HomeMy WebLinkAboutPermit Building 1982-7-27
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CONSTRUCTI~/PLACEMENT
PERMIT ((1 'pP
PLEASE USE BLACK INK ~d PRI~~
.
FOR OF?ICL GSE O~LY
TO""SH"; 7 j RAe) ~ I SE~~ ..:3,.?] TeOcfJOUT or
'UBO'V'S'~k'lJ;' "f apQ5Cab1t ^rIm()f:.. I '4ARCEL I BrK
L~8')$bS;) I ~ ~ 1)\ , ~ ~M 0A77 ZIP
S~'CTU7??-r._tlL; .0" PHU~V\qW~J5J?-0WdL '
orff1T{J ~'+Tfjo) ~ (4fx\ ~ ~un
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CONTRAr~nbOa~ ~ ) '-' 0 - ,~r J
CONTRA~R'S6SRi I OI~r~rmrt) ~:b ~ ~.; UJ+-an
~ +0 ~ ) E)Yl l } f;;>N ~ Dn - ~ cYJ-I rtY
r II/WE CAREFULI,Y EXAMINED TilE COMPLETED APPLICATION FOR PERMIT, and d h cd>'! r:'~rW lh.1t: il1\ infrJrmiltioll )11:'1<;")11 i~: trll<": ilnd conect. 1llld 1
certify that any and all work performed shall he done in accordance with th Ordillil;lCCS of Lilnc County ilnd t;111~ I,,:r.~s of th'l SUI!;'! of Ol"'l~!l\ 1'<)
to the work described herein, and that NO OCCUPANCY will be made of any 5tructur~ ....ithout the pcrmi~sioll of the Building Divi~ion. I n"
that. registration with the Builder's Board is in full force and effect as requir(!d by ORS 701.055. that if exempt the basis for cXt'r.lptioll .
hereon. and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. I HAVE REi\D NIO
APPLICATION THOROUGHLY.
APPlicotiq~rQ__<JL/'
Perm~ t ~ -In/? t^J-L/
o Two Copies 0 ans-
o Two Copies of Plot Plans
DHechanical Checklist
o Plumbing Ched:list
Dplan Check Info Sheet
COHPLETE THIS BLOCK.
PROP~ US!; or" PROPERTY-' --.----
, ~ Residenti"al Olndustrial
o Commercial
Dpublic
~ f V.LU~
':'),l J. ~
o proposed
~xisting
'fELEPllONE NUl1BER
(~"T--~
'tELEPflt..1:m NUl-lEEk
-f--WILL I.1'1Jrl NA}f;Pli~J~~~~L ~
-;JjiL ~TU~;;// dld-t
o 'Owller
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1
D.;Tl"
o Cont.r~C:"a:::
o Ag()llt
~/fh
o PLANNING/ZONING: Zone ~- a "artition #
C ~ C
Ninimum Setback!:;: L, front L, sid0
Dt" j'; i+ '-"'ta2-4-f S./.~(I\("
"t-. VV1 t-...,
if FLOODPLAIN : In flood hazard area? ftS No '0' Yes, see attached sheet.
o RURAL ADDRESSING: OR'D CDORD,"An N
ta'SMHTATION: s. 1. # 8. P. # CfS-7~
Inst.allation '" Gallon
Specifications: ~ Tank
Parcel n
Parcel siz-:
Comments:
interior
t:..O
rear
c::.. ..
U
f'{/}.,.JJ b/~'" "/;k~
Date, ' 7 hi! ~
,
R,-4-BZ (~
o
O'ate:
E
Date:
-" Ie( S-c-
lns~allation Record Issued? [] Yes [] No
Lineal Feet
of Drainfield
Haximuro Depth
of Trctlchet;
Comments:
"BUIl...D'l}(~
LOD~
Type ~ N
t 0 tJ ~, /'t "'..:1""1 /)IJ
f)R.~ FIO~ t:/.
Group
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hI r=r-
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Date, J5/;;.1K"U tj/b
Use t)1A.J1O.....' ~
U.21Lr::-O R.JI"L TO II VI FtJ rz...~
SA,::.r:r;" c.()n~
'oate,XJjO V ~ ~ 5(j
~~ANS EXAMINATION:
corrunents:~\.. '-
CONSTRUCTION AUTHORIZED BY THIS PER}1IT
TOTAL FEE
$j.o. ao
$
$
S
S
$
$
$
$ .t=)~. ZJ
(~tl~ >
Sq. Ft.
Fixed Fee/
Unit Cost
Floodplain Fee
Subsurface Fees
Building Fee
se~/Storm Drain/Water
Plumbing Fixtures
Mechanical
Plans Check Fee
State Surcharge
PERMIT APPROVED BY BUILDUlG OFFICIAL/OESIGNEE
,," ,:^(f~~r"' D ,,,^
J~~ -'i~v 81-
-.805 (1)) DATE
TOTAL VALUATION $
LANE COUNTY DEPARTMENT OF PLA.NNING & COHNUNITY DEVELOPM!':NT 125 EAST EIGHTH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
1
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SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATION OF THIS PERMIT,
CITATION UNDER PR~VISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, ANDIOR OTHER. REMEDIES ALLOWED BY LAW.
W"F.N READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST 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 directions to site.
.
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BUILDING DIVISION:
REOUIRED IIISPECTIONS '.
1) FOUNDATION INSPECTION: To be made after trenches are excavated and forms erected and when all materials for the foundation
are delivered on the job. Where concrete. from a central mixing plant (corrmonly termed lItransit mixedll) is to be used,
materials need not be on the job.
2) CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after a1l'in-s1ab or under-floor building service equipment,
conduit, piping accessories and other. ancillary equipment items are in place but before any concrete is poured
or_floor sheathing installed, including the subf10or. .
. ,
3) .FR~ING & INSULATION INSPECTIONS: To be made after-the roof, all framing, fire blocking and bracing are in place and
all pipes, fireplaces and chimneys and vents are complete and all rough electrical and plumbing are approved. All
wall insulation and vapor barrier are in place..
4) LATH AND/QR GYPSUM BOARD INSPECTION: To be made after all lathing and. gypsum board, interior and exterior, is in place
but befor" any plastering is applied or before gypsum board joints and fasteners are taped and finished.
5) FINAL INSPECTION: To be made after the building is complete and before occupancy.
APPROVAL REQUIRED. No work shall be done on any part of the building or structure beyond the point indicated in each
successive inspection without first obtain.ng the approval of the building official. Such.approva1 shall be given only
after an inspection shall have been made of each successive step in the construction as indicated by each of the inspections
requi red. . i
. . \' . " ... -- . -
NOTE: All building permits require inspections for the work authorized, such as but not limited to:
A. BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured. This inspection 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 comolete.
Installation shall be in accordance with an approved nationally recognized testlng agency cud the manu-
facturer's installation instructions.
C. 110BILE HOME: An inspection is .required after the mobile home is connected to-an ~pprovedsewer or septic-
system for: setback requirements. blocking, footing connection, tiedowns, skirting, and plumbing
connecti ons. .
(1) Footings 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 floodplain
management letter. .... . '.. . .
.1 (3) 'Mbbile ho~e.t!iOdowPsi ",hen'reqiiired,;and- Skktirig sha'11:bednstan~d and reaA\' for inspection
... within at least 3D.days after occupancy. Tiedowns and skirting shan ,~e installed per ,enclosure.
. .' \ . ; '\ i'
D. SWIMMING POOL: Below grade when steel is in place and before concrete is po~red. Above grade when pool
is installed.
APP~OVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN
WIT' IN ;:2 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED ~OR~MORE THAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PER:,tIT WAS ISSUED ON THE BASIS OF INCmiPLETE OR ERRONEOUS INFORMATION.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT HIS OWN RISK
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
(1)
'.: (2)
Permits ~hal1 be effective for one year from the date of issuance.
Upon comple~in~the construction for which a permit has been issued the permit holder shall notify. the
Department by SUbmitting the installation record form. The Department shall inspect the constructlon to
determine if it complies with the rules contained in this division. If the constructlon does comply wlth
such rules, the Department shall issue a certificate of satisfactory completion. to the permit holder. If the
construction does not comply with such rules, the Department shall notify the permit holder and shall require
satisfactory completion before issuing the certificate. Failure to meet the requirements for satisfactory
completion within a reasonable time constitutes a violation of ?RS 454.605 to 454.745 and this rule.
Setbacks - Subsurface SewaQe Disposal
From: Interi or property 1 ines
Edge of road right-of-way
Building foundation
Wells. other water sources
SeDtic Tank
10'
10'
5'
50'
Drainfield
10'
10'
10'
100'
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~ANNING & COMMUNITY DEVELOPMEN~
ACT~ITY INFORMATION SHEET
bne county .
"
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!.
1. J/JtILLJlhM 14. ~NVJUE:_
PERSON MA ING REQUb I
;;/.s7;.:z m~~ I?~IV~
. MAILING ADDRESS
c;~i:
PROPERTY OWNER
MAILING ADDRESS
'5~hU4F/~~
CITY
Of(
STATE
Y?-P?
'ZIP CODE
CITY
STATE
ZIP CODE
BUSINESS TELEPHONE #
]'f7-G.jt:>p
HOME TELEPHONE #
BUSINESS TELEPHONE #
HOME TELEPHONE #
2.. PROPERTY ADDRESS SA_e:-
i (IF DIFFERENT FROM MAILiNG ADDRESS)
i 3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
/15 .JAMM 01-3
TOWNSHIP RANGE SECTION
;/'00
TAX LOT(S) OR PARCEL #
ZONING
. TOWNSHIP RANGE ~t~IION
TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
ACRES
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable) j1Ie.Ke,v2Jc J1'/PMJ();#
LOT 4
BLOCK J
. 5 REQUEST (state exactly what you plan to do) ADD (I"".--c:u
11 i!S:GA'". (!D t.J eP E.....
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PAn~~J~ilh:~i I AIff7~orU([-=
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! 6 01 RECTIONS TO SITE:
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** FOR STAFF USE ONLY **
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ZONE/LAND USE:
BY: DATE:
NUMBER
DATE
-j
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TIME IN:
OUT:
Q~=:,,:'
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PERMIT WILL' ISSUED UNTIL TffiS APPLICATION HAS
1't30-7C;
hRMIT if
BEEN APPROVED
APPLICATION FOR:
CJ
CJ
!JILL/Am
Name
MOBILE HOME CJ
J.t 0LAJvl '-LE
Address
PLAN REVIEW
CJ
CHANGE OF OCCUPANCY C=:J
OWNER
;}.lj'92-
h114d!!.R' DR S~
City Zip Phone,
/
/
,Phone
"1J-1~}df
-
CJ
CONTRACTOR
."f".Fc.F
Name
Address
City
Zip
O.S. REG. D
1Wp. 17
Rang.D -~
Section J S. 3 .~ax Lot
1(, crO Code'()f9-o~
..
Census Tract
Subdivision
Lot
Block
Property Acreage
ACCESS TO PROPERTY (Road Namel.J:.uAVd/? D& (}F
Existing Structures on Property: /');J,:: JkJlr5e:/ Pv"TArr..uG,) GA.r?,b(;.C. /
Property Location - Address/DireCriOns:_~57'2.- klAJCJd~ [)rfluE 5r-:;pl/t,f"..-F1&..r>
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Width______Depth
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Below for Office Use OnlvXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
FEES:
Jo~o-o
. 0,(70/
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PLUMBING:
Installed by CNner c:=J
PLUMBIN<H~ 3
,...:....; U of Fixtures
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Existing Sewage Disposal System ~~fNew System Required c:=J
Na~~~ommunity or Public System
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(~/t.~~/c:=J Name
Sewage
Connection
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q()F(jd /0./0 . D)(foms) .
"""10 /~i:A,-J?f /ji;~#,qD~_
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~ Valuatlo~ ~
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fJC= EiJLAA.r1~.
SEWAGE DISPOSAL:
Site Inspection n
WATER SUPPLY:
Well
Public
c:=J
Spring
Other
Community c:=J
Bldg.
Plumbing
3% Surcharge
Waste Disp.
Plan Review
Mobile Home
Water
Connection
--t.
"1,1
FURNISHED
FACILITY PERMIT
TOTAL
I
f7
o CASH
~CK
CJ
q /;;9. I~
A(-_--/a-
'Date: 7-/'7- 7-6
Signature of App
Fee Received By:
Min. Septic Tank Capacitv
~ M. .tAL.. 6.-..tL
.............,"'J- lu._ ~
Type of Construction
.., ,-
I ~ IV Group
y
/
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Fire Zone
Use Classification
Bldg Setbacks ~rom Center of Road Right of Way:
Front ~" Side Int. 5 S~C^Lerior
Rear
~ Zone ~ /l-:-
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~ANITAT O~i DATE:/ d BUI~ING:.# #7f/' DA~:
. ~ "1-21-~/rJ ~ff:;:..r 7-.2.'2 -?h
COUNTY DEPAR ~NT OF<1:NVIRONMENTAL MANAGEMENT ,-