HomeMy WebLinkAboutPermit Sewer Connection Record 1987-8-18
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Lane County Authoriza ion--f - .:- / ..
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1\JW::SHI P I RANGE^ ~ I ;;CTlON~ ~. - I ~/LOT/,\ ,J",JOUT OF' PROf'~USE o~ PROPERTY .
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'" ?~EDROCX'IS ,-If eFoe.;o*s l 1\ If OF Ef'JPLOYE~ I --r- R. E-PL'( h "\ 0 Proposed
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O;~~REr1cIzL ~ tQ Id.25l-.., ~~HONE NOMBER
~1noR1s~E AND OSR # ~Cfu -~ " /-?F'irf~N.:~~ -
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I VE CAREFULLY EXAMINED THE CCMPLETEO APPLICATION POR PERMIT, df,d ,10 hero!J)' cet if, that all in nnation hereon is true ..nd correct, and that I:
have the following leg nterest in the property: Downer of rCCOl.d; 0 C(,h~rd",t. l>'lrcha:;cr; o <l.ut.hori zed agent.
1 f~rther certify that any and all work performed shall be done in o.Cl.:Ul.uane", Id th tb,l ()nhllance~ of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will be :nade of ar.y SfTlIcture without the perm.ission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force Hnu effect d& required by QRS 701.055, that if 'exempt the basis for exemption
is noted hereon, and that only subcontractors and employees who are in cOmpliance with ORS 701.055 will be used on this project. I HAVE READ AND
" CHECKED THIS APPLICATION THOROUGHLY. ~ .
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.,. NAME (please print) r \ ~ SIGNATURE
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READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION !lAS BEEN BASED ON THE FOLLOWING CONDITIONS!
[] PLANNING/ZONING:
Zone
Pacti ticn II
Parcel #I
Parcel Size
Hinimum Set~f?;.s:
COMo'1ENTS~
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CL, front
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HJ n< Ot~L'pllfl;25~:t~2!t~l^-'X rear
~ . DaUl] 1I1Jx. ~~ t1ij?
B. P. # lnstallat~ Issued? 0 Yes 0 No ( .
Gallon Lineal Feet kaximum Depth
;;(~1r7-f-: ~~~_~fn';F 5r ~f~ -
~~^~ ..,e...\l, Date: <f'~.Y'-_b~
o SANITATION:
S. 1. II
Installation
Specifications:
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[] PLANS
COMHENTS:
Dale:
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~~vE1 BY BUILarNG TIFFICIAL/ GNEE (oer ORS 456.805(1)) DATE
LANE COUNTY DEPARTME F PUBLIC WORKS LAND MANAGEMENT DIVISION. 687-4061.
125 E 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION .INFORMATION C 14-2~ RR4-
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SETB,\CKS ;..~O 07!!:R CC::OITLO::S OF APPROVSL"" ~IUST BS 5TR1C':':':: O<:$.ER\'ED. VIOLATIO~ CAS R!:SULT I~ REVO-
C;,:'IO:: Of "US i'ER}1l7, C IT"TI 0;: U;:nER PROVISrO:IS Of' L';;:E';':,n:::"j\,':i gn:,;CTIo:-, ORDI:;:;:,C~;, ;.::OjOR OTHER
RE;'IEDIES ALLOWED B~' LAW. _ _"
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..'HEN READY FOR I:;speC,IO:.!, eM.:' 587-..065. . A. ~:ua:.1U:'1 Of ,\T L::t\ST 2.. If OURS ,\OV,\:;(:[: :;QTICE fOR r:1SPF.C-
T~Q:; IU::QL::;:;7S ;.,:":ST i!!:; GIVE:::-:-Tra'lc tne ~ollowing in::>:;::I<1::,:.on :;cady: ?crmit nu;uber, j6b"'addCcss, type
of inspection, when it.will"be rcndy. your name and ?~o~e ~u~~er, and any's?ccial atTcctiChS to si~c.
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BUILDI~G DIVlSIO~:
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REQUIRE::> I::SPECTIO:IS:
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i-. Found"tio:l InsT2ection, TO be_mad~ after trenches are oxca\'ated ilnd [orms ~nkt;od-ii..nd when all
~atorLa15 ~or the loundatlon are pcllvcrcd on the job, ~hcrc co~crctc from a cc~tral mixing
'plaia (commoply termed "tran5i~ mixed"}'is to ~c US~d, materia'ls ~oed not.be-..on the j,?b.
2. .COJIcretc s'lab or Under-Floor Insnection;, .-rot bJ mace after"'ilH in~slab-or unde.r-tloor building .-
servlo.:Q, c....uiprncnt. eO:lOUlt. pIpIng accessories. and other ancillary equipment' items are in .
, pl"'tco OUt beiorc any concrete is pourE!d.'or floor sheathing iristalled',including the subfloor.~
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3: ~raminq &. Insulation Insoections; Tolbe maae a:ter the ,:oof, all framing, fire blocking, a!ld
racl~g are In ?laCe a:lO all pIpes, fireplaces, chimneys, and vents are c~mplete and all roug~
elect.rical and plumbing are approv~d._ _,~l wa~l insulatio:'l and" v~;>or parrier are in place:_'
4..; Lat,h and/or Gvpsum Boare Inspection: ~o be made .after all ~athing "nct gypsum board, l,nterior
ana-ex terIOr, Is.ln-prace but bOloro any plastering is app~ied and before ~ypsum' board joints,
~nd.fa~~er~ are taped2ryd_fiil,ishe.~. \)-/ _ '\. ... J .' f I;'~' ;,. .':'.
s.....;~in'al Ihs'oection: To he made after the building is complete and before~ occupancy.
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APPROV,L REQUIREO. ::0 ....'ork shall be done~on any part of the bui_lding or structure beyond the poin!;..
indicated in each successive inspection without first obtai~ing the aporoval of the building official.
'Such approva~ shall be given only a~fter anltnspection shall have been ~ade 9f~each suc~essive step
i~.the.co[ls~ructiOn}s 'ifl;d~cat:d by. each Of, t~e inspe::=tions requi~ec. . : _' "
NOTE; All building permits require inspection5 for the work authori~ed, such as but not limited t.o;
A. Block Wall: TO be made ~fter reinfoicing is i~ place, but before any grout. is poured. This
InSpectIOn is required for each bond beam pour. There ~ill be no approval until the plumbinq
and electrical inspections have been made and approved. .
B. ~ood~: To be made after completion of masonry (i[ applicable) and when installation is
eonplete. Installation shall be in accordance witn an approved, nationally recognized testing
agency and the manufacturer's installat.ion instructions.
C. Nobile Home: An inspection is required after the mobile home is connected to an approved
sewer or septic system for setback requirements. blocking, footing connection, tiedowns,
skirting. and plumbing connect.ions.
1. Footings and piers to comply wit.h State foundation requirements for mobile ho~es pr ~s
recoinme'ndcd by the manufacturer. . - ~ . .
2. Mobile home minimum finish floor elevat.ion shall be certified when required by a flood-
plain management letter.
3. ~lobile home t.iedowns, when required, and skirting shall be installed and ready for inspec-
tion within at. least. 30 days after occupancy. Tiedowns and s~irting shall be installed
per enclosure.
D. Swimrnin9 Pool: Below grade when st.eel is in place and before concrete is poured. Above grade
wnen pool-rs-installed.
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,'l,PPROVED PLA:.lS ~lUST BE O~ TilE JOB SITE AT ALL TI:>1ES DURING WORKI:-JG HOURS:-- TillS PERl'IIT WILL EXPIRE I
If" ~ORK DOES NOT BEGI:-J WlTllIN 180 DAYS"; o"R IF WORK IS St;SPENDED OR ABANDONED FOR ~.:ORE THAN l!lO~,D"YS.
SU5~ENSION OR. REVOCAT;qU ;'V"Y OCS;UR 'IF ..!"IS PER..::!.Iir_ I!AS,'IS..?YEQ.'@ .!It.E BASIS OF. .lNtOl1PL~T' .OR ERRQNEE.,US_
INFORHA'NON.
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'ANYONE PROCE~OlNG Pl,ST TIIE..I>OI::T OT REOUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
JUBSU;FACE AN~ ~~E~:-J~T~VE ~ DISPOSAL SYSTE~S,
Permits shall be effective for one year from the cate of issuance.
Upon complet.in~ the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Corr~unity Develop~ent by submitt.ing the
installat.ion record form. ~he Department shall inspect the construction to det.ermine if it
. comp~~es with the rulo5~eont.ained in this division,~ If t~.construction does comply with such .. \....
.._ _.~_''': ........(ulo&t~~r.e Dep;;llltment; 'Sqall i~s.l::!a_a,(;ci'q;'lfi(JQte of sil,tl€"fifcj;,ory complQ,;.ti.Q.n-to tl;lC' ~er~i.ti ~,oldcl;l~ '1 . '
- It fhe'Consuuc.tion dtfih'''lTot ~rnpl}. wrr~' suc~ule€', j-t.h'eDt!-~d..":lcnt. shlill notrtY t."ii'q....perlll.lt - .- ..y:-
"... \holde,r ~nd ~~~l requi.re sat~s~actory cd;;plet~on befo:-e issuing thc..cQ.;"tiUc.-i,te: ,Fililurc,to . ":.. "
~. meet. t:h~ r~\J'l.remcnts for saustactory cornpletIQn:~t;h.ltita_re;;lpo,.n~.l.t;."pm<i co~U~tes il Y.Jo~.... ~.....~ ~ "".';...J_~"':-"':"_"
l"ation of ORS ~5~.605 to ~5~.7~5 am] this rule. \." -.. \""
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~et.bacl<:n - Subnurfilco S~waqe Disposal "
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f:-orn: Interior property lines
Edge 0:' road rl<,ht-of-way
BUllliinq founrlat:on
~clls. other wat.er sources
S('otic '!'ank
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5'
50'
Dr;;linfield
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ACTIVITY INFORMA TION SHEET
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Please complete all Items above dotted line
FILLING OUT * LINES WILL GET YOU INFORMATION ONLY
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REQUEST KI'lAYo./a &'L::>A.J;::-,e QWNER /7'.t2.ra...... /.<//7 rr- e
ADDREss3?~q<? [J~,e77'-t:dP/f.Lj 7<1 ADDRESS 4R'f /H H/t} ~ />p Ic;/.
CITY lUa ",(20/ D STAT~1l ZIP779C<-C'( CITY .$pb..Ot:;' J:/e.,,?; STATiO'J!' zIP77~.? 7
TELEPHONE (BUS) (HOME)..B5 ,.,:)~~ 7. TELEPHONE (BUS.1 (HOMEI 7~ - 77/ /)
*PROPERTY ADDRESS-=t,PR J1-j 17 /1)_~ he /d S.otP/AJQ...D'e../d.~.e 97<(77
OR (- I . ,
MAP & PARCEL NUMBER (Found on lax maps in the Assessment & Taxation Dept.) , .. . ' \..
.I 7 03 d--3,;J/f _z:;Co 00 iO A ~~.w DETEr~ - - I
. T..,,,,, "'"9" "''''"" T., "" ~';0 'l!f!:.~'Z7 ~
Township
Range
Section
Tax Lot
Zoned
Flood Plain
Township
Range
Section
Tax Lot
Zoned
Flood Plain
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
.ACRES
*RE~~EST(desCrlbe what you want to do) ~,
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Dire:]tns to
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site J.c4(_ ~zA-!U -/97?.. ~nCUM_ ,A
&7,~ .2t ,~o:f/<.'J7J}-h/ at ~1'1an.J~
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Comments:
Land Management Division, Public Works Department 125 E, 8th Ave" Eugene, OR 97401 phone 687-4061