HomeMy WebLinkAboutPermit Mechanical 1986-10-22tD
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ICE USE ONLY
IOTIPARCEL BLOCK
PROPOSED USE OF PROPERTY
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DATE
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coMPLETllD APPLIC4TTON POR
in the propertr,$1rt.,
I work perfomea*6ai1 be
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YOUR
Partition *
Installation
Soecifications: Tank
Date :
C L
Gallon
COMI.IENTS
tr
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B. P. *SANITATION: s. I. *
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Date:
Installation Record Issued?
ORIZATION I{AS BEEN BASED ON THE FOLLOWING CONDITIONS:
Parcel Size
PLANS EXAMINAT]ON:
COl,lllENTS
fl pleNNruc,u zoNrNG:
Mi.nimun Se
COI,$1ENTS
i,nterior rear
Lineal Feet
of l)rainfield
l"taximum Depth
of Trenches
Parcel *
READ THIS SECTION CAREFULLY
LANE COUNTY DEPARTMENTOF PUBLIC WORKS LAND MANAGEMENT DIVISION,687.4061,
125 EASTSTH AVENUE, EUGENE, OREGON 97401
SEE REVERSE EOR INSPECTION INT'ORMATION C1lL..2\ Rt14
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L,ood Stove Perr,rit Application
A PERMIT CANNOT BE APPROVED UNTIL A COPY OF THE MANUFACTURER'S
INSTALLATION INSTRUCTIONS IS SUBMITTED
/(E//6 - ??og* NAME
,T ADDRESS FOR INSTALLATION
,. NAME 0F
Acrh
PHON
CITY {t,
E.noo* Natr'lfi+vti @Ef
oRs #
CIRCLE THE SKETCH I4OST
CLOSELY RESEMBLING YOUR PROPOSAL )
nht1 .7 D t-* INSTALLER
CONSTRUCTION:
* A. The unit is listed by;
t-
0ther (name)
B. The floor protection is .' :- inches thick. (Material )
C. The walI protection wiII be: (l4aterial)
* D. Type of chimney:Factory @fi.ron., (lined?ffi., flr.l
+wrc<noil Mrcxe
OHts t
tlJsThLL/uq NsFRT
ffi'flrceo
rD
LL
E
n otn.'
Type o;f stove pipe : - l-lractory IzOgu (or heavier) ga'll. sht' mt1 .
{vent connector)
DI SIONS: (in 'inches)
l. Side of uni t to protected wall-(unprotected wal l-- 1
2. Rear of uni t to protected wa1'l*(unprotected wal l )
3; Floor protection at side of unit- at rear --in f ront .--
{. Length of wall protection at rear of unit rat side
5. Height of wall protection-
6. Edge of rall protection to nearest door or window-
7. Air space between wall protectlon and wall-
8. Diameter of chimney and stove pipe(vent connectofl--
NOTES:
(t) gutside combustion air is reorrtred for all fuel burnin-q instal'lations-. A 7.Sq. inch (min. area) closabie vent loc
ated within 24'of ttre firep'lace or app'liance on the floor or base of a wall'
(Z) A copy of the approved manufacturer's installation instructions must be on Job site at the time of lnspection. In-' spection cannot be made with out these instructions.(3) Ti'eiApproved'plan/application shall be kept on the Job site for use at the time of inspection.
l+i rfoi.ii'rriis al.e ii:pibreo for corner instailations oi reduced clearanceswith wall Protection. (Refer to manufac-
tul i?"i,irlrlltll!*;tl, tr to be used-, i-t tus-t be-rined (lequired by Law) Exrstins flues must 5e approved by inspector
- ,rioltguse. fou musf-Drovi4F accgss for tIIe insDector
[Ol f, fi."pf..e lnsert is tJUJinstattiO, vlriiicatron or wal] header'location ln relationship lto breast of fireplace
is requlred bY law.
tZl iiripiiii-iniirts are not permltted rn factory-buirt or prefaDrlcated-mtal "0" clearance fireplaces, unless
speciflcally tested and Ilsted,(a) Fireptace lnserts are not pemitted ln masonry fireplaces with existing heat form type metal fireboxes unless
speclfically tested and'llsted.(g) Uir'ttstea units shall be lnstalled ln accord with the State l,,lechanlcal Code, utilizing the materials and clearances
set forth ln Chapter 5,
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IF YOUR INSTALLATION DIFFERS
FROM THESE EXAMPLES OR IF THE
INSTALLATION IS A FIREPLACE
INSERT, PROVIDE A PLAN AND
ELEVATT0N DrAiJl.Uq !JITH DIMEN
SIONS OF YOUR PROPOSAL.
I
l-i
t-_,c-L4-32 APPROVED AS NOTED
By
/e-ZZ-AQDate l-
PERMIT #4+og*8G
LAND MANAGEMENT DIV. / PUBLIC IIORKS DEPT. / 125 E. 8th Ave., Eug. 0R 97401 (503)687-4051
I
IA
l/I,l
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4eq
n
ALT.IVITY INFORMATIG..I SH EET
COMPLETE THIS SECTION. INCOMPLETE FORMS lilILL BE REJECTED!6r:
lI) /err) r br \j rcholeos
EN l' t (le(
L
SS I
1rl:'/+
I
ffi NE ffi HOME TELEPHONE #
2 PROPERTY ADDRESS
( rF DrFFEnrnr rno
3 rvlap e PAFIeEL NTJMBEFT
( REQUTREp r NF0RFTATT0N)
(from tax maps in Department of Assessment and Taxationor from tax statement)t? a3 e(41
TOWNSHIP RANGE SECTION
a78m ZON I NG
MINSFTP MNGE SEETI_on W MNTN-G-
MTNSFIP MNGE SEETI-OII
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISI0N (if appl icab'le)
W ZON I NG
ACRES
LOT BLOCK
5 REQUEST (s;tate exactly what you plan to do)h/f 9a*
6 DIRECTIONS TO SITE:
rnerfu
7? o u/h
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Urn /q+iL*L {n
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** FOR STAFF USE ONLY **
14-33
LAND MNAGEMENT DIVISION / 125 E. 8th AVE., EUGENE , OR 97401 / 687-406I
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Z0NE/LAND USE,