HomeMy WebLinkAboutPermit Building 1983-06-10G6
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Lane C y Authori za,ttort f ..,lf :
FOR OFFICE USE ONLY
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Two Copies of Plans
Three Copies of PIot plans
Mech/Plumbing Checklist
Legal Interest Document
Plan Check Info Sheet
RANGE 3 /Z 2',787*
s-BDrlre;,ry LOTIp+BCEL *3
ZIP PROPOSED USE OF PROPERTY
EG
PubI ic
s idential I ndus trial
Commercial
-BE VALUE
- OF BEDROOMS
-.\5 SUPPLY P
istingedrI\flYIE 4\U TELEPHONE NUMBERru/.q
TELEP}IONE NUMBER6f3-5363BE MAI ztrd:7"D- , ,+4r^;u""2**1""o ,rQ*rrur.o lohr"orro" .o*
nuu" 1{/toti*ing regar io:reKt in the propertr,ffiorr.. ,
I f:rtfier certify that any and aII work perfomed r(ira)f Ue .
PERl,llT, and do hereby certify that all infomation hereon is true and correct, and that I
of record; Icont.."t purchaseriIauthorized agent with evidence of authority attached
done in accordance with the Ordinances of Lane Couty and the Laws of the State ofpertaining to the work described herein, and that NO OCCUPANCY will be made of ily structure without the pemission of the
s Board is in full force and effect as required by ORS 701..055, that if exempt the bas.is for exemption
THIS APPLICATION
NAME DATE
*
Oregon
Build.i.nq Division. I fur-ther certify that registration with the Builder'
is noled hereon, and that only subcontractors ad employees who are in with .055 will be used on this project. I I{AVE READ AND
L
or
READ THIS SECTION CAREFULLY
parcer *"yEQ zrfl planwrnc,zzoNrNG:
l'liniml.un Setbacks:
YES, SEE ATTACHED SHEET.
Installation Record Issued?
Maximum Depth
of Trenches
Date:
CON!.IIENTS:
iiate:
1
tr
NoYes,(
UseGroup.x
D
cL, frort
!'LOODPLAIN: In flood hazard area?
SANITATION: s. I. #
PLANS EXAI'IINATION: Type
ff,,"n
COTI}IENTS:
ZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS:
Partition +Parcel *
Date:
Date:
callon
Tank
Linea1 Feet
of Drainfield
Installation
Specifications:
/ "", "ru"
TOTAL VALUATION S CONSTRUCTfON AUTHORIZED BY THIS PERMIT
tion Sq. Ft.
Pixed FeelUnit Cost34.*
Floodplain Fee $
Subsurface Fees S
Building !'ee $
i'lech/Plmbg Fee $
Prans Check Fee $
State Surcharge S
DEQ Surcherge $
TOTAL FEE SS
6rq
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PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE oRS 456.805
8 D.82
1 DATE
I,ANE COUNTY DEPARTMENT OF PLANNING & COMMUNITY DEVEIOPMENT / I25 EAST EIGHTH AVENUE, EUGENE, OREGON 9740L
SEE REVERSE F'OR INSPECTION INFORMATION
.(
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*
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tr
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED, VIOLATION CAN RESULT IN REVO-
CATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S TNFRACTION ORDINANCE, AND,/OR OTHER
REMEDIES ALLOWED BY LAW.
WHEN READY FOR INSPECTION, CALL 687-4065.A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE FOR INSPEC-
owing information ready: permit number, job address, tyPe
name and phone number, and any sPecial directions to site.@u . nave the-Tol1
of inspection, when it will be readyr lour
BUILDING DIVISION:
REQUIRED INSPECTIONS
I. Foundation In ection: To be made after tr
mater or oundat ion are delivered
enches are excavated and forms erected and when-a11
on the job. Where concrete from a central mixing
to be used, materials need not be on the job.Splant (commonly termed "transit mixed") j.s
2. Concrete SIab or Under-F1oor Inspection: To be made after all in-slab or under-floor building
serv tlconduit, piping acce ssories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framing & Insulation Inspections: To be made after the roof, all framing, fire blocking, and
Elaclng are-In-pTace ila-ell plpes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. ALl wall insulation and vapor barrier are in place.
4. Lath and/or Gypsum Board Inspection: To be made after atl lathing and gypsum board, interj-or
a:ril-eiE-eriorlls-Tn-pTace-EuE-EeEore any plastering is applied and..bef ore gypsum board joints
and fasteners are taped and finished.
5. Fina1 fnspection: To be made after the builtling is complete and before occupancy.
APPROVAL REQUIRED. No work shall be done on any part of the building or Structure beyond the point
indicated in each successive inspection without first obtaining the approval of the building official.
Such approval shall be given only after an inspection shall have been made of each successive step
in the construction as indicated by each of the inspections required.
NOTE: AIl building permits require inspections for the work authorized, such as but not limited to:
A. Block WaIl: To be made after reinforcing is in place, but before any grout is poured. This
Il-s-pecEIot is required for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
B. wood Stove: To be made after completion of masonry (if applicable) and when installation is
compfete. Instaltation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturerrs installation instructions.
C. Mobile Home: 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 plumbi-ng connections.
1. Footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufacturer. I
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-
plain management letter.
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be install-ed
per enclosure.
D. Swimming Pool: Below grade when steel is in place and before concrete is poured. Above grade
wEen pool-fs installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TTMES DURING WORXING HOURS. THIS PERMIT WILL EXPTRE
IF WORK DOES NOT BEGIN WITHIN I8O DAYS, OR IF WORK TS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IP THIS PERMIT WAS ]SSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQU]RED TNSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:.
Permits shall be effective for one year from the date of issuance.
Upon compteting the construction for which a permit has been issueil, the permit holder shall
notify the Lane County Department of Planning and Comrnunity Development by submitting the
installation record form. The Department shall inspect the construction to determine if it
complies with the rules contained in this division. If the construction does comply with suchrules, the Department shall issue a certificate of satisfactory completion to the permitl holder.
If the construction does not comply with such rules, the Department shall notify the permit
holder and shalL require satisfactory completion before issuing the certificate. Failure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-Iation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurf4ce Sehrage Disposal
Septic Tank
10!
10t
5r
50'
Drainfield
From:
I
)
Interior property lines
Edge of road right-of-way
Building foundationWeIIs, other water sources
10 r
10!
10!
r00 t
C t4-25
lane county6l!'--
CHECKTIST
PtUilI BI N G / fUIEC HAN ICAI
APPLI CANT INFORIvIATION :
OFFICIAL USE ONLY
Appli./
Permit #-
ame or fln-ase
PLUMBING CONTRACTOR n Yes Firm
Address
E No fls"rr
MEGIANICAI CONTRACTOR D Yes Firm
Address
fl uo ! serr
,ICSS or
Cont. OSR#
1p
Cont. OSR#
PLTJI\,tsING
Type of Fixture Nurnber of Each Fee On Each Total
Sink $ s.oo
J,avator 5. 00
Tub (with or without shower)5. 00
Shower. separate I 5. 00
ater oset to s. 00
Dishwast 5 .00
Disposer 5. 00
5.00
Water He 5.00
Floor Drain 5.00
Sewer--lst 50ft.I 15.00
each additional 100 ft.10.00
Water Service--1st 100 ft.,15. 00
1 ti 100 t 10. 00
Storm and Rain Drain--lst 100 ft.15.00tt10.00
Special Waste Connection 5 .00
e ector 5.00
It4obile F ater 10.00
Other (specify)
SUB-TOTAI (lt{inimum $10. 00)
TOTAT FEE
MEGIANICAL
Type of Equipment l.Iuunber of Each Fee on Each Total
Mechanical Permit Base Fee $ ro. oo
Furnace up to 100"000 BTU/H $ 6.00
Furnace over 100,000 BTU/H 7.s0
Clothes D:ryer Vent 5. 00
Bathroom Ventilation Fan & D:ct 3. 00
Range Hood with Mechanical Exhaust 4.50
Wood Stove b. 0u
Air Conditioner Only 6. 00
Heat Pump O. UU
Floor Furnace 6.00
Gas Piping System 1 to 4 Outlets
Per Outlet 50
Other (specify)
SI.JB-TOTAL
TOTAL FEE
ng Machine
lane county
PLANNING & C0MMUNITY DEVEL0Pt*t-''-
AC r 1VITY INFORMATIOT"I SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
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E T PROPERT Ot^lNER
MAILING ADDRESS MAILING ADDRESS
CI STATE ZIP CODE CITY STATE ZiP CODE
ffi
2 PROPERTY ADDRESS
HOME TELEPHONE #BUSINESS TELEPHONEJ HOME TELEPHONE #
(IF DIFFERENT FRO
3 rvrap e PAFIeEL NuMBEEI
( REQU r REp r N FORI4AT r 0N )
(from tax maps in Department of Assessment and Taxationor from tax statement)
ToTNSETP mNGE SmTmN Tn-to-W ZON I NG
mt,t-NSmP AANGE SmImN TAx L0T(S) 0R PARCEII mNI[6-
TOfrN-sNTF MNGE SEETM.N m 7ONIXG-
ACRESTOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
+ SUSOIVISION ( if appl icable)LOT BLOCK
5 REQ UEST (state exactly what you plan to do)
7n---'
6 DIRECTIONS TO SITE:
** FOR STAFF USE ONLY **
ZONE/LAND USE:
NUMBER
DATE
-lN(/,
-{
BY: _ DATE:_ TIME IN:_ OUT:_
lane county
PLANNING & COMMUNITY DEVELOPIil-'T
AC ' 1VITY INFORMATIOi''I SHEET
COMPLETE THIS SECTION. INCOMPLEIE FORMS t,JILL BE REJECTED!
@
1 Gd.",6 \cl-
T N
Z,e)zls't
I IDl<--ik.ev-4
?T 7wSTATE ZIP CODE CffiHOME TELEPHONE #
<-}r* e- "
BUSINESS TELEPHONE #m
2 PROPERTY ADDRESS
(IF DIFFERENT FRO
3 vlae I PAFIeEL NIJMBEFI
( REQU I RED INFORI4ATION)
(from tax maps in Department of Assessment and Taxationor from tax statement)
7
TOWNSH I P
63 2q-.tz
MN6E' SMTMN
Z-7 zi
TAX LOT(S) OR PAREEIT MNIXG
TOilN-sN-IF RANGE SMTMN W ZON I NG
MfiNSHTtr MNGE SEC]TON W ZON ING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:ACRES
4 SUBDIVISI0N (if applicable)Et Ba'I,,l.". C**&,.-or 2 BLocK 2^4[&1,
5 REQUEST (state exactly what you plan to do)&,r-r\l
;{, o*
6 DIRECTIONS TO SiTE:
** FoR STAFF USE oNLY **
ZONE/LAND USE:
NUMBER
DATE
-{7u1
-{
BY : _ DATE:_ TIME I N:- OUT :-
t:
{##-IOLID SLIP lane county
APPLICATION #
LOCATION
rus ^A
h4
NAME
ADDRESS>6ra /tt lV
Z C E
The Lane County Bu'ilding and Sanitation Djv'ision cannot proceed with processing
your application because:
l. D Incomplete application (items deficient).
Address and/or djrections to application site.
Proposed number of bedrooms in dwelling.
Approvable p'lot plan (see attachment).
Notification of date test holes will be ready.
tl Verjfjcation of existing system required (see attachment).
n Two test holes (2'x4'x5'deep) required for expansion or repairof exist'ing sewage disposal system jn the area of the proposed
drainfields.
f Other:
2
3
4 x '^*
Irl
DATES IGNATURE
from to
PHONE
]I no response has been received in regards to this matter bythe application will be denied
BUILDING AND SANITATIOil DIVISION / ENVIRONMENTAL I,1AI{A6t'4INT DEPARTMENT
COURTHOUSE.PUBLIC SERVICE BUILDING / 125 EAST 8TH AVENUE / EUGENE, OREGON 9740I / PHOI{E (503)687.406
H
742
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LANE COUNTY, OREGON
DEPT. OF ENVI RON M ENTAL MANI---:EMENT
CtrlFIFIECTIclN NGITIEE
CONSTRUCTION PERMITS
S INSPECTION DIV.
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JOB ADDRESS
TO
NOTE
DATE
BLDG. PERN/IT
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c 5 5-7 3
'.E-lNtPEcrloN
FlEoulElEEl
Phone EiEj7-4clet55 FoFl aPPFlovAL INSPECTOR
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i OOTIN6 / FOUNDATION
Ao?roved4plf__Date
UNDERSLAB PLBG. f]
Approved &z ll Date
Approved Date__--_ ___/'orrec
- -i-liSPET-T-IbN-
,iorrect'ion Da te I nspector
i on--.----Da te__=._- .-I nsPe ctor
lr F-LR_P-LB I NSPECT
,.orrect'ion Date I nspec tor
il
PLUMBING GROUNDI^IORK INSPT.CTiON
STE-B-TNSPFcTI0il-
Approved__Date _*__Correcti on Da te Inspector
NG ION
Correcti on
cti on
Approved- 8? Date
N
Approved Da te
Date I nspe ctor
I ns pector
Approvedl?/z Date /iZ=ZZtco*ection Date I nspe ctor
ON
rec ti on Date I nspe ctor
LMHTGYPS_UE_Eo-A R D--I N.S P E C T I O N
A ved Date ilorrec t'i on Date Inspe ctor
t LME t_l
-smfE I(lorrectjon Date
t
Approved ___Date- --- ____l
F-i.r.ffiT-F,L IJfr ETNG_IXSFE CTITi'i
Inspector
Aoproved _AL_|ate r.orrec ti on Da te
F INAL I BUI
e'rRfi-rmitE-0-F tl-cn?AilTrn --- - _-*-TEliip-0Rr[Y"
Approved_ -Date -_ .-- Insir _ . _ _ __ Approved. -
/d=7--82-l
.-/._
LDING U /MO
I nspector
Approve
NS PECT,I ON
a -a/__ -oate l2=S=89 / .orrection
: i iLi-H-o'l'fi D*/}e P-rn-CEt'1-r r[T- fl -
Da te I nspector
CERTIFICATE OF OCCUP
_ _- _ -.Date_ _-.I
ANCY E
nsp.
(ttutts
I
er-ex\mJ-hrA^ss,n-.
I.
App roved Da