HomeMy WebLinkAboutPermit Building 1976-08-13-_
LANE COUNTY PERMIT FOR PERI\,1 lT NO
n Owner
coNSTRUCTION t I lvloBlLE HOIVIE t I PLAN REVIEW t I CHANGE OF OCCUPANCY I l
NAIVIE ADD R CITY N
n Contractor CITY ZIP CODE PHONE
NAIVE ADD RESS
O.S. Reg. +
Tw Range--- Section Tax Lot_-__--- Code- Census Tract-
Subd ivision ----=------..--- Lot
Access to Property (Road Name)
Directions to Property - Address:
B lock Acreage --Width
Depth
Existing Structures on ProPerty:
STRUCTURE (# BEDROOIVIS)SO. FT VALUATION
SEWAGE DISPOSAL:
PUBLIC[] SEPTICTANK[]
PLUIVIBING INSTALLED BY
OTHEB [ ]OWNER L ]OTHER [ ] NAIVI F
BUILDING-
PLUIVIBING
3% SURCHARGE--
MOBILE HOIVIE
WASTE DISPOSAL
TOTAL
WATER SUPPLY: PROPOSED I ]
EXISTING t ]
PUB LIC
COIVIVIUNITY . NAME
CONSTRUCTION PEBMITS & INSPECTIONS AND WATER POLLUTION CONTR OL SPECIFICATIONS
IVIIN. SEPTIC TANK CAPACITY
GALS.IVIIN. DRAINFI E LD--LIN. FT IVIAX. TRENCH DEPTH I NCH ES
STAY 1OO' FROIVI ALL WELLS
TYPE OF CONSTRUCTION- GROUP FIRE ZONE-- USE CLASSIF
SETBACKS FT. FROIVI CTR. OF r/W
FRONT SIDE EXT
FT. FROTVI PROP. LINE:
SIDE INT.
-
REAR ZON E
AUTHORIZED SIGNATURES
lsl
ISSUANCE DATE
BLDG. PEBMIT _ WHITE
OFFICE COPY - WHITE
COUNTY TAX _ PINK
PLUMBING - CANAFY
BUILDING - GREEN
SANITATION - GOLDENROD
IMPORTANT:
Call 687-4065 to schedule all required construclion 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 cerlificate of
occupancy before being occupied.
(See Details on Reverse Side)
POST THtS PERMIT ON MAIN BLDG. AT SITE
LANE COUNTY, DEPT. OF ENVIBONMENTAL MANAGEMENT
COUFTHOUSE ANNEX, 135 EAST 6th, EUGENE, OFIEGON 97401c5s-r 3
PLAN REVIEW
] PRIVATE WELL
] OTHER . SPECIFY:
t
t
t
t
'a
h,ILDIT.IG SI'iE EVALUATION {r'Vnl'r /7
SUBDIVISION:
Lor-Seb_
N ButLDtNG pERlltr AppL tcATtoN No"
( ) srrE INSPECTIoN
r?82 -7L .t
APPL I CANT
LOT:BLOCK:
CKID
Setb
Front
Setbacks from interio nes:
Side
Rear
DATE
PLANN I NG D tvlsl0N Not
nlPsu cabl q
P, tr 6.
iii\l( ) (t
4-a
t. Zoning Ordinance Compl iance: ZonefFf-
2. Subdivision Ordinance Compl iance
3. Requi red Access
4. guitaing Site (Area, }tidth, Frontage)
5. Other (see conrnents)
r)()
()
()
()
c0r{ilENTS
) No( ) APPLI T ION#PLANNING DIVISION ACTIO PEND I NG: YES (
BUILDING INSPE cTl0N Dlvlsl0N
Plans Submitted
Soil Stabil lty (footings)
Flood Plain
0ther (see conments)
Not
licable No
7
8
9
0
Yesw()
()
()
CI()
()
()CKI D BY
CO}{MENTS::
lrrAT ER PoLUTI0N CoNTR0L Not
I l. l{eets Department of Envi ronmental
Qual ity Standards.
12. Other (see comments)
Aool icabler Norur)YesrT
()() ()-1-)LCKIO BY:
DATE
C0HHENTS!
-
TO APPLI
Y Bui lding / Site lnsPection:
Can be approved"
) Cannot be apProved at this time as
Questions and further information o
indicated on item N0.
n items I through 5 co
s and further informat
tr above.
il ntact the LA NE-
ion on iteiliT
i
G 0lVlSl0N" Question
t rough 2 conta ct the LANE C0 BUILDING AND SANITATION lvlsl0N.
( ) llill be held in this office unt you can reso ve the p
c55-28
Your bui ldin
ems ind cated.
ls being returned.
ermi t lication f is b
135 Sixth Avenue East Eugene Oregon
PHoNE: 687-4055
LANE COUNTY PLANNING DIVISION PHONE:
r 97401
587-41 86
CI
?)
PERIVIIT NO
CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ]
NAIVIE ADD R ESS C ITY ZIP CODE
n Owner
PHONE
n Contractor
NAN4E ADD RESS
O.S. Reg. *
Twp- Range- Section-Tax Lo
CITY ZIP CODE
Census Tract
PHONE
t Code
Subd ivision
-
Lot
Access to Property (Road Name)
B lock Acreage Width
Depth
Existing Structures on Property:
Directions to Property - Address
STRUCTURE (# BEDROOIVIS)SO. FT VALUATION
SEWAGE DISPOSAL
PUBLIC I I SEPTICTANK t1 orHERll
PLUIVIBING INSTALLED BY:
owNER[] OTHER[] NArVr tr
BUILDING
P LU l\ilB ING
3% SURCHARGE
IVIOB ILE HOIVIE
WASTE DISPOSAL
PLAN REVIEW
TOTAL
WATER SUPPLY: PROPOSED t ]
EXISTING t]
PUB LIC
COVINIUNITY NAIVIE
PR IVATE WELL
OTHER .SPECIFY
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
IVII N. SEPTIC TAN K CAPACITY
GALS N4IN. DRAINFIELD-LIN. FT IVIAX. TRENCH DEPTH- INCHES
STAY lOO' FROIVI ALL WELLS
TYPE OF CONSTRUCTION GROUP FIRE ZONE USE CLASSIF
SETBACKS- FT. FROIVI CTR. OF rAfi
FRONT SIDE EXT
FT, FROIVI PROP. LINE
SIDE INT REAR ZONE
AUTHORIZED SIGNATURES ISSUANCE DATE
/s/
c55-l 3
BLDG. PEBMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX _ PINK
PLUI.,4BING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
IMPORTANT
Call 687-4065 to schedule all required construction 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 PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, .I35 EAST 6Ih, EUGENE, OREGON 97401
LANE COUNTY PERMIT FOR:
i.:L;
-I
D r s rppnoveo
.)
SITE INSPECTION
Ap pRov r o
RruaRxs
Dare I ruspecton
FOUNDATION I NSPECTION
Ap pnov E o
Rruanx s
D I SAPPRoVED Dare I Hseecron
FRAM I NG
AppnovEo
Re t,taRx s
I NSPECT I ON
DrsappRove o I NSPEcToR
LATH OR SHTETROCK I NSPECT I ON
D r sappRoveo Dnre I NsPEcroRAp pRov r o
RrNlRx s
FINAL INSPECTION
AP PRov E o
Rrua nx s
* DTsAPPRovE , D oorr-l- >3-??I rusprcron
CERTIFICATE OF OCCUPANCY
Reaov ro lssur
REMARK S
D Nor Rerov ro lssur D DorE-I Hsprcron
D
D Dorr-
NoTE:NoPERMITwILL.-IssUEDI]NfiLTIIIsAPPLIc,ATIoNn<snrptt:;,W,;:,ru[
APPLICATION FOR:
coNSTRUcrroN E MoBTLE HoME
owNER Pailuck , flulu E-
PLAN REVIEW C}IAI'IGE OF OCCUPANCY
na ---- /Address nlty Zi_-T rlnor.e ,va,;ii
CONTRACTOR
Name Address Clty zip Phone
o. s. REG. il
,^Tap. 17 RanCe___eJ_lSect.ion Tax Lot .fO Code t, -Ol Census Tract 2O -/o'i9
/-Existing Structures on Property: NAN O.-
..,,Property Location - Address/Directlons NorTh <^trt d,/ t{ar7h )aA-
.fTreeT + tr'<sT s,'4e,
x
Use
Sprlng
Sq. Pt 0,f,30
Pub1lc
Comunity
of Fixtures
, fnrs
CHECK Signature of Appl
NO
I
Fee Received By:
Drainfield Required - Lineal Feet
{-s4
SEWAGE DISPOSAL:
Slte Inspec tion /l
WATER SI]PPLY:
Well
FEES:
Bldg.
Plunblng
3Z Surcharge
Waste Dlsp.
Plan Revlew
Moblle Home
*3p
rtro Ins
PLIJMB
Name of Community or Public System
Name
Sewage Water
ComectionConnecti.on
PI.A.NS F'URNISHED FACILITY PERMIT
YES H
TOTAL
Mln. Septlc Tank Capaci
Date { ?:'r
Maxlmum
c55- 12 LANE COT]NTY DE
,TION:
OF
re zor,e 3
MANAGE},IENT
Zorre
DAlE
gpe of cons rructloa-ff181fu!1)._c.oup-----E-rt Use Classificat
Bldg Setbacks - frou Center
pa6nr -;Stirr Side rnr
of Road Right of !Iay:
. .fr | +ftrr-ffir'€r-rdr
DATE:*E
,-11
r--r
Subdlvlsion Lot------Block----!roperty Lcreage f eete Widt\4$4(pepxhah&
,.,AccEss ro pRopERTy (goaa nane) 7D fu *Sfi
Disposal system l----l or New System Requlred n
77,,eT
f--l other f_-l
NO
I
\
Rear
t
L