HomeMy WebLinkAboutPermit Building 1987-7-17
~I .)\1i~~~\J:/i;17--,1 )e(~~,~~7
~ 1- LJ'rl.e ~nty AuthorIzatlon lor Apphcahon/ .
, SEPTIC INSPECTION FOR LOAN REVIEW Perm>t #~~~
I RAt\lGE
02
S~BDIVISION/PARTITION (~[ appl~cable)
7'OWl SHIP
I8
SECTION
061l,
J TA.'{ LOT
10300
IOT/PARCr:~ I
o OUT OF
PROPOSED USE OF PROPERTY
~SJ.dentJ.al DlndustrJ.al
D Commerclal 0 Publl.C
BLOCK
LOCATro'l ADDRESS
SiBEFT
CITY
ZIP
3988 Jasper rd., sprlngfle1d
5TRUCTU~S CURRhNTLY ON PROPERTY
SFD
iJ1HLC"rION::i TO SITe:
Freewav to 42nd KG R to Jasoer Rd. - R on Jasper Rd,
3.10 -I o~ a ml1e
~:SCRIPTION OF PROPOSED WORK - BL SPI:CIFIC
DECLARED ~ VALUE
SEPTIC INSPECTION
I *' OF STORIES
o ,......ER I 5 "lAllE AND ADDRESS or
TRIPP, June K
CONTRACTOR'S NAHE AND OS~
PCRNlT TO Be MAILED TO (NANE AND 'ADD,",~ ~I: ~/,..
__ 1- "-
..1 ~ 1~:;..Gavl1n Tl.nglum
I HAVE CAREFULLY EXAMINED THE COMPLETE.D APPLICATION I'OR P"fRMIT dltU ua here';" ce~'tqfY t-hat all lnfonnat:lon hereon lS true and correct: and that I
have the follow~ng legal J.nterest J.n the property Downer of re<::Old 0 cont-!;"cl< t pl1rchaser DauthorJ.zed agent
I f_rther certJ. fy that any and all work performed shall be done in at.t.01d<llf'f w~ th tl e OrdlllanclO~ of Lant;. County and the W...s of the State of Oregon
pertaJ.nJ.ng to the work deScrlbed hereJ.n and that NO OCCUPANC.Y w.ll1 bt< 'lIOlde of a r strm::ture wlthout the pCrffilSS10n of the BU11dlng DJ.vlSlon I fur-
ther <::ertlfy that reglstratlon wJ.th the BU11der's Board J.S J.n full force ;;md effect as rec;ulTed by ORS 701 055 that lf exempt the basls for eXempt10n
lS noted hereon and that only subcontractors and employees who are 1n compl1ance W1th OR~ 701 055 10'111 be used on thlS proJect I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY
:= OF BEQqOOMS
FOR LOAN REV I Eli
f # OF EMPLOYEJ:'s
h'A'JER ~UPPLY
same
o Proposed
11 Ex~st~ng
TELEPHONE NUMBER
June !': Trlpp
Dropped off
7-15-87
NAME (please prlnt)
SIGNATURE
DATE
READ THIS SECTION CAREFULLY
YOUR AUTHORIZATION 9AS BEEN BASED ON THE FOLLOWING CONDITIONS'
[J PLANNING/ZONING
Zone
Part~t~on #
Parcel #
Parcel S.lZf>
Mln~mum Setbacks
C
L, front
C
L, Slde
In terlor
rear
COM.1ENTS
SEPTIC INSPECTION FOR LOAN REVIEW NO SPECIAL
PLANNING ACTION REOUIRED
7-15-87
Date
-k-
~ '-V (
Record Issued:>!li Yes 0 No
Max~mum Depth
of Trenches
[J SANITATION
5
I
#
B P
# )139-lc)
Installatlon
Installat~on Gallon
Speclflcatlons Tank
C0l>1NENTS 7fp. Wi,j, yv/ _<}('>....L)tU#
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M ~()J~~<> 8-f- -/l.J" N
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of DraH'f.leld
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Date 17 .J~ /'; 87
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[J PLANS EXAMINATION
Type
Group
U,e
COMNENTS
Date
n
L~ /Z'<k? tf'?
VED BY BUILDING OFFICIAL/DESIGNEE (oer ORS 456 B05(1)) ~;l DATF
COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION. 6117-4061.
125 EAST 8TH AVENUE. EUGENE. OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
C.1L._?~ RI'ld.
SETS, ChS A'lD O-'iER to DITIO"S 0<' APPRO'JAL 'U<;T BE STRIC-~\ ORSE<<VED VIOLATIO'J CA' Rr;SULT IN REVO-
Cr.~IO\ Of ~'llS rr:R'lIT CITATIC L DE<< PROVISIO S OF LA\C .:::J......n - I'JFRACTIO'J OR~)I r.'\CE A'D/OR OTHER
RE~~DIES ALLOWED B, LAW
hHEN RE"'DY FOR
TID'J R<'QL.I:::;;"","
of .tnspec!:.ton
I'.SJ'r:l.:!O'J CA~~ 687-40[,'> ^ 'lIt.I\ L. \ Of' r.T LEllST 2~ JJOLRS ADVA CE '\OTICE FOR INSPEC-
~:;,e ilE GIVE'I-~'I.3.ve tht..-follow.t"lg In"'o-nat on !"eady F'prmlt number Job address type
when .tt w.tll be ready }OU- name and orore nu~ber and any s~cclal Clrectlons to slte
BUILDI~G DIVISIO~
~EOUIRED I SPFCTIO'lS
Found~t.ton Insoect.ton ~a be made after trenches are
~ater.tals .or the toundatlon are Jellvered on the Job
plant (commonly termed trans.tt m,xed ) ,s to be used
excavated and forms erecteD and when all
\Ihere concrete from a central 'TllXlng
mater~als need not be on the Job
~t~ S~~ o~ Und~r:~~ Insr.cct.ton To be mace after all In-slab or under-floor bUlldlng
serv.t_e c~u~2mcnt con~ult P1P.tng accessor.tes ana other anClllary equlpment lLcms are In
place but berore any concrt..te .ts poured or floor sheathlng lostalled lncludlng the subfloor
Fram.tng ~ Insulatlon Inspectlons TO be made after the roof all framlOg flre blocklng and
brac~ng are In ~laCt.. a1C dll pipes, f.treplaces cn.t~neys and ve"lts are complete and all rough
electr.tcal ana plumolng are approved All wall 11sulatlon and vapor barr.ter are In place
Lath and/or Gvpsum Bo~rc ~ectlon To be made atter all lathlng and qypsum board nterlor
ana-ehter:0r, is in ?1ace but~fore any plaster.tng .ts applled and beiore gypsun board J01~tS
and fasteners are Laped and f.tnlshcd
Flnal Inspectlon
To be fiade after the bu.tld.t"lg .ts complete and before occupancy
APPROVAL REQuIRED ~o work shall be done on any part of ~~e ~g ox s~cture beyond t~e po.tnt
~nd~cated In each succeSSlve lnspect.ton Without first Ohtalnlng the aporoval of the bUlld.t1g off~Clal
Such aop-oval sh~ll b~ glven only ~fter an lnsp~ctlon shall have been made of each success.tve step
.t"l the construct.ton as lndlcatej by e~c~ of the .tnspectlons reJu.tted
~OTE All bU1ld.tng oermlts requ1re 1nspect.tons for the work authorlzed such as but not Ilmlted to
A BlocJ< I-Iall To be mace after relnforc.tng .ts In place but before any grout lS poured Th.ts
rnspect.ton .ts requlred tor each bond beam pour There w.tll be no approval u~t.tl the olumb.tnq
ana electr~cal lnspectlOns have been made and approved
B Wood Stove TO be made after co~plet.tO"l of masonry (.tf appllcable) and when lnstallatlon .tS
comPI~ Installat.ton shall be In accordance wltn an approved natlonally recoq~.tzed testlng
agency and the manufacturer's lrstallat.ton lnstructlons
C Moblle Ilome An lnspeCtlon .ts roqu.tred after t'1e moblle home .tS connected to an approved
~or-sept.tc s~stcm tor setoack requ.trements blocklng, footlng connectlon tledowns,
s~lrt.tng and plumbing connectlons
Footlngs and p.ters to comply wlth State foundatlon reau.trements for moblle homes or as
reco~ended by t1e manufacturer
~Obllc hone mln~mUm f.tn.tsh floor elevatlon shall be cert.tf.ted when requ.tred by a flood-
pla.tn management letter
~ob.tle home tledowns when requlred, and s~lrtlng s'1all be lnstalled and reaoy for 1nspec-
t.ton wlthln at least 30 days after occupancy Tledowns and sllrtlng shall be lnstalled
per enclosure.
o
SWlmffilng Pool Below grade when steel .ts 1n place and before concrete .ts poured
wnen pool-rs-.tnstalled
Above grade
APPROVED PLA\S ~UST BE ON THE JOB SITE AT ALL TI'lES DURII\G WORKING !lOURS "'flIS PERMIT \HLL EXPIRE
IF hORh DOES NOT BEGI'J WITHI~ 180 DAYS DR IF WORK IS SLSPCNDED OR ABANDONED FOR ~ORE THAN 180 DAYS
SUSPENSION OR REVOCATION ~~Y OCCLR IF THIS PE~lIT WAS ISSUED ON THE BASIS OF INCO'lPLETE OR ERRONEOUS
INFORMATIO'l
AJYONE PROCEEDING PAST THF POI TO' REQUIRED II\SPECTIOlS hILL DO SO AT THEIR OWN RISK
~UBSURcACE r.'lD ALTER~AT~V~ SE~AGE DISPOSAL ~
Permlts shall be effectlve for one year from the date of lssuance
Upon completlng t'1e constructlon (or WhlCh a permlt has been lssued the permlt holder shall
notlfy the Lane Count) Department of Plannlng and COmmunlty Development by sUbm.tttlnq the
.tnstallatlon record ~orm The Department shall lnspect the constructlon to determlne lf .tt
compIles w.tth the rules contalned In thlS alvls.ton If t'"le construct.ton does comply wlth such
rules the Department shall issue a certlflcate of satlsfactory completlon to the permlt, '1older
If the constructlon does not compl~ wlth suc'"l rules the Department shall natlfy the pcrmlt
holder and shall requlrC satlsfactory completlon before lssuing the certlflc~tc Fallure to
meet the requlrements ~or sat.tstactory completlon w.tthln a reasonable tlme COl1sututes a V10-
lctuon of ORS 454 605 to ..54 745 anu thlS rule
Setbacks - Sub""rf..,.,,, ~ D151'osal
o;cptlC Tank
Dralnfleld
<'-01'1
I~torlor propert, 11"leS
Edge o. rOild rl-nt-of-way
B\nlolnq toundatlon
~ells ot'1or ...ilter sources
10'
10
5'
50'
10'
10'
10'
100'
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HEALTH AUTHORITY "FPROVAL :'.;::::.:~.. "".
INDIVIDUAL WATER SUPPLY AND SEWAGE DISPOSAL,SYSTEM",--,__.I ~
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RECORD OF APPROVAL OF
INDIVIDUAL SEWAGE DISPOSAL SYSTEM ANC
APPROVAL TO OCCUpy RESIDENCE
ISSUED TO
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We", Supply by )-ubi,c ~_ Individual SY'I.m_ __ Commu"lty System
I ,,~- ,
LANE COUNTY
Permit No (!j j _'L _ I
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No
_ c./her
5EPnc TANI( D"lance from w.1I :: fMt Matorlol :...~_
'7 L~ ___ ___ _ _ gal Inlide tOngth
I
[J'OrMtctf" feel Uquld depth -2 _ _ _ tnl
litE DISPOSAL fiElD OI."lbuUon boa _ _ ",-rei.'::" _ no _ othttr
o..tance from "".11 _ _ _ _ ___ fHt1 S.ulldlng fo\lnda1Jon I ft
Noorest Lot ""'0 fronl !:._~ _"'!:..:..._ __ft ~ ,Mf. _ _ I. __ft.J reor _ _ __ 'HI
Length of ~h line 2. 'i~-~~ -4..-- _'oet No of liMa- _ --:..... _ _ _ _ -. -..L- _ _ __ ~_
Toted "ngth of Molin.' ---P ~ -..#oet Dlttonce betwMn II".. __ -'_'::" __ __ __ _fe<<
Total effectIve ab~pt'on Qf9Q In bottom qf trench-*'_ _~~ ~ _ _ ___ IQ It
Trench wIdth .-: ..- _Inchea.
fro-of"',., mal.noll _ _ --~k.n .tono______ , Other___ _________
Depth of flit., materlol bon~ die 1-- Inch.., Depth of filter over tile _._ :.-. _____ __In
Gorb Gn ldOT
Totolllquld cap<)oclty
_No of CClmparlrnenh
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Rernarkl:
Oalo oll.'PO<llo. f~/Lz--.
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ACTIVITY INFORMA TION SHEET
I:MD-.
>-
7
'-""O"~N^,.'M',," <Iv",,,""
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Please complete all Items above dotted Irne
* LINES WILL GET YOU INFORMATION ONLY
!{
* DA TE_:J__I ~_I k1- ~\~
Y ~ i.J ACTUAL {t
~ I n PROPERTY ' /
./, ~ (",(...,/~ \ /OWNER 'A~ K f/u#
qk\( ~.k1ir ~ I _P ~ ADD ESS ~~ # ,
U y ~STATE&1 zl~7J1rCITY "'--" -STATE ZIP
(H30MqE) Z!;: - It! f 7 TELEPHONE (BUS)J~ . (HO"", _
* PROPERTY ADDRESS X X II ~, /;J i/
OR " I I /~
MAP & PARCEL NUMBER (Found on tax ma s In the Assessment & Taxat,on Oept)
STAFF WILL DETERMINE_
It &:<.. ;Jlo ~/-+ /05CJO
Township Range Section Tax Lot
Township Range Section Tax Lot
Township Range Section Tax Lot
Zoned
Flood Plarn
Zoned
Flood Plain
Zoned
Flood Plarn
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP
ACRES
AR UEST(deSCrlbe~what ~u want to dO~r k~, cg
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Irectlons ~~Ite
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. ....................Staff Use On~....................
Comments:
Land Management DIVIsion, Public Works Department 125 E 8th Ave, Eugene, OR 97401 phone 687-4061
USER FEE SURVEY
~y_",... ... ,,"'W",' ", . ....
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Application Number
For:
Please record the amount of time, IN MINUTES, you spend on this application On the appropriate
date line, enter the lime, In minutes, under the column for your position.
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Land Management Division, Public Works Department, Lane County
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