HomeMy WebLinkAboutPermit Building 1982-1-25
"
~ FOR OFFICB USB ONLY
~~~i~Q~i7';? 3' -cf Z
o Two Copies of Plans
PLEASE USE BLACK INK AND PRINT. 0 Two Copies of Plot Plans
/ d. J RANGE tJ c::< I SEC~N< ! 3' J ;;_'~.n_ OOUT or 1 OMechanical Checklist
_ V 0. //\ Vr/ OPlumbing Checl:list
~Z~) dZ/~ I 3EL I B7 I. OPlan Check Info Sheet
. L7~ ~RESS. I./:: TREET '", h ~ ~~~...,./~ PROPOSED US!; OF PROPERTY
1'~=.:Sc=~V'-/:; . "f';:"/-9~~ 7/Y7 /' ~esidential DIndustrial
~~ ~~ 4~A~~~~/ o Commercial o Public
O~ON OF P~~"ORK / _ / .- d ~ / I $ VALUE
I' .1'.././ ./"'"./..4'//l-M'/~/ // '/ A.' n~- .
" Of' BEDROO'JS:;;> -~OF STO l # OF EMP~-'~ I '''T ~.28: 7' /'/ n/./ 0 propo~ed
)\~.~ ? 17' /Z/N ~ ,lffA~~~ ~Emt>ng
O/~~;:N~'E~ ~~A'%/~ ~~. }?i?~;;~~y'
~fft:~s ~~D AS ~~. - zrZE%??/7'
l.~~~ r$;.?yjb~ ~/~~ .~/ ~ //~ ~L ~-/
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I HAVE CAREFULLY ..l"AMINED THE COMPLETED A[lP ATION FOR PERMIT, and do herehy certify that alL inform.'1tion h\"'u~on i:l leur'! and corn'ct llnd I fuctlwr
certify that any ;jI{;~l work performed shal c done in accordance with the Ordinunces of Lane County und the L~""s oC ttlll Stlltll of On''1~)I1 I"H tnininq
to the work described herein, and that NO UPANCY will be made of any structure ....ithout the pcrmblsion of tho Building Division. I furth'lr c\!rtify
that registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for Oxcmption is nCJt".d
hereon. and that only SUbcontracto~s and employee" who are 1n compllance w1th ORS 701.055 w111 be used on this pro)l!.ct. I HAVE READ AND CllECY.ED THIS
APP;!!:ATj THO~UGHLgY' ~".r
',P/lJe.S'.. "P///O'/I/ "'V"",!"LA_ t. ~ _\""",,-~-15:L. OContracro,'
N (plea'!'ie pnnt) /"' SIGNATURE DATE 0 Agent
Zone P /I
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CONSTRUCTIcI/PLACEMENT
PERMIT R-m I-Z~
COMPLETE THIS BLOCK.
TOI-lNSHIP
o PLANNING/ZONING:
Parti Hon #
Parcel n
Parcel
size ;ZJg
:::~~i:;7~_
o FLOODPLAIN: In flood hazard area?
o RURAL ADDRESSING: GRlD COORDINATE
o SANITATION: s. 1. #
eL, side interior rear
0.// ~/"'../ I ~A":T;-
r
Date:
/~~~
/ / n
D
ONO
o Yes.
see attached sheet.
Date:
N
E
Date:
B. P. #I
Installation Record Issued? 0 Yes 0 No
Installation
Specifications:
,
Gallon
Tank
Lineal Feet
of Drainficld
Maximum Depth
of Trenche!;
Comments:
~PLANS EXAMINATION:
Comments:
Type~
., Date:
Group_~ use~~iJ Lf,fJ.f.. I
ca.~a..r";" ~7~ur-4'7lfF1<'
Date, 1.- ,,'?.....~ 1-
D
~~JJ.) L~
D
CONSTRUCTION AUTHORIZED BY THIS PERMIT
tr/~
I I~/~~A /
7/~~~.~
. 2d.'r'~'
-c:7
Sq. Ft.
Fixed Fee/
Unit Cost
Floodplain Fee
Subsurface Fees
Building Fee
Sewer/Storm Drain/Water
Plumbing Fixtures
Mechanical
Plans Check Fee
State Surcharge
$
$
$
$
$ -C"' '"0;:/.
$ /7-
$ ~ 7S-
$ 7~
4L/~-;/
TOTAL VALUATION
$
M ~ J?/L-1tJ
PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (~r ORS 456.805(1)) DATE
LANE COUN1'Y DEPARTMENT OF ENVIRONMENTAL MANAGEMENT / 125 EAST EIGHTH AVENUE, EUGENE, OREGON
97401
C74-194
SEE REVERSE
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,-
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SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATION OF THIS PERMIT.
CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOWED BY LAW.
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WHEN READY FOR INSPECTION CALL 6B7-4D65. 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.
BUILDING DIVISION:
REOUIREO IIISPECTlONS
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 (colTl1lonly termed lItransit mixed") is to 'be used,
materials need not be on the job.
2) CONCRETE SLAB OR UNOER-FLOOR INSPECTION: To be made after all In-slab Dr 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 subfloor.
3) FRAMING & 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 ;n~ulation and vapor barrier are in place.
, -
4) LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place
but before 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 Dr 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 shall have been made of each successive step' in the construction as indicated by each of the inspections
requi red.
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 applicablel and when installation is comolete.
Installation shall be in accordance with an approved nationally recognized testlng agency and the manu-
facturer's installation instructions.
C. MOBILE HOME: An inspection is required after the mobile home is connected to an approved sawer or septic
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 Dr as recommended
by the manufacturer.
(2) Mobile home minimum finish floor elevation shall be certified when required by a floodplain
management letter.
(3) Mobile home tiedowns. when required, and skirting shall be installed and ready for inspection
within at least 3D days after' occupancy. Tiedowns and skirting shall be installed per enclosure.
0, SWIMMING POOL: Below grade when steel is in place and before concrete is poured. Above grade when pool
is installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN
WITHIN 180 DAYS OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN lBO DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PERMIT WAS ISSUED ON THE BASIS OF INCDtlPLETE 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 shall be effective for one year from the date of issuance.
Upon completing 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 lnspect ~he constructlon to
detennine if it- compl,ies with th~ rules contained in this division. ~ 'I,f the constructlon does comply \tilth
such rules, the Oepartment shall issue a certificate of satisfactory completion. to the permit holder. If the
construction. does not comply with such rules, the Departm~nt shall n~tify the permit holder a~d shall require
satisfactory complet".ion before issu.ing' the certificate. . Failure to, meet the requirements f'o~..satisfactory
completion within a reasonable time constitutes a violation of ORS 454.605 to 454.745 and thi~ rule.
Setbacks - Subsurface SewaQe Disposal
'!
From: Interior property lines
Edge of road right-of-way
BUilding foundation
Wells. other water sources
SeDtic Tank
10'
10'
5'
50'
Drainfield
10'
10'
10'
100'
./.tfJ'14.,61
E.on.mental Man,(1gement
'. ACTIVITY.. INFORMATION
.
SH EET
klne county
(I
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
CD :Ill\"',<'
~ H\1T(...,...;
PERSON'MAK~G IlliQUEST
.Tallll>c t;. t!., /1;..,.
PROPERTY OWNER
ID~
Dt'JV1JrP) <;/\
MAIL~NG ADDRESS
">-11 f}"",r!ec.. <;-r
MAILING ADDRESS
,
<. fJ F r:J
CITY'
'~r4!..
STATE
"l'lLl-"
. zip CODE
CI?FcP
CITY
r.-rf
STATE
D,u 1'"
:iip caDi .
1.:J..(L~44.
BUSINESS TELEPHONE "NUMBER
1.H - CK'-!'1
HOME TELEPHONE NUMBER
72 h. " ~u u_
BUSINESS TELEPHONE NUMBER
'2~t; 9~"" q
HOME TELEPHONE NUMBER
. ,
o TAX MAP/PROPERTY DESCRIP,TIO~ NUMBER (from tax maps in D~partme.nt of Assessment & Taxation or
Ilap . Parcel Number: I'?I O.;L 0 (0,/,:3 Tax Lot(s): tf'Q.,c.o 11'l"1I1.
Township Range Section
from tax statement):
n')"i/OO
DOut of TL t
By Partition !
Tax Map & Parcel Number of.~djoi~ing Property in Same Ownership:
Tax Lot(s):
Township Range Section
/. [8 None 0 Unknown
(j) SUBDIVISION (if applicable): _}fI" r.J r9 0 ul (...~ ,Fc;7ZLT; <;'
@REQUEST (briefly describe information needed): _t:OY TWlllc..-r;./Q' 0"'"
BLOCK" j
o {: , Fwe.. YJ /'" ~
,
LOT: ~
''''<:oyT'
COMPLETE. THIS SECTION FOR LAND USE, .
CONSTRUCTION APPLICATIONS, OR PROPOSALS.
@ PROPERTY AODRESS:'
I 0 d...J.-
flnn <,0" a
L~, - I
C;-r
acres
**FOR STAFF USE ONLY"
NUMBER: ~~
/ -is ~
TIME INITIATEO: /.'oD~
C:::5f--
OATE,
SEE *NOTE SELOW.
<D TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
. . .,.....' -; ~ .-
(j) PRESENT USE OF PROPERTY: HrlY'\ ~
<;., y" C.:,v<A-L.
CHECKED BY:
Garage_
Shop_
Barn
ATTACHED EXHIBITS:
o Plot Plans (2)
[] Constr. Plans (2)
o Site Plan
o Copy of Tax Map
OOther
GO NUMBER OF STRUCTURES ON PROPERTY: Standard home~ Mobile home_
Modular home
RV in use as residence_____
Storage_
Other (specify)
G) ACCESS TO PROPERTY: Public Road -Name . f)(jI1J€-CI
--
~ I
SCREENING VERIFICATION,
Private Road Name
By:
Road Easement
Width
# of
Users'
Date:
@ OTHER EASE'IENTS OVER PROPERTY:
...
(i) WATER DISTRICT: iJJ; I/rw"a' (",,,, UhT~ii1D FIRE DISTRICT,
Time In: Out:
.:"
o Accept O:Reject
9/81 REV
(OVER)
ROll ted to:
*NO'TE: ATTACH ,\ COpy or
TA~: MAP: SHOH ExfSTI~G
STF.i.lCTURES A:m Tt\;'; LOTS
IN YOUR Oh~ERSHIP. OB-
TAI:-l TAX Hi\P IN SELF
HELP AREA or A & T.
@ PENOING PERl>HTS ON PROPERTY:
COMPLETE THIS SECTION FoLD USE OR CONSTRUCTION APPLIcloNS.
(9 PROPOSED USE OF PROPERTY IN OETIIIL:
,
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{Y BUILDING REQUE~TS:
, ~, '.
Contractor IS#:
,
I'
f' .I ~ ,,:", \
(for mObile home setup also)
."f.. fI
?.::t. h DH,1I
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mal" <.. T. Sf /cP.
f~YIA"s U~L!'" ::r...fti..,JJ"-A ~
7
y"~",, ~/c, c;. ~LV< tfYfJ.-
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Directions to Site: gb Tn
~~i _ ,,~J ,~..,
(hYl(gei' ~~/",~,'e{j"';'~.('V^$S
Check the type of permit requested:
o Dwelling: 0 New
o Addition.
o Modular Horne
o Replacement
o Alteration;
[] Mobile Home - Model
o St,!np.aFd: C~n.st;1tcti:on;
o Additional;
Ye-ar
'(
ORV
Dplan
I,
,.. .. ,
n.
Check on~.y
.-1 hI,
.' .... \'
o commerci~l: Use
Floor Area
..
. -.. D Agr icul tural: Use
O'Others :.. + t!se Floor Area
o Cha.~ge of Use - How?
"
~ NUMBER OF BEDROOMS
NUMBER OF STORIES
,
. ~ ~. I 1
.
{} SANITATION REQUESTS:
[] Site evaluation for 50S feasibility
o New system installation
o Repair/replacement
o Alteration/relocation
~
D Hook to existing
AODITIONAL INFORMATION:
l
&.0 YlJ(&I
"'V\cY
I~
~lj4 T '\ t.' F,y'~ I
- .- . ~ .....
sf
't"""",
s(:
o V\,J.
3. nf
ko,,", > ll..-
0",-
'({ ;; h. I
...
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**FOR STAFF ;;~~LY*'*
ZQNE/LAND USE:
By:
,
".
Date:
Time.In:
',Out:,
o Accept ,:. 0 Reject
f. ,
o Planning' Applica"tion
o construc~ion Permit App.
D Inf'or~at{on Only
Zoning:
Compo Plan Designation:
SANITATION:
By:
Date:
Time In:
Out:
o Accept
o Reject
o Constr. permi tIssue
~. ( . 'IT] Site Evaluation Issue
PERMIT ISSUED (SAME DAY QNLY1:
Permit ff
By,
Date:
Time In:
Out:
...
21/,;~i!:;~~~t,~~_~~i.:~'::::; :" \.;:.~' ,. ... , .
.~:~~ ,'t),::\:);;;+d;11~::);y; ".:,:;:!;~"\, . .;' ",:', ,', '. . " .
'::;U';;:G::~.WOeD. S'TOVE PERM IT:S
i 1~~{~%'~E~'rii~--.-"~-'-'--_."~'.'o'-'-~~~'~:"
';;)';i'\'i~/THE;':EOLLOWING.1NFORMATION,'IS' REQUIRED, TO
.' ....:~f.':..,I~...:...t.\ ....~,'...::-.~~,.':r,~. .:\.' ..",::. _ ,":' . . '.' t. '. '. . . " .
/i'+i:,;::-,/:;.;:;:r:i::i:.;{:';'i'>.:'<' 'APPLY' FOR A STOVE PERMIT: ,
!~~\~;iit~l~~~~~;#"t he m." u I. c 1 u ,e i', '"' 1.". i !'~o~ 0.' "~I' u C~lfj.,:,
::.:}:::[2l:'2Co'Ples"ofthe floor plan and elevations',:" '" ,:,;."
.. .: :'''''::''. .' . ~. #. . : . ':' " .,'" '. .' .. : '. . ...., '. - ~. . ".
:i:::::>';a.,Jndicate all clearances tq w~lI~ and~,!~dO~S::,:<:;i': ' "';.
i'" b. Noncombustible materials to be used for' the' tie~hh
p
and
'"
reduced ",' . wa II s .
for clearances to
"'"
c., The model name or number of the stove. .1"
, .
d.
The, chimney manufacturer.
Details 01 the combustion
air
duct and opening.
e.
~: .
NO PERMIT WILL BE PROCESSED, UNLESS ALL THE'
REQUIRED INFORMATION IS SUBMITTED.
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**
A COPY OF THE ~lANUF ACTURER' S I NSTALLATI ON
1'lUST ACCQi'IPANY YOUR APPLICATION. .
INS TRuer IONS
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6ne county
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STOVIE
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I'HO:I[_____..___...__ _...___._
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~;Il~[ Of ~t\!Jrl,C1UR[R
I',JOEl ti,;:'~E lind/or I:wt.:.:ril:__...._____________.____.
--
8:
om::l~IO:IS:
-Aii~:;:c;:--thr 'oll01lln9, fill In nu~er of inCh!!, in dlagr"lm
1. Side of unit to prot~cteu .."ll_lnCIl(!s{unpr\l~cc~rd wJl1h___inch('~l
1. Rl:ilf Of unit to pI"Otrcted w411__.inchc~lunprotcctl'd wJIl_inCh['~)
J,floorprolllclionushloofunil__)nChI'S
~. flaor"rUll.'ctiDnlnfrDntO(lInit__inclll~s
5.l1:n~thuf"'Jllprutt'ctlonitrcJrofunil__lnChl!S
6. lrn?lh of ....111 prOLf:ctlon H side of un;t___jnche~
1.H'tgl1tef~..l1protcctlen_inchc~
b.l'<l';cefwJllprot~ctionlO"e"reH<lOQror..lnl1o.._lncl1e\
9. Air ~polce betwten wJ11 prot,ction and wJI1_lnchc~
10. ~lJ~.~er of Chlm" a04 ....tot conncct.,r_inchc~
$
PLAN 1
f!l:~!illLrrLQt~:
A. Th, ..mit I, ll~t,d b/:OUL DICCJ DOthef{nJ~'~'I__~__.__ _.___
B. The floor protection 1'__lnches thic~ JIl~ "ill ~e:or.\h{'\:(l\ ~ilH'n;,p;::
CO\Cfe.~ WI t.~ ~(':,! 1
"-0
OStoncor O{\~htr
bric~ (dC'~crib{')
C. The wall protection will bt:OA'i.tli~:Os l~il1b~Jnl
C(H'crel.! ...llh r....:.11
OStontcr
tJric~
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--......' 10 "-v-I'i~
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11
OOthtr(descri:Je)
O. Type of chl::vJ~I: OraClerl cllill11\.'1
O;-:.Honry[f1~e l\n,'r:j'
to:,,!,> On"
DOther(c:e~ct'tbcl_._____________..___.__~_~___.._
['Ti'P!'ofv('otcO~?ector:Or"ctor/Chjr41C)' D'?t'<;J\ort.C'.Ivit"')':Jl-:.\!lt.r.:l.
,
F. Will tle 'JSlng:OPLA:: '1 Dt>Li':l -2 Oati,,'r, ~C't' .IttJCh,..j
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IIOTE :
''-{@
Not all units are approved for corner installations 01' reduced
clearances with wall protection.
IF YOUR INSTAllATION DIFFEIlS FRO:.l1I1ESE EXi\I,\PlES,
PROVIDE A PLAil MiD ElEVMIOil OF YOUR INS1/'llATION
II
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Ollt\tde Air In!(!I:Prodde ,n ouUidl,! "Ir inlet, .1 l:IillilllJm of 3MIl to ,>u;'f1ly .1ir I~r
propu fuel cO~u$lion. This inlet \h311l>eclou:.le Id.\l"?crl
Iron the ~\Ithlin<; lnll,!rior. n.... Jir inlet sU:llJly :iuct sU.lll till'
tnCOI~.:::uHltlle allll (cntlnllou~ ff;li:l the interior inlet to the
e ~ teri or of th~' !Jui 1 oJ i 11'1. ihl.' in 1 ct ~h.\ 11 t..c 1 (lC.I t e.l lhl'\lu~!l
the...!!1 (nt'Jr the llo0r') Qf f\llur..lthirl ;>.t" of l!ll' Hav!;' or
llrcpl'te.
\
ElEVATION
BUILOING'AND SANITATION DIVISION / ENVIRONMENTAL 11ANAGEMENT DEPARTMENT
LANE COUNTY-PUBLIC SERVF' BUILDING / 125 EAST 8TH AVENUE / EUGENE,OREGON 97401/PHONE 687-4061
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t BACKUP ,
~ . APPLIC{1NT HUTTON,
1'1' .j".U:' 1802061307800
I NEW BL.DG TYPE
.::ODE APf"L NO
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LANE COUNTY DEPT ENV MGT RECEIPT I 12382 DATE 012582
JAMES I~. ' ADDR 1022 DONDEA ST., SPRINGFIELD, OREGON.
SUBDIV MEADOW GREE~ ESTATES LOT 3 BLK 1
USE R BDRMS 3 UNITS 001 STORIES OBLDGS 001 PHONE'726 0444
ACTION DE.SCRIPTION SQ FT ,UNIT COST VALUATION FEE DAY~.
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f:' i:"CI~
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pr;v
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NO. FIXTURES:'
LC 123132 WS '
NO.. CONNECTORS:
MECH,~N I Cr~lL f'TE
STA TE SURCHAF:GE
F'I..M! CHECK FEE
I
1 ~:' . 00 EACH ..
e
4%
6.~i%
19.00
0.76
4.75
e
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CATG:
.,EQU:
TAI<EN
APP RA
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BY F~L.H
FP
SDS
SI
PCI<
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02,)1 B2
OTH ISS
EST. COMPL.ETION DATE
TOTAL. FEElf*
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!ii'''1i.1 '';~ .. h..,,\-"!.~
. LANE COUNTY INSPECTION RECOROZ -.3 -3 2.
PHONE NUMBER '
j/Zh -d444
PHONE NUMBE~;J .
/26 - 7-3'49
#PLUMBING FIXTURES
OWNER'S NAME~~~
I '2-1;721.-0 /1/ ~tJ-n)
t-~rRj'(rTORI-S NA"ME
~~~ ~~~~TREQUIRE~~~T~IDE
l,OR~AUTHORF~,D BY PERMIT,! /
-....T~ .-J. / .fJ.-:1u2/ J T: ~
DlRECJIONS fa SITE,.L.. ,1/ ..,.L /J , /,,11 / /1/ ~), i
,::fZ/7d. jL//~/.J. ./~1JA..t('~~ {Jd.d.LU/u,-,~{AL:Jj~J.t(,5/J--.-:r:p1 /
j()pJc;& A ~0 jluu ~iJ;. &~d --- I
SiTE A2!lRESS /(J I /I / J!, //' i/ /J, PERMIT NUMBER
/ !J ? y /lV-cht-d..Ld.... ,/U ~~ U/L I Z, r - '? 2
FOOTING / FOUNDATION INSPECTION ,ORI MOBILE HOME SET UP INSPECTION
Approved Correcti on Di sapproved Da te Inspector
INTERIOR
REAR
\.
CONCRETE SLAB / UNDER-FLOOR INSPECTION
Approved Correction Disapproved
Date'
Inspector
UNDER SLAB / PLUMBING GROUNDWORK INSPECTION
Approved Correction Disapproved Date
Inspector
~OUGH PLUMBING INSPECTION
Approv"ed Correction Disapproved Date Inspector
FRAMING INSPECTION
Approved Correction Disapproved Date Inspector
INSULATION / VAPOR BARRIER INSPECTION
Approved Correction Disapproved Date Inspector
II\TH / GYPSUM ~OAKU iNS~tCTIllN
Approved Correction Disapproved Date
Inspector
FINAL PLUMBING INSPECTION
Approved Correction
Disapproved
Date
Inspector
FINAL WASTE DISPOSAL SYSTEM INSPECTION
Approved Correction Disapproved
Date
Inspector
FINAL INSPECT)ON BUILDING MOBILE HOME 17. --"
Approved. / Correction Disapproved Date 7-~/7-?z..- Inspector ~
2:./7-8"=----.W~ J<.-.7~o. -,...,......___--' ~_ ..2._..-.... ~ ~_"-:..a._~
$1ffi'(FI~TE/OF-OC~A~CY "~-,, ,~_p'-p TrM1oRA~f'cEbmg)TE'o~ofClJPANf( ~, j
Approved Correction Disapproved Date Inspector
~ It.;L~_-L,.~. ~__--,__T _:.j~ /h..,..-.--_.A- L.4~ ~ ___ _ I--..-;"--T;._L-I' /..(- --.r::-..e....
~ ; ~---r ,..~/:..., ~ jeu.-si' ~
Form C74-197
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