t Code Lot B lockSubd ivision Access to Property (Road Name) Acreage Width Depth Existing Structures on Property: Directions to Property - Address STRUCTURE (# BEDROOIVIS)SO. FT VALUATION SEWAGE DISPOSAL: PUBLIC[] SEPTICTANKT]oTHER [ ] PLUIVIBING INSTALLED BY: OWNERT] OTHER[] NAN4 E WATER SUPPLY: PROPOSED t ] EXISTING t1 PUB LIC COIVIIVIUNITY . NAIVIE PLAN REVIEW TOTAL PRIVATE WELL OTHER SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY GALS IVI IN. DRAINF I E LD- LIN. FT IVIAX. TRENCH DEPT I NCH ES TYPE OF CONSTRUCTION GROUP FIRE ZONE USE CLASSIF SETBACKS FT. FROI\1 CTR. OF r,Aff SIDE EXT. FT. FROIVI PROP. LINE SIDE INT REAR - ZONEFRONT AUTHORIZED SIGNATURES lsl ISSUANCE DATE BLDG. PEFMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANABY BUILDING _ GBEEN SANITATION - GOTDENROD IMPOBTANT Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required septic system inspeclions. All construction shall comply with the State Buidling Code, O.E.O. standards for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate o, occupancy belore being occupied. (See Details on Reverse Side) POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6Ih, EUGENE, OREGON 97401 ---tLr - COUNTY PERMIT FC BUILDING- PLUMB ING 3% SURCHARGE- IVIOBILE HOIVIE- WASTE DISPOSAL STAY 1OO' FROI\1 ALL WELLS BUILOTNG SIT E EVALUATION d b //z s 2t/TAX LOT 7oo t /od oL Not Iic ble rl IT/ -suao tYls \0 >t BUILDING PERHIT APPL ICATION NO. SITE INSPECTION PLANNING DIVISION Zon i ng 0rd i nance Cornp I iance: Zone Subdivision 0rdinance Compl iance LOT BLOCK: cK'D BY, ruj3 , /1g 7/ Setbacks from Front -ch=of-rciiid Side Exterior Setbacks fronr interior I ines: Side Rear ()APPL ICANT DATE I 2 3 4 5 Reoui red Accessguitaing Site (Area, }Jidth, Frontage) Other (see conrnents) ) ) ( ( No Yes CI 1'I' 6( ) (l)( ) (l)( ) (l)( ) (r) ?A.tCOHHENTS: a Ot) u Y T-TATPI rcAr I BUILD ING IN.SPECTION D IVIS ION . Plans Submitted . Soi I Stabi I ity (footings) . Flood PIain . Other (see corments) Yest() ();*"a A Not licable No 7 8 9 0 r) ) () () ()CKI D 7- /i-yuCOHHENTS: }JATER POLUT I ON Not Aool icable No Yesr) Tp- () ROL I l. l'leets Department of Environmental Qual ity Standards. 12. Other (see comments)() ()CKIO BY: DATE COH}4ENTS: TO APPLICANT: Your Building / Site lnsPection: (tYcan be aPproved,( ) Cannot be aPProved at this t ime as indicated on item N0. you can reso above. w Ab Questions and further informa tion on items I throug h 5 contact the LAN E. COUNTY PLANN ING D I V !-S,! !N " Quest i on s and fu BUILDING rther informati on on i temil Er-oGE-lZ contatt the LANE D SANITATION DI 0N. ve the prob( ( ) ) Will be held in this office unt ls being returned. c55-28 Your bui ldin ems S n cated. ermit I ication fee is b tn V RO AL 135 Sixth Avenue East Eugene Oregon 97 PHSNE, 537-4o65 LANE COUNTY PLANNING DlVlSloN PHoNE: 687 40r -4t 86 //,) n Owner LArr,c COUNTY PERMIT FO,.:PERIVIIT NO CONSTRUCTION i ] MOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] ZIP CODENAN/IE ADD B ESS CITY PHONE D Contractor NAIVIE ADD R ESS O.S. Reg. + Twp- Range- Section-Tax Lo C ITY Code Acreage - ZIP CODE Census Tract PHONE t Subd ivision Lot Access to Property (Road Name) B lock Width Depth Existing Structures on Property: Directions to Property Address STRUCTU R E ( # BED ROOIVIS)SO. FT VALUATION SEWAGE D ISPOSAL: PUBLIC [ ] SEPTICTANK [ ] OTHER [ ] PLUMBING INSTALLED BY: OWNER[] OTHER[] NAM E BUILDING PLUIVIBING 3% SURCHARGE-- IVIOBILE HOTVIE WASTE DISPOSAL PLAN REVIEW TOTAL WATER SUPPLY: PROPOSED I 1 EXISTING t ] PRIVATE WELL OTHER-SPECIFY CONSTBUCTION PERMlTS & lNSPECTIONS AND WATER POLLUTION CONTRO L SPECI F ICATIONS IVIIN. SEPTIC TANK CAPACITY GALS.IVIIN. DRAINFIELD LIN. FT IVIAX. TRENCH DEPTH I NCH ES STAY lOO' FROIVI ALL W EL LS TYPE OF CONSTRUCTION- GROUP FIRE ZONE USE CLASSIF SETBACKS-FT. FROM CTR. OF rAV FRONT SIDE EXT FT. FROIVI PROP. LINE SIDE INT REAR - ZONE- AUTHORIZED SIGNATURES ISSUANCE DATE BLDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PLUMBING _ CANARY BUILDING _ GHEEN SANITATION - GOLDENHOD IMPORTANT Call 687-4065 to schedule all required conslruction inspections. Call 687-4061 to schedule all required septic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. standards for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of occupancy before being occupied. (See Details on Reverse Side) (POST THIS PERM!T ON MAIN BLDG. AT SITE LANE COUNTY, DEPT. OF ENVIRONMENTAL i/ANAGEMENT COURTHOUSE ANNEX, .I35 EAST 6Ih, EUGENE, OREGON 97401 --\r-l ] PUB LIC ] COIVIVIUNITY . NAIVIE: E-.Ei5EI,C I rusprcroR SITE INSPICTION AppRovroDDrsAppRovEoDDarr Rruanx s - FOUNDATION I NSPECTION APPRovED REuanxs D Drsrppnove o Fl Darr I Hspecton FRAMING INSPECTION Appnoveo D Drsappnoveo D DarE RexnRr s l nseecton LATH OR SHEETROCK INSPECTION Ap pRov r o RrMaRxs D DrsaPPRovE o F-a Dar e I NSPEcToR FINAL INSPECTION Ap pRov e o REuanx s D t sappnoveo I NspecroR CERTIFICATE OF OCCUPANCY Rraov ro I ssuE REuaRx s Nor RErov ro lssuE DarE I ruspecroR D Dorr- -.--=c PERlrrr ,,fl/- gl NOTE: NO PERI'TTI WI:I ]E ISSI'ED TINfiL TIIIS APPLICATIC .IAS BEEN APPROVED APPLICATION FOR: CONSTRUCTION MOBILE }IOME E PLAN REVIEW CIIAI.{GE OF OCCUPANCY OI^INER ol Name dress Ci zip Clty o.s. REc. tt /- Twp 0 Sect :*^-Q lf , fuJ1,*Lot /oo o-y\*u"o census rr^"r Jo €O loA I^Jld th_Depth_Subdlvision Lot B Acrea?ACCESS TO PROPERTY (Road Name) Existing Structures on Property:. Property Location - Address/DlrecEi.ons 7.Y t/ r Offlce Use Ft?[z -2 SEWAGE DISPOSAL Site Inspec tlon /i ExlsEing S WATER SUPPLY: Well FEES Bldg. Plunblng 3Z Surcharge Waste DlsP. Plan Revlew Mob11e Hone Spring ru Name of Conmunlty or Publlc System Name wf PLUMBING: Installed by PLIJMBING FEES /l of Flxtures Sewage Connectlon Water Coonection FACILITY PERMIT Date: Dep th PLANS FURNISHED ./o, oo TOTAL Mln s Tank 1 YES Signature of Applicant: Fee Recelved By: 1e1d Requir ed - Lineal Feet fB *o YES FCZNo '{?1' e of Cons Flre Zone Use Classif ication- Setbacks - from Center of Road Right of Way: N/ t+*tide rnt. slde Ext 7nn o_ DATE:DATE: LANE COT]NTY DEPARTMENT EIWI RONMEN TAL I'{ANAGM{ENT DATE: )a * r--.1 Comunity PubIic I t CASII /0t oo i CHECK {