HomeMy WebLinkAboutPermit Building 1978-9-14 (2)
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Acreage or Lot Sizp 1\ X \ ~')-
Contractor's O,S. #, /Cf 4 '7';}'
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LAN~ ~OUNTY PERMIT aJlt /tlJfIJ , 1 /'
Partitioning # ,.,//4 () Completed Subdivision L~t,'f/l.se~N ~ b
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APPLICANT'S NAME AND ADDRESC:: \,,.A yy\(j("'o,<'l.rr\
OWNER'S NAME AND ADDRESS v
CONTRACTOR'S NAME AND ADDRESC::
Mail permit to ( ) Applicant ( ) Owner
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FLOOD PLAIN MANAGEMENT
Department of Public Works
125 East 8th Avenue
Eugene, Oregon
687-4195
/PERmT PROCESSING
PLMNING '
PUBLIC vlORKS
SITE ADDRESS
PERMIT VALUE IS A SUBSTANTIAL IMPROVEMENT.
SITE IN FLOOD HAZARD AREA
YES
PERrm NUMBER 263'3 -78
PARTITION NUMBER
SUBDIVISION
OTHER
YES
NO
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SITE LOCATION IS WITHIN A FLOOD HAZARD APPROXIMATE STUDY AREA, EXTRA
PRECAUTIONS MAY BE APPROPRIATE TO ASSURE THAT THE BUILDING SITE WILL
BE REASONABLY SAFE FROM FLOODING.
,: SITE LOCATION IS WITHIN A FLOOD HAZARD DETAIL STUDY AREA.
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1. MINIMUM FIRST FLOOR ELEVATION OF (M.S.L.) REQUIRED.
2. MINIMUM FOUNDATION ELEVATION OF (M.S.L.) REQUIRED.
3. MOBILE HOME TIE DOWNS REQUIRED IF GROUND ELEVATION THAT MOBILE HOME
WILL BE PLACED ON IS BELOW THE REQUIRED MINIMUlt FIRST FLOOR ELEVATIOtL
4. SITE LOCATED lHTHIN A DESIGNATED FLOODWAY CHANNEL, BUILDHlG PROHIBITED. j;
RECOMMENDATIONS: I~
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DATE
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LANE CO.V DEPARTMENT OF ENVIRONMEAL MANAGEMENT
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
c=J PLANNING DIVISION
Partitioning'
Parcel NO.
Current !Onin9~
[]pending [JCompleted
FEE
AVERAGE PROCESSING
TIME
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Partitionlnq ReQuired
Other.
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Minimum Elevation fJJ
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~ WATE. POLLUTION CONTROL
New Site Inspection(.)
sos Construction g New
Number ot Bedrooms.
f ot Sitell
o Repair
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$
$
Commercial/Industrial - , ot Employees
Othor 9,R-,;;J03!
$ ..:2..."" CJ i)
~ CONSTRUCTION PERMITS AND INSPECTION FEE
~ (See above tor . of bedrooms/' of employees)
[] ~cbl1e Home $
Total V!llu.ltion
~ Plumbing fixtures at
~ Sewer/W~ter Conn. ^t
o Permanent
o Temporary
o Renewal
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_ _ 7/'/9 tit) ~,'llJ ~/L) $
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$ '7. R9
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Subtotal
4' State Surcharge
Plans Check Fee
Change of OCcupancy
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TOT~L BUILDING PERMIT FEE
Minimum atructural setbacks: ~~
From centerline ~;treet' ::::~~:::.:jf1 J~~;"
From interior lot li~1de~,~'r~E'
o Comm'l plans sheet to apphcant ~a~Plicant
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~PUBLIC LANDS
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PUBLIC WORKS
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Facili ty Permit
Address
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ENVIRON!'U;N~H ._
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AFFIDAVIT: If this permit 1s for an agricultural building. I hereby declare that this building
will be used for agricultural purposes as allowed 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 application are true and accurate, and that I have the following legal interest in the
pr y: ~~r 0 r '-"~..:;,, ._~tract purchaserl lessee; holder of an exclusive option
t purchasel~duly authorizeo-to a~t for a person wno-hae the TOIlowing legal interest:
~ ; or that the owner of record is knowledgeable of this
.PP!lcatron~. _ ~ ~m no~ the owner. I f,urther agre~COmPIY with all apPliC3bje codes reIatin9
to t~per ~
Dat.r=-'") <;.. Applicant's Sig::ature ~ ~~. 1
~ THIS IS YOUR RECEIPT, ANO OOESNOT GIVE YOU PERMISSI~ ~UILD'
lOR INFORMATION ABOUT THE PROGRESS OF YOUR APPLICATION, CALL PERMIT CONTROL, 687-4357 (681-HELP)
lane county
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C74-170
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APPLICATION.
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
1;J5 EAST 8TH AVENUE, EUGENE, OREGON 97401
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. , f) 1. ' j Written Directions ,p /.u,-f- /~ ~ / /Lo ,,'. .c A . '-/4J1. /.., .?.t, /Jdj /1" <;,../
Subdivision:, q./l tX. J'j/U (J CL6 t<.J >iju~/1 Q/'/- 13- c: I. .J- f'it ./ 50-" Jj /'1) / 7;;, //1/ / /;>{7 .+-
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SITE FEASIBILITY REPORT FOR SUBSURF~CE AND ALTERNATIVE SEWAGE D~~p6sAL~..I ~f c.(l ,
APPLICANT'S NAME AND ADDRESS ;: /} /} / ;:::/.' '}y;c. (;;rJ /;, /'L>/1 '" J ;)'} a '7 ;/{U..Il /u/ <<:/n."" Phone ?c/7 - /bO? <
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( I /, Phone
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STRUCTURES NOW ON THE PROPERTY ./') - /
.ROPOSED USE OF PR~PERTY S F /J /,
WATER SUPPLY -!~b'?...J..~ WITHIN ON7E ~E OJ: THE'CITY OF,~~Y;L--() (NO)'
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I hereby certify that the above statements are true and accurate, and that I have the follo)"lng legal interest in the property: owner of record;
contract purchaser; tential buyer; realtor or agent. I further cert'tY that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware nd approves of this action.
OWNER'S NAME AND ADDRESS
Mail report to (l)-Aji'plicant () Owner
* * * * * * * * * * * * * * * * * * * * * * * * * * OFFICE USE ONLY LOW THIS LINE * * * * * * * * * * * * * * * * * * * * * * * * * * *
Signat rp, ~ 1L '1"J',).,:"< !:}
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TEST HOLES READY
SITE: ISD MEETS STATE STANDARDS
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Acreage or Lot Si?~
Partitioning #
Parcel #
LAND USE COMPLIANCE
!ten
'1'(/ x I;:) I ' (TOTAL)
( ) Completed
( ) Pending
DOES NOT MEET STATE STA ARDS,
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LANE COUNTY SPECIAL PERMn '
1"....
Division of Water Pollution Control
N ENSURE THE ISSUANCE OF A FUTURE BUILDING PERMIT, ANY PLANS OR EXPEND I.
RE AT YOUR OWN RISK, IF SITE IS APPROVED, SEE REVERSE SIDE.
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t/ AUTHORIZED SIGNATURE
Permit Processing Section
125 EAST 8TH AVENUE,EUGENE, OREGON 97401
?-1,,-7r
DATE
~3-1- 7rP
THIS IS A PRELIMINARY REPORT WHICH DO
TURES MADE IN RELIANCE UPON THIS REPOR
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AUTHOR'IZED SIGNATURE
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
C55-32
687-4061
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OAR Chapter 340, Division 7, Section 72,020(6): This report shall remain in effect until issuance of a
permit to construct, unless in the meantime conditions on this or adjacent properties have been altered in
any manner which would prohibit issuance of a permit, in which case this evaluation report shall be con,
sidered null and void. Technical rule changes will not invalidate any evaluation report issued pursuant to
this section.
Before construction is started bring this form to the Department of Environmental Management and apply
for a building permit, Exact specifications for the sewage disposal system will appear on the permit,
If the property is only a portion of a tax lot, a partitioning or subdivision must be approved before the
permit will be issued,
Only persons having a valid license issued by the Department of Environmental Quality under ORS 454,695
to install subsurface sewage disposal systems or an owner or contract purchaser or his regular employees
may install subsurface sewage disposal systems. A certificate of satisfactory completion will not be issued
if persons other than the above perform the installation.
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C74-1S0
Vicinity Map
Job Location (Address) II r;,::r'1 cF.,.,,r"
Permit f,7r - dO :6For
Permit IQ.!---KJLL For
Permit /J / , For
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SITE EVALUATION WORKSHEET
PROPOSED USE:
AMOUNT USABLE AREA: cf" I'J)
PUBLIC 0 INDIVIDUAL I I
LOCATION:
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RANGE J.....
TWP.
ZONING:
SIZE OF PROPERTY:
WATER SUPPLY: COMMUNITY D
SUBDIVISION/PARTITION
SECTION
6,</
TAX LOT #
/JOi:>
LOT
BLOCK
PARCEL
IF SITE MEETS STANDARDS FILL OUT:
Type of structure and approximate sewage flow: Single Family ~
Multi-family gpd Industrial
Connnercial gpd Institutional
MINIMUM DESIGN REQUIREMENTS:
Length of disposal trench required
Distribution Method: Equal ~.
Curtain drain required: Yes 0
Other:
J.ro1;#-
Serial D
No ~
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gpd
gpd
gpd
/150 gal.
SPECIAL SITE CONSIDERATIONS OR VARIANCE OPTIONS OR OTHER ALTERNATIVES:
NAME:
A~A~
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C74-126
DATE OF EVALUATION:
j -10 -7r
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# 1 T EST H 0 L E
1,' " PERCHED WATER PROFILE
! Predicted in. Inch
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.' Observed in.
, Date
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srja "/tf-.2d '(
TE"T HOLE
# 2
PREDICTED WATER
PROFILE
Predic ted
Observed
Date
in. Inch
in.
12- S:L. ' 12_SL.
SATURATED ZONE SATURATED ZONE
Predicted
Observed
Date
in,
in,
24-
Predicted
Observed
Date
in
in
24 -
36.
36.
Restrictive Layer ~in,
Impervious Layer in,
Mottling in,
48 -
Restrictive Layer'}?~in
Impervious Layer in
Mottling in
48 -
SLOPE
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60,
SLOPE
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SITE DOES ~ DOES NOT D MEET MINIMUM STANDARDS.
ADMINISTRATIVE RULES REOUIRE ~ MINIMUM DEPTH QI:
ON YOUR PROPERTY THE DEPTH
~:
'"'.J D 36 inches to an impermeable layer
0 30 inches to a restrictive layer
0 60 inches to a permanent water table
0 24 inches to a temporarily perched water table
OTHER REASONS FOR DENIAL
inches
inches
inches
inches
Drainage or
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JOB LOCATION
LANE COUNTY PERMIT
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Acreage or Lot Sizp '\
Contractor's O,S. # -').. of - //
Partitioning #
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Subdivision! I .
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APPLICANT'S NAME AND ADDRE""
OWNER'S NAME AND ADDRES~
CONTRACTOR'S NAME AND ADDRESS
Mail permit to ( ) Applicant ( ) Owner
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(owner, etc,) when ready,
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STRUCTURES NOW ON THE PROPERTY
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THIS PERMIT IS FOR
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WATER SUPPLY
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
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SEWAGE DISPOSAl
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PLUMBING BY
I hereby certifv that the above statements are true and accurate, and that I have the following legal interest iri 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 ,?w"!er is aware and approves of this action, I herebv agree to comply with all applicable Codes relating to this permit.
Fee Paid $ .-"1 i_~':'~ ~..) Signaturp ~ - r.' ':., ,I. ~ Date
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) NEW ADDRESS (, ,) FACILITY PERMIT TO TRANSPORTATION DEPT, '
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(,.-(SPECIAL PMT, AREA, MIN, ELEVATION:
Minimum Septic Tank Capacity (Gallons)
Drainfield Required, Lineal Feet
Maximum Depth
BUILpING'
" Type of Construction ,,'
I Ise Classification
Group
Fire Zone
SANITATION
Comments:
"
. Comments:
By: Date: By:' . Date:
PLANNING REQUIREMENTS SATISFIED. By: ;'J'~,: ,\', ',t..C' Date:"! Date Issued: ,.
ZONE: SETBACKS: FRONT" :-11 ", SI,DE FACING STREET (FROM C/L) INT, SIDE YARD :.",!.. REAR' i' i(f'RGM P/L)
LANE COUNTY DEPARTMENT OF ENVIRONMENTA[ MAt;lA,GT:MENT, 125 EAST 8TH AVE., EUGENE, OREtb'N '97401': 'PHO~E; 687-4394
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POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PERMIT -WHITEj BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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~FLOOR
PLUMBING GROUNDWORK
ApPROVEO LEI DISAPPROVEO Cl DATE 11-;:J/-7f INSPECTOR N-
REMARKS
GAS PIPING GROUNDWORK
ApPROVED Cl DISAPPROVED Cl DATE
INSPECTOR
REMARKS
ROUGH PLUMB I NG
ApPROVED
~ DISAPPROVED
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DATE 9-t - 79
INSPECTOR
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REMARKS
ROUGH GAS PIPING
ApPROVED c:J DISAPPROVED Cl DATE
INSPECTOR
REMARK S
FINAL PLUMBING
/PIL
ApPROVED LZf DISAPPROVED c:J DATE 9-..:J-9CJ INSPECTOR
REMARKS
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FINAL GAS PIPING
ApPROVED c:J DISAPPROVED c:J DATE
INSPECTOR
REMARK 5
CERTIFICATE OF OCCUPANCY
READY TO ISSUE Cl NOT READY TO ISSUE c:J DATE
INSPECTOR
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FOR SANITARIAN'S USE ON L Y: ,0 System Approved ~System pisap~roved o Needs Correction
COMMENTS:r.~ ~~~~,.....;...~-~~,
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Signatu'!:. <:>/J ~.~ __ Date: /--2 -3' - 71
Filler Depth Below Tile ~
FOR INSTALLER'S USE: Trench Depth
Tank Capacity I (Y)o r.a. l Manufacturp'
Measured distance to well from tank~~'
from drainfield~.
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INSTALLATION RECORD AND CERTIFICATE OF SATISFACTO & OM~LETION '
When signed by the County Sanitarian, this certificate is evidence as per S 4At663 qJ~t'.8 r> \-1 ,
isfactory completion of a subsurface sewage disposal system at the abov~tib'(l" v 00\1.,+;00 ,
'1~ater r' I
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Return this form to: Permit Processing Section, Department of Environm llifaodallement, 'I
Public Service Building, 125 East 8th Avenue, Eugene .. - - iT. /11
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TfiS, TI JOB LOCATION
LANE COUNTY PERMIT
Acreage or Lot Si7~
Contractor's O,S, # ,
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APPLICANT'S NAME AND ADDRFC:C:
OWNER'S NAME AND ADDRES~
CONTRACTOR'S NAME AND ADDRES~
Mail permit to ( ) Applicant ( ) Owner
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(owner, etc,) when ready:
) Contractor. ( ) Prefer to pick up. Call
STRUCTURES NOW ON THE PROPERTY
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THIS PERMIT IS FOR
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# BEDROOMS .,> # PLUMBING CONNECTIONs.......L
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THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF . PLUMBING BY, t.:.
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: -1Lowner of record;
contract purchaser; _ potential buyer; _ realtor or agent, I further certify that (if not the owner) I am authorized to ~ct for the owner of
record, and that said ow~er js aware and approves of this action, I hereby agree to comply with all applicable Codes relating to this permit,
Fee Paid <l: ' " ", ',: ~ ': .J Signatur~ t ~ ,\',' Date '
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) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT,
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SEWAGE DISPOSAl
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WATER SUPPLY
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Minimum Septic Tank Capacity (Gallons)
Drainfield Required, Lineal Feet
Maximum Depth
BUILDING
Type of Construction
Use Classification
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Comments:
Comments:
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By: Date:
PLANNING REQUIREMENTS SATISFIED, By: ."., ". ~\\,
ZONE:, SETBACKS: FRONT 0:2' ,',;,'SIQE FACING STREET
By:
Date:
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Date: f Date Issued:
(FROM C/U INT, SIDE YARD :,v REAR
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LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE" EUGENE, OREGON 97401 '" "PHONE: 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
C5S,13
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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INFORMATION SHEET
DUK'<.. .f- 1:,dtJll~ S'r..{
( v(Site Feasibility Study for Septic Tank, Number of sites "Z-
Test holes...willjl.e ready /lJOvJ/-{ ~~:s
Subdivision_~ Ma A_f'lru J ~ Lot...:;J
) Bui Iding Permit ,
~18ou ?I,~ )Z.z..'
Acreage or Lot Siz~ "J.~D1..- /Y2.~ I/~'
Partitioning #_/7/0 -77 () Completed
\H'Z.~o'Z.- (v1Pending
APPLlCANrSNAMEANDADDRESS EAlL'- L, f'I\((.L>-l,....y 2?9?
OWNER'S NAME AND ADDRESS, if different from applicant's ~-
CONTRACTOR'S NAME AND ADDRESS
Mail permit or results of site feasibility study to (v') Applicant ( ) Owner (
( ) Prefer to pick up, Call (owner, etc.) when ready,
,s,U2.L.,NG,'D,oI .-4L1E, S'PI'Q. OIL Ci7',7'7
) Contractor,
COntractors O. S. #
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STRUCTURES NOW ON THE PROPERTv
Ai O~ L
PROPOSED USE (this permit)
WATER SUPPLY SfFO
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Phonp 7 <,oP-/t. I!- J/68 ""/70
Phonp
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(existing or proposed well, etc, If public, name of system I
SEWAGE DISPOSAl
.<;;'E-Pi"< """""'k f-M"opo~eD
I~xisting or proposed septic tank, etc,l S,I. #
tJ, A ,
Address
PLUMBING BY
( v( PROPE RTY IS WITH I NONE MILE OF CITY (
S Prz. ,N (, F. de'-'/)
) Special Permit Area,
Minimum Elevation'
......... ** ** ..**... ** **... ***... *** ** *...* ** ** ...*...** **... **... 0 FF ICE USE ON L Y BE LOW TH IS LI N E ***..... ** **...... *.... **...... ** *............... ** **............
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( ) NAdd~CeSSary ( ) Facility Permit Necessary
ZONE~, ,- SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAD)
I nterior Side Yard Rear
(FROM PROPERTY LINES)
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To: Planning/Building Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
.
Permit Processing Section
ResponsP'
C55,12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
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Fee Received By ~ Date' D
LANE COUNTY DEPART ENT OF ENVIRONMENTAL
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Mamt. due
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MENT
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LANE COUNTY DEPT ENV MGT RECEIPT . 283378 DATE 100979
_.'J~,I';~ I'"",:..r,,(, 1 Eli ..",Dr, PO BOX 'I..:i48 SF'F:INGFIEL.D 97477
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L.C 283378 REIN FRAM REIN/PLAN AP
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APPLICANT MORGAN. TED ~ADDR FO BOX 1348 SPRINGFIELD ~7417
TLO 1802064201800 SUBDIV MEADOW GREeN ESTATES LOT 2 ~LK 3
.NEW BLDG TYPE USE NO BDRMS 01l NO UNITS 00'1 NO STORIES NO 3LDGS 001 .
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DAYS
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LANE COUNTY, OREGON
'O'EPT, OF ENVIRONMENTAL MANAGEMENT
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CONSTRUCTION PERMITS
& INSPECTION OIV.
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JOB ADDRESS
TO:
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DATE
q - z - 80
2-%'33-7 R'
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lJ2lihlCClIl"\lCEl 1Ei1Sl#,-~(QJlSi!5 t=DII'Il AIJ:IlIJ:llIl'llDVA!.. INSPECTOR:
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BLDG, PERMIT:
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,iANE COUNTY, OREGON
""DEPT, OF ENVIRONMENTAL MANAGEMENT
'!;?t?.A. /0 5t..J /J ~ CORRECTION
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CONSTRUCTION PERMITS
& INSPECTION DIV,
NOTICE
3 ~/6 7Jv~E.. DATE /n-z..?_1'9
4dL)~;C.;A-A/ BLDG, PERMIT 2.$?~3-7a
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NDTE:@ ,W5l..ILA rjA"JA/ LlE 1=~.1=r' -rO~.5 MIT<-'-
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JOB ADDRESS
TO:
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RE-INSPECTION REGUIREO
Phone 687-4065 FOR APPROVAL INSPECTOR:
(]~ ~~ A-
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C55-73
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CORRECTION
.
NOTICE
LANE COUNTY DEPT. OF ENVIRONMENTAL MANAGEMENT
Construction Permits & Inspections Division
EUGENE, OREGON
This building or structure does not conform to Lane County building regulations. ordinances or codes
as noted below:
Pc2(')( }/lv-,; (" rv 1 dTl/ Aq'J;1CVI3....,
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C55-73 "RE.INSPECTION REQUIRED
: FOR APPROVAL /
Inspector
Building Permit #
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JOB LOCATION
Acreage or Lot Si70
Contractor's O,S. #
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Partitioning #
) Completed
Subdivision '
Lot,
Bloc~
APPLICANT'S NAME AND ADDREC:::C:::
OWNER'S NAME AND ADDRESC:::
CONTRACTOR'S NAME AND ADDRESS
Mail permit to ( ) Applicant ( ) Owner
,
Phonp
Phono
Phono
(owner, etc,) when ready,
) Contractor.
) Prefer to pick up, Call
STRUCTURES NOW ON THE PROPERTY
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THIS PERMIT IS FOR
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.
WATER SUPPLY
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SEWAGE DISPOSAl
# BEDROOMS~# PLUMBING CONNECTION~ '
;;. If
. . \; ..:~ 5.1. # <
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
I.....
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PLUMBING BY,'
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the propertv: _owner of record;
contract purchaser; _ potential buyer; _ realtor or agent, I further certify that (if not the owner) t am authorized to act for the owner of
record, and that said owner is aware and approves of.this action, I hereby agree to co.mply with all applicable Codes relating to this permit,
Fee Paid :t
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Signature
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, Dato
,) NEW ADDRESS ( ,) FACILITY PERMIT TO TRANSPORTATION DEPT.
(Jf'SPECIAL PMT, AREA, MIN, ELEVATION:
SANITATION
.
Minimum Septic Tank Capacity (Gallons)
Drainfield Required. Lineal Feet
Maximum Depth
BUILDING
I ' Type of Construction
. 'A , /) '.' Ilse Classification
; Group
Fire Zone
Comments:
,"
Comments:
.. .
-
~ Date: By: .', ' Date: /
PLANNING REQUIREMENTS SATISFIED. By: . c' Date: I Date Issued: "
ZONE: SETBACKS: FRONT' SIDE FACING STREET (FROM CIL) tNT, SIDE YARD :.':, REAR
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL. MANAGEMENT, 125 EAST 8TH AVE" EUGENE, OREGo'N 9740;'
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of
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7
PHONE: 687-4394
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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SITE INSPECTION
ApPROVEO ~'SAPPROVEO
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DATEr:-Z-~ .77 INSPECTOR~l ~
(/ F-
REMARKS
FOUNDATION INSPECTION
ApPROVED r----? DISAPPROVED / / DATE
REMARKS ~ OK "" LJ.- __ '3_ 2.'1_ 7?
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INSPECTOR
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FRAMING INSPECTION
ApPROVED ~'SAPPRDVEO CJ DATE/""~2.t/-J( INSPECTOR
REMARKS o/~/7r . L , ~A:::, A
fl'<' ,I'lL") - - ~ ./,jf:. ~IIUd'J _ ,I{,H<;ez,p ~d 2-10
. _'11-' 17 r:. _'lilT
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REMARKS ju,;1,J,h" - ~ ~H_ ..;?~ '5~ ~
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ApPROVED / ~ DISAPPROVED
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FINAL INSPECTION
ApPROVED lZf' 01 SAPPROVED
CJ DATE q- f?..8'~ INSPECTOR
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REMARKSc..I- /':
CERTIFICATE OF OCCUPANCY
REAOY TO ISSUE ;---y NOT READY TO ISSUE I / DATE
INSPECTOR
REMARKS