HomeMy WebLinkAboutPermit Mechanical 1984-01-10d t/A
1
1
Lane County Authori za,tion for'
u'*'ft*r,tl-)Mil.|I€,
FOR OFF USE ONLY
Application/
Permit *
Two Copies of Plans
Three Copies of plot plans
Mech/Plumbing Checklist
Legal Interest Document
Plan Check Info Sheet
DECI,ARED
i RANGE
,Z OUT OF
d q ZTPc PROPOSED USE OP PROPERTY
ffiReside-ntia1 l-l tndus trial
I n,.,u:-i-.Commercial
-BEOF
= OF BEDROOMS Proposed
xisting
NUMBER
is noted hereon, and that only subcontractors dd employees who are in conpliance with ORS 701.055 will be used on this project- I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY.
DATE
f:rther
HAVEI EXAMINEDCAREFULLY APPLICATIONCOI4PTETED true corand re and that
1ninterest the offothe deevI ofnce authori ttachedalegalpropertyI lowing ty
t a1certithaand work rfomed besha11 doneI the ofLaws the ofteanyPefy Oregon
to the describedwork herein thatand OCCUPANCYNO beI omade tructure thout the omasston the Bui Di ronrtainingmypeIS I fur-lding
rthe that tration thwa Buithe fde Board 1nas ul force efand ASfect 70oRs that if forthece rtify reg byrequired basisexempt xemption
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION HAS BEEN BAS ED ON THE POLLOWING CONDITIONS:
Parcer. # Parcel size ttatAPLANNINGZONfNG:Partj-tion *_
Mi-nimun Se cL, frort c ._L, srde_rear_
I nr.oooplerx:In flood hazard area?No Yes, SEE ATTACHED SHEET.
Date:
Date:
SANITATION: s. I. *B. P. #Installation Record Issued? ! v." !No
Installation caIIon Linea1 Feet
of Drainfield
Maximum Depth
Specifications: _ Tank of Trenches
CO}I}.IENTS:
Date:
PLANS EXAMINATION: TyPe Use,t+ryt?1t'c lt@, Ttrt
COI,I.IIENTS:
l11,
v Date:
TOTAL VALUATION $CONSTRUCTION AUTHORIZED BY THTS PERMIT
scription Fixed Fee/
Unit Cost
$$
,
PERMIT APPROVED BY BUILDING OFFICIAL,/DESIGNEE (PET ORS'456
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
Sq. Ft.
Floodplain Fee
Subsurface Fees
Building Eee
I{echlP1mbg Fee
Pr ans Check Fee
State Surcharge
DEQ Surcharge
TOTAL FEE
t
$
)
(
$
$
)
Y
Oir'lJE4
ccl
\
and that hereoninfomation IShe re by
thwtIorr..agent
of Lane andCouty
T
Zone
i\terior_
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VTOLATION CAN RESULT IN RE\IO-
CATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY,S TNFRACTION ORDINANCE, AND/OR OTHER
REMEDIES ALLOWED BY LAW.
WHEN READY FOR TNSPECTTON, CALL 6qf-4065. A r"lrNrMUM OE AT LEAST 24 HOURS ADVANCE NOTTCE FOR TNSPEC-
ffiNffirr"*i"ginformationready:permitnumber,jobaddreSS,type
of inspection, when it will be ready, your name and phone number, and any speclal directions to site'
BUILDING DIVISION:
REQUIRED INSPECTIONS:
I. Foundation Inspection: To be made after trenches are excavated and forms erected and when aII
*rffitffina-f-"""dation are derivered on the job. where concrete from a centrar mixing
plant (commonJ-y termed "transit mixed") is to be uled, materials need not be on the job'
2. concrete Slab or under-F1oor rnspection: To be made after aII in-slab or under-floor building
ffi""fr"ip*".tffii'ri,q".".ssories,andotheranci11aryequipmentitemSarein
;i;;;-;"4=rEro.. any concret" i" frorr.ed or floor sheathing installed, including the subfloor'
. 3. Framing s rnsglelie! rnspections: To be made after the roof, all framing, fire blocking, and
bracing.'"ffiffi;s,firepIaces,chimneys,andventsarecompIeteandaIlrough
electrical ana plumbing are approved. AiI wall insulation and vapor barrier are in place'
4. Lath and/or Gypsum Board rnspection: To be macle after all lathing and gypsum board, interior
""a-.;€.ra'ffii"_pr"""ffi"anyp1asteringisapp1iedandbeforegypsumboardjoints' and fasteners are taped and finished-
5. Final rnspe,ction: 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 ipproval of the building official.
i".n upp."val sha1l be given onl!, after an inspection shall have been made of each successive step
in the construction as indicated by each of the inspections required.
NOTE: A11 building permits require inspections for the work authorized, such as but not limited to:
A. Block WaII: To be made after reinforcing is in p1ace, but before any grout is poured- This
InilpecEIoi- 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. rnstallation shall be 1n accordance wi-th an approved, nationally recognized testing
agency and the manufacturerts instal-lation 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 connectiohs
1. Footinqs 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 shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
D. 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 EXPTRE
IF WORK DOES NOT BEGIN WITHIN IBO DAYS, OR IF WORK IS SUSPENDED OR ABANDONED POR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INPORMATION.
ANYONE PROCEEDING PAST TIIE POINT OT REQUIRED INSPECTIONS WTLL DO SO AT THEIR OWN RISK.
SUBSURT'ACE AND. ALTERNATI"VE SEWAGE DISPOSAL SYSTEMS:
-
-
1. Permits shali be effective for one year from the date of issuance.
' 2. Upon completing ihe constructign fgr which a permit has been issued, the permit holdAr shall
notity the f-ane County. Depll.trrbnt bf planning and Community Development by submitti4g the
installation record form. -e Department shtll inspect the conr^uction to determine if it,
complies with ihe rules cor.-rined in this division. If the conr uction does comply with- sYch
rulls, the Department shaIl issue a certificate of satisfactory completion to the permiti holder.
If the constrircti-on does not comply with such rules, the Department shall notify the permit
holder and shaIl require satisfaclory completion before issuing the certificate. Failure to
meet the requirements for ^ isfactory "omptetion withi-n a reasonable time constitutes a vio-
Iation of oRS 454-605 to 4- .745 and this ru1e.
Setbacks - Subsurfq.ce Sewage Disposal
Septic Tank Drainfield
Prom Interior property lines
Edge of road right-of-way
Building foundation
We1ls, other water sources
c t4-zs
r0!
10 t
5t
50'
10 r
10r
10 r
r00r
TRS#
-1- D DATE ISSUED:PERMIT#
S
C
KRE IRE ENTSM
CFRONT
f<\eb
I NTER I OR
la
REAR
\r.3l{" \S*,r.i\\o\o }A
FApproved_Date TCorrecbii\Jl)a
INSPECTION
te Insp ector
PLUMBING GROUNDI,IORK INSPECTION
Approved Date /Comecti on Date Ins pe ctor
UNDERSLAB PLBG. NApproved Date Correcti on Date I nspector
SLAB INSPECTIONApproved Date Correcti on Date I nspector
ROUGH PLUMBING (TOP OUT) INSPECTION
Approved Date Correcti on Date I nspector
FRAMING INSPECTIONApproved Date Correcti on Date Inspe ctor
ROUGH MECH-ANICALApproved Date Correcti on Date I nspector
INSULATION / VAPOR BARRIER INSPECTION
Approved__l Date Correcti on Date Inspector
LATH / GYPSUM BOARD INSPECTIONApproved Date Correcti on Date I nspe ctor
Approved aU< Date Z - A - 84 lCorrection Date Ins pe ctor kr<,
FINAL PLUMBING INSPECTiONApproved Date Correcti on Date I nspe ctor
FINAL INSPECTION BUILDING N /MOBILE HOME N /AG PLACEMENTI
Approved Date Correcti on Date Inspe ctor
CERTIFICATE OF OCCUPANCY TApproved Date_Insp.TEMPORARY CERTIFICATE OF OCCUPANCY tr
1t7 4-t97
Approved Date Ins p.
LANE- COUNTY INSPECTION REC()RD
L..ANE: C0Ul'll'Y $!rfll' [:l.l"J t'i6]' $lE:f,L.I l]l' :F :l$ilIi'tr IiAl'[: t] i *e{:}4
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ACTIVITY INFORMAT ION SHEET
COMPLETE THIS SECTION. INCOMPLETE FORMS I,,ILL BE REJECTED!
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I /V on-r lf .// EJr / 1 v rt5 /f4to.oC.8tla.q fe.rc,u Ar6Lo
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PERSON MAKING REQUEST
th*tr,l ,ff
PROPERTY OWNER
L-rCL M 3Ttb
MAILING ADDRESS MAILING ADDRESS
,-fet lNq, P rst- o o tL q 1+'t 7 J r't rNl cr euo, ott ctl I I t
C ITY
1L6-o{tt I
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2 . PROPERTY ADDRESS
5IAIL I,IP UUUt
S i-a,U' F,rvq so
3*z- €orl
STATE ZIP CODE
14( - 3: t(
M FUSINESS TELEPHONE # HOME TELEPHONE #&
( IF DIFFERENT
3 ruae 6i PAFIeEL NUMEIEFI (from tax maps in Department of Assessment and Taxation
or from tax statement)REQUTRED INF0RI4ATI0N)
m[Nsrm mm smTmN ffi
miNSmF mm SEeTTott ffi ZONING
TMNSHIP RAN'GE SEE]TON ffi ZONING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION ( if appl icable)
ACRES
LOT BLOCK
5 REQUEST (state exactly what you plan to do)Lo PT' th- 38o'{
&6* I Ctl o ()o L F3
6 DIRECTIONS TO SITEE T 3t iA
** FoR STAFF USE oNLY **
ZONE/LAND USE:
NUMBER
DATE
{Ft./,
BY : _ DATE:_ TIME IN:_ 0UT:-
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(
ZONING
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