HomeMy WebLinkAboutPermit Mechanical 1986-3-21
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.c1/2.a.bc.J..t INSTALLATION INSTRUCTIQNS IS SUBMITTED ':< /:
"'-v"- GvMe.r:so!,- (owner)
* . NAME E. >t!(' P / ('.(1..Y\ .<;f1u...rJ 0 T-prg PHONE <lA<./
* ADDRESS FOR INSTALLATION In.. '\t. /Y1aj( 0 rd . clTY...6..pr; no -1= i p.ld.
* NAME OF MANUFACTURER l/n..kn(lf.WL ('fin +aaor i1"M~rli';Y\+ -l
* INSTALLER ~x('e.J r r'I_n.<'n/;r1nfed -.J ORS # ,17~t,3
CIRCLE THE SKETCH MOST
CONSTRUCTION: CLOSELY RESEMBLING YOUR PROPOSAL
* A. The unit is listed by: OUL OICBO OOther (name) \''''',,,@, (~~ \
B. The floor protection ;s / ~I/ inches thick. {Material)."ij ....utafe.d.. Dr.r.K ./
C. The wall protec.tion will be: (Material)~" :-:iMil Jo.ted brirJ:::,
* O. Type of chimney: Q{lFa~tory DMasonry (lined? []yes Dno)
o Other
E. Type of stove pipe: OFactory 12{126ga (or heavier) galv. sht. mtl.
(vent connector)
,
lIMENS IONS: (; n ; nches)
" II
Side of unit to protected wall-!B-(unprotected wall 3Go)
Rear of unit to protected wall /8 .'(unprotected wall 3G:> ")
. /. .:', .'liii' /......... r:.7-0
Floor protection at side of unit (/) at rear' lX.~-J' ......in, front L.:;. .nfl_
Len9th of wall protection at rear of unit 3(0 at -side
Height of wall protection.5 A ~et bif'O'S~ v"i+
Edge of walt protection to nearest doc or window a
Air space between wall ,protection and wall I
8. Diameter of chimney and stove pip.(vent connector) ~
" ' 1.
2.
3;
4.
S.
6.
7.
NOTES:
(1) Outside combustion ~fr i~ real/ired for all fuel burninq installatio"ns, A 7 Sq. inch (min. area),closable- vent loc
ated within 24,,'of the"'t1replace'or.appliance on the floor or base of a wall. "
(2) A copy of the approved manufacturer's instalhtion instructions must be on job site at the time of inspection. In.
spect10n cannot be made with out these instructions.
13) The 'Approved' plan/application shall be kept on the job site for use at the time of inspection.
4) Not all units are approved for corner'1nstallations or reduced clearances with wall protection. (Refer to manufac-
turer's list1n.sl.)
(5) If masonry chimney is to be used, it must be-lfned: -(Required by Law) EXisfing-flues must lie approve-d by. inspector
prior tll use-:- tou must E!-Q.V11f' -llieSS tor the irisoectnr _ -
(6) iT flniplace insert is to be installed, veriflC1\'t10n ot walt' header location 1n relationship Ito-breast of fireplace
is required by law. - - -
(7) . Fireplace 1nserts lire not pennitted 1n factory-bullt or prefabr1cated-metal "0" clearance fireplaces. unless
specificallY tested and l1sted.
(B) Fireplace inserts are not pennitted 1n masonry fireplaces with existing heat form type metal fireboxes unless
spec1fically tested IInd listed. --.0.
(9) Unllsted units shall be installed In accord with the State Mechanical Code. utilizin9 the mater1als and clearances
set forth in Chapter 5.
/ J..) 'S774LL
C-14-32
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APPROVED AS NOTED
By ~. 'P.
Oat" "3- 2/- B Co
PERMIT # 8/S-~ sCe
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LAND MANAGEMENT DIV.
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IF YOUR INSTALLATION DIFFERS
FROM THESE EXAMPLES OR IF THE
INStALLATION IS A FIREPLACE
INSERT, PROVIDE A PLAN AND
ELEVATION DRAWING'WITH DIMEN
SIO~S OF YOUR PRO'POSAL.,
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/ PUBLIC WORKS DEPT. / 125 E. 8th Ave.. Eug. OR 97401 (503)687-4061
..
RURAL ADDRESSING
C}e;t(EO MAR 19
Lane County Authorization
WOOO STOVE INSTALLATION/RELOCATION (UNLISTED STOVE)
e
for:
RfCK
3~;;L.l>
FOR OFFICE USE ONLY
APPlication/~jI'~,1
Perml.t # V;;
1'001,5,'7 I RANGE 03
S~BDIVISION/PARTITION (if applicable)
SECTIO~ 2. 1 . 3 ) TAX 'f420~OUT OF
I LOT/PARCE!. I BLOCK
PROpoSED USE OF PROPERTY
~ Residential 0 Industr ial
o Commercial 0 Public.
LOCATION ADDRESS STREET
636 Mallard St., Springfield
CITY
ZIP
DIRECTIONS TO SITE
Harlow E to pfheasant, N on Pheasant to Mallard, W on Mallard to address
h
~
,~
STRUCTURES CURRENTLY ON PROPERTY
SFD
Wood stove relocation of
= OF BEDROOMS J ! OF STORIES
Q;mER' 5 NAME AND ADDRESS
GUNDERSON, Elizabeth
existing
I ij OF
stove from
EMPLOYEES
ha 11 area to
I liATER SUPPLY
a round the
I DECLARED :;; VALUE
corner in LR
o Proposed
fXt Existing
9'f5P~O~1 (\'UMBER
4'it4P~~MUMBER
~~SCRIPTION OF PROPOSED WORK - BE SPECIFIC
25205 Lamb, Elmira 97437
CONTRACTOR'S NAME AND QSR #
EXCEL CONSOLIDATED
2610 W. 5th St., Eugene 97401
P:::RNIT TO BE MAILED TO lNAME AND ADDRESS)
'. ':'.u'::'~ .......IlE NUMBER
I HAVE CAREFULLY EXAMINED THE ca-tPLETED APPLICATION ~'OR PERMIT, cml! tIo hereby cert.ify that all information hereon is true and correct, and that I
have the following legal interest in the property: Downer of recoJ,:d; 0 contract purchaser; ~authorized agent.
I f:.:.rther certify that any and all work performed shall be done in acr.;onlanr.:f< wi th thl:! OrdinAnces of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will be made of ar.y st,rllctllre without the permission of the Building Division. I fur.
ther certify that registration with the Builder's Board is in full force ,mu effect as required by ORS 701.055, that if 'exempt the basis for exelllptior.
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.
Eue) r-"lllc~'1I.i.d~ teJ-.
NAME (p~oase print)
vl7~.~
,/ ...... -, ~ SIGNATURE
3-19-86
DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS~
[] PLANNING/ZONING:
Zone
Partition It
Parcel It
Parcel Size
Minimum Setbacks:
C
L, front
C~, side
interior
rear
CO/>t'IENTS :
NO SPECIAL PLANNING ACTION REOUIREO.
[] SANITATION:
S. 1. It
B. P. It
3-19-86 ~
Installation Record Issued? 0 Yes 0 No
Date:
Installation
Specifications:
Gallon
Tank
Lineal Feet
of Drainfield
Maximum Depth
of Trenches
CCl-IHENTS:
Date:
n
[] PLANS EXAMINATION:
COMMENTS,CAL L
Type ------ Grouo
J::cR RlFGU/REO
Use
ws
J A)SPFc-rtoV.
Dale, "l-G1-~
~
.WJ=~ ~ ') ~7 -f/~~ ?/k/2
PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE Coer ORS 456.8~5(i)) DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE. OREGON 97401
\-2/-&~
C::RR RRURRC:R FOR UJC::PR(,'1'TON TNPORMll.'1'T()N
".1 ...~ on...
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"
.
.
..
.
SETBACKS A~D OTHER CO~DITIO~S Of APPROVAL MUST BE STRICTLY OBSERVED. VIOLATIO~ CA~ RESULT IN REVO-
C;"7IO~ Of TIllS PER~IIT, CITATIO:: U~DER PROVISIO:-JS Of LA~E COliXTY'S INFRACTION ORDI::A:-ICE, AND/OR OTHER
REMEDIES ALLO~ED BY LAW.
\<1HEN READY fOR I:,SPECTION, CALL 687-4065. A :-lINH1U~1 Of AT LEAST 24 HOURS ADVA::CE NOTICE FOR INSPEC-
rIOl'< KI:;Q"J:;:;T::i ~;U5T BE GIVe:.:. Huve the tollowi ng informa tion ready: permi t number, . job address, type
of inspection, when it will be ready, your name and phor.c nu~ber, and any special d~rections to site.
BUILDING DIVISION:
REOUIRED I~SPECTIONS:
1. foundation Insoection: TO be made after trenches are excavated and forms erected ~nd when all
materials tor the toundation are delivered on the. job. 11here concrete from a central mixing
plant (com."IIonly termed ~transit mixed") is to be used, materials need not be on the job. \
2. Concrete Slab or Under-floor Insr.ection: To be made after all in-slab or under-floor building
SerV1Ce equipment, conault, plplng accessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Frami~9 ~ Insulation Insp~ctions: TO be made after. the roof, all framing, fire blocking, and
orac1ng are 1n p~ace and a~l plpes, fireplaces, chimneys,.and vents are complete an~.all rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
4. Lath and/e,E. Gvpsum Board Ins;l?ection; To be made after all lathing and gypsum board, ~.nterior
ana-exter10r, 1S In-pIaCe out Detore any plastering is applied and 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. ~o work shall be done on any part of the building or structure beyond the point
indicated in each successive inspection without first obtaining the approval of the building official.
Such approval shall be given only after an inspection sha~l have been 'made of each successive step
in the construction as indicated by each of the inspections required.
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
lnspectron 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~: To be made after COmpletion of masonry (if applicable) and when installation is
complete. 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-5eptic system for setback requirements, blocking, footing connection, tiedowns,
skirting, and plumbing connections.
1. Footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufacturer. .
. ~.... . .
2. Mobile horne.minimum,fqnish floor elevation shall be certified when required by a flood-
plain ma-nagemerit 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.
D. SW!mm!n9 Pool, Below grade when steel is in place and before concrete is poured. Above grade
When pool-rs-!nstalled.
,~
,
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. TillS 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 11AY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFOPJ1ATION.
ANYONE PROCEEDING PAST THE POIt,~ or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
,
SUBSURFACE Al'<O ALTERl'<ATIVE SEWAGE DISPOSAL SYSTEMS:
1. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installation record form. The Department shall inspect the construction to determine if it
complies with the rules contained in this division. If the construction does comply with such
rules, the Department shall issue a certificate of satisfactory completion to the permitl holder.
If the construction docs not comply with such rules, the Department shall notify the pnrmit
holder and shall require satisfactory completion 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:
,
Interior property lines
Edge o~ road riqht-of-way
Buildin<;l foundation! , .
....ells. other water sources
Sewage Disposal
Septic
10'
10'
5'
SO'
~
Drainfield
10'
10'
10'
:100'
'"
..
,/
.
TRS/TAXLOT
OHNER
APPLI CANT
(IF DIFFERENT)
JOB ADDRESS
VALUATION .
REVISIONS CALCULATED BY:
DATE:
.
AODRESS
ADDRESS
REVISED
[ ] Addition
[ ] Correction
Bldg.
Invest/
Db 1 Fee
Mech.
Plmb.
Fi xtures
SHR FT
\.JTR FT
. RAIN FT
/q.QO
PCK
Surcharge
4.7~
.7C,
Sidewalk
Fldpln
SDS
DEQ
Other
TOTAL
"24.5"/
~tP
~ - 'Z./-SCo
.
APPLICATION #
815-- 8Ce
PHONE'
PHONE
PRIOR [ ] Refund
[J Dep. Only [] Amt. Due
/~.oo
tI.o~
.fr,cJ'
20 . Cr.,!
(AMI. PAID)
3,00
. 75:"
. /2.
~ ~ 87
(AMI. DUE)
LANE COUNTY DEPT ENV MGT RECEIPT I 81586
· APPLICANT EXCEL CONSOLI Df'HED, ('lDIH\ 2610 W., ~5TH ST., EUGENE
TLI 1703221314200 SUBDIV LOT
."IEW BI._DG. TYPE USE I, BDR~iS 0 UNITS 001 STOI;:IES '~BLDGS 001 PHONE
OWNER NME GUNDERSON, ELIZABETH ADDR 25205 LAMB ST.. ELMIRA
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION
.BP
BP
BP
.rw
BP
'I ,"iECH LC B15B6 WS
."'l IF I X/BATH :
MECH
SUI'~
.'CK
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46
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SWI'!:
FT. WTR:
ME:CH,~N I C(,L FEE:
STATE SlmCHARGE
PL,~N CHECK FEE
.
CATG:
.SEQU:
.. tAKEN
.
1"1'"
PCI<
3
SDS
API':'
I'!A
2
S1
BY GT
EST. COMPLETION DATE
.
.
FT.
I'!AIN:
4%
25%
OTH
ISS
4
TOTAL FEElHi
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DATE 031 'i'8(.
BLI<
484 'i'8f3S.
FEE
FT
16.00
0.b4
4.00
20.64 CK
DAY;,~' '
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AC~ITY INFORMATIO~SHEET
lane county
~
.-'
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REjECTED!
. 1 f )(Lf>) CQrJS0 GrJ, P. feci
PERSON MAKING REQUEST
Qr;., /() JAI. \~u Qj-;,
MAl LI NG ADDRESS
'€uqp,n f.-' , () R.
-.J CITY STATE
"fji;?n hp.Th Gr/J..n.de (',c:;nn
PROPERTY OWNER
Ol..<;,:}()/) j !?rn h
MAl LI NG ADDRESS
9'7</Q(
ZIP CODE
-0/mICO
CITY
J
()R
STATE
q<-.<,O.2
ZIP CODE
</.-9<(- 9~A
BUSINESS TELEPHONE # HOME TELEPHO E #
2 PROPERTY ADDRESS ~ ~ (Q M i;{ /Jo,.,rd ,
(IF DIFFERENT FROM MAILING ADDRESS)' -
't:?>S - 1\ '3 J ()
BUSINESS TELEPHONE # HOME TELEPHONE #
'-~pr-I f\jrf; plr1~ ()R
i
3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation
or from tax statement)
17 o:~ .O?c;{ /3 /.1../&00
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
\,
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TOWNSH I P RANGE' SECTION
TAX LOT(S) OR PARCEL # ZONING
ACRES
LOT BLOCK
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'i.nJrl +hp; livll'\'j
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
5 REQUEST (state exactly what you plan to do) ~C_Gl1-P.
h.a II Os'Pa +0 around +kp, rrll~ne.l"
~.fJ ~
rOOM
6 DIRECTIONS TO SITE: jjo..r/()IA) pn.<.+ iCL.___e.h.e.a.c:;o.n+-J-nn r+h Or\.
Plvoo.,<;QV\T+o fYlQllo.r-rl_, IA..lp,,<:.,f t')f\ ff1oJIOJ'rf +/'1 o.dd..cess:
\
** FOR STAFF USE ONLY **
ZONE/LAND USE:
BY: DATE:
DATE
....
;;0
VI
....
r-:
NUMBER
TIME IN:
OUT:
LA~D MANAGEMENT,'D'rvfsION /. 125 E. 8th AVE., EUGENE. OR 97401 / 687-4061
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