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Home My WebLink AboutPermit Mechanical 1976-05-05NOTE: NO PERMIT IfILL ISSI'ED T'NfiL THIS APPLICATION APPLICATION FOR: PLAN REVIEW e,432 I City 43// 7/'* City 87e-7 PERI'Irr #"1#*,4/; BEEN APPROVED CH CONSTRUCTION O}INER CONTRACTOR 0.s. REG. d MOBILE HOME C}IAI{GE OF OCCUPANCY /. J ? tion 4.3.4 ,,*4/,de /? *O/cun.usTract Lo &Acreage Wldth_Deprh_ 7P /, Valuation Exlst Sewage D sal System or New System Requlred Name of Comunlty or Public Systen PLII{BING: Installed by Name PLi]MBING Fixtures Sewage Water Connect.ionConnectlon PLANS FIJRNISHED FACILIfi PERMIT CASH YES NO YES Signature of Applicant Fee Recelved By Date Dralnfield Requlred - Lineal Feet I ACCESS T0 PROPERIY (Road Name) Existing Structures on Property Property Locatlon - Address/Dlrections: Use On SEWAGE DISPOSAL: Slte Inspec tlon /l WATER SUPPLY: I.Ie11 Spring 0ther FEES: e 7 5Bldg. Plunblng 3Z Surcharge Waste Disp. Plan RevLew Moblle Horoe TOTAL Mln. Septlc Tank Capacl Type of Construct Group Fire Zone Use Classlfication Bldg Setbacks - from Center of Road Right of Way Front Slde Int Slde css-12 LANE COT]NTY DEPARTMENT OF ENVI DATE:DATE:,f-PIANNING:DATE:SANITATION: T 7 Subdivlsion r -w l--l ottrer I -----,71- +r-l-5,7T-6 n Owner LANE COUNTY PERMIT FOR PERI\1IT NO CONSTRUCTION [ ] IVIOBILE HOIVIE [ ] PLAN REVIEW [ ] CHANGE OF OCCUPANCY [ ] o NAN/E ADD R ESS CITY ZIP CODE PHON E r Contractor NAIVIE ADD RESS CITY Acreage ZIP CODE Census Tract PHO NE O.S. Reg. + Tw Subd ivision Lot Access to Property (Road Name) Range-- Section Tax Lot-- Code B lock Width Depth Existing Structures on Property: Directions to Property - Address STRUCTURE (# BEDROOTVIS}SO. FT VALUATION I SEWAGE DISPOSAL: PUBLIC[] SEPTICTANK[]OTHER I ] PLUIVIBING INSTALLED BY: OWNER[] OTHER[] NAIVI E BUILDING WATER SUPPLY: PROPOSED t ] EXISTING t ] PUB LIC COVIMIUNITY NAIVIE PLUIVIB ING 3% SURCHARGE IVIOBILE HOIVIE WASTE DISPOSAL PLAN REVIEW TOTAL PRIVATE WELL OTHER SPECIFY CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS IVIIN. SEPTIC TANK CAPACITY GAtS IVI IN. DRAINF IELD-- LIN. FT IVIAX. TRENCH DEPT I NCH ES STAY 1OO' FROIVI ALL WELLS TYPE OF CONSTRUCTION GROUP FIRE ZONE USE CLASSIF SETBACKS FT. FROIVI CTR. OF r,AtV FRONT SIDE EXT FT. FROIVI PROP. LINE SIDE INT R EAR ZON E AUTHORIZED SIGNATURES ls/ ISSUANCE DATE BLDG. PERI\,,IIT - WHITE OFFICE COPY _ WHITE COUNTY TAX _ PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT Call 687-4065 to schedule all required construction inspeclions. Call 687-4061 to schedule all required septic system inspections. All conslruction shall comply with the State Buidling Code, D.E-O. standards for subsurface sewage disposal and the State Plumbing Code. All buiidings require a certificate ol occupancy before being occupied. (See Details on Reverse Side) POST THIS PERMIT ON MAIN BLDG. AT SITE LANE COUNTY, DEPT. OF ENVIBONIvIENTAL MANAGEMENT COUBTHOUSE ANNEX, -I35 EAST 6th, EUGENE, OBEGON 9740,Ic55,1 3 LANE COUNTY PERMIT FOR PERMIT NO CONSTBUCTION [ ] IVIOBILE HOI'/IE I I PLAN REVIEW [ ] CHANGE oF occuPANCY I j n Owner NAIVIE ADD R ESS CITY ZlP CODE PHONE tr Contractor NAN/IE ADD R ESS CITY ZIP CODE Census Tract PHO NE O.S. Reg. +* Tw Range- Section-Tax Lot-_- 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 PLUIVIBING INSTALLED BY OWNER[ ] OTHER[ ]PUBLIC [ ] SE PTICTANK[]OTHER[]NAIVI F BUILDING- PLUIVIBING 3% SURCHARG E IVIOBILE HOIVIE- WASTE DISPOSAL PLAN REVIEW TOTAL WATER SUPPLY: PROPOSED t ] EXISTING t ] PUB LIC COVIMIUNITY - NATVIE PRIVATE WELL OTHER . SPECIFY CONSTRUCTION PERMITS & INSPECT IONS AND WATER PO LLUTION CONTBOL SPECI FICATIONS IVIIN. SEPTIC TANK CAPACITY GALS.IVIIN. DRAINF IE LD--_---LIN. FT MAX. TRENCH DEPT I NCHES STAY 1 OO' FROTVI ALL WELLS TYPE OF CONSTRUCTION=- GROUP FIRE ZONE USE CLASSIF SETBACKS- FT. FROt\4 CTR. OF r/W FRONT SIDE EXT FT. FBOIVI PROP. LINE: SIDE INT. --- REAR ZONE ISSUANCE DATEAUTHORIZED SIGNATURES lsl BLDG, PEBMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBTNG - CANAFY BUILDING - GBEEN SANITATION - GOLDENROD IIVIPORTANT POST THIS PERMIT ON MAIN BLDG. AT SITE LANE COUNTY, DEPT, OF ENVIRONMENTAL N4ANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required septic system inspections. Allconstruction shallcomply with the State Buidling Code, D.E.O. standards foi subsurface sewage disposal and the State Plumbing Code. All buildings require a certilicate of occupancy before being occupied. (See Details on Beverse Side) c55 -1 3 Dare I NspEctonDr SAPPRovED SITE INSPECTION APP Rov E o Rruanxs FOUNDATION INSPECTION AppRoveo REul nx s D r s appRovro Darr I ruspecron FRAMING INSPECTION Appnov r o Retranrs D Drsappnovm D Drrr I Hsprcron LATH OR SHEETROCK INSPECTION Appnovro RrxaRx s D Drsappnovro F-a Darr I Hspecron rINAL INSPECTION Ap PRov e o ReMa Rx s I SAPPROVED Dare I ruseecro CERTIFICATE OF OCCUPANCY Rraov ro lssuE Nor Rerov to I ssue Drre REurRx s 4/o z I rusprcron n - -7r