HomeMy WebLinkAboutPermit Building 1984-3-21
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Lane County Authorization
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for:
FOR OFFICE USE ONLY
Applicatio.d //7..... tPJ/ I'
Permt l...fa) /'(j /
DTWO Copies of Plans #
DThree Copies of Plot Plans
DMech/Plumbing Checklist
DLegal Interest Document
I D Plan Check Info Sheet
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S~BDIVISION/PARTITION (~f apf11cable) I LOT:IARCEL I B~~K
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-PER>llC OMAlLEO 1 '.\ Clh~lY1) ,lei ,) r; '- ' .~~ELoPHON~)
I HA~RE~NED THE COMPLETED ~TION FOR PERMIT, ~o hereby certift'that all ,oformatloo hcr.oo " true aod correct, aod that I
have the following legal interest in the property: Downer of reco~d; 'n contract purchaser; Oauthorized agent ~ith evidence of aut~ority attached.
I f'.,;rther eertif at any and all work performed shall be done in acc.l;;'dance with the Ordinances of Lane County and the Laws of the State of Oregon
pertaining to e work described herein, and that NO OCCUPANCY will be'made of any str ure without th permission of the Building Division. I fur-
ther cartif a registration'with the Builder's Board"is in full force and cfEe a cquired by OR' 01.055, that if exempt the basis for exemptiol1_
is noted h n and~~~nlY subContractors and employees who are in complianc ORS 701.05 be uge~ on this project. I HAVE ,READ AND
_ ~D TH PLlCA;7:L::J?- ' Y _
( I , NAME (1Jlk~e print) J SIGNATURE / I
ZIP
P~ED USE OF PROPERTY
~Reside_ntial D Industrial
D Commercial IJ Public,
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C);.roposed
1.'1Existing
TELEPHONE NUMBER
DATE
READ THIS SECTION~AREFU~~ AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING
o PLANNING/ZONING: . Zone Partition #' Parcel
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COM..'IENTS: ""'"" \.... ~.
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In flood hazard are.~~ Ye" SEE ;TT~:EE'T'
interior'
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CONDITIONS.~ G' I' I
Parcel Size' :x ~
(ear' \S '\\' ,"
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o FLOODPLAIN:
Date:
~ANITATION:
Installation
Specifications:
Gallon
Tank
Linea"l Feet
of Drainfield
In:tallation ~cord Issued? DYes 0 No
Maxi~urt:I Depth
of Trenches
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B. P. *'
2*,
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IB"'PLANS EXAMINATION: Type !?J.../ Group 173
COMo'IENTS: fPA'U. .~, ,~dJlfllh:IJ/AEf&{L/)J 11 .
Date:
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TOTAL VALUATION $
CONSTRUCTION ,AUTHORIZED BY ,THIS PERMIT
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Description .
Od.cLin <1 D D '.PO 1/YIe;;-
Fixed Feel . Floodpla~n Fee $ ,',
Sq. Fp un~~ - Subsurface Fees $
9'/J. , ,3 , .-:-- ~ $
S
. Pans Check 'Fee $
State Surcharg~ $
DEQ Surcharge $
TOTAL FEE $$
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PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per oas 456.805 (1)) _ DA'rF-
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-401:11, C 14-25
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED, VIOLATION CAN RESULT IN REVO-
CATION OF THIS PERMIT. , CITATION UNDER PROVISIONS .OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER
REMEDIES ALLOWED BY LAW,
WHEN READY FOR INSPECTION, CALL 687-4065. A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE FOR INSPEC-
TION REQUESTS 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 directi~ns to site.
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BUILDING DIVISION:
REQUIRED INSPECTIONS:
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Foundat~on Inspect1on: To be made after- trenches are excavated-an9 forms erl?cted 'and when all.'
materials tor the foundation are delivered on the job. .Where concrete from a central m1x1ng
plant (commonly termed "tran~it mi-xedl:) .is."t? b~ ,:s~d, mate:ial~ ~eed_ no.t b'7 on the job. .
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2. .Concrete Slab or Under-Floor Ins~ection: To be made after all in-slab or under~floor building.
service equipment, conduit, piping accessories, 'and other ancillary. equipment items are in
place but before any concrete is p~ured or ~loor sheat~ing installed, including the subflo~r.
3. Framinq & Insulation Inspections:' To be- made after the roof, alj.' ,.framing, -fire blocking, and,
,bracing are ~n place and all pipes, fireplaces, chimneys, and vents are complete and all rough
elec~rical and plumbing are appioved.~ ~ll wa!~ ~~s?l~ti9~.and~vapor barrier a~e in place.
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4. Lath and/~ Gy~sum Board Inspection~ To be made after all lath~ng and gypsum board, interior
ana-exter~or, ~s ~n place-OUt betore any plastering is applied.~nd_before.gYPsUm:board~~oints'
and fasteners ~re taped and fipi?hed.
5. Final ~pection: To be mad,e a~ter the buil,din~ is, complete and be'fore, occupancy.
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APPROVAL REQUIRED. No work shall be done on any part of, the building or structure beyond the pOlnt
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 ?f the. inspections required.
NOTE: All building permits r'equire inspec"ti~ns for the work authorized, such as 'but not limi'ted to:
A. Blo~k Wall: _ To be\m~d_e_ after re'inforcing i;:;,ln place, but before any' grbu~ 'is poured. This
rnspect~on is required for each, bond beam pour...There-will be -no approval until the plumbing
an~ electrical inspections have been made and approved.
.B. Wood Stove: To be made after completion of masonry (~f applicaqle) and when installation is
compl~ Installation shall be in accordance with an approved" nationally recognized testing
agency and the manufacturer's installation instructions.
c. Mobile Home: An inspection is required after the mobile home is connected to an approved
sewer or septic system for setback r~quirements, blocking, ~ootirig connection, tiedowns,
skirting, and plumbing connections.
~. Footings and piers to comply with State foundation requirements for mobile homes or as
recommended b~ the manufacturer. I
2. Mobile home minimum finish floo~ elevation sh;il be ce~tified 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.
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D. Swimmins Pool: Below grade when steel i~ in place and before concrete is poured. Above grade
when pool-rs-installed.
APPROVED PLANS MUST'BE.ON THE JOB SITE,AT ALL ,TIMES DURING ~ORKING HOURS, THIS PERMIT.WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF. THIS PERMIT WAS ISSUED ON THE BASIS OF ,INCOMPLETE OR ERRONEOUS
INFORMATION. ' , . .
ANYONE PROCEEDING PAST THE POINT or REQUIRED INSPEC~IONS~WILL DO SO AT THEIR.OWN.RISK.
SUBSURFACE ,AND ALTERNATIVE SEwAGE DISPOSAL SYSTEMS:
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Permits shall be effective for one year.fr\.om":..the~~~~t~ ~of"~~~~.~n<::e:.\ '- -: . \..
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Upon completing the construction for which a permit has been issued" the permit holder shall
notify the Lane County Department of Planning an9 Community Dev~lopment by submitting the
installation recprd form. The Department shall inspect the construction to determine ~f it
complies' with. 't.he rules contained in this division. If the cons.truction does comply with such
rules, tt~e Department shall iss.ue a certificate of ,satisfactory completiolJ, to the permitfholder.
If the construction does not comply with such rules, the Department shall notify the permit
holder and shall require .,satisfactory complet.i6n before issuing the certificate. Failure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
lation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface
From:
Interio~ p~operty lines
Edge of road right-of-way'
Building foundation
Wells,' other water sources
Sewaqe Disposal ~~
\~sePtic Ta'nk
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5 .
50 .
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Drai'hfield,
10 I
10'
10 '
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TRS, TL Job Location (Address) :t. p~ 6. ,t//l-;tIt;R.. ///2 -.f:lf::2) I
, Permit (J 'For /tt)7P/ ,7"(OLJ/ Permit (J' , For
PI atP Is n Permit (J For'- Perinit (J For
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Vicinity Map
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ACTIVITY INFORMATION
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COMPLETE THIS SECTION, INCOMPLETE FORMS WILL BE REJECTED!
: 1. 6~R6E J." 64F;=;tt/
PERSON MAKING REQUEST ,
;{ pr{; y, HMtJR.. j/R.l J~
MAILING ADDRESS '
cSPrD O;2E f7~~7
-CITr---- STATE ZIP CODE
lane county
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3 MAP & PARCEL NUMBER' (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORMATION) ~~ ~rom ta~~atement~ ~ ~
TOWNSHIP RANGE s~f~JN 2 TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # . ZONING
TOTAL CONTIGUOUS PROPERTY IN SAME, OWNE~SHIP:j~ /1 A-r!~.h, ACRES
4 SUBDIVISION (if apPlicable)Uc.kJdftF U~f).e.. LOT 4 BLOCK ~
5 REQUEST (state exactly what you plan to do) -7 AM Pv5::H/tlJ6 L ;-/c:-
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. 6 OIRECTION~"~~ SITE:;;/J-~E28~ k6.~ - ~ Z~4:.3'-~J.:e.-
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** FOR STAFF USE ONLY **
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BY: '\ )TE: TI~~: fJUT:
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NUMBER
DATE
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LAND MANAGEMENT DIVISION / 125 E; 8th AVE.. EUGENE, OR 97401 / 687-4061