HomeMy WebLinkAboutPermit Building 1982-04-13@ CON STRU CTI--N/ PLACE M ENT
PERM IT Kps"zr
FOR OIFICE USE ONLY
Plan Check Info Sheet
COMPLETE THIS OCK. PLEASE USE BLACK INK AND PRINT.
E]PLANNING ZONING:
f]two Copies of Plans
l-l roro Copies oi Piot Plans
f]laechanical- Chebklist
fnJ-umbing Checklist
Zone
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Partition #Parcel #Parcel Siz
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I'lirlimrm Sctbacks: CL
Corunents r
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Irndustrial
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P roposed
sti-ng
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TELEPTIONE IJUMBER
TqzrZ ?ELEPHG\E NUMBEK7/Zds€
IIAVE CAREFULLY EXA-UINED THE COMPLETED APPLICATIOi{ FOR ptrRMIT, and do her.rby ,.crLif), thrt all information hercon is true and corroct inC I furthe
hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project, I HA'E READ AUD CilECf.ED THIS
APPLICATION THOROUGHLY.
['or,.",
prj,nt)I es.rt
L
TURE
3 t /.4 '' *- ,P(o'tractorNAr,lE (p / ' / o\fr.-
that and all work sha be lndone accordance theth 1!lord ce Laneoffyanyperforred aud LawSr.h e thof jj lieta ofCounty 0req a)Il ['r]the and NOthat OCCUPANCY be11 ofnade struc t u w1re thethouttoworkdehereinribedany o the Bui d rifuLhegeIpermissioni.g tllvision vthatthw1theBuilder1SBoardfulanforceeffectanda5redregistration701oRs055ifth at th bas forrequlbyexempt c ie lrpt i ctr dtc
FLOODPLAIN: rn f .rood hazard area'?fi "" f, v"u, see attached sheet
Date:
Date:
Date:fl nunai, ADDRESSTNG:CRID CoORDINATE N E
W SANITATION:". ,. o4O"? V/ /a [!l v"= l-l wo
3hat6^tadMaxrmun DeptL\
lnstallati-on Record Issued
oral
Date
Installation
Specificatj-ons:
Gal l-orr
Tank b5 of Drainfiefd
Use
I Lineal Feet
ry
. r'YPe Group
Co[unents:
Date:
tion Fixed Feel Floodplain Fee
Subsurface .:eesr €
Building Fee
Sewer/Storm Drain,/Water
Plumbing Fixtures
Mechanical
Plans Check Fee
State Surcharge
$&--'---.tm--f ,/t>
-s *l/'-{aFtSqCost
70'--
$
$
i-zr.e-$--77f-
t=<0€--:T
TOTAI, VALUATION S
TOTAL FEE
FEES PATD BY:
By:
Date
PERMIT APPROVED BY BUTLDING GNEE oRs 6. BO5 (DATE
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT / 125 EAST EIGHTH AVENUE, EUGENE, OREGON g74O\
c74-t94 SEE REVERSE
7
La l)
s
tr
CONSTRUCTION AUTHORIZED BY THTS PERMIT
SETEACKS AND OTHER CONDITIONS OF APPROVAL M!II-9I STRICTLY OBSERVED. VIOLATION CAN RESULT^II,I.REVOCATION OT TUTS PER*4IT,cITATI0N UNDER- PRovIsIoNs 0F rnr'rr couniFs' rr,rrnncrioi'i-onoir'rnruce ,'nrozon^oiilii"tEiliiiris ALLo,ED ei-iAw. - '
WHEN READY FoR INSPECTI0N CALL 687-4065. A MINIMUM 0F AT LEAST 24 HOUR ADVANCE NOTTCE FoR TNSPECTTON REQUEST MUST BEGIVEN. Have the fol)owing information reaay. Ferrii "rrOIi,-t:ob address, type of inspection, when it wi.ll be ready,your name and phone number, and any speciar-dinections 6-;i;a:- ..., .... rpEeurvrr' w,rElt I L wr I
BUILDING DIVISION:
REQUIRED IilSPECTToNS
l) F0UNDATIoN INSPECTI0N: 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,
materials need not be on the Job.
2) CoNCRETE SLAB 0R UNDER-FLo0R INSPECTIoN: To be made after all in-slab or under-floor building servjce equipment,
conduit, piping accessories and other ancillary equipment items are in place but before any concrete is poured
or floor sheathing installed, including the subfloor.
3) FRAMING & INSULATI0N INSPECTI0IIS: To be made after the roof, all frami n9, fire blocking and bracing arE in place and
sandventsarecomp1eteanda.l.lroughe1ectricalandp'lumbingareapproved.A1I
wall insulation and vapor barrier are in place.
4)LATH AND/OR GYPSUM B0ARD INIPECIM: To be made after a'll lathi ng and gypsum board, interjor and exterior, is in place
nts and fasteners are taped and finished.-but before any plastering is applied or before gypsum board ioi
5)FINAL INSPECTION: To be made after the buildi ng is complete and before occupancy
APPR0VAL 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
requi red.
N0TE: All building permits require inspections for the work authorized, such as but not limited to:
A. BL0CK I,|ALL: To be made after reinforcing is in place, but before any grout is poured. This inspection is
required for each bond beam pour. There will be no approval unt'il the plumbing and electrical inspections
have been made and approved.
B. W00D ST0VE: To be made after completion of masonry (if applicable) and when installation is comolete.
installation shall be in accordance with an approved nationally recognized testrng agency arrd the manu-
facturer's'installation instructions.
C. l,l0BILE HoME: An inspection is required after the mobile home is connected to an approvqd gew91 or septic
system for: setback requirements, blocking, footing connection, tiedowns, skirting, and plumbing
connecti ons.
(l) Footings and piers to comply rvith State foundation requirements for mobile homes or as recommended
bY the manufacturer.(Z) l,t-oUite home minimum finish floor elevation shall be certified when required by a floodplain
management letter'(3) l'4obiTe home tiedowns, when requ'ired, and skirting shall be installed and ready for inspection
within at least 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure.
D. SWIMMING p00L: Below grade when steel is in p'lace and before concrete is poured. Above grade when pool
is installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING I'IORKING HOURS. THIS PERMIT WILL EXPIRE IF I'IORK DOES NOT BEGIN
wrtriu-lso-Dnis,-on ir wonr rs suspENDED 0R ABANDoNED FoR MoRE THANl80 DAys. suspENstoN 0R REVocATION MAY OccuR IF THIS
FEnlrii r^lAS ISSUED 0N rHE BASIS 0F INCoMPLETE 0R ERRoNEoUS INFoRMATIoN.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS I'JILL DO SO AT HIS Ol,iN RISK
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
(t )
(2)
Permits shall be effective for one year from the date of issuance.
Upon completing the construction for which a permit has been^issued the PelTil holder shall notify-the
ili;.il;;i-bV irUmitting ttre initatlation recbr( form. The.Department sha1l inspect the construction to
a.i.i"rir.-ii"ii-iomp;fiei *iif, it" rules contai!9d jn this division.'If the construction does colplv vtith
,
such rules, the Depi'rtment shalI 't,ssue a certificate of satisfactory completion.to.the permit ho'lder. If the
construction Aoes not-compfv *itn such rules, the Department_shall notify the pirmit holder and shall require
tiiiiriiioiv complet1on-bbfire issuing the certificate. Failure to meet the requirements for satisfactory
;ilpi;;i;; iriir,ii u riisonable time c6nstitutes a violation of ORS 454.605 to 454.745 and this ru'le.
Setbacks - Subsu rface Sewaqe DisPosal
From Interi or property 1 i nes
Edge of road right-of-waY
.Building foundation
[.lells, other water sources
Seotic Tank Drainfield
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50
YICINITY MAP permit pe Saj-B?. Twnshp
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MUST\a BE IN BLACK INK
Range o?.Section \'1.3
form c55-11_
Tax Lot 5 bcao
Standard System E Alternative S ystem n (Specify?,'\ro \a Type
Job Location (Street Address)s{d^
Subdivision/Partition # Parcel-B
IDETAIL SYSIEM PLOT PLAN AS CONSTRUSIEID
Scale \ ":3o''
.rc*tt;\
I hrre pereonrlty lnepected the
system shown hereon and certify that lt
La eonstructed Ln full cmrpl!.ance wtth
the proviel.ona of OARdlv 71.
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lnstaller
Telephone
License No
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USE BLACK INK ONLY
FOR INSTALLER'S USE:Trench rt Gravel Depth Below Ti
Ta n k Ca pa citV--\SS-Q-+\-Manufacturer e.
Measured Distance from Well to T From Drainfield
-
Total Length of L tnes o
COMPLETE THE FOLLOWING IF A PUMP WAS USED ON THIS INSTALLATION
I (installer's name certify that a (Mfg (Model No ump
and Mercury Float Switch (Mfg. and No have been installed with this sewage installation
Signa
FOR SANITAR]AN USE ON S E System D E Needs rrection
COMMENTS
trS Corrected Date-
oate 1'b*tTSystem Capacity---{-P--gal. /day Signat
INSTALLATION RECORD & CERTIFICATE OF SATISFACTORY COMPLETION When signed by the County Sanitarian, this certificate is
evidenceasperORS454.665 ofsatisfactorycompletionofasubsurfacesewagedisposalsystemattheabovelocation.
Public Service Building, 125 E. 8th Avenue, Eugene 97401.
ng Compa
oate G\rr\$L
lf ln By Owner-
Date-
lSignature of Owner)
Applicant's Name I Address
C
"I\ro \ 3S \e,
3o,..*.!..\\ O*t-
Permit No 5ej-se Twnshp
MUST BE IN BLACK INK form c55-tl
5 bcs()\'\Range C)?.Section \tt.3 Tax Lot
StandardSystemEAlternativeSystemE(SpecifyType)
Job Location (Street Address)A'\ro \3s\d,.-
Subdivision/Partition # Parce Lo
IDETAII, SYSTEM PI.OT PLI\N AS CONSTNU TEI)
Scale \ "= 3o1
e personrlly tnsPected the
ahcnr hereoo and certlfY tha
etructed tn ful1 comPllance a,
ovlslous of OARdlv 7L.
6lze l82
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USE BLACK IHK ONLY
FOR INSTALLER'S USE:Trench Depth 36'l la
Gravel Depth Below Til
Tank Capacitv \O OO r.^\Manufacturer Of\r)<\\,aC- .S=..(* .*, $n..\n-.1c\
Block-
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ACTIV. fY INFORMATION S-rlEET
COMPLETE THIS SECTION. INCOMPLE
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- Co-L Ot^^-kA*CT
L-l 3.1 -?ttr
BUSINESS TELEPHONE #
2 PROPERTY ADDRESS 2
3 rvtap e PAFTeEL NUMETEFT
( REQUiREp rNF0RI4ATr0N)
"^Jr! R, C*
PROPER
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T2-'-cz t)itta-let i< K./47
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726 - ?t0 I 72 6 -/y//
HOME TELEPHONE # BUSINESS TELEPHONEI HOME TELEPHOI{E #
0 N, S-tt':t.0n. 77
( IF DIFFERENT F ILIN
2Vs3 A/.31//4 5f .
MAILING ADDRESS
(from tax maps in Department of Assessment and Taxationor from tax statement)
c2 /7 {2-C/6CC Po;il
RANGE SEETTON WS./^4//7
TotlNSH I P ZON i NG
TOilNSH-TP NANGE SECTMN MrTOI(-S]-INTAReETT ZON I NG
MTNSETP MNGE SETNON
TOTAL CONTIGUOUS PROPERTY IN SAME OI,JNERSHIP:
4 SUBDIViSI0N ( if appf icable)
5 REQUEST (:;tate exactly wtrat you ptan to do) //gr-/
cO fz-^"_
W ZON I NG
ACRES
BLOCK
t4
LOT
t/oL<
6 DIRECTIONS TO SITE Zu )p-/ + Sf r/" Jt*-..t
35-t'<u e. " ?2/27tc
ZONE/LAND USE:
BY : _ DATE :.- TIME I N:_ 0UT:_
NUMBER
DATE
-tvV,
LAND MANAGTMENT DIVISION / 125 E. Bth AVE., I.UGENE, OR 9740I / 687.406I
h
t-77
/a
/t
** FOR STAFF USE ONLY **
{-i
LIil!'--
CON STRU CT ION/PLAC E M ENT
PERM IT
COMPLETE THIS BLOCK. PLEASE USE BLACK INK AND PRINT.
FOR OFFICE USE ONLY-',r
ApFIi cat ion,'
Pernit t .
Irwo Copies of Plans
Irwo Copies of Plot Pfans
f]uechanical Checklist
!elumbi.,g Checklist
lrtan Check Tnfo Sheet
1
,bSECTION5 TAX LO{,r Eour oF?RANGETOIiNSHIP/
/
jA
BLOCK1T
PROPOSED USE OF PROPERTY
ffnesidential
I commercial
fl rndustridl
I irubrr-c
ZIP
/7 7d;_?tSTREET
$ VALUEDESCF.IPTION OF PROPOSTD
'{ddt/
# OT HML'LOYEES f 4 Proposed
isting,4+ OF STOR]ESf OF BEDROOMS
TELEPHONE NUMBERDwNERrs NA,1E Ar{D ADDRESS tu,'T-#y',
TIILEPiJO:i|- il'!:,3EF:aOi.ITFACTOR'S NAI'IE AND ;laDRESs
-rd 4r '.dn
.,ry //4
.r HAVE CAREFILLY EXAMTNED THE COMPLETED APPLTCATION FOR PERMTT, and do hereby r:crt-ifi' that all informatiol hereon i:i true and corrc?t and r ft)rti)c
certify that any and all work perforned shall be done in accordance with the Ordinances of Lane County and the Lails of the Starte of oreq.n I'lrLair)inq
lo the work describri&herein, and that NO OCCUPANCY wiLl be made of any sLructure without the pemission of the Building Divisj-on. I further c(rrtify
that.registration witL the Builder's Board is in fuLl force and effect as required by oRs 701.055, that if exenpt the basis for exemPtion is noled
hereon. and that only subcontractors and employees who are in conpliance with oRs 701.055 will be used on this project. I HA!'E READ AND CtlECr'-ED THIS
APPLICATION THOROUGHLY.
f] owner
ffontractor
f| asent
W,MI,, S}G:]ATUFI(please print)
I pr,auxruc/ZoNrNG:Zone
front
Partitlon # lf,I'arcef Slze
re ar
/4 Parcel #
in teri-orCllinimum Sctbacks: L,
Coments r
c"s ide
I rr,ooopr,arx:
fl nunar, AppRESSTNG:cRr.D CooRDINATE N
E]SA}iITATION:
In flood hazard area?F *" I ves, see attached sheet.
Date:
Date:
Date:
lnstall-ation
Specifications:
ca1 lon
J tanx
Lrnea.L i eet
of Drainfield
pv". !N"
llaximw Depth
of Trenches
S. I. #B.P.+/^lnstallation Record Issued?
Corments
Date:
I pr,aus E NATION: rype Group .r Use
Cornments :
Date:
CONSTRUCTION AUTHORIZED BY THIS PERMIT
e F ixed Fee,/
Unit Cost.
i ,'' o'',2 7LA l, :'*'
$
s
)
)
>
$
)
)
I
Floodplain Fee _- /.!.-
Subsurface Feesr t) - "
Building Fee
sewer/Storm Drain/water
Plumbing Eixtures
Mechanical
Plans Check Fee
State Surcharge
TOTAL FEE
FEES PATD BY:I crrect< f] cash
Description FtSq e'lt€'
t/ &._yiz d
TOTAI, VALUATION $
By:
Date:
cr9
PERMI?
LANE COUNTY
c74-L94
APPROVED BY BUILDING OFFICIAL/DESIGNEE (peT OR.S 456.805(1),).''..
DEPARTMENT oF ENVIRoNMENTAL MANAGEMENT / :-25 EAST EIGHTH
' SEE REVERSE
DATE
AVENUE, EUGENE, OREGON 9740L
U
(r
,4
*it
E
trI
-
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATION OF THIS PERMIT,
cITATIoN UNDER PRoVISI0NS 0F LANE CoUNTY'S INFRACTToN oRDTNANCE, AND/oR oTHER REMEDTES ALLoTdED By LA!\,.
t,lHEN READY FoR INSPECTI0N CALL 687-4065. A MTNTMUM 0F AT LEAST 24 HoUR ADVANCE NoTICE FoR INSPECTT0N REQUEST MUST BE
GIVEN. Have the following information ready: Permit number, job address, type of inspection, when it will be ready,your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED IIISPECTIONS
I) F0UNDATI0N INSPECTI0N: 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,
materials need not be on the Job.
2) C0NCRETE SLAB 0R UNDER-FL00R INSPECTI,0N: To be made after all in-s'lab or under-floor buildi ng service equipment,
conduit, piping accessories and other ancillary equipment items are in piace but before any concrete is poured
or floor sheathing instal'led, including the subfloor.
3)FRAMING & INSULATION INSPECTI0NS: To be made after the roof , a'll framing, fire blocking and bracing are in place andall pipes, fireplaces and chimneys and vents are complete and a'll rough electrical and plumbing are approved.wall insulation and vapor barrier are in p1ace.
4) LATH AND/0R GYPSUM B0ARD INSPECTI0N: To be made after all lathing and gypsum board, interior and exterior, is
but before any plastering is appfied or before gypsum board joints and fasteners are taped and finished.
5) FINAL INSPECTION:To be made after the building is complete and before occupancy.
A'r'l
'in pl ace
APPR0VAL REQUIRED. No work shall be done on any pant of the bui"lding or structure beyond the point indic
successive inspection without first obtaining the approval of the building official. Such approval shal'lafter an inspection shall have been nade of each successive step in the construction as indicated by each
ated in each
be given onlyof the inspections
requi red.
N0TE: Al1 building permits require inspections for the work authorized, such as but not limited to:
A. BL0CK WALL: To be made after reinforcing is in p1ace, but before any grout is poured. This inspection is
required for each bond beam pour. There w'ill be no approval until the plumbing and electrical inspections
have been made and approved.
B. W00D ST0VE: To be made after comp'letion of masonry (if applicable) and when installation is comolete.
Insta'llation shall be in accordance with an approved nationally recognized testtng agency arrd the manu-
facturer's instal lation instructions.
C. I4OBILE HQME: 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
connecti ons.
(f) 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 fioodpla'in
management Ietter.(3) t4obiie home tiedowns, when required, and skirting shall be installed and ready for inspection
within at least 30 days after occupancy. Tiedowns and skirting shal'l be installed per enclosure.
D. SWIMMING P00L: Below grade when steel is in place and before concrete is poured. Above grade when pool
is insta'l led.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT I'IILL EXPIRE IF I'IORK DOES NOT BEGIN
I,IITHIN]8O DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN]8O DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PERMIT I^IAS iSSUED ON THE BASIS OF INCOI1PLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS I,JILL DO SO AT HIS OtlIN RISK
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
Permits shall be effect'ive for one year from the date of issuance.
Upon completing the construction for which a permit has been_issued the Peryi! holder sha11 notify.the
OEpi.ir.ht by iubmitting the installation recbrd form. The Department shall inspect the construction to
determine ifit compliei with the rules contained in this division. If the construction does comply with
such rules, the Department sha1l issue a certificate of satisfactory completion to.the permit holder. If the
construction does not comply with such rules, the Department shall notify the permit ho'lder and shall require
siiiifactory conrpletion Ubf6re issuing the certificate. Failure to meet the requirements for satisfactory
co*pieiion *itf,ii' a reasonable time c6nstitutes a violation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewage Disposal
t
(t )
(2)
Septic Tank Drai nfi el d
-T0'--From: Interior property iines
Edge of road right-of-waY
Building foundation
llells, other water sources
'rryol s)
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50'
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LANE COUNTY INSPECTION RECORD
N PH
FRONT SIDE I NTERI OR REAR
ED BY PE
DIRECTIONS TO SITE
SITE ADDRESS PERMI NUMBER
TING / FOUNDATlON INS OR MOBILE H P INSPECTION
rovedp Correcti on Di saPP roved ---Date Insp ector
NDER- FL R INS
Approved Correcti o n_ Di sapproved Date F-<-82-tnspectorW_E
TNTER-T LAT IP-l U I{E I N G G RO U N DW O R K I N S P E C T I O N
,Approved Correcti on D'isapproved Date i nspector
ROUGH PLUMBING INSPECTION
Approved Correction Disapproved-Date I nspector
FRAMiNG INSPEITION
Approved X Correction Disapproved _ Da te / bAuo &2 tnsp ector \rU Lo-A
INSULATION / VAPOR BARRIER INSPECTION
Approued y'-Correction---Disapproved Date 8-rE-82 Inspector M
IL S
proved Correcti on D i sapproved Date Ins ec tor
FINAL PLUMApproved- Correc Li on- Di sapproved Date --_l nspector
BING IN S PECTI ON
TTI.IAL WASTE DISPOSAL SYSTEM INSPECTION
Approved Correcti on Di sapproved Date-=-=-.--_l nspector
SPEC NB
Approved Correction r sapD
MOBILE HOMEproved nateT2.?-81'zlnsPector a*L/
orm C74-L97
r sapp).ove d Date Inspector
OCCUPANCYCERTIFICATE OF OCCUPANCY
Approved____Correcti on D
TEMPORARY CERTIFICATE OF
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