HomeMy WebLinkAboutPermit Building 1974-7-25
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~ PROPERTY OWNER
fARL. GA DUL.L
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LANE ..cou..rY
BUILDING 0
BUILDING PERMIT OR MOBILE !-tOME USE PERMIT
MH ~ PERMIT NO.
MAILING ADDRESS'
1 J 21::i N ,,8T~'" ~p~ I fJr:~ I t'I'n_ ODt'(.)nN
MAIUNG- ADDRESS .
vnH 30,-2 -?'1
l>H302- 74 . ,
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PHONE ~. .'
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CONTRACTOR
PROPERTY lOCATION - INCLUDE POST OFFICE
~A~ HAPfl.nn nJ3J\[~ ~PRI..n~lcrlr'- O.,c-nnN
~-PROPERTY LEGAL DEstRIPTION - METES, BOUNDS .
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RANGE
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SECTION .TAX L"OT NO.
. 8; II.;?;;J.. 1i/3 0tJ
CODE
CENSUS TRACT
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APPL.
NAME
&
EXISTING-STRUCTURES ON PROPERTY
NOllE
LEGAL ACCESS TO PROPERTY
HARBOR DRIVE
PROPERTY SIZE - FT.
WIDTH' 82-. DEPTH
97 . AREA
MAILING
ADDRESS
FOR MOBilE HOME PERMITS ONLY
No. of Bedrooms 3
STRUCTURES TO BE BUILT THIS PERMIT.
Connect to Existing Sewage System 0
TYPE CONSTRUCTION' 'SQ. FT. :tt BDRMS
New System I])
VALUATION
MoelLEHoME
SEW AGE DISPOSAL
.
FEES
PLUMBING INSTALLED BY
OWNER 0 OTHER: NAME
WATER SUPPLY
PUBLIC' 0
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW'
PARK TRAILER
SEPTIC TANK 0
OTHERD
"0.00'
4.00
PUBLIC ~
D OTHER
TOTAL
.
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.04
lSlI.04
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
, UN. F~ 150
I
,
1 % SURCHARGE
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAl.
,I
900
TRENCH WIDTH fT.
2
OR SQ. FT.
300
No CONNECTIONS TO BE MADE 'UNTIL WATtR SYSTEM HAS P'INAL APPROVAL~. AEE ATTACHED
SHEET .
TYPE OF STRUCTURE
r-H
OCCUPANCY
FRONT
BLDG. SETBACKS ~~ FT.
45
/s/ J.E. Boss BY CHARLES HARBAUGH
FROM CTR. OF ROAD RIGHT OF WAY'
SIDE INT. 5 SIDE E~T. . 110
AUTHORIZED SIGNATURE - DATE
REAR
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUilDING - GREEN
SANITATION - GOLDENROD
IMPORTANT:
Call 687-4065 to schedule all required inspections. All construe.
tion shall comply with Uniform Building Code, D.E.Q. standards
for subsurface sewage disposal and county regulations covering
plumbing. All buildings require a certifi~ate_ot,.2ccup-',?ncy before
being occupied. J'lY' /Vf /'/
(See Details an Reverse Side)
,..
. 'I'ORM == C55-13
(POST THIS PERMIT ON MAINBLDG, AT SITE)
LANE COUNTY, DEPT. OF ENVIRONM'.NTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
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APPLICANT: n /'
NAME I/O
AODRESS
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BlYILDf.NG SITE EVALUATION
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Building Permit Application No. M J+3D':l-7V
( )
( )
( )
Site Inspection
PHONE
DATE
Pre-Permit Investigation
LANE COUNTY PLANNING DEPARTMENT NOT NO YES NAME OATE
aDDl i cab I e
I. Zoning Ordinance Compl iance ( ) ( ) ( )
(Zone )
2. Subdivision Ordinance Compl iance ( ) ( ) ( )
3. Requ ired Access ( ) <d((;\'~
4. Bu i Id i ng Site (Area, Width, ( )00 ()
Frontage, Setback)
5, Other (see comments) ( ) ( ) ( )
COMMENTS:
-
BUILDING INSPECTION SECTION NOT NO YES NAME DATE
aDDl icab I e
6, Plans Subm i tted ( ) ( ) ( )
7. Soil Stabil ity (foot i ngs) ( ) ( ) ( )
8. Flood Plain ( ) ( ) ( ) t~~
9. Ot he r (see COfM1ents) ( ) ( ) ( ) tj~;;o~?t,t
COMMENTS: V
-
SANITATION SECTION NOT NO YES J~ DATE
app I icab Ie Z/;;)7~
10. Sewage Disposal ( ) ( ) ( .)
,
II. Us ab I e Area . ( ) ( ) ( )
12. Water Supply ( ) ( ) l ;
13, Other (see Comments) ( ) ( )
COMMENTS:
TO APP LI CANT:
1- d- ~~-11
~
Yo~Building Permit / Site Inspection:
(vj Can be approved.
() Cannot.be approved at this time'as indicated on item NO. above.
Questions and further information on items I through 5 contact the Lane-
COUNTY PLANNING DEPARTMENT. Questions and further information on items 6
through 13 contact the Lane County Buildinq and Sanitation Division,
Wil I be held in this office until you can resolve the problems indicated.
Is being returned.
Your building permit appl ication fee is being returned under separate cover.
( )
( )
( )
LANE COUNTY PLANNING DIVISION
135 Sixth Avenue East, Eugene, Oregon 97401
Phone (503) 687-4186
LANE COUNTY ENVIRONMENTAL MANAGEMENT
135 Sixth Avenue East,' Eugene, Oregon 97401
Phone (503) 687-4065
C55-28
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LANE COL. .rY
BUILDING 0
BUILDING PERMIT OR MOBILE nQME USE PERMIT
MH ~ PERMIT NO. ~~j02-74
MAILING ADDRESS PHONE
PROPERTY OWNER
rAAL l:i. OULl_
112.. III 'j8TIJ Sl>,,''''''O''~'n. lh...."..
MAILlNG- ADDRESS
7h.'7_Q<tAt::
. PHONE"
CONTRACTOR
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PROPERTY LOCATION - INCLUDE POST OFFICE
roBll14~R""" l'!;!.V", ~'p",...t.l",...n.
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS -
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RANGE
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SECTION
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:TAX t..:'OT NO,
CODE
CENSUS TRACT
18
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APPl.
EXISTING STRUCTURES ON PROPERTY
ftOIlLt
LEGAL ACCESS TO PROPERTY
!fAtlDOR OIl I Vir
NAME
&
MAILING
PROPERTY SIZE - FT.
82
DEPTH
97
AREA
ADDRESS
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms 3
STRUCTURES TO BE BUILT THIS PERMIT
WIDTH
Connect to Existing Sewage System 0
TYPE CONSTRUCTION SQ. FT. ;; BDRMS
New System I1J
VALUATION
tI'.oO 1 L & HOIolIt
SEWAGE DISPOSAL
PUBLIC 0
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
.
FEES
PLUMBING INSTALLED BY
OWNER 0 OTHER: NAME
WATER SUPPLY
SEPTIC TANK 0
OTHERD
1 i& SURCHARGE:
'50.00
~.OO
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.04
(111.04
COUNTY BUILDING & SANITATION SPECIFICATIONS
PUBLIC l'!!I
o OTHER
TOTAL
.
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
900,
DRAIN FIELD REQUIRED
UN. FT. 15'0
TRENCH WIDTH FT.
2
OR SQ. FT.
300
~o CON~tCTtO~O TO at MADE U"TIL ~ATER OYSTE~ HAC rl~AL APPROVAL.. Atlr ATTACHEO
SHltET.
TYPE OF STRUCTURE
Mi
OCCUPANCY
FRONT.
BLDG. SETBACKS__
45
/0/ J. E.
FT. FROM CTR. OF ROAD RIGHT OF WAY
l!o
SIDE INT. 5 SIDE EXT.
AUTHORIZED SIGNATURE - DATE
REAR
ZONE PUBLIC UTlL. EASEMENT
RA.- r4i
USE CLASSIFICATION
7
DATE
J. 5HOOI\ 1.25-14 Be>
Boss BY CHARLe5 HARBAUGH
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUilDING - GREEN
SANITATION - GOLDENROD
Coli 687.4065 to schedule all required inspections. All construc-
tion shall. comply with Uniform Building Code, D.E.Q. standards
IMPORTANT: for subsurface sewage disposal and county regulations covering ~
plumbing. All buildings require a certificate of occupancy before ;
being occupied.
(See Details on Reverse Side)
FORM =C55-I]
(POST THIS PERMIT ON MAIN BLDG, AT SITE)
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
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SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED ;---y DISAPPROVED ~ DATE
INSPECTOR
REMARKS
GAS PIPING GROUNDWORK
ApPROVED ;---y DISAPPROVED ;---y DATE
INSPECTOR
REMARKS
ROUGH PLUMB I NG
ApPROVED ~ DISAPPROVED .CJ DATE
INSPECTOR
REMARKS
ROUG~ .GAS PIP I NG
ApPROVED .CJ 01 SAPPROVED / / DATE
INSPECTOR
REMARK 5
FINAL PLUMBING
''''''"0''0 = ,,;,lJ'.-)L ,".,,,,~P
ApPROVED ;;g:!J
REMARKS
FINAL GAS PIPING
ApPROVED .CJ DISAPPROVED ;---y DATE
INSPECTOR
REMARKS
CERTIFICATE OF OCCUpANCY
READY TO ISSUE / / NOT READY TO ISSUE ;---y DATE
INSPECTOR
REMARKS
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BUilDING PERMIT OR MOBilE-HOME
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MAILING ADDRESS
, 112'\ H 158TH $1'11 ..... "'Tn. OII~..o..
MAILING ADDRESS
USE PERMIT
PERMIT NO.
Mi"Z~71t
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TAX LOT NO.
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rPROPERTY
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LOCATION - INCLUDE POST. OFFICE
JOe3 HAIl.BIl OR'Yt.SPIlIND'I~LO.
LEGAL DESCRIPTION - METES, BOUNDS -
OIufto..
.PROPERTY
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i -'APPl.
NAME
&
EXISTING STRUCTURES ON PROPERTY
NONE
LEGAL ACCESS TO PROPERTY
HAIllllllI OItlYE
1"1 MAILING
ADDRESS
FOR MOBilE HOME PERMITS ONLY'
No. of Bedrooms 3
PROPERTY SIZE - FT.
62
WIDTH
DEPTH
91
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AREA
New System'l ~ "1
VALUATION~.\~::)t .
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STRUCTURES TO BE BUILT THIS PERMIT
Connect to Existing
TYPE CONSTRUCTION
Sewage': System Dl
SQ. FT. ~BDR_~S
lib. I'Ll HONE
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SEPTIC-.TANK 0
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WATER SUPPLY
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TOTAL-,'.-_ " ,,' .';".~t
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;"; .! B~9:G., SE}BA.SK~t:-f.T>;~:;~:?~' S~~. OF' RO"AD RIGHT. OF WAY'_ ,'., >v;/":
~ j FRONT -_;' ,~ '.. SID.E 'INT. ~ SIDE EXT. . ,REAR
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COUNTY BUllDINC;"'&~, SANITA TI()N
DRAIN - FIElD'--'REQU-IRED
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SPECIFICATIONS,
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BLDG. PERMIT::'::' WHiTE
JOFF1,CE COPY,~:WHlTE~
COUNTY TAX - PINK '
PLUMB'NG'-C:ANA_~Y
""BU llD I NG-7.G~{EN -_.
'SANITATlO~ ....:.:.GOlpEN.R'OD
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IMPORTANT:
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(POST THIS PERMIT ONMAIN,B~DG. AT SITE)
LANE COUNTY, DEPT, OF ENv'IRONMENTAl MANAGEMENT
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./ .J,?RML: .~-'~S .:~'C~~:~~~i2;:;~,>{~:i: .'i-.~~~j~jj ~.~. . CO~RTHOUSE ;AN~EX';.;0:~_E;;:,~~::. ~:~~GON 97401,
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S!TE I NSPECTI ON
ApPROVED ~ . DISAPPROVED ~ DATE
INSPECTOR
REMARKS
FOUNDATION INSPECTION
ApPROVED 1--/ 01 SAPPROVEO 1--/ DATE
INSPECTOR
REMARK 5
FRAMING INSPECTION
ApPROVED / / DISAPPROVED /7 DATE
INSPECTOR
REMARKS
LATH OR SHEETROCK .INSPECTION
ApPROVED ~I DISAPPROVED ;----] DATE
INSPECTOR
REMARKS
FINAL I NSPECTI ON
ApPROVED ~-&SAPPWV,ED/J~ DATE' /INSPECTOR
REMARKS' y~ fU;Jj;-,?I/{C/~
CERTIFICATE OF OCCUPANCY
READY TO ISSUE ~ NOT READY TO ISSUE ~ DATE
INSPECTOR
REMARKS
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.. '~ROPO~ SEWAGE "~~'ISPOSAL SYSTEM RECORO' - ~., .' ~:\
'1 NSTALLER :X' Comp 1 ete.to.p'pa..f' t of form' to:'; i.griature and submi t ,both cop i es i th app ).i cat i ~n'; .
.. . '"/hA/YJ' A/.. '., . 'p RMIT NO. M130<:'-74 Ji
... INSTALLER r S -NAME .'" . :' .' PROPERTY ADDRESS. .
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. HA~BOR DR rYE'
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'No. Livin9Units, :.~edroo,m.s.. Baths Basement., ,Wate~'SJuP&., ..
,...;. . ,/'.::s., . ,OJ Yes '. No 'Publlc~ Other-LIst
Septi"c Tank:., /' '. .'. . . .': "-
Ft. ,f~om wel,Y S'teel D." Concret'e ~,~: ,cOmpartm~nts / Gal. Capacity /,dJ,,::L&:?
Inside Dimerisions::-Ft. Tile Disposal Field:",..'
Lensth W'i dth Di ameter . .Deoth' '0 istr i b'u't i on Box: Yes.,/ No'
OWNER Other. Di str i but! on"Type i ..
NAME. EARL' DULL' . .:. .
Feet fr.om.
WEn ,,"
'. lot Line..
SPR 1,~Gf"1 ELO,.OR"EGON . . Front
Length oj.. Lines~Ft. . ,,[TrenCh .,. Total Sq. 1.,Ft. .Between.
1.r6'2 {-i3. 4. 5. 6:. WiatliL F.t. f tf?t? 'Lines /~
:'lot Plan (see instructions!.:',.
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DateU/.... ;1'. /97"V.. '. , . . , 'Signature ;X..?~/f ~ Yu/f .
t.' / CERTifiCATE OF SATlSFACTORY'I!OMPLETION -. '- ~~
For"Sanitarlan Us'e Only:'. ". ' . Date: c .,f,
In.. accordance wi.tti 19.73 Oregon Laws 'Chapter 835. Sect"ion .214 ,this. certifica'te is iss .'( .
as ev~dence.o{ satisfactory.'cOTpletionof a sutisurface'sewage.'disposal system at the above
locatIon. ....... .. . , .
0C1 Appr~ved:' Syst~m 'fnstal'lation conforms to current standards
, '0 Disappro,!ed: 'Does- not conform to',current standards"
Remarks: .
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. MAILING
ADDRESS
1"25 N:' 58T.H
~ EteE ~V\E D.
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AU)-;O 51974 .
. LANE COUNTY
ENVIRONMENTAL MGMT,
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DEPARTMENT OF ENVIRONMENTAL QUALITY,
STATE OF OREGON
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LANE COUNTY. BUILDING PERMIT OR MOBILE HO"~ USE
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APPlICA TIO&l'PI .
PERMIT :;//(.3'01... ...1)1
PHONE
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. M~ILlNG A~DRESS .;J. <:"'"') .
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MAILING ADDRESS l
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PHONE
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PROPERTY LOCATION - INCLUDE POST OFFICE
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TAX LOT # - CODE:
97"77.
DYE
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'CENSUS TRACT
PROPERTY LEGAL DESCRIPTION
LOT - BLOCK -,. SUBDIV.
TWP RANyE
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APPLICANT
NAME
AND
MAILING
ADDRESS
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DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY
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LEGAL ACCESS .TO PROPERTY - ROAD -i'I.A~ME OR #
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PROPERTY SIZE-WIDTH DEPTH
AREA
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Connect to Existing Sey.t.oge _System 0
TYPE CONSTRUCTION /"' SQ. FT.
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/ PLUMBING INSTALLED BY
OWNER 0 OTHER 0 NAME
PLANS FURNISHED
or New System Req. ~
# BEDROOMS VALUATION
FOR MOBILE HOME PERMIT ONLY
,g
Number of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT'
SEWAGE DISPOSAL
PUBLIC 0
BLDG.
WASTE OIS.
PLUMBING
PLAN REVIEW
PARK TRLR,
TOTAL'
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SEPTIC TANK ''lfJ
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FEES
NO .Is
OTHER 0
WATER SUPPLY
PUBLIC ~
PLUMBING FEES
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, PERMIT #
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DATE
7' A-?"I
DATE,
CASH 0
CHECK n
~ FIXTURES
SEWER' I
CONNECTION'F ~
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'\. COUNTY ILDING & SANITATION SPECIFICATIONS
"'". JRAIN FIELD REQUIRED
9 c> I.::> ,.. / l.,N. iT.lbCJ TRENCH WIDTH FT. .::2... OR SQUARE FEET ~ () C'\
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TYPE OF STRUCTURE
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PUBLIC UTlL. EASEMENT
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BLDG. SETBACKS -'FT.
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COPY 2 - JOURNAL
COPY 3 - AUDIT
Form # CS'S'lZ
.USE CLASSIFICATION
'Y'o
REAR ;7
Date BLDG. INSP.
f/34e1(7-~ 3-'7t"
A
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