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Home My WebLink AboutPermit Building 1973-10-11IANE COUNTY Bt BUTLDTNG I ,ING PERMIT OR MOBILE HT HOME L-. PERMIT PERMIT NO.M PROPERTY OWNER MAILING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCTUDE POST OFFICE PROPERTY LEGAT DESCRIPTION _ METES, BOUNDS RANG E SECTION TAX LOT NO CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTY TEGAT ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existi Sewo e TYPE CONSTRUCTION New System f] BDRMS VALUATION m STRUCTURES TO BE BUILT THIS PERMIT SQ, FT SEWAGE DISPOSAI. PUBLIC N SEPTIC TANK N OTHERE PLUMBING INSTALTED BY OWNER n OTHER: NAME FEES WATER SUPPTY PUBUC !tr OTHER BUILDING WASTE DISPOSAT PtUMBiNG PTAN REVIEW PARK TRAITER s TOTAI COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAt. DRAIN FIEI.D REQUIRED tIN. FT TRENCH WIDTH FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIT. EASEMENT BTDG. SETBACKS FRONT FT. FROM CTR. OF ROAD RIGHT OF WAY SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BLDG, PERMIT _ WH ITE OFFICE COPY - WHITE COUNTY TAX _ PINK PTUMBING _ CANARY BUII.DING _ GREEN SANITATION _ GOLDENROD Construction to comply with uniform building code ond county covering plumbing ond sewoge disposol. All buildings requireof occuponcy before being occupied. (See Stotement on Reverse Side) regulotions o certificote (posT THts pERMtT ON MAIN BLDG. AT SITE) TANE COUNTY. BLDG. & S,AN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronurg55-13 APP[. NAME & MAITING ADDRESS OR SQ. FT. LANE COUNTY BI BUTLDTNG E ,ING PERMITnnr OR MOBILE HOME L,-- PERMIT PERMIT NO. PROPERTY OWNER MAITING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCTUDE POST OFFICE PROPERTY TEGAL DESCRIPTION _ METES, BOUNDS RANG E SECTI ON TAX LOT NO.CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPT. NAME & MAII.ING ADDRESS tEGAt ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect io Existi Sewo e TYPE CONSTRUCTION New stem se. FT BDRMS VALUATION Li&HE CSU${TY SpEffA!. pERe1&lI AREA SEWAGE DISPOSAT PUBTIC tr SEPTIC TANK tr oTHERn PTUMBING INSTAIIED BY OWNER E OTHER: NAME BUITDING WASTE DISPOSAT PI.UMBING PI.AN REVIEW PARK TRAITER s FEES WATER SUPPTY PUBr.rC n tr oTHER TOTAT COUNTY BUILDING & SANTTATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIETD REQUIRED LIN. FT TRENCH WIDTH FT OR SQ. FT TYPE OT STRUCTURE OCCUPANCY ZONE PUBIIC UTI[, EASEMENT BTDG. SETBACKS. FT. FROM CTR, OT ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BI-DG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PTUMBING - CANARY BUITDING _ GREEN SANITATION - GOI.DENROD Construction lo comply with uniform buildin covering plumbing ond sewoge disposol. Alof occuponcy before being occupied. g code ond county regulotions lbuildings require o certificote (See Stotement on Reverse Side) . i \\ (posT THts pERMtT ON MA|N BrDG. AT S!TE) TANE COUNTY, BTDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronv f,655-13 SITE INSPTCTION Appnovro D DrsappRove, D RruaRx s Datr lrrrspe cron FOUNDATION INSPECTION D DTsAPPRovE o F7 Darr Ir'tspEcronAp pRov e o REMARK S FRAM I NG AppnovEo Rrnanx s I NSPTCT I ON D DrsAppRovEo D Darr I rspecron LATH OR SHTETROCK INSPECTION D DrsAPPRovEo 7 Dorr-I NsPEcroRAp pnov r o Rruanx s rINAL INSPECTION Ap pRov e o Rrua nr s DISAPPROVED E CTOR CERTIFICATE OF OCCUPANCY REaov ro lssuE D Nor Reaov ro lssur D Dorr- REuacx s I Nsprcron /l /rl -rg 2o A 2 o-/'rD IANE COUNTY E -..DING PERMIT OR MOBIIE HOME triE PERMIT BUTLDTNG E MH E PERMIT NO. PROPERTY OWNER MAII.ING ADDRESS PHONE CONTRACTOR MAITING ADDRESS PHONE PROPERTY TOCATION _ INCLUDE POST OFFICE I PROPERTY LEGAL DESCRIPTION _ METES, BOUNDS RANG E SECTION TAX LOT NO,CODE CENSUS TRACT EXISTING STRUCTURES ON PROPERTYAPPL. NAME & MAITING ADDRESS LEGAL ACCESS TO PROPERTY PROPERTY SIZE _ FT. WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms Connect to Existing Sewoge Syste m!New System STRUCTURES TO BE BUILT THIS PERMIT SEWAGE DISPOSAT PUBLIC tr SEPTIC TANK N oTHERn PLUMBING INSTALTED BY OWNER n OTHER: NAME BUITDING WASTE DISPOSAT PTUMBING PtAN REVIEW PARK TRAIIER q FEES WATER SUPPTY PUBI.IC OTHER TOTAT COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GA[. DRAIN FIETD REQUIRED IIN. FT TRENCH WIDTH FT TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTIt. EASEMENT BLDG. SETBACKS FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT. SIDE EXT. USE CTASSIFICATION REAR AUTHORIZED SIGNATURE - DATE DATE BLDG. PERMIT _ WHITE OFFICE COPY _ WHITE COUNTY TAX - PINK PTUMBING _ CANARY BUITDING _ GREEN SANITATION _ GOLDENROD Construction to comply with uniform building code qnd county covering plumbing ond sewoge disposol. All buildings requireof occuponcy before being occupied. (See Stotement on Reverse Side) regulotions o certificote (posT TH|S pERMtT ON MA|N BrDc. AT S!TE) IANE COUNTY, B[DG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I ronv # C5s- l3 *t//. Pg, K -.0 *nr TYPE CoNSTRUCTIoN sQ. FT. # BDRMS VALUATIoN OR SQ. FT. SLAB FLOOR PLUMB ING GROUND^/ORK Ap pRov r o RrltnRx s D DrsAppRovEo fa Dnrr I rus er cron GAS P lP I NG GROUNDI/ORK Ap pnov r o ReuaRx s Dr sappRovrD D DarE,I Nspecron ROUGH PLUMBING AppRovro D DrsrppRovrD D RrNanxs Darr I rusprcron ROUGH GAS PIPING D t sappRovEo Dare I ruspecroR F I NAL PLUMB I NG AppRovro & Dr sappnove o D ,orrl-- ?2L Rr l,tanr s lNspEc FI NAL GAS PI PI NG Ap pnov e o Rr t'tanx s D r sappRoveo Date I NseEcron CERTI F I CATE OF OCCUPANCY Reaov ro lssue RrunRr s Nor REaov lo lssue Dare I rsprcroR Ap pRov r o Reuanx s D ? 36k Trrr/ r ptinrf ,1nn l-g t min't i4uru1 tf watl it ud (-,/ I -/ o --+ s\\9 \;0 loo 00T 3 tr973 k? (rt-t ) ;f 'J,$ R.\' M h $..lli lJ i $NE UUUIIIY }IIAIIII UNII fA/4 G7/-7e I D t BUILDING S ITE EVALUATION :l\ Bu i ld ins Perm it App I icat i"" N"./nH b7 | -Ui S i te Inspect ion Pre-Perm i t lnvest igat ion J,C,'K^#'e/ rHx Lo\582-v ,( APPL I CANT NrtJtl E ADDR S() PHONE DATE LANE COUNTY PLANNING DEPARTH ENT NOT NO YES NA}'t E DrrTE _eff l_icab le I . Zon i ng Ord i nance Comp I i ance Bu i ld ing S i te (Area, Width, Frontage, Setback) Other' (see comments) (Zone ;laf ) Subd ivis ion 0rd inance C6mp I iance Requ i red Access rT-( ) (tr vf () () ) 2 3 4 5 () ()() (w ) () ()# */- ,*^ .- /o./, - CO}A}AENTS: BUILDlNG INSPECTION SECTION 6. Pl ans Subm itted 7. Soil Stability (footings) 8. Flood Plain 9. 0ther (see Corments) COI4I4ENTS: NOT NOY NA''tE DATE cable () () ) )( () () () () () ()-/0 - )3 SAN ITAT I ON SECT I ON 10. Sewage Disposal I l. Usable Area 12. Water Supply |3. 0ther (see Conrnents) aool icable**rT-()x NOT NO YES NAI'18 DATE () ( () () () () g P4 VQr'lt , , uftpz- ( COH}IENTS TO APPL I CANT: Your Bu i ld i ng Permit ,/ Site lnspect on lf-Can be approved .to-ll ve"d at th "73 icated on item N0.above.Cannot be appro is t ime Questions and further information on items I through 5 contact the Lane- COUNTY PLANN ING DEPARTMENT. Quest ions and further informat ion on i6; 5 through ll contact the Lane County Building and Sanitation Division. Wil I be held in this off ice until you can resolve the problems indicated. ls being returned. Your buildinq permit appl ication fee is being returned under separate cur'€F. . LANE COUNTY PL^NNING DEPARTHENT LANE COUNTY BUILDING S SANITATION DIVISION 135 Slr(rh Avente East, Eugerre, 0regon 9740 I 135 Sixth Avqrrue East, Errc;en<', 0r'egon 97 l+0, fnorrr 3{2.-l3ll Ext.ztt PH0NL 142-tlll [xr. 4tl () () () Mq(*,R 4a INDIVIDUAL SEVIAGE DISPOSqL SYSTEM RECORD Installer: Complete top pa of form to signature and return both copies to Lane County Building Sanitation Department- sd{' No tal s Name vOther-ListPubl *,e Bedrooms Baths Basemenf/ vesil NoE \pplican Nane !1 ailing Address LengthtJFzi | 3.+a4 .6 Ft. from well Steel ! Concrete Length z- Width 4 t-J I )e Diameter No. Compartments I Ga1. Capacity da T leD rspos Depth L d"Distribution Box:ves( No fl r tr Feet F tion Lot Line & rz a Fa. t Rearr below-F J/b o Trench width "( fotd6qlFt. between ft. 3ao lrines za FiIIer ., rype / 1 *- Filler depthabovetile & in- Sketch See instructions bn F 9i3 $I{E {KUITIY HEALTH UflII .'lo' b5'J3- ta' # T 4 ") J ,- ) 2 , I fii l11 I l DEC 20 1 Date Signature For S2/:-Xarian Use OnlY EI'Approved: SYstem : Instaltation Conforms to Current Standards n Disapproved: Does Not Conform to Current Standards Remarks: I z1u2 Lane County Building & Sanitation Dept. Date: c5s - !r itarian's Signature ) Y \+.tr$ vrrlrl* f LANE COUNTY BUII' \G PERMIT OR MOBILE HOME U5' \PPTICATION PERMIT TYPE _ BUILDING MOBILE HOME MAILING ADDRESS MAITING ADDRESS REG. #PERMIT b 7/- PHONE PHONE OWNER CONTRACTOR LOCATION - INCIUDE POST OFFICE PROPERTY TEGAT IPTION LOT_BTOCK-SUBDIV,METES & BOUNDS ATTACHED N YESnNo TWP RANGE SEC.TAX LOT #CODE CENSUS TRACT03d-o DESC RI BE ISTING STRUCTURES ON PROPERTY IF ANY IDTH DEPTH APPTICANT NAME AND MAITING ADDRESS a ACC - ROAD N AA,l! OR # FOR MOBILE HOME PERMIT ONLY Number of Bedrooms d STRUCTURES BUILT THIS PERM Connect to Existing Sewoge m FT or New m Reg VATUATION 2 atV]H\'I,# SEWAGE DISPOSAI-PTUMBING INSTAI.IED BY PUBLIC BtDG. WASTE DIS. PTUMBING PLAN REVIEW PARK TRLR. TOTAT SEPTIC TANK Jo, a-d3. 5 d 3o. d.) J J ..'O OTHER FEES WATER SUPPTY PUBTIC cAsH E CHECK s rr' OTHER owNER D OTHER NAME PLANS FURNIS ED YES RECEIVED BY PERMIT # FACITITY PERMIT YES o PtUM F EES - FIXTURES NNECTION FEE s) DATE -3 DATE -3- PUBI.IC WATER CONNECTION FEE /, sn /Lil bil- 73 APPI.ICANT,TURE O COUNTY BUILDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL.73-O DRAIN FIEI.D REQUIRED TIN. FT. ) SZ TRENCH WIDTH FT. TYPE CTURE /4 OCCUPANCY ZONE REAR YARD USE CTASSIFICATION PUBI.IC T. EASEMENT BI.DG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT SIDE INT SIDE EXT.REART Dote Dote BIDG. INSP '7.3a Directions lo Find Property: Form # css-rz Dote COPY I _ OFFICE COPY 2 -JOURNATCOPY 3 _ AUDIT TYPE {b:t.d 't_* 'lIf llr