HomeMy WebLinkAboutPermit Miscellaneous 1988-4-4
r:NOTlce: Plans submitted herewith must b--ared by- an engineer or architect
registered in Ihe Slate of Oregon :KUSI comply with the requirements
01 OAR Chapter 33, Section
Vj~D ~O(P
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LANE COUNTY ENVIRONMENTAL HEALTH ~
I
Application for a Permit to Construct/Alter
A Public Swimming Pool and/or Facility
TO: ENVIRONMENTAL HEALTH SERVICES
125 E, Bth Avenue
Eugene, Oregon 97401
Application is hereby made to construct/alter the following swimming pool and/ facility. It Is understood
that a construction/alteration permit Issued under this application must be received by the owner or his/her
legal agent prior to any actual work on the project.
A construction permit for a swimming pool and/or bathhouse is valid for the calendar year In which the
permit is issued. A final construction approval is required from the Department upon completion of the
work. Applicants must notify the Department when construction is complete, and apply for and receive
an operating license before the pool is used. Pool or bathhouse operation without a valid license Is a violation
of Oregon Law.
Name of Pool and/or Facility:
Location: 7335 MAIN
(Street Address)
SAtrrJPr60 QlVIMuNrnES
SmJl\I6AELD
(City)
LPI're
(County)
~eoN 9"1477
(State)
Owner: SI'I(j~ J. D'ISCEFE (w)-c:rBI- Bf>Ofl
,
Address:~Qf(l~2q; Wa7DJ?(JPN OPoEeoN '<'f,a71
Builder: tl&~'f I'lW€NS , ~\ VAlLE'LflloLS fJjo ~ · (dJ'O-(P7.27
Address: n"f]~ttI6tttltrl ~13J6EN€~~2.
ArchiteCtlEngineerj~g1'll3l2jS8bz-'l ,ApcHIIt:L1 · 3lt3-3/34
Address:
37 WEST" 13'TH SUIlE 2D1" l::U6BiEl ()R.ffiOH q74{)J
Type of Facility: (X which applies)
'(X) Swimming Pool ( ) Bathhouse ( )Wading Pool ( )Spray Pool ( )Spa
Type of Companion Facility with which Pool is to be Operated (Motel, Apartment, Mobil Home Park, etc):
Type of Construction: O() New Construction, or ( ) Alterations
I agree that the above described facility will be constructed in compliance with the plans and specifica-
tions as approved by the Environmental Health and further that it will be operated subject to the provi-
sions of Chapt. 448, ORS & Chapt. 333 of the Administrative Rules of the Oregon State Health Division.
I
NOTE: A TO"'!"AL OF $200.00 MUST ACCOMPANY THIS APPLICATION UNLESS THE
ABOVE MENTIONED FACILITY IS OPERATED BY AN ENTITY EXEMPT FROM
THE PAYMENT OF FEDERAL INCOME TAXES PURSUANT 10 THE INTERNAL
REVENUE CODE OF 1954, AS AMENDED. THE $200.00 FEE INCLUDES $100.00
FOR THE CONSTRUCTION PERMIT AND $100.00 FOR PLANS REVIEW BY THIS
DEPARTMENT.
OWNER'SJ~URE: Fkltft~ ePiv -'. DATE:~L ~~