HomeMy WebLinkAboutPermit Miscellaneous 1978-9-11
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JOB LOCATION
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LANE COUNTY PERMIT
Acreage or Lot Si,a
Contractor's O.S. #
Partitioning #
) Completed
Subdivision
Lot
Bloc~
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APPLICANT'S NAME AND ADDRE""
OWNER'S NAME AND ADDR"""
CONTRACTOR'S NAME AND ADDR"""
Mail permit to (~ ) Applicant ( ) Owner
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Phona
Phona
(owner, etc.1 when ready.
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) Contractor. (
) Prefer to pick up. Call
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STRUCTURES NOW ON THE PROPERTY ,.
-.HIS PERMIT IS FOR . .
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# BEDROOMS~# PLUMBING CONNECTIONs..lJ
WATER SUPPLY
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
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SEWAGE DISPOSAl
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PLUMBING BY
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I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _owner of record;
contract purchaser; _ potential buyer; _ realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply with all appHcable Codes relating to this permit.
Fee Paid ~. Signature
) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT
Data
) SPECIAL PMT. AREA. MIN. ELEVATION:
.omments:
~.
Minimum Septic Tank Capacity (Gallons)
Drainfield Required. Lineal Feet
Maximum Depth
BUILDING
Type of Construction " Group
. .,' Ilse Classification
Fire Zone
SANITATION
Comments:
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Date: 7-! I )/ '.
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Date Issued>.,.. Il - I,
INT. SIDE YARD. ., REAR --(FROMP/Ll
By: Date:
PLANNING REQUIREMENTS SATISFIED. By:
ZONE: :, .". . SETBACKS: FRONT
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SIDE FACING STREET
Date:
.(FROM C/Ll
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
PHONE: 687.4394
C55.13
BLDG. PERMIT -WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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SITE INSPECTION
ApPROVED Cl DISAPPROVED Cl DATE
INSPECTOR
REMARKS
FOUNDATION INSPECTION
ApPROVED;----? DISAPPROVED ~I DATE
INSPECTOR
REMARK S
FRAMING INSPECTION
ApPROVED I I 01 SAPPROVED I I DATE
INSPECTOR
REMARK S
LATH OR SHEETROCK INSPECTION
ApPROVED ~I DISAPPROVED ~I DATE
INSPECTOR
REMARKS
FINAL INSPECTION
ApPROVED 0C1 01 SAPPROVED Cl DATE:2,X F~T3 B"i INSPECTOR r..J ~
REMARKS_b. t"'P~"Vi'-v 'PI..AIJS /MDU4/r- L'f y,," /':/101-1
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CERTIFICATE OF OCCUPANCY
READY TO ISSUE Cl NOT READY TO ISSUE ! / DATE
INSPECTOR
REMARKS
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.TRS,TIII0~--1',1.-{J LJ 1J:-3/()r) JOB LOCATION
LANE COUNTY PERMIT
Acreage or Lot Si,a
Contractor's O.S. # _
nG\
hO\
Partitioning #
r\ CI ( ) Complet~d Subdivision 'n C\
Lot
Bloc~
APPLICANT'S NAME AND ADDRE"" '-)0 ;'.C, I.-I .t,
OWNER'S NAME AND ADDRE!'''
CONTRACTOR'S NAME AND ADDRES"
Mail permit to (>() Applicant ( )Owner ( ) Contractor. ( ) Prefer to pick up. Call
.TRUCTURESNOWONTHEPROPERTY 3 bf>r/(1()oyY) l-\omtC
THISPERMITISFOR IIYICr1S+{\\1P 'i' €"\'CCJI cJ\\V~'f'\-e_~
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SEWAGE DISPOSAl
U),f.C'Ciln,.:).'-J"l(P tJe.6rc:
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D{\. So..(:,--l oR. Phona7'/h-3.f~
Phona
Phon a
(owner, etc.) when ready:
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# BEDROOM" ,-1 # PLUMBING CONNECTION5-LJ
WATER SUPPLY
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THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
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. PLUMBING BY
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I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _owner of record;
contract purchaser; _ potential buyer; _ realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply_yvith all applicable Codes relating to this permit.
Fee Paid!l: (';,;:).(j Signature IS/i'\.JOYl (J..Jt U ~"-'Q) Date q-J.. -'IX'
) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ) SPECIAL PMT. AREA. MIN. ELEVATION: rV tJ.
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Comments:
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BUIJ,DIf'lG ? 2.. ;;:
~--JLJType of Construction l' - . Group - Fire Zone
?...." J~-r- J9 Use Classification'/
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Comments:
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By: Date: By:"'-, (Jt!~ ~ s:.41 ft 17.-# Date: q-! 1- /y
PLANNING REQUIREMENTS SATISFIED. By: c...-...Oate: Date Issued:q'_ II - 7,r
ZONE:AILJ-Tn-!-. t'1I1f\SETBACKS: FRONT - SIDE FACING STREET (FROM C/Ll INT. SIDE YARD - REAR -(FROM P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401 PHONE: 687-4394
Minimum Septic Tank Capacity (Gallons)
Drainfield Required, Lineal Feet
Maximum Depth
SANITATION
C55.13
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PERMIT -WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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Parcel No.
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
M:::~~:~~::T~~EU~ 91401,.
AVERAGE PROCESSING
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~LANNING DIVISION
Partlt10ninq I
Partitlonina Reouired
Other,
$
~NATEa POLLUTION CONTROL
Yew Site Inspection(.)
60S Construction [] New
Number of Bedrooms,
Commercial/Industrial -
Other
$
o Repoir
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I of Sites
I of Employees
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CONSTRUCTION PERMITS AND INSPECTION
(S.e above for I of bedrooms/' of employees)
o :o1obillll Home $
o Permanent
o Temporary
o Renewal
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FEE
Ft. Valuation
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Total V!lh,.,tion
_____ Plumbin9 fixtures at
Sewer/Water Conn. ^t
$ y~s:~ $
$ E4ch $
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Subtotal
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$
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4\ State Surcharge
Plans Check Fee
Change of Occupancy
TOThL BUILDING PERMIT fEE
Kinimum atructural setbacks: ~
From centerline of street: Front
Exteri
From Interior Jot Iln.s, Side , R..r
[] Comm'} plans sheet to applicant [] Curb cut to applicant
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Address
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rUBLIC LANDS
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Address
[] Minimum Elev~tion
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Elevation
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PUBLIC WORXS
Facility Pert:lit
ENVIRONMtNTAL HEALTH
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AFFIDAVIT, If this permit i8 for an agricultural building. I hereby declare that this building
will be used for aqricultureol purposes as allO\ll'ed by zoning and/or the State Building Code, and
tor no other purpose. I further certify that the statements and other information submitted on
this apP1dro" 'on are true eond accurate, and that I have the following legal interest in the
property: owner of record, contract purchaser, lessee; holder of an exclusive option
to purcha e: ___duly authorizea-to act for a person w~ha8 the roIlowing legal interest:
: or that the owner of record \S knowledgeable of this
not tht? owner. f further agre. e tJcomP1Y w th al applicolble codes relatin9
Applicant's SignatureY / YJ-;;t
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THIS IS YOUR REC., AND DOES NOT GIVE YOU
INFORMATION ABOUT THE PROGRES YOUR APPLICATIO~, CALL
PERMISSION TO ~.
PERMIT CONTROL,~7-4357 (681-HELP)
lane county
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application. it I am
to thi~ermit. ,(7
0... 7-/-7%
C74-170
lone county
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APPLICATION
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CDlTUCTOI PttO!4E
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:". HAlt. CUKl'LttlD 'UJUT to APPLlCAMT/O\4tU/COIiTRACTOa (CltCLE OMtlD PlEPta TO 'Iel UP. CALL.
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Lot
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Vicinity Map
C74-150
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