HomeMy WebLinkAboutPermit Building 1984-06-206l!'--
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FOR OFFICE USE ONLY
Applica
Permit #
Two Copies of Plans
Three Copies of Plot Plans
Mech,/Plumbing Checklist
Legal Interest Document
Plan Check Info Sheet
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OF PROPERTY
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,Y PROPERTY
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SPECIFIC
I l@/r-istingsed
IS NAME AND
IwIroR,s(
ITT I Wt*\_,/ \-_) ( )I llAVE CAREFULLY EXAMINED THE COMPLETED APPLICATIOmR PERMIT, and do hereby certify that aLl infomation hereon is true and correct, and that I
have the following legal interest in the propertyrIorr.t of recordi !contract purchaser;!authorized agent with evidence of authority attached.
I f:.rther certify that any and all work perfomed shalL be done in accordance with the Ordinances of Lane Couty and the Laws of the state of Oregon
pertaining to the work described herein, and that NO OCCUPANCY wilL be nade of any structure without the pemissj-on of the Building Division. f fur-
ther certify that registration with the Builderts Board is in full force and effect as required by oRs 701.055, that if exempt the basis for exemption
eklx=
NAME (please print)
th
/. Z)4-f4e&z r stu/t*;rz f 6F_"__
.is noted hereon, and that only subcontractors ed employees who are in
CHECK.ED THIS APPLICATION THOROUGHLY.
70I.055 will be used on this project. I HAVE READ AND
AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS !
, front
8""nv.", sEE ATTACHED
Date:
<-
11i 5e cL
V
Date
Use 5TypeialGroup&
#
ar
FLOODPLAIN: In flood hazard area?
SANITATION: s. I. #B. P. *
READ THIS SECTION CAREFULLY
I pmnurwc/zoNrNG:Parcel #I Size
interior
COTl}lENTS:
COMI'1ENTS:
Date:
Date:
Ga1lon
Tank
Lineal Feet
of Dxainfield
Installation Record rssued? f] x.= f] ll"
_ a! :?1ls.i::*
Partition
L, SIOC
Installation
Specifications:
PLANS EXAMINATION:
ToTAL VALUATIoN $CONSTRUCTION AUTHORIZED BY THIS PERMIT
Fixed Fee,/
Sq. Ft.Uni Cost
Floodplain Fee $
Subsurface Fees $
Building Eee $
uech/Plmbg ree $
Pr ans Check Fee S
State Surcharge S
DEQ Surcharge $
TOTAL FEE S$
Description
I ltb 4t<r,
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PERMIT APPROVED BY BUILDING oFFICIAL,/DESIGNSE (peT 6 DATF
LANE COUNTY DEPA.RTMENT OF PUBL]C WORKS LAND MANAGEMENT DIVISION, 687-4061,
I25 EASTSTH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
(
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SETBACKS AND OTHER CONDITIONS OE APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVO-
CATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND,/OR OTHER
REMEDIES ALLOWED BY LAW
WHEN READY FOR TNSPECTION
T MUS GIVENof inspection, when it will be readyr lour name and phone number, and any special directions to site
BUILDING DIVISION:
REQUIRED INSPECTIONS
CALL 687-4065. A MINII,IUM OF'AT LEAST 24 HOURS ADVANCE NOTICE FOR INSPEC-
:- Have tEe f-ollowing information ready: permit number, job addreis, type
I
2
3
Foundation Inspection: To bematerials for the foundationplant (comrtonly termed "tr:rns
Concrete glab or Under-Floor.
EEE vlZE-eAuIFmE n t ;-c ona[f €_;place but before any concrete
Framing & Insulation Inspections:bracing are in place and all pipes,
electrical and plumbing are approve
Interior proPerty 1ine5
Edge of road right-of-way
Building foundationWells, other water sources
made after trenches are excavated and forms erected and when a]lare delivered on the job. Where concrete from a central- mixingit mixed") is to be used, materials need not be on the job.
Inspection: To be made after all in-slab or under-f1oor buildingiping accessories, and other ancillary equipment items are ini,s poured or floor sheathing installed, including the subfloor.
To be made after the roof, all framing, fire blocking, and
fireplaces, chj-mneys, and vents are complete and all rough
d. A11 wall insulation and vapor barrier are in place.
4 Lath and/or Gypsum Board Inspection: To be made after all lathing and gypsum board, interiorarrd-eiE-erior-js in-place-EuElEEEore any plastering is applied and before gypsurn board joints
and fasteners are taped and finished.
5. Final Inspection:To be made after the building is complete and before occupancy.
APPROVAL REQUIRED. No work shall be done on any part of the buililing 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 stepin the construction as indicated by each of the inspections required.
NOTE: A11 building permits require inspections for the work author:-zed, such as but not l-imited to:
A. Block WalI: To be made after reinforcing j-s in place, but before any grout is poured. This
inspecElon 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
complete. Installation 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 plumbing connections.
1. Footings and piers to comply with State foundation requirements for mobiLe homes or as
recommended by the manufacturer.
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 shal1 be installed and ready for inspec-
tion within at least,30 days after occupancy. Tiedowns and skirting shall be installedper enclosure.
D. Swimming PooI: Below grade when steel is in place and before concrete is poured. Above grade
wEEn poot-ls installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DUR]NG WORKING HOURS. TH]S PERMTT WTLL EXPIRE
IF I^,ORI( DOES NOT BEGrN WTTHTN 180 DAYS, OR IP WORK rS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POINT OT REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE DTSPOSAL SYSTEMS:
Permits shal1 be effecti.ve for one year from the date of issuance.
Upon completing the construction for which a.permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Cornmunity 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 gonstruction does comply vrLth strch
rules, the DepartmenL shall issue a certificate of satisfaqlory completion to the permit(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 ru1e.
Setbacks Subsurface Sewage Disposal
Septic Tank
10t
10 r
5r
50'
Dra i nf ie 1d
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10!
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100 r
From
lane county
APPLI CANT INFOR]VIATION :
Drfurza- Z 9t/r'P62
ame or 1rm-ease 1n
PLUNtsING CONTRACIOR ! ves Firm
Address
E No Es"rr
I{EGL\NICAL CONTRACTOR N Yes Firm
Address
fl ruo[sett
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CHECKTIST
PLUMBING/MECHANICAT
'ilft 'IZ.D2frl
qq1ng 1 yor ohn 1p
Cont. OSR#
Cont. OSR#
PLI.]NtsING
}EOIA},JICAL
OFFICiAL USE ONLY
Appli. /
Permit #-
Type of Fixture Ntlnber of Each Fee On Each Total
Sink I $ z.so
I-avatory Wash Basin a 1 .s0 l
7. 50
7. 50;m-
Tub (with or without shower)i^
Showcr, sel)ai'ate r
trVater Closet 'toiletr trr L
Dishwasher /7. 50
grinder)7. 50
I{ashing I'lachine 7. 507:50-_
7. 50
iVater Heal-er
Floor Drain I
Seher--lst 100 ft I 30. 0 0
1s.0c
20.00
each additional 100 ft.
lVater Sen'ice--1st 100 ft I
each adclitional 200 ft.15. C0
30. 00Storm and Rai.n Drain--1st 100 ft
each additional 200 ft.15 00
7. 50Special l\raste Connection
e e ector 7. s0
15.00I l{ater
Other (specify)
SllB-T0T{I (lrtinirnum $fS. OO)
1-OTAI FEE
Tlpe of Equipment irumber of Each Fee on Each Total
lUechanical Permit Base Fee /$ 10.00
Furnace up to 100,000 BTU/H /$ 6.00
Furnace over 100.000 BTU/H 7. 50
Clothes Dr1'er Vent I 3. 00
Bathroom Ventilation Fan G Drct 2_3. 00
Range Hood r.'ith }bchanical Exhaust /4. 50
Itood Stove fl{ood Stove Vent 33- 00)I 6. 00
Air Conditioner Onlr,6. 00
lleat Pruru'r O. UU
Floor Furnace 6. 00
Gas Piping S)-stem 1 to 4 Outlets 2.00
Per fut1et Over 4 50
Other (specifv)
SLIB-TOTAL
TOTAL FEE
c74-200
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ACTIVITY INFORMATION SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS t,llLL BE REJECTED!
?reea-tr -g/ur'Ma Cie-pa r9r,*F@s
PERSON MAKING REQUEST PROPERTY OWNER
De/S/i/86 Z {esr
SPr-o7=rt*D 9PP-'?v/77
C ITY rTA-TE ZIP CODE
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BUS r rfrss- -rr LETtTT]rr *
7{783?6 7{7- ?s/5
HOME TELEPHONE #d-ffi HTME TELEPHONE #
2 PROPERTY ADDRESS
( TF DIFFERENT TnO
3 ruae el PAHeEL NIJMBEFI
( REQUiREp INFORI4ATI0N)
/7
MENSHIF
(from tax maps in Department of Assessment and Taxation
or from tax statement)
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il[-r-Ot[S)lH PARCEL #MN'IN6
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?(milN'SHTP mNcE SEeTI-orl ffi ZONING
MTNSFTP RA_N-6E SEETT-ON ffi ZONING
IQIA|. CONTTGU0US PROPERTY IN SAME OT,jNERSHIP:area Ffi ncws
4 SUBDIVISI0N (if appl'icable)c3LailDorU flcex LoT /3 BLOCK
5 REQUEST (state exact'ly what you plan to do)
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6 DIRECTI0NS T0 SITE , //aPoaz) Jer/r.- Ed # - ,(), 3{ "d I
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** FoR STAFF USE oNLY **
DATE: TIME IN: OUT:
NUMBER
DATE
{F
a./l
{ZONE/LAND USE
BY:
-s u136
LAND MANAGEMENT DIVISION / 1?5 E. 8th AVE., EUGENE, OR 9740I / 687-4061
a--\
May 17, 1984
Iane Cor:nty Suilding Departrnent
Lene County, Oregon
Building Officialc
We the owners of Lot ff 11 C.tendon Acres, I{ap # 17-02-19-11Parcel 901r jrl rrane county, authorize Darrel R. snyd.er to applyforabuildi:rg pe::nit and a septic tank permit in our behalf. rli-s our desire to develope said property for resid.ential use.
Sincerely,
s
fil!''-
L v I tion fon
CONSTRUCTION AUTHORIZED BY THTS PERMIT
Fixed Fee/
Uni Cost
*nA
TOTAL VALUATION $
Description c^Ft
Floodplain Fee
Subsurface Fees
Building Eee
Ilech/PImbg Fee
Pl ans Check Fee
State Surcharge
DEQ Surcharge
TOTAL FEE
S
)
)
)
)
S
$
s$
fr
d bw-s{PERMIT APPROVED BY BUILDING DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
I25 EASTsTH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
FOR OFFICE USE ONLY
Applicat
Permit *
[mo copies of P s
Three Copies of Plot Plans
Mech/Plumbing Checklist
Leqal Interest Document
PIan Check Info Sheet
i\]WiiSHIP
YT ar,RANGE SECTION
t{1 I
TAX LC Eour oF
S'JBD LOT
ZTPSS9#(Jl *
PROPERTY
PRoPosiqusE
Fl'Reside-n tial
OF PROPERTY
Industrial
1,."-
l--'l commercial [-l p.luri.
d,
IC
OF
)
WA
istingsed
NAME AND
PERI4IT, and do hereby certify that all infomation hereon is true and correct, and that II HAVE EXAI'/,INED THE COMPLETED
CHECKED THIS APPLICATION THOROUGHLY
NAME (please
f:rthe
ofowner record contract er1ninterestthethe authorized evidencewith of authoriIegaIpropertyfollowingpurchasagent attachedtyrthatandworkdbesha11f,ndonecertifyanyperfome waaccordance therh ord.i Laneof and Lawsthe ofCouty the ofState OregonntthetodeworkhereinscribedandNOthatpertain9willoCcUPANCYnadebeofwithoutstructuretheslonofanype mi the Bui 1d_i Division I fur-ngtherrtithatthewithBuilderBoardanISfyregistrationforcefu11e ffe ctand as .o5701 i.fthat!equired by the for ebasa5exempt xempt.i
as hereonnoted and that ubcontractorss ad arewhoonly an rhw1 701oRs will055 usedbe thison I READrlAvEemployeescomplianceproject.AND
AUTHORIZATTON HAS BEEN BASED ON THE EOLLOWING CONDITIONSI
I rr.ooopr,erru: rn flood hazard areaaffi uo [-l y"", SEE ATTACHED
, front
Installation
Specifications:
COM}IENTS:
Date:
PLANS EXA}.,IINATION:
CO}4T1ENTS:
Date:
(
Se c L rear
TvDe ffi Use 5Group.
;,1 '
interior"r,side_{-
I saurrarror'r' s. r. *B. P. #
TItt
READ THIS SECTION CAREFULLY
Parcel #Size
Installation Record rssued? [] v." I lr"
Date:
Date:
Ga110n
Tank
Lineal Feet
of Drainfield
fl pr,aNnrnc,zzoNrNG:Partition #--
Maximum Depth
of Trenches
C t4-25
Aub.iJ t
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SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVO-
CATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTYTS INFRACTION ORDINANCE, AND,/OR OTHER
REMEDIES ALLOWED BY LAW.
WHEN READY FOR INSPECTION, CALL 687-4065. A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOT]CE FOR INSPEC-
@n._ttavE-TEE-To11owinginformationready:permitnumber,jobaddreis,typeof inspection, when it will be ready, your name and phone number, and any special dj-rections to site.
BUILDING DTVISION:
REQUIRED INSPECTIONS:
I. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
materials for the foundation are delivered on the job Where concrete from a central mixing
plant (commonly termed "transit mixed") is to be used, materiafs need not be on the job.
)
3
Concrete SIab or Under-Floor Inspection: To be made after aII in-sIab or under-floor building
EErvIce equlpment, conauit, plpTng accessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
Framing o
bracing a.
Insulation Inspections :
re in place and all pipes,
el-ectrical and plumbing are approved. AII wall- insulation and vapor barrier are j-n place.
Lath anvor cypsum Board Inspection: To be made after aII lathing and gypsum board, interior
anE-exterlor-s in place-ElE-EETore any plastering is applied and before gypsun board joints
and fasteners are taped and finished.
Final Inspec.tion: To be made after the building is complete and before occupancy.
To be made after the roof, aII framing, fire blocking, and
fireplaces, chimneys, and vents are complete and all rough
4
5
NOTE:
L
APPROVAL REOUIRED- 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 sha1l have been made of each successive step
in the construction as indicated by each of the inspections required.
All building permits require inspections for the work authorized, such as but not limited to:
Block WaIl: To be made after rej-nforcing is in place, but before any grout is poured. This
Ins-pectT6n is required for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
Wood Stove: To be made after completion of masonry (if applicable) and when installation is
complete. Installation shall be in accordance with an approved, nationafly recognized testing
agency and the manufacturer's installation instructions.
Mobile Home: An inspection is reguired after the mobile home is connected to an approved
sevrer or septic system for setback requirements, blocking, footing connection, tiedowns,
skirting, and plumbing connections.
1. Footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufactuler.
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 j-nspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
Swimming pool: Below grade when steel is in place and before concrete is poured. Above grade
wlen pool-fs installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMTT WILL EXPIRE
rF woRK DOES NOT BEGIN WTTHTN 180 DAYS, OR TP WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BAS]S OF INCOMPLETE OR ERRONEOUS
fNFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED fNSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
Permits sha1l be effective for one year from the date of issuance.
Upon completing the construction for which a permit has been issued, the permit holder shall
notity the Lane County Department of Planning and Community 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 such
rules, the Department shalI issue a certificate of satisfactory completion to the permitlholder-
If the construction does not comply with such ru1es, the Department shall notify the permit
holder and shall require satisfictory completion before issuing the certificate. Failure to
meet the requiremenis for satisfactory completion within a reasonable time constitutes a vio-
lation of oRS 454.605 Lo 454.745 and this rule.
Setbacks - Subsurf-ace Sewage Disposal
Septic Tank
10!
r0 r
5r
50'
Drainfield
B
C
D
2
Interior property lines
Edge of road right-of-way
Building foundation
WelIs, other water sources
From 10r
r0r
10t
100 r