HomeMy WebLinkAboutPermit Building 1974-1-14
.
S' '_EM~ BU!LOING PERMIT N Qt:l~":7..s
, 'Lane County. Oregon '.. '~~
.
OWNER
,__,\ ' I \ r.. _' c
, I 1-+ 1/2',('",c,'" \ ' .
j~ . , ,'='" . \, - J. V VI '"
L 7' .... '-r
MAILING ADDRESS t OS J o (,').Pf'
I}
,', '
'1<.(
CONTRACTOR
PROPERTY ADDRESS
J-/7o~
'""T- or, ~ ..
.In y",,..r
MAILING ADDRESS
() , -. r, I I
t....ci. S'-::,-!;/'\u;-';P d_
'J
, r
~ ADDITION;
~ \; "
ex f,' v.'\'!(~"I....
.nO,:;),,:"
r
D CORRECTION:
j. \
; , lJl 0"'-.1:)1 Q teLL-
, ,
" ',\0\1(,' eo \ .
\)
" II,~ ~
CHANGE RESULTS IN:D REFUND OF FEE, OR
...
D ADDITIONAL FEE:
BUILDING ~
SEPTIC TANK
SANITARY CONNECTIONS
TOTAL ~ r,. v-- D 0"""""-
DATE FEE PAID Cash Check
LANE COUNTY DEPT, OF HEALTH & SANITATION
"',J
_J
l..}
y L _ ." 1--11.-
//.;'-i/, /,..
/
- Datp
1- / t.j-"/ if
I
~
Supplement N~
1588
5 By /? P
.
,
J
/
,
" I
/1') IJ
/c IV
I ,,,1
\/ I
1
,~' "~:"'W-----:""""""T'.r-"-=,,,.,..........- - ,- -----,-..-,--~~~-.:'t',.~
j.'- ,.' ,,,;...l!:>;,,,. ,,,,-, \ ...-......
-l!\( r. _: '~,~ "
~p" '~/'~ . '( ,!"''#
LANE COUNTY BUILDING PERMIT OR MOBILE"'HOME PERMIT
BUILDING I[J MH D. PERMIT NO,
MAIb.ING ADDRESS'
419'3 JilIi"'tIf Ro.
J'ulItil IQo.tI!)
" PROPERTY slze'!- FT.r. .
-'-'.. ....} - "I: ~. -:. ::0,- ~ ,'J',:',.... ')..~ . \ "",'
WIDTH ' DEPTH AREA . AC!i1l:
J ~~.~\\-. .J.~-'~~ 'i'~ ~.''':-'~.'' >.
Connect to Existing Sewage System 0
TYPE CONSTRUCTION SQ. FT. :tt B,?RMS
U~ G 12. (2)
~!,61 ~.
196 1M.
"
PROPERTY OWNER
~,,,.., "''''''....,
.'; t, ~ t,w)" ..PLt'ft
CONTRACTOR
IVAN'
S~nINa.'~LD. OR.
MAILING ADDRESS
PROPERTY LOCATION - INCLUDE ~q~~I~R.~F~CE
.1;jOl5 JAIJIlta RD.. ~tt;':Wtl1;l>""" ..CftO$$ "'RIlM Room,- ROAI) rllt.'1&:
. PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
TWP
RANGE
SECTJON
TAX LOT NO,
CODE
CENSUS TRACT
'2\.)
02
05
~
11:}..~1
EXISTING STRUCTURES ON PROPERTY
~1o~J1!:
LEGAL ACCESS TO PROPERTY
APPL.
NAME
nlTI.USEN.. 1\l1\"a
470S .uSP;W n~
".~ \......
ADDRESS $1'11' IfliGfltl.D,o on. 914n
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
, ,
~--\:.
&
~. "
MAILING
',", ~, 't
"~'I ,'). - ...
y\'
.... .(.
..
STRUCTURES TO BE BUILT THIS PERMIT
C1::2..t..lim
"
fi1Il.!!C
, '
, "-
n~7,1G{:..Al.Ul!l-'trfl*~8~
l.\-'{'" .. ,:-, .
,
\,'
a~'e-rztic&
SEWAGE DISPOSAL
PUBLIC 0
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
FEES
PLUMBING INSTAL~ED BY
OWNER 0 'OTHER: NAME
WATER SUPPLY
D! 1:1' Iita
SEPTIC TANK ,[!] .. OTHERD
. . < Qi!l:.W
'\:~ \~" l.:1.~
" \ ......J
PUBliC :ib
D OTHER
'\'-\\-~'
......
TOTAL
~.~
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
$
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX; GAL.
UN. FT
TRENCH WIDTH FT.
OR SQ. FT.
'\.~
\~
'~\
r11' - OJ ..
\l,\-ot '~ '-,,~
~- '.\
I,~'~',",' ,
"."'If......... :;;;r.. ..:r......
"~
.....;-
~~\~ t\..\s-" -
TYPE OF STRUCTURE
:?J
BLDG. SETBACKS _ FT, FROM CTR.
~i~'
FRONT <y"
OCCUPANCY
I t, J
ZONE
Alllt
2%-&71
PHONE
Nt.'k PunJril.tt'
PHONE
New System 0
VALUATION
n.S&'4
0;,;4
784
I:),)~.OO
PUBliC UTlL. EASEMENT
/o!
OF ROAD RIGHT OF WAY
1lJi.
SIDE INT." SIDE EXT.
AUTHORIZED SIGNATURE - DATE
..3.~. DaiS tiy C. HARI;).\!.K'.Ii
J. OlOOl<, R.S t ,$ANI'tAll MN
USE CLASSIFICATION
11);'
REAR ,
DATE
t.7.73
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUilDING - GREEN
SANITATION - GOLDENROD
Construction to comply with uniform building code and county reguladons
covering plumbing and sewage disposal. All buildings require a certificate
of occupancy bef~re being occupied.
, (See Statement On Reverse Side)
, ,"......
.,.... '\
.'-.' '.
'-
(POST THIS PERMIT ON M~IN BLDG. AT SITE)
lANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 97401
. ~~
FORM ::t C55 .13
/
'--':"-~
''".-- "'
,^.~-"'V_';'i<-'
,...
.- ..
~.,~.."
t'~" ..." .
-"---~~~:)-~;"':--;t.~F'~
., ,
r",
SITE INSPECTION
ApPROVED ~ DISAPPROVED.~ DATE
INSPECTOR
REMARKS
FOUNDATION INSPECTION
APPROVED 1Pf"'~'~'APPROVED r--7 OATE ~-~? 7'1 INSPECTOR~
REMARKS&-N~~;;t 1'~:'<-t.Z'#('Z"<-';'0qKh -/ -7</c{~
..1
IU~~L ~--L ? " ~ - ')'l/
I
'FRAM,ING INSPECTION
ApPROVED I-~'I SAPPROVED
INSPECTOR
({?L'
-:?-?-7Lf
17
DATE
REMARKS
LATH OR SHEETROCK IN~?ECTION
,
....- --
Ap~ROVED ~I DISAPPROVED I
I NSPECTo!fl/ ~,I,.
I DATE '3-I/-IJf/
REMARKS
FINAL INSPECTION ' ", I~))
ApPROVEO ~DIS'PPROVED 17 DATES - ;}. 0 ~ '71, NSPECTO~'
REMARKSrJ.~rf/,2I.''1g,- At.,-; ()1U.~ ~- 10.'-7"
CERTIFICATE OF OCCUpANCY
READY TO ISSUE 17 NOT READY TO ISSUE 17 DATE
INSPECTOR
REMARK 5
!' '
tfl ' /1/,
iI/~v/,~
:2l/68'-7,- r!J~, ~~ /Co(,
~'C
"
~. t.
t!l/
~/
"-
,1l'::~~
'~~~I" '
",t
.",
c~;:
".1.- 0'
':~r?y ,-
~~
,.,,',;...y
''''-~':'-r~
, ,~"
\..,' '
Jf~I;'
, ,"~~
'~-\~1
i:'jii'
,:;;
'''':-..
.,~
.IN
1
i
~
"
'1
.,"
'~'-~-~~J~~~---"~-"-~;.s>---~~~,-~ ':"""0"_'-....-----..;- y~
. .' . ~ / . -;..J"1/~ cf~._ . r.;t . \l_ /" i \
" , :~\~ '9 -.p LA~E C~UN~Y B~~i;;G 'PERMIT OR MOBI~h:j'~ME L r'pERMIT
BUILDING ,[lJ Ml;f U" PERMIT NO,
MAiliNG ADDRESS
t)'it)1j Jc,n:>co GO.
MAILING ADDRESS.
"-,...~'~\:
PROPERTY OWNER
nll'-&' 7';1
PHONE
D 11LEP'SEtl. IVAN
CONTRACTOR
S?~U::3i!)nfl"C. ~.
[\'1) ~j~.'"t
PHONE
PROPERTY LOCATION - [NCLUDE,~.P8.~~ ~FFICE
In;yj J~o:>f!:1l n".. !:):;>QOt:fWIt;Wpp tlC"CJ$ I'rlG:'J F)@GItV fu'lAG Or.evlJ
PROPERTY LEGAL DESCRIPTIO~ - METES, .BOUNDS
.....;"r~..j..1
TWP
RANGE
SECTION
TAX LOT NO
CODE
CENSUS TRACT
18
02
0'1
2~CI
t~?1
EXISTING STRUCTURES ON PROPERTY
APPl.
NAME
&
MAILING
[) 111.lW'S[r~. evUJ
t~1U'1 Ji',WItO nOllO
c~:"~
LEGAL ACCESS TO PROPERTY
,bn?Em a~;:)lil
PROPERTY SIZE - FT.
"
ADDRESS S::>n Ot~:.')1" Df:'w. 0.1. ()7~71
FOR MOBILE HOME PERMITS 'ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT"
WIDTH
DEPTH
AREA 1 I1cne ,
Connect to Existing Sewage System D
TYP~ CONSTRUCTION SQ. FT. :# BDRMS
New System 0
VALUATION
O"Uit!.1. 1C!3
;"-
I"'nl1.m:
Ui'i!? 0 12. un
~ ::j..i:2~J
\'" . .
.l"~ -.... ,,-;, ",
, ......... ,-
~8~OE~~\?Ac.13~tt;el~~~O
'..'~',-.'-i ~ 't
, '....
or ~":-,,,......
\00 (; ~.
196 el.
<1J~
$'"',>0'0"
"r;......h~~
1?..'r
'>j~1-"....,:r-~
..,~:;t'~r-""W
SEWAGE DISPOSAL
PUBLIC 0 SEPTIC TANK
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAilER
~OCYl(.;3
[!] .. OTHERD
$ Uii:.oo
FEES
PLUMBING INSTALLED BY
OWNER 0 OTHER: NAME
WATER SUPPLY
t--.
tq.5b
PUBlIC:tb
o OTHER
MIN. SEPTIC TANK CAPACITY
$ l;;9 . ':!J
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
TOTAL
WITH DIST. BOX: GAL
UN. FT
TRENCH WIDTH FT. '
OR SQ. FT.
TYPE OF STRUCTURE
~J
OCCUPANCY
I c,J
ZONE
Ann
USE CLASSIFICATION
PUBLIC UTll. EASEMENT
BLDG. SETBACKS _ ~T.. FROM CTR,
er",
FRONT ",...
/0/
OF ROAD RIGHT OF WAY
05'
SIDE INT. r SIDE EXT.
AUTHORIZED SIGNATURE - DATE
Ilm cv C. t~g~t.'!m
tr:t
REAR .')
J.e:,
J. SlimJ:~.. R..S. D S~rHVM11~IJ
DATE
1 Q Fr:!
BLDG. PERMIT - WHITE
OFFICE COpy - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BU'ILDING - GREEN
SANITATION - GOLDENROD
Construction to comply with uniform building code and county regulations
covering plumbing and sewage disposal. All buildings require a certificate
of occupancy before being occupied.
(See Statement on Reverse Side)
_ (POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, BLDG. & SAN. DIY., COURT HOUSE, EUGENE, OREGON 97401
FORM == C55-13
,..
.~~..~ .
SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED fI 01SAPPROVEO C/' DATE
REMARKS
GAS PIPING GROUNDWORK
ApPROVED / /.0 I SAP~ROVED 17 DATE
REMARKS
ROUGH' 'PLUMB I'NG
,
ApPR.DVED
'pzl
DISAPPROVED
/ /
REMARKS
"ROUGH GAS, PIPrNG:
ApPROVED .C/" ,DISAPPROVED fI DATE
REMARKS
FINAL PLUMBING
,
~
DATE
]"-/-741
.,-,. ",
ApPROVED !Xl
DISAPPROVED
Cl 'O~Tr5-/ 1- 7t(
REMARKS
FINAL GAS PIPING
"
ApPROVED .C/ DISAPPROVED / I DATE
REMARKS
" .' .
CERTIFICATE OF OCCUPANCY
.~--
......
"
READY TO -ISSUE' / ,I .No'T READY.kTO ISSUE I / DATE
REMARKS
, .
"
>.'
.:'1,
~~
;7-i' ~ I'
........:,-1.
INSPECTOR"
. .~,
I NSPECr'OR
INSPECTOR ~
,
, .
INSPECTOR
"
;_///
'-INSPEC~ . .
,(/ ,
INS PE C,1;OR
1NSPECTOR
"
,.'
"
."
"
~' .