HomeMy WebLinkAboutPermit Building 1981-06-126l!'rI7
^ .CONS
U*BLOCK.
TR 'CTION /PIryCEMEN]
PERM IT
CONIPLETE PLEASE USE BLACK INK AND PRINT.
FOR OFFICE USE ONLY
i::ii:";'""'t r g E-3 t
Irro Copies of Plans
flrro Copies of PLot P1ans
f, laechanical Checklist
f] elrrmf i.,q Chec]'.Iist
lE3fan Check Info Sheet
TOWIISHIP
t7
RANGE03 SECTION t
27.3. +TAX LOT|760 OUT OI'
SUBDIVISION,/PARTITION (if APPIiCA.bIE)
laj add. -to flo,y.r- T^all-L
LOTIPARCEL2 BLOCK
7
LOCATION ADDRESS2375 CITY IP
S
PROPOSXD USL ('F P;(OPERTY
ffnesidential nlndustrial
[-lcommercial f]rrruri"
t or nn[3oor',rs
A.
\-.r,
* oF SToR}ES1t-#oF SUPPLY Proposed
xi sting
Gn On
, and do hercby r:r:rtify that all information rrelcon is true and correct ar)d J furthl,certify that any and all work performed shall be done in accordance with the ord-inaices of Lane County aod the Lans of the st;ri:e of oreq.n I/_,rLajrrin,lto the work described herein, and that NO OCCUPANCY wj"Il be made of any structure without the pemission of the Building Division. I further c{rrti.f},that registration with the Builderrs Board is in fu1I force and effect as requircd by ORS 701.055. that if exenpt the basis for exemption is not.:dhereon, and that only subcontractors and employees who are in conpli.ance with oRs 7ol.o55 will be used on this project. I HAVE R-EAD AltD cilEcrcD THISAPPLICATION THOROUGHLY
h a-
DATE
3-t,t
NAI'{E (print)
I HAVD COMPLETED APPLICATION
I o",..,
[t/cor.rr.tot
f eg"rt
u PLANNING ZONTNG:,on. W'
l,lilimum setbacks, CL, frort
Cotrments
Partition f
C-L. SICIC
Parcel SiParcel #.
interior re ar
L-3,zt
tr FLOODPLAIN:In flood hazard area? n *" fJ ver, see attactled sheer
Date:
Date:
Date:tr RURAL ADDRESSING: CRID COOR.DINATE N
I sarlrrATroN:
E
s. r. f D. t. tr Installatj-on Record Issued? ! vu" I f,f"
Maximun Depth
of Trerrches
InstaLlation
Specifications;
Comments :
Gal 1on LineaI Feet
of Drainfield
Date:
S EXAMINATION:trn.5L] n,o,rK' j-.Use
Corunents:
ilffS FOR ALL ETECTRICAT WO K
Date:
COMtv\ERCE, ELECTRICAL
SAFTY SECTION.
Description
CONSTRUCTION AUTHORIZED BY THIS PERMIT
Fixed Fee/
Unit Cost
Floodplain FeSg. Ft
,50Z
Subsurface Fees
Building Fee
Sewer/Storm Drain/WaternO Plumbinq Fixtures
*.fr"r'ri..f
Plans Check Fee
State Surcharge
TOTAL FEE wL
w$
$
$
$
$
$
$
TOTAL VALUATION $ I ,a!_rEES PAI ! crrec:< [ casrr
-a
By
Date:
PERMIT IGNEE (per ORS 456.805(
LANE COUNI'Y DEPARTMENT OF ENVTRONI4ENTAL MANAGEMENT / 125 EAST ETGHTH AVENUE, EUGENE, OREGON 97401
C74-L94 SEE REVERSE
tr
T
SETBACKS AND OTHER C0NDITI0NS 0F APPR0VAL Mt}sf BE STRICTLY OBSERVED. VI0LATI0N CAN RESh# IN REV0CATI0N 0F THIS PERiIIT'I
CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOWED BY LA}l.
I,IHEN READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST MUST BE
GIVEN. Have the foltowing information ready: Permit numberr job address, type of inspection, when it will be ready,
your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED II{SPECTIONS
l) F0UNDATION INSPECTI0N: To be made after trenches are excavated and forms erected and when all materials for the foundation
ffioo.Whereconcretefromacentralm.ix.ingp1ant(conrmon1ytermed',transitmixed,')istobeused'
materials need not be on the Job.
2)C0NCRETE SLAB 0R UNDER-FL00R INSPECTI0N: To be made after all in-slab or under-f'loor buildi ng service equipment,
ci1.laryequipmentitemsareinp1acebutbeforeanyconcreteispoured
or floor sheathing installed, including the subfloor.
I
3)
4)LATH AND/0R GYPSUM BOARD INSPECTI0N: To be made after aIl lathi ng and gypsum board, interior and exterior, is_in place
fasteners are taped and finishedEut before any plastering is app'li or before gypsum board ,joints and
5)FINAL INSPECTION: To be made after the building is complete a nd before occupancy
i
APPRQVAL-dfQUInEO. No work shall be done on any part of the building or structure beyond the point ind'icated in each
successive inspection without first obtaining the approval of the build'ing official. Such approval shal'l be given only
after an'inspection shall have been made of each successive step in the construction as indicated by each of the inspections
requi red.
N0TE: Ali building permits require inspections for the work authorized, such as but not limited to:
A. BLQCK I,IALL: To be made after reinforcing is in place, but before any grout is poured. This inspection is
required for each bond beam pour. There will be no approval until the piumbing and electrical inspections
have been made and approved.
B. W00D ST0VE: To be made after completion of masonrv (if applicable) and when'installation is comolete.
Installation shall be in accordance with an approved nationally recognized testrng agency arrd the manu-
facturer's installation instructions'
C. l.l0BILE H0ME: 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
connecti ons.
(l) Footings and piers to comply with State foundation requirements for mobile homes or as recommended
bY the manufacturer.(Z) NoUite home minimum finish floor elevation shall be certified when required by a floodplain
management letter'(3) l4obiie home tiedowns, when required, and skirting shall be installed and ready_forinspection
within at least 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure.
D. SWIMMING p00L: Beiow grade when steel is in place and before concrete is poured. Above grade when pool
'i s installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING I,IORKING HOURS. THIS PERMIT WILL EXPIRE IF I'JORK DOES NOT BEGIN
I^IITHIN]8O DAYS, OR IF I^IORK IS SUSPENDED OR ABANDONED FOR MORE THAN]8O DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PTRUTT WAS ISSUED ON THE BASIS OF INCOI1PLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUiRED INSPECTIONS I,JILL DO SO AT HIS OtllN RISK
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
FRAMING & INSULATToN INSPECTIoNS: To be made after the roof, all framing, fird bloiking and bracing ari in.place and
sandventsarecomp1eteanda.llroughe1ectrica]ahdp1umbin9areapproved.'ATl,.
wal l insulation and vapor barrier are in piace.
(r )
(?)
Permits shall be effective for one year from the date of issuance.
Upon completing the construction for which a permit has been_issued the PelTiI holder sha11 notify.the
ofipi"tilht by iubmittins the installation recbrd form. The Department shall inspect the construction to
O"i"i.rri.. it ii iompliei with the r.ules contained in, this divii'ion: If the construction does comply with
such rules, the Department shap isbue a certiiicate of satisfacig"v i*pi"tion to.tne permit ho]iei'. If thd
conitructi6n aoes irqt-lompti *itt such rules, the Department shal'l notify the permit holder and sha'lI require
#ii;i;;il;; I.ilprliii.r'il[i'.'ii.ilqri.s th.-[6'iiiiiiie. railqrg to meet the requirements for: satisfactorv
;;pi;ii;; iilr'li i-."itonuur",iti'i," c6nstitutes ,u,r,1,1.,*.or ols fs+t005
to 434.74?,un9;lniti"rl". -.. .,
Setbacks - Subsurfa ce Sewaqe D isposa'l
From Interior property f ines
Edge of road right-of-waY
Bui1ding foundation
lrlells, other water sources
Seotic Tank Drainfield
-To-i- -TO]--'t0'
'10'
'l 00'
0
5',
50'
Y! i.. i" . tt.t
FI.. NO. FIXTUBES :
,ECH
stlR
F,CK.F LC t 1888{ SUPF
FL
suR
1
NO . CCINNECTORS:
IIECHANICAL FEE
STATE SURCHARGE
F'LAN CHECI( FEH
F P SDS SI - F'CK
EST. COI.IPL,ETION DATE 06t681
15.00 EACH 5
47"
OTH ISS
TNTAL FEEITX
I LANE COUNTY DEPT ENV I.iGT RECEIFT * { t 888I DATE O6t 581
AFPLICANT SCHAR, JASON ADI}R NA
TL.* 0000000000006 sutrDrv LoT BLK
. NEI,I BLDG TYFE USE X NO BDRI"IS OO NO UNITS OO{ NT} STORIES NCI BLDGS OOt
CODE APFL NO ACTION T}ESCRIF'TION SQ FT UNIT COST VALUATION FEE DAYS
BF
BF
F.
BF
BF
P
CATC : API-'EQU: 1
AKHN BY RL.H
I 5.00
t 0.00
't .00
?6.O0 CK
1
HA
lane county
APPLI CANT INFOR}4ATION :
PTUMBING IMECHANICAT6l!'
-
CHECKLIST
OFFICIAI USE ONLY
App1i./
Permit #
J
or 1rm-
PLIJMBING CONTRACIOR Yes Firm
Address
f] No f]s"rr
MECTTANTCAT CONTRACTOR t]Yes Firm
Address
I No! serr
1 1ng SS 1 or ol{n
Cont. OSR#
Cont. OSR#
PLUI\tsING
Tlpe of Fixture Nt-rmber of Each Fee On Each Total
Sink $ s.oo
Lavatory Wash Basin 5. 00 h.ou
Tub (with or without shower)5. 00
Showcr, separate 5. 00
Water et to 1 /urinal'5. 00 .5 ot)
Dishwasher 5 .00
Disposer (r s. 00
5. 00
a 5.00
Floor Drain 5. 00
Sewer--lst 50ft.15.00
10.00
Water Service--1st 100 ft.15.00
each additional 100 ft.10. 00
Storm and Rain Drain--1st 100 ft.15.00
each additional 100 ft.10.00
Special Waste Connection s. 00
e e ector s.00
I Water 10.00
Other (specify)
StjB-TOTAI (Minimum $10. 00)
TOTAT FEE lc,oo
MEGIANICAL
Type of Equipment I,lurnber of Each Fee on Each Total
Mechanical Perrnit Base Fee $ 10.00
Furnace up to 100,000 BTU/H $ 6.oo
Furnace over 100,000 BTU/H 7. 50
Clothes Dryer Vent 3. 00
Bathroom Ventilation Fan G D:ct 3. 00
Range Hood with lvhchanical Exhaust 4.50
Wood Stove 6. 00
Air Conditioner Only 6. 00
Heat Puurrp 6. 00
Floor Furnace 6.00
Gas Piping System 1 to 4 Outlets
Per Outlet 50
Other (specify)
SI.IB-TOTAL
TOTAL IEE
ng Machrne
:er
rhrr
,-, t(-D? zz. ? +4 t\ffi,..-' ,,'W p@. oglql,-,ruLO i.. ,.';tr i 6,--tdfr Tcounrv 'i'nsprcrou
RELur(D
nk
OWNER'S NAME PHONE NUMB
SET BACK REOUIREMENTSCL, FRONT C1, SIDE I NTE RI OR REAR
#PL UMBING FIXTURES
I,JORK AUTHORIZED BY PERMIT
DIRECTIONS TO SITE
PERMIT NUMBE
FOOTING / FOUNDATION INSPECTION OR MOBILE HOME SET UP INSPECTION
Approved Correction Disapproved_Date Inspector
CONCRETE SLAB / UNDER-FLOOR INSPECTIONApproved Correct'i on_ Dj sapproved Da te Inspector
UNDER SLAB / PLUMBING GROUNDI^JORK INSPECTION
Approved Correct'io n Di sapproved__Date inspector
ROUGH PLUMBING INSPECTION
Approved y'- Correct j on D j sapproved_Date 6- rrfl_I nspector
N
Approved Correction Di sapproved Dat d-:ZZ:S/t ns pec tor 9-a_6-mmmApproved Correcti on Di sapproved Date I ns pec tor
NApproved Correction Disapproved - lDa te Inspector
Approved
UMBING INSPECTION
l/ Correction Disapproved Da te 7-Jo6/I nsp ector RI
FINAL I^IASTE DISPOSAL SYSTEM INSPECTION
Approved Correcti on__Di sapproved Date
PECT,I ON BU
t/ corr
ILDING MOBILE HOME
Approved ection sapproved e
Inspector
Inspector Ad-
CERTIFICATE OF OCCUPANCY
Ap p ro ved
TEMPORARY CERTIFICATE OF OCCUPANCYDate Inspector
Form C74-197
Correct'ion s approved
Ir _r'_l
SITE ADDRESS