HomeMy WebLinkAboutPermit Building 1973-07-16IANE COUNTY
BUTLDTNG E
BUITDING PERMIT CR MOBILE HOME USE PERMIT
PERMIT NO.MH
PHONEPROPERTY .)WNIIR MAII.ING ADDRESS
CONTRACTOR MAILING ADDRESS PHONE
PROPERTY TOCATION _ INCLUDE POST OFFICE
PROPERTY LEGAL DESCRIPTION _ METES, BOUNDS
RANGE SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTY
APPT.
NAME
&
MAII.ING
ADDRESS
LEGAT ACCESS TO PROPERTY
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connecl to Existing Sewoge Sysrem !New System
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION SQ. FT. # BDRMS VALUATION
SEWAGE DISPOSAI-
PUBUC n sEPTlc TANK n oTHERn
PLUMBING INSTALLED BY
OWNER E OTHER: NAME
BU ITDING
WASTE DISPOSAI-
PTUMBING
PtAN REVIEW
PARK TRAIIER
F EES WATER SUPPTY
PUBUC tr tr OTHER
TOTAT
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GA[.
DRAIN FIETD REQUIRED
tIN. FT TRENCH WIDTH FT OR SQ. FT
TYPE OF STRUCTURE OCCUPANCY ZONE PUBI.IC UTII. EASEMENT
BI.DG, SETBACKS
FRONT
FT. FROM CTR. OF ROAD RIGHT OF WAY
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 _ GOTDENROD
Construclion to comply with uniform building code ond counly
covering plumbing ond sewoge disposol. All buildings require
of occuponcy before being occupied.
(See Stotemenl on Reverse Side)
reg ulotions
o certif icote
(POsT THIS PERMIT ON MAIN BIDG. AT SITE)
LANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I
ronv t 955-13
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TRACT
()Building Permit Appl ication No.
( ) Site Inspection
( ) Pre-Perm i t lnvest igat ion
APPL I CANT:
Ni\l{E
ADDRESS
PHONE
DATE ,2-
L ANE COUNTY PLANNING DEPARTHENT NOT NO YES
Ellr icable -
NAI'IE DATE
Zoning 0rdinance ComPl iance
( zone_)
Subdivision 0rdinance Compl iance lfil
()
()()
rI
lp
()
2
3
4
5
Requ i red Access
Building Site (Area, l.Jidth,
Frontage, Setback
0ther (see comments)
)
CO}IHENTS:
B UTLDING INSPECTlON SECTION NOT
;lg!-igeb-!er)
00
pd
NO YES NAJ'IE DATE
6.
7.
8.
9.
P I ans Subm i tted
Soil Stabil ity (footings)
Flood Pl a in
0ther (see Conrnrents)
() ()
()
()
()
()
()()?*/o-Q3
TS
SANITATlON SECTION
10. Sewage Disposal
I l. Usable Area
12. l.Iater Supply
13. 0ther (see Comments)
NO YES
() ()
NA}"18 DATENOT
I i cab l'e
(
((
)
)
J
()
()
()
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(
COMHENTS:
notcPNFP97/t
1At
fo rm
I'lT.
ermit / Site
roved. A,;
approved at t
and further i
NN ING DEPARTI'ILA
cont a
ld in
eturne
inq pe
Your Building
Wz:i^'ii''
Ques t ion
COUNTY PW
TO APPL I CANT:
4
I
aboven,o.c- ?i tem
L
ime
ati
Qu
Cou
PP
e
5 roug
her
Lane-
tems S
h 5 contact the
information on i
s i nd i cated on
on items I th
tions and furt
can reso
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s
t
o
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L
fno
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E
and San i t ation Division.
ve the Pro blems i nd i cated.you
7-
ee retu;'ned under seParate cuver'
nuBdaneLct t hel3
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rough
llbe
be in
ur bu
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II\Nt COUNTY PI-ANN tNG DEP/\RTHINT
l'trr Sixtlt l\.t:nue Iast, Eutlette, 0rt'qun
I'llrltJl: ttr.,_llIl tXl. ?il
LANE COUNTY BUiLDiItG €. SANITATION DIVISICi
135 Sixth Avenue East, Eugenc' 0rcqon :i7'l
t,itttNt-: Jlr2-llll EXT. l+ll
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rir
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LANE COUNTY
BUTLDTNG l-l
BUITDING PERMIT OR MOBILE HOME USE PERMIT
PERMIT NO,
PROPERTY OWNER -
MH
MAITING ADDRESS PHONE
CONTRACTOR MAILING ADDRESS PHONE
PROPERTY TOCATION _ INCI.UDE POST OFFICE
PROPERTY I,EGAL DESCRIPTION _ MEIES, BOUNDS
RANG E SECTION TAX LOT NO CODE CENSUS TRACT
EXISTING STRUCTURES ON PROPERTYAPPT.
NAME
&
MAITING
ADDRESS
TEGAT ACCESS TO PROPERTY
PROPERTY SIZE _ FT.
WIDTH DEPTH AREA
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms Connecl to Existin Sewo e
TYPE CONSTRUCTION
New System
B DRMS VALUATION
m
STRUCTURES TO BE BUILT THIS PERMIT SQ. FT
SEWAGE DISPOSAT
PUBUC tr SEPTTC TANK tr OTHERI
PTUMBING INSTATTED BY
OWNER n OTHERT NAME
BU ITDING
WASTE DISPOSAI-
PTUMBING
PLAN REVIEW
PARK TRAILER
TOTAT
F EES WATER SUPPTY
PU BIIC OTH ER
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
wlTH DIST. BOX: GA[.
DRAIN FIEI-D REQUIRED
tIN. FT TRENCH WIDTH FT OR SQ. FT.
TYPE OF STRUCTURE OCCUPANCY ZONE PUBTIC UTII.. EASEMENT
BTDG. SETBACKS FT. FROM CTR. OT ROAD RIGHT OF WAY
FRONT SIDE INT. SIDE EXT.
USE CLASSIFICATION
REAR
AUTHORIZED SIGNATURE _ DATE DATE
BLDG. PERMIT _ WHITE
OFFICE COPY _ WHITE
COUNTY TAX _ PINK
PLUMBING _ CANARY
BUILDING _ GREEN
SANITATION _ GOTDENROD
Construction to comply with uniform building code ond county regulotions
covering plumbing ond sewoge disposol. All buildings require o certificote
of occuponcy before being occupied.
(See Stotemenl on Reverse Side)
(POsT THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, BTDG, & SAN. DIV., COURT HOUSE, EUGENE, OREGON 9740I
ronu*c55-13
SITE INSPECTION
Appnovro
Rrunnxs
D r sappRoveo Darr I ruspecton
FOUNDATION I NSPECTION
Ap pnov r o
RrManxs
D r sappRoveo Dare I ruspecron
FRAMI NG
Ap pnov r o
RrMlnx s
I NSPECT I ON
D Drsrppnoveo D Dare I xsprcroR
LATH OR SHEETROCK
Ap pnov r o
Reltanxs
I NSPICT I ON
Dr snpPRovEo I NSPEcToR
r I NAL I NSPECT ION
AppRoveo M Drsrppaove " D oo-rr_/2{-,p_
ReuaRx s
I ruspecron
CERTIFICATE OF OCCUPANCY
Reaov ro I ssue
RruaRx s
D Nor Rerov ro lssuE D Dore_
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NG PERMIT OR MOBILE HOME UsE APPTICATIONLANE COUNTY BUITD!
PERMIT TYPE _ BUILDING
'/PERMIT #MOBILE HOME OSC REG. #
MAILING ADDRESS 6,tr-r PHONE
PHONEMAITING
PROPERTY - INCI.UDE POST OFFICEL*2,,
PROPERIY I.EGAT DESCRIPTIONLoT-BtocK-suBDtv.METES&BOUNDS EYES
AT]ACHED
AREA
NO
IWP
APPI.ICANT
NAIAE
AND
MAITING
ADDRESS
TAX tOT CODE CENSUS TRACT
DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY
RTY SIZE_WIDTH DEPTHb4-vrt4
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms Connecl to Existing Sewoge System ! or New System R"q. E
STRUCTURES TO BE BUII.T THIS PERMIT TYPE CONSTRUCTION # BEDRooMS vAruATroN
J.E22z:-
SQ. FT.
v
SEWAGE DISPOSAT PI-UMBING INSTALTED BY
PUBTIC
BIDG.
WASTE DIS.
PI.UMBING
PTAN REVIEW
PARK TRLR.
SEPTIC IANK OTHER
FEES WATER SUPPTY
PUB[IC
OWNER OTHER NAME
OTHER
PLANS FURNISHED
YES NO
SIGNATURE OF APPTIC
FACII.ITY PERMIT
NO
DATE
7-.6 z
DA
-92,
PUBTIC UTII. EASEMENT
YES
PTUMBING FEES
--
FIXTURES
TOTAI.
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX; GAI.
TYPE OF STRUCTURE
BTDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY
rRONT SIDE INT. SIDE EXT.
SEWER
CONNECTION FEE
PERMIT
PUBTIC WATER
CONNECTION FEE
COUNTY BUILDING & SANITATION SPECI TIONS
cAsHF
CHECK E
4 <eL
ZONE
OR SQUARE FEET
REAR YARD
USE CTASSIFICATION
REAR
DRAIN FIETD REQUIRED
TIN. FT. TRENCH W
occu
Form # css-t2
Properly:
Dole BLDG.DoleSANITARIAN
Direclions to Fin
Dote PLANNING P.
COPY I _ OFFICE
COPY 2 - JOURNAI.
COPY 3 - AUDIT
PROPERTY
7
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