HomeMy WebLinkAboutPermit Building 1973-10-29 (2)
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LANE 'COUe BUILDING PERMr;. OR MOBILE aE USE PERMIT e:!7'1J"t'>--.-~
BUILDING IK! MH 0 PERMIT NO. ~07Cl-7~
MAILING ADDRES9I..... .. .. PHONE
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PROPERTY OWNER
III II. f10llnrt fl_
CONTRACTOR
A70 U_ Ccntenninl Snrinnfiold. r,re~on 07477
MAILING ADDRESS
74G-(;~1 (;
PHONE
,
PROPERTY LOCATION - INCLUDE POST OFFICE
1.20<; Oond,,1'l Stroot
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
Third Add.
TWP
M"Dd~ r.reon Estntns lot
RANGE SECTION
10
02
06 . c.j, Z-
1l10dt ~
TAX LOT NO.
~/9~
CODE
CENSUS TRACT
APPL.
NAME
&
MAILING
ADDRESS
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
3.1-11)2 A
EXISTING STRUCTURES ON PROPERTY
tlono
LEGAL ACCESS TO PROPERTY
OondeD St.
PROPERTY SIZE - FT.
WIDTH
DEPTH
AREA
Connect to Existing Sewage System 0 New System 0
TYPE CONSTRUCTION SQ. FT. # BDRMS VALUATION
tlllin
1003 (.) l?
I? ..L"
Goraaa otto unc.
616 n ,
l.,'hl
-13--' T.F
.:-..'f
I~stoll Sc~o~c OlsDOSDI Svsteo
7 PI~~~ln~ FI~turcs
SEWAGE DISPOSAL PLUMBING INSTALLED BY
PUBLIC D
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
SEPTIC TANK D
f
OTHERO
.;(, nn
?n.on
.,?4.;n
^
FEES
OWNER 0 OTHER: NAME
WATER SUPPLY
PUBLIC D
D OTHER
TOTAL
,
11'10 .;n
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX, GAl. SOO
Hold trenches to 0 24" maxlr.1um
all parts of the dralnfleld.
UN. FT
depth.
240 TRENCH WIDTH FT.
StDY~ ten foet from the
3 OR SQ. FT.
prQperty 11 no
720
and heuse 1.11 ~Il,
TYPE OF STRUCTURE
OCCUPANCY
ZONE
PUBLIC UTIL. EASEMENT
5 t1 I & J
O BLDG. SETBACKSu FT. FROM CTR. OF ROAD RIGHT Of WAY
UltC I uonoea 4'
FRONT 45' SIDElNT. 7 P. U. ESIDE EXT. 0 REAR
AUTHORIZED SIGNATURE - DATE
USE CLASSifiCATION
7' P.U.E.
DATE
/5/ J.E. 0055 by Harbaugh
G.H, Gray. Sanitarian
10-29-73
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
Construction to comply with uniform building code and county regulations
covering plumbing and sewage disposal. All buildings require a certificate
of occupancy before being occupied.
(See Statement on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 97401
i
~
fORM :t C55-13
.,
LANE COay
BUILDING II!
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BUILDING PERMIT OR MOBILE HOME USE PERMIT
MH D ..' ,.:> . PERMIT NO.
MAILING ADDRESS
(;;;:1 U.. f:~'.~(:c-:J8nu G,:('oc.v.ld(\ < '/<::~::) :~/;:.';/i)
MAILING ADDRESS
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J,. .,.....
'.. .
PROPERTY OWNER
\.1 . ~
./
PHONE
~}n DO" r~'''';:~7~ ri..
CONTRACTOR
,,'
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PHONE
.
PROPERTY LOCATION - I~CLUDE POST OFFICE
Of~~-; r;~~~~:) C~C?C::"(i
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
'il:J8v(] Clr::i. t:::.":'::::1 Grc::::) notn~w be? 0
TWP RANGE SECTION
DO Oil C3. 4, 2--
,
mc~;~ ::1
~.L/Ty~
.,
CODE
CENSUS TRACT
:J;~oD ~~~I L
APPL.
,:NAME
~,. ~ ,~\-
S3
.'
C\'~-~<'\\
t::::::I
LEGAL ACCESS TO PROPERTY
EXISTING' STRUCTURES ON PROPERTY
I
&
MAILING
AODRE..SS
FOR MOBILE HOME PERMITS ONLY
No. of B'edrooms 't."
C:::::.'::n GR. .
PROPERTY SIZE - FT.
~
. ~
WIDTH
DEPTH
AREA
..STRUCTURES TO BE BUILT THIS PERMIT
Connect to Existing Sewage System 0
TYPE CONSTRUCTION SQ. FT. # BDRMS
New System D
VALUATION
C:;JU:l
DCl "DOl
'"
GDrel::) oca. t:;:~lI CoC)
Or.:JW~U Gc:<;:~:J Dic-:;CJOUI::.S;iV~ ~,,\ \J:.~~,,,",~-.. .'-~ "'k,.,'\ ~"''',b.'\ ,\" .'"
'J ~k:;)Uc.J H,-.'1I:fi),'~~~, _~. :'. \ . '- \: ., '" '\ < - ,,' \
' ..... '---" .,_ ......."".,'...:.>" "\~'.",,,. ." ~"':'.' "t
'..,'- "~--..\." ::~~ ~."". .-~.\
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PUBLIC 0
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
SEPTIC TANK 0
5
OTHERD
GG.Cfl
110.C3
~~..G~
FEES
PLUMBING INSTALLED BY
OWNER 0 OTHER: NAME
WATER SUPPLY
SEWAGE DISPOSAL
PUBLIC 0
D OTHER
TOTAL
nC:J.G!~
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY DRAIN FIELD REQUIRED
WITH DIST. BOX: GAl. ~~~ L1N. FT n!::) TRENCH WIDTH FT.
~~~u v~~~~:;';?YJ c~~~;'t?~l~~-:::J ~~~0t~\ I;Cl vc". V.CJ 1:..8
- \ \ ,
5
a. OR SQ. FT.
"?'~."'M Ul''''
v-" '-- .. I..> ~ ....~
~
...., ,
(j(,,)
~ i... ,
'}. ""'~.'8 -\ ~~ ~~
V
TYPE OF STRUCTURE OCCUPANCY
(; i; 0 G .1
'LBLDG. SETBACKS u FT. FROM CTR. OF ROAD RIGHT..OF"WAY
",.~ I' ';)0 I'> 0 ..'J'_,~~ r,O'
FRONT)J SIDE INT. V V.. U SIDE EXT. ...
AUTHORIZED SIGNATURE - DATE
!nl .1.:';. 0(;:10 DV C::::7~C::C:l
lONE
PUBLIC UTll. EASEMENT
REAR
USE CLASSIFICATION
'I' P.U.G.
DATE
G.V. G7~V' Gc~8CC?ICO
o Cof1!?V))
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(POST THIS PERMIT ON MAIN BLDG. .AT SITE)
,
Construction to comply with uniform building code and county regulotions
covering plumbing and 'sewage disposal. All buildings require a certificate
of occupancy befc:re be~n.g occupie~.
'" .- .
. .. \ (See 'Statement on Reverse Side)
\-"
BLDG. PERMIT - WHITE
OffiCE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
,
\
LANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE. EUGENE, OREGON 97401
FORM =C55-13
.
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SITE INSPECTION
"ApPROVED Cl DISAPPROVED Cl DATE
REMARKS
FOUNDATION INSPECTION
ApPROVED ~ DISAPPROVED /
DATE /1- 6-..7'
I
REMARKS
FRAMING INSPECTION
.
INSPECTOR
I NSPECTO(2.
',:t
"
, APPROVEO~ 01 SAPPROVEO 17 DATE INSPECTOR'
~W~('~~4-',J
~~ . . ..h~ " ~1:i:;ro/ - '/- ~ 8-731/
LATH OR SHEETROCK INSPECTION
ApPROVED 1-../ DISAPPROVED c::J DATE
REMARKS
INSPECTOR
FINAL INSP~CTION-"
ApPROVED !JZ::1 DISAPPROVED 17 DATE /~--.~ 7""~7 ~NSPECTOR
REMARKS ~'A~j,J J- ?f-'J/f T
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,
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CERTIFICATE OF OCCUPANCY
READY TO ISSUE / / NOT READY TO ISSUE Cl DATE
REMARKS
;{ 079~ 73
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1/ /1", JP {: {"/ ~'"
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Iff.{/fffl l<oo2~~~
INSPECTOR
v>
/ ?-/6';;' A
BUILDING SITE EVALUATION G.G,"
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.;
p( Bu i I ding Pe rm i t App I i cat ion No.';;;~79-73
f ( )
Site Inspection
( ) Pre-Perm i t Investigation
~ROd?S c:O~TAX LOT
~ TRACT . '.
. 3 'JlIJP /llMi19iJJ GI"-EN) ~Sf L -I 8 -a
APPL/ CANT: / /..
Ni\l1E /",J:~
ADDRESS .
PHONE
DATE /6)-/8-73
-- "'::
LANE COUNTY PLANNING DEPARTMENT
I.
Zoning Ordinance Compliance
(Zone"RA )
Subdivision Ordinance Compiiance
NOT
app I i cab J e
() ()
( )
( )
( )
( )
NO
YES
NAME
D,ilE
3.
4.
Required Access
( )
( )
( )
( )
(-r-- ~_
(-r-
(r-
n---
/0-2.3-7-'"
2.
Building Site (Area, Width,
frontage, Setback)
Other (see comments)
( )
s.
COMMENTS:
"
7. Soil Stabil ity (footings)
NOT
appl icab I e
() ()
(1) ()
~) ()
(k) ()
NO YES \
~
BUILDING INSPECTION SECTION
NAME
DATE
6. Plans Submitted
8. flood Plain
( )
( )
( )
{tJ/dt~)I()-'].ft.~7
I
9. Other (see Comments)
COMMENTS:
SANITATION SECTION
10. Sewage Disposal
NOT NO YES
app) icable
() ()~)
() () ()
() () ()
( , () (,)
NAME
DATE
12. Water Supply
13. Other (see Comments)
~
~
10./0 !J,1'J
\C:l ,.P
II. Usab Ie Area
COMMENTS:
TO APP L/ CANT:
Your
11
I )
( )
( )
Building Permit /~ite In~p ction:
Can be_approved.-<r\.c.....--; l!> ).... r
Cannot be approved at th s time as indicated on item NO. above.
Questions and further information on items I through'S contact the Lane-
COUNTY PLANN ING OEPARTMENT. Quest ions and further informat ion on j tems 6
through 13 contact the Lane County Buildinq and Sanitation Division.
Wil I be held in this office until you can resolve the problems indicated.
Is being returned.
Your building permit appl ication fee is being returned under separate cu'er.
LANE COUNTY PUINN I NG DEPARTMENT
135' ~1)Crh Avenu", E.ut, Eugene. llrto!9on 97!fOI
rtlONE:: 31j2..1311 F.XI. 231
LANE COUNTY BUILDING & SANITATION DIVISION
135" Six th ~veTlue Eas t. E"'lc"". Ol'cgon 97/10 I
rHllNL: P/2-ljll [lIT. 411
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LANE Cay BUILDING
BUiLDING OJ MH 0
MAILING ADDREl;S
ijJ~J tJ.. r,a~ltc::~Ir.U
MAILING ADDRESS
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PERMIT OR MOBILE TOME USE PERMIT
PERMIT NO.
-v,
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.
j(:t{.;o,)'l}
PROPERTY OWNER
'!II. ['.'.;nrl~ [1.
CONTRACTOR
PHONE
r;. \rl~' ,110M. l\r(,~.::l.
(';'j,';:n
Il~~)U( ,.~~ ()
PHONE
PROPERTY LOCATION - INCLUDE POST OFFICE
1 'Cj p.:'::..--:~:,,() fltrr:"'1:
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
vtll r(] ~:I. ~;'~:::1 n!"C':-:l r.~9:[)(tr:!1
TWP RANGE SECTION
lee I Die:.:!:: Sl
TAX LOT NO.
CODE
CENSUS TRACT
10
Oil
!l~
~~'G~ (',.
EXISTING STRUCTURES ON PROPERTY
t:~no
LEGAL ACCESS TO PROPERTY
r~n<'cw hi:.
PROPERTY size - FT.
APPL.
NAME
&
MAILING
ADDRESS
FOR MOBILE HOME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
WIDTH
DEPTH
AREA
Connect to Existing Sewage System 0
TYPE CONSTRUCTION SQ. FT. # BDRMS
New System 0
VALUATION
':oln
lei:::! i n~ i ~L C:"~)
{)16 n ~ Li..~
.,
, , f~;i>::i
('OIClH::l otto U:lC.
On~~oll GC~Cl,,:) Olo~~~l GVGt~
y PI~~lna rl~eurcG
SEWAGE DISPOSAL PLUMBING INSTALLED BY
PUBLIC 0 SEPTIC TANK 0
BUILDING c.
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
OTHERD
1;('i.tUl
~O.C;;)
~I.l.r,l'l
FEES
OWNER 0 OTHER, NAME
WATER SUPPLY
PU BLlC 0
o OTHER
TOTAL
.
loa. C):)
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH D1ST. BOX: GAl. ~oa
,QI(] trC:1CfnO to 0 LlQ" ['.::;\ICu::l
oUI Doreo of tho drlolnvlold.
DRAIN FIELD REQUIRED
L1N. FT 2l;~ TRENCH WIDTH FT.
Cl:;pti'l. tltovn CC:1 \'COI: vre:J W::J
;l OR SQ. FT.
pra;Jcr'l:V 10 roC)
?f:J
C~:::J ~::Jlj:1C t.HE~~
TYPE OF STRUCTURE
!i [J
c~~8' SETBACKS -- FT.
FRONT I)~j I
OCCUPANCY
I (l. J
ZONE
PUBLIC UTIl. EASEMENT
101 J.~.
FROM CTR. OF ROAD RIGHl..OF....J"YAY
7' n ,,~uu,,~~~ ',nl
SIDE INT. .~. u. U.SIDE EXT. ....'Y
AUTHORIZED SIGNATURE - DATE
DCB!) [)V C1r.rClOU~h
REAR
USE CLASSIFICATION
7' r.U.fl.
DATE
G.V. [rev. Sonltorlo~
lCr.2~-'i~
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
Construction to comply with uniform building code and county regulations
covering plumbing and sewage disposal. All buildings require a certificate
of occupancy before being occupied.
(See Statement on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
LANE COUNTY, BLDG. & SAN. DIV., COURT HOUSE, EUGENE, OREGON 97401
FORM:: C55-13
.'~j;';:"- "
::. """"4 t\.; -ft...
'':.\.0
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SLAB FLOOR
PLUMBING GROUNDWORK
,.
~.
ApPROVED / / DISAPPROVED ;---y DATE
REMARKS
GAS PIPING GROUNDWORK
ApPROVED / / DISAPPROVED L / DATE
REMARKS
ROUGH PLUMB I NG
ApPROVED !Z7 D'SAPPROVED / /
DATE II. )<(. ') 3
REMARKS /1/1> ",,~JI .p...___!~
~
~ i~' ~ A.-~~,_.,.. "'"
ROUGH GAS PIPING
ApPROVED ~ DISAPPROVED,~ DATE
REMARK S
FINAL PLUMBING
ApPROVED LX! DISAPPROVED ~ DATE.J- .J,I~~U
REMARKS
FINAL GAS PIPING
ApPROVED ~ DISAPPROVED /. . /. DATE
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE ~ NOT READY TO ISSUE ;---y DATE
REMARK S
1'0 f
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.
INSPECTOR
INSPECTOR
INSPECTOR~~
t/
INSPECTOR
INSPECTOR~~
'(/
INS PE C lOR,
INSPECTOR
,
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InstallerOs.Nam~
t7')zn_~",,--,,_ .
No. LiVi7g Units I BeJomsI Bjths
sept:LC Tank:
Ft. from well Steel 0
.LnSJ.oe DunenSJ.ons: ,t"c..
Length Width
Applicant ~ / /', /
Name "Ak//
, . 4/. ~
Mailing g 71) 1//. ~"'~ "4./---!. / ~:~~ from Foundation /0
Address ~hJ'_' ..:rl- ~/. ~ . ~~~n~ine Side Rear
Le~~th ~~ Trench-t. tai Sq~Ft.betweenIFiller IF~ller deothlFiller depth
:I.2~@.51,4. 5. 6. Width.:)' ftSfO Ilines/4" Type ~i~~e h' in ~N~w..:t iu.
Sketch (See instructions):
l' {\
i to
10
-{r 2(,,' , f' _
I ____~_~
-I I '6~
I
1 I
,-
.
.
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Date /.--.:5 - 74-
~VIDUAL SEWAGE DISPOSAL SYSTEM~ORD,
~aller: Complete top part of ~ to
signature and return both copies to Lane
County Building'Sani~ation Department.
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..:J117t9-7..3
~
P"RMIT No.
/).~~J7~P,
I Basement _ J Water Supply
Yes 0 No I!3"""'I Public V5ther-List
Concrete ~NO. Compartments
I Gal. Capacity, 90-0
Tile Disposal Field:
Distribution BOX:YeS~ No 0
Other Distribution- Type
Diameter
Depth
--
Sb'
------
-
"'-
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,41
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0: r~ (rn ~ n WI I~' -0')
.11 -. . U
, JAN 03 1974
'8'
U\WE GOUNlY HEALTH UNIl
J..~('I
o
Conforms to Current Standards
to Current Standards
Signature
.d.t1~
For ~itarian Use Only:
~ Approved: System Installation
o Disapproved: Does Not Conform
Remarks:
~.,)
.
'.
Date: /-i-7'-i
Lane County Building & Sanitation Dept.
AtJ.~/
- Sani tarian ; s ~na ture
r) ~Y" .
,
. fl- tl PI:; .
LANE COUNTY Bur.!pING PERMIT OR MOBILE~ME USE APPLICATION
PERMIT TYPE - BUILDING 2l( MOBILE HOME DOSC REG. # PERMIT:#: ~ 7 f-7..3
PR9~ OWNER ~ d MAILING ADDRESS , A PHONE'
.'<~.L-./~y- ~ '. ??LJ 1//(?2~~_~~~ t y/~ ~/ 7d6-'79J~
CONTRACTOR '/ MAILING ADDRESS ffle.- -t./ ;' PHONE ..
, \~-t~.R ~f7,4_? 'r7~?7
PRO~ERTY LOCATION - INCLUDE PO-ST ~FICE t ---;/1 / '- /I
k;:2 d. 5' IJ/ A-n....bfT, ....&UJ, L..T""
PROPERTY L GAL DESCRIPTION .'? ~/, /11 "j / c.LL
lOT - BLOCK -=_SUBO~~: ,on ')."J ///~~ '7?? ~~ ~.PfuJ~~r-.-_t""1.RZl!,w;lJ
TWP.J RANGE SEC. TAX LOT # cODe .
/f1' .~ Oa. mr
APPLICANT
NAME
AND
MAILING
ADDRESS
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms
~U:?:E :1" THIS PERMIT
~
a~_/
. ,?l.L Nt) 'j,!E~S & BOUNDS 0 YES
~~ 1',,~:AnACHED 0 NO
CENSuSTRACT .5
S 5-15'~- B
DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY
h., __0
LEG;1ACCESS ;0 PROPERTY - R~A~NAME OR #
/.~- '" 0V',
PROPERTY SIZE-WIOTH DEPTH
AREA
Connect to Existing
TYPE CONSTRUCTION
Sewage System n or New System Req. [J
~5' FT. # BEDROOMS VALUATION .
//MY &/.., /.:q IJ '1 f?
(" / k, CiJ)..:? /. fI /,/-;/
/.3.,r~f
/
~~~- ~..Z:;C 7/~_,
. () .
SEWAGE DISPOSAL
PLUMBING INSTAllED BY
~
TOTAL
/CJ{'),sn
OTHER 0 OWNER 0' OTHER 0 NAME
FEES WATER SUPPLY PLANS FURNISHED FACILITY PERMIT
PUBLIC 0 OTHER YES Xi _NO 0 ~ YES 0 NO)(]
PLUMBING FEES d-;'tI ~ ./ ,.,s~LAPPLlt -- .~__.4 ' DATE
--Z. FIXTURES ,..2// .- ~ =.;...f.__ ~~ "" ~ / IJ - J j' - 'J..9
CASH 0 SE~" r ~E RECEIVED BY "- DATE
CHECK ~NNECTION FEE ;:'J'"..,J t/7 P>/... ~ /0 -JJ1->.~
PERMIT #
PUBLIC WATER
CONNECTION FEE / ,6-d
COUNTY BUILDING & SANITATION
DRAIN FiElD REQUIRED
L1N. FT. .:2t/1J TRENCH WIDTH FT. :;]
~79-7-S.
SPECIFICATIONS
PUBLIC 0
BLDG.
WASTE olS.
PLUMBING
PLAN REVIEW
PARK TRLR.
SEPTIC TANK 0
$ ~fo,~
~,d13
- ~-7"~-
MIN. SEPTIC TANK CAPACITY
WIT~ DI~T. BOX, GAl. q,1 ()
M _ ~_~f <1A
-+:-- d1 J rrZ
~ ~+;fJftJ" (J
TYPE O'F STRUCTURE '-~ Ai OCCUP~r::f' ZONE REAR YARD
_~L.oG-,--SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY ........ USE CLASSIFICATION
'""-'''-L p~~" /
FRONT 4- ~ ' SIDE INT. ., I r><-lI::..... SIDE EXT. 40 REAR 7 PUP ~ .
s;;:rt' ',./ " ' Dot. PLANNING Dot. BLDG. 'INSP. JAr", A.J1'/.J -II. f ///)) , k Dol.
r tt)-(?1- 1(j-.7(,'~f1A3-:..... 10-2..."'::>-7...... r'f"1JJ~~ n...- /0"1-? /Y
Directions to FiU Property: f./
OR SQUARE FEET
7;zu
Z'a
7'i~~~,~.J ~/ _ ~ _~.. 1"e:fL
_"cU;;v, ~j ___Z_/A~_ I,~ J P ,(MAE ~
pUYIC /ASEMENT
V
COPY 1 - OFFICE
COpy 2 - JOURNAL
COPY 3 - AUDIT
Form # CSS-IZ
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