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Home My WebLink AboutPermit Building 1974-1-26 . ~J' , '----.: .--- J ='-" I " .' '/ -/ I ' I I . LANE COUNeBUILDING' PERMIT OR MOBILE H. BUILDING [J MH 0 MAILING ADDRESS ::,r) t'~~n<;: C:":'I~(l 'f['l. ::)r!11'-~"':8h'. ,'jC:,C.~ MAIliNG ADDRESS USE PERMIT PERMIT NO, 1':-,':. .. . , PROPEItTY OWNER PHONE ~.r.:~_ l'V II t:! 1. ~. ..t" 'I~:- .. CONTRACTOR PHONE .i: Lt: PROPERTY LOCATION - INCLUDE POST OFFICE L' ,~: ;,i': J~ 1 ~~,:':.:~ '.jr,; [Hifj i t i cn..::j~~:"':c..:".) Grc~;~ :;~'i:Qtos PROPERTY LEGAL DESCRIPTION - METES. BOUNDS ~G!:.I .)::!to Streot TWP RANGE \" .' O~ SECTION uS1113 TAX LOT NO. .JI92/ z.-. CODE CENSUS TRACT 3~41 EXISTING STRUCTURES ON PROPERTY :!:J.l:: LEGAL ACCESS TO PROPERTY Ju:tO ~~rcct PROPERTY SIZE - FT, APPl. NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms , H .1~rt ~l_ ,:':i'l WIDTH DEPTH AREA STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. # BDRMS '::::,~ II i.n - ;\{) I n Fro:];! 1:12~J'2(;) New System 0 VALUATION 1~.;.':':. (k~it: ~c .. r.r;CC!::lCU - uncoi lcd . ~~l .--:-..": .,:. j >. SEWAGE DISPOSAL PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK [) OTHERD . 5:;.00 30.00 ?1.:J(J FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY Jcckn~;!l \):~:..;:)! ~' PUBLIC fu o OTHER TOTAL .IIO.~~ COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED MIN. SEPTIC TANK CAPACITY WITH oIST. BOX: GAL SJO UN. FT 220 TRENCH WIDTH FT. 2 OR SQ. FT. l:~O ::.,:~Ji10(,:-:(~ ::-t-lC.'O J15(.:0501 Sy5tc~ to :)0 ins~o11cL en per rovls::,,: pi~-:: f.>lC:l. TYPE OF STRUCTURE OCCUPANCY I C. J BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY ZONE ~~". PUBLIC UTll. EASEMENT USE CLASSIFICATION FRONT L:.r: SIDE INT. 5 SIDE EXT, AUTHORIZED SIGNATURE - DATE I'1tlr )CUf ::, REAR 1 0 J. .:, HC55 bv :. JO~i:l SI'l~:t 1-2.:-71) DATE r.'.-= ~, 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 certjficate 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 97.401 FORM:: C55-13 INFO~l^TION REQUIRED FOR BUILDING PERMIT - DWELLING , Ma in Floor ///2.., Sq. Ft. 2nd Floor -0- , Sq. Ft. . (above living area) Garage ~7 Sq. Ft. Carpor~ , Sq. Ft. Deck , Sq. Ft. n1 rg ((g ~ n w ~ ~ JAN 0 7 1974 lANE COUNTY HEALTH UNIl # of Plumbing Fixtures {, (Partial List of Common Fixtures) Water Closets Wash Trays Dishwashers Disposals Water Heaters Bath Tubs <'Automatic Washers Sho,"er Baths Kitchen Sink . . . '. BUILDING SITE EVALUATION 7:>~Clf. "A,I" iJ, ~LR 0.:2-5 06 .TAX LOT ,,' .:v' ~aH~~~XJ 'M ' (,j APPLlC~ A Y'/' . -' ~ /" Building Permit Application No. 1."..-7/ Ni'JA.E~A./ ~ ADDRESS ' ( ) ( ) Site Inspection L/\NE COUNTY PLANN I NG DEPARTMENT NO PHONE DATE _ /-./- 71L NAME ~ Pre-Permit Investigation I. Zoning Ordinance Compliance (Zone 12~ ) Subdivision Ordinance Compl iance NOT app I icab Ie () () ( ) ( ) ( ) ( ) YES ? , . Required Access ( ) ( ) ( ) ( ) (.-1" ('1' (..,. ('"'r ( ) '-# DiHE jekL 2. 4. Building Site (Area, Width, Frontage, Setback) Other (see comments) 5. COMMENTS: - BUILDING INSPECTION SECTION NOT NO YES .!!I!pl icable - (fr 6. Plans Submitted () () 7. So i 1St ab i lit y (foot i ngs) (t; ( ) ( ) 'J 8. Flood Plain rpl ( ) ( ) W) 9. Other (see Convnents) (fYl ( ) ( ) ~ = - COMMENTS: NAME DATE , 6 '}jB11f:['~1~ /-7,/1-7// n (/ - SANITATION SECTION NOT NO YES J~- DATE appl icab I e y) 1- 26'-7!1 10. Sewage Disposal ( ) ( ) II. Us ab I e Area ( ) ( ) vf 12. Wa t e r Supply ( ) ( ) ({ I J. Other (see Comments) ~) ( ) - - COMMENTS: Ao/I /h-r 171' vJ ,nloT o/an / /"f'rknrlClI1-r (J/O'f'M {/ (I ,/ TO APP 1I CANT: ;"l . _.r 'J. -, - ( I: 0/2- ...., Your Building Permit / Site Inspect ion: ~ Can be approved. *Cannot be approved at this time as indicated on iten; NO. 13 above. \ Quest ions and further informat ion on items i through 5 contact the Lane- COUNTY PLANN ING DEPARTMENT. Ques I: ions "nd fu rt he r in format ion on i tems 6 through IJ contact the Lane CounLY Buildinq and Sanitation Division. -0;. '.Ii II be held in this office UMi I you can resolve the problems indicated. () Is being returned. () Your buildin~ permit appliccJtiun fee is being returned under separate Cul/er. I-..(f \Sf' LANE COllN'1 Y I'UINN ING OEI'/IRTMENT , J,~ S i.J< rli Avenue [~S I. <uHelle. 0'''9on 9740 I 1'/WNl:: 3!jl,.UII 01.231 LANE ,COUNTY BUILDING & SANITATION DIVISION 13'> Sixth tlv~lue East, E"~le''''. Or"9on 97401 PIlONL: J42-1311 fliT. ~ll M55-2S--- --.- , ~~J. !/D J1 cfl -e cr.. LANE COU4BUILDING PERMIT OR MOBILE H BUILDING 0 MH 0 MAILING ADDRESS fiJ.JC1 ( . USE PERMIT PERMIT NO, PROPERTY OWNER PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION -INCLUDE POST OFFICE PROPERTY LEGAL DESCRIPTION - METES, BOUNDS TWP RANGE SECTION TAX LOT NO. CODE CENSUS TRACT APPl. NAME & MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT EXISTING STRUCTURES ON PROPERTY LEGAL ACCESS TO PROPERTY PROPERTY ~IZE - FT. WIDTH DEPTH AREA Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. :# BORMS New System 0 VALUATION SEWAGE DISPOSAL . fEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC 0 BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAILER SEPTIC TANK 0 OTHERD PUBLIC 0 o OTHER TOTAL . MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FielD REQUIRED lIN. FT TRENCH WIDTH FT. OR SQ. FT. \ TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTll. EASEMENT BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION FRONT SIDE INT. SIDE EXT. AUTHORIZED SIGNATURE - DATE REAR DATE " 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 sewoge 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:::: C55-1] e e . SLAB FLOOR PLUMBING GROUNDWORK ApPROVED ;---? DISAPPROVED ~ DATE INSPECTOR REMARK S GAS PIPING GROUNDWORK ApPROVED / / DISAPPROVED L / DATE INSPECTOR REMARKS ROOGH PLUMBING 1'- -.I. '/-) ~I NSPECTO~ ..z.~2.~-?;~-< P/h -:.1-,/1 1/", -rr~+: '~~ //1 J/I . rr-;;.t;;V ApPROVEO /,t'" / D I SAPPROVEO /iiii!t' DATE REMARKS~/-:..f "" .J,,{). /iA C-".z.LI-",-P hi _'i;7ek~o~ ROUGH GAS PI PI NG ApPROVED ~ DISAPPROVED ~ DATE INSPECTOR REMARKS FINAL PLUMBING ApPROVED ~ DISAPPROVED ~ DATEL:.,L~ .:; !J~ I NSP.t.ttOr.-"~ (/ REMARKS FINAL GAS PIPING ApPROVED ~ DISAPPROVED / / DATE INSPECTOR REMARKS CERTIFICATE DF OCCUPANCY REAOY TO ISSUE ;---? NOT REAOY TO ISSUE ;---? DATE INSPECTOR REMARKS INSTALLER: Complete top PRaED part of form .. % SEWAGE DISPOSAL SYSTEM RECO. . , '.. . to signature and submit both copie with applicati9n. .~" PERMIT NO. J '~.y..;'"L. 7..,... PROPERTY ADDRESS I'~-- ~'1' INSTALLER'S NAME IV b'QfV\ ( c:J((.t=- c.7J No. Living Units Bedrooms I <> Septic Tank: Ft. from well Baths I 3i.L/ I Basement Yes No 'Ii: '~I{F Water Supply Publ ic It Other-List Steel D Concrete ~ No. Compartments I Gal. Capacity J ()-E}-eJ Inside Dimensions: Ft. Length Width Diameter OWNER '-:7 I . I ' NAME l"-Oh(u...:1, JJ, NI / I ' Depth Tile Disposal Field: Distribution Box: Yes ~ No Other Distribution-Type Total Sq. Ft. 30("') Feet from WEll Lot Li ne Front ,- I 't. Between Li nes /0 Foundation /(-, MAILING .5:>7D W ADDRESS (?e it 1'1 "'... I A4 <... ~ Length of Lines-Ftl ITrench I . pt)2<J03. 4. 5. 6. Width2- .jot Plan (see instructions): Side Jb Rear Jb IFiller IFilier Depth IFIller. Below Type I.r" Above Tile ::Lln.ITile/,"- in. -- 10' I 10' I - i'ot I -- ,- J ~I 11,1 " J _ I I -2-1-1-.1 I I -}-1 s-ol _.- l!J VI -1 I I 1-10- 1~1 I ~ ?::> ,;. I Date .----,. Signature \~ 7J~ ~-. CERTIFICATE OF SATISFACT.6!\Y COMPLeTION it / For Sanitarian Use Only: U Date:.S7ltf. 7 In accordance with 1973 Oregon Laws Chapter 835, Section 214 this certificate is issu d ~ as evidence of satisfactory completion of a subsurface sewage disposal system at the above loca~i . Approved: System Installation conforms to current standards Disapproved: Does not conform to current standards Remarks: ~-L-14 C55-11 \~~ t }Sanltarian1s Signature V LANE COUNTY STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY ... "... " . LANE COU. BUILDING PERMIT OR MOBILE HA BUilDING 0 MH 0 MAILING ADDRESS ~ , USE PERMIT PERMIT NO. PROPEfHY OWNER PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE PROPERTY lEGAL DESCRIPTION - METES, BOUNDS TWP RANGE SECTION TAX LOT NO. CODE CENSUS TRACT r ~ ! APPl. NAME & MAILING ADDRESS FOR MOBilE HOME PERMITS ONLY No, of Bedrooms EXISTING STRUCTURES ON PROPERTY '.'~ --.)~' '.- \\ \'. \. LEGAL ACCESS TO PROPERTY . " ~ PROPERTY SIZE - FT. WIDTH DEPTH AREA . "". 'Connect-ta .Ex"istin'g TYPE CONSTRUCTION Sewag'e System 0 SQ. FT. # BDRMS New System 0 VALUATION STRUCTURES TO BE BUILT THIS PERMIT ~. " <. .' , . , \"'~~'."'.'\~ , ~ ')\ ,:. ....::. , .'- '- '- , ." '. \~~,...,"""~. \)~~~~' ,......~""'\.- ",+:, \, \~~ ~ ~~\\:-...~{..:~.~~\!\ -\ , \. ~~~"~,\:,.t.: ~~~'.~~ ~,\",..~.(,'\, PLUMBING INSTALLED BY, ''\ - - - . .. " SEWAGE DISPOSAL PUBLIC D SEPTIC TANK 0 OTHERD . . WASTE DISPOSAL' BUILDING . ,. FEES OWNER 0 OTHER: NAME WATER SUPPLY , " i'- 0.- PUBLIC ;b o OTHER PLUMBING PLAN REVIEW PARK TRAILER .. ' . ~ .. , .,J TOTAL ~ .. . v" MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. COUNTY BUilDING & SANITATION SPECIFICATIONS DRAIN FielD REQUIRED UN, FT TRENCH WIDTH FT. OR SQ, FT. I .Al \l\,.\\,-'" ~~'" ~. t,....._ ..: TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTlL. EASEMENT BLDG. SETBACKS _. FT. FROM CTR. OF ROAD RIGHT OF WAY USE ClASSIFICATION FRONT SIDE INT. SIDE EXT. AUTHORIZED SIGNATURE - DATE REAR DATE 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 ond 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 rORM :: CSS-13 . r/ e e 5 i -, I, SPECTlON t,P(l ~l.' , Cl DISAPPROVED Cl DATE ~~' J-/-7!/(fJ!- INSPECTOR HE. '~/..I FO',,\,),;I 'ON INSPECTION ApP':,':~v 0 r77'7 01 SAPPROVED 1-/ INSPECTOR ~ DATE -L2/-7t{ RE'I,t.R;C:, Flli'" If.SPECTION ...."c. JET" ""....'" = '''' 3-/;.;;~:Z::~ e I p~- Li",' O~ SHEETRO.J-INSPECTlON ~PP.Oi'O rv1 D'SAPPROVEO L-I DATE3-JI"'?f' /.......' ., - .""- ~--e REt-1A:~,,,S :::""",J.io- -4''':,~ ,,-:;1;..5~ INSPECTO~ ~~ :;:::~.'~':/ ,p, n . ,0 1-" 71/ ...",tf" cfl t ~"IAR'" ~~:/J.'7;~ C[qTlflCATr or Dce " RfAD'l' TO IS'jV f --,. -'-- - ,/ 7 .~y TO i""LE I"lSprCTOR C . T r- ,\".; l'~n.~,:.! :,::: --;'N{y~/f?Jr~ -.oJle ~ --t,f'/ /J.c. ~ Q JP__ AA ;YF/--""'..i~ r;;q~~A . , ~ . .. LANE cOUNTvtalLDING PERMIT OR MOBILE HOM_SE APPLICATION PERMIT # / V - 7'1' SLY1~r;;;J;itI -zi;~Nm6 I ~ PHONE .y' " lm-t7h Rhk.\ (iJ~si;) TAX LOT # CODE CENSUS TRACT .' ~.)- -/5 .J- <L---- DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY hon-e..- LEGAL AC;:: .TJ{~:ERTY - ROAD NAME OR # 1)U J( I; .. . __ _ s:;t-, PROPERTY SIZE-WIDTH DEPTH AREA I ~5' b 5 PLUMBING INSTALLED BY ~ ~ ~ O~~:~S~URN~~~~R ~NAME -, Jaz'L1TY ~RMIT um ~ OTHER._ YES 1!iI' ~ YES.D _ NOD @""3eQCh... SIOi-/).T PLI~~A'/..p / DATE. II 3.- 1<1;.--- ~#'~ _ J-i-7, 2, -- Y'RECE - ~Ltt p eweQe/- DATE PERMIT it 1.60 /L/-1Y , PERMIT TYPE - BUilDING ~ MOBilE HOME Dose REG, # PROP'fj,',rE,R R()hfrf ;() V'OADDRELJ. Cfll1lfl7/0/ CONTRACTOR I MAILING ADDRESS f /I .. , .;f PROP7~tATI:? tINCLUD@lF2? :?d QrlrI 11.tdeu) PROPERTY LEGAL DESCRIPTION LOT - BLOCK - SUBDIV. TWP RANGE It{ -:2 SEC, b APPLICANT NAME AND MAILING ADDRESS FOR MOBilE HOME PERMIT ONLY Number of Bedrooms STRUCTURESI)'f!d'lB~ BUILT THIS PERMIT, _Olt-Q J - hI.QlJ'J (;.C1rQ(jf'.., -alf. t.JhC,. Connect to Existing TYIT CONSTRUCTION +mtnp ./ SEW AGE DISPOSAL PUBLIC 0 BLDG. WASTE DIS. PLUMBING PLAN REVIEW PARK TRLR. SEPTIC TANK '&r' ~q. -- , 1e"' --- :2/. ,,0 OTHER 0 FEES WATER SUPPLY PUBLIC )![ PLUMBING FEES ~ FIXTURES CASH 0 SEWER CHECK n CONNECTION FEE PUBLIC WATER. CONNECTION FEE $ TOTAL $' /I D,5'O METES & BOUNDS 0 YES ATTACHED 0 NO Sewoge System 0 or New System Req. 0 U}i.' (5)# Bi~Ofa:Ft~3ql/ Ll07 Q 3. 1?-~ I COUNTY BUilDING & SANITATION SPECIFICATIONS MIN. SEPTIC TANK CAPACITY 0/00 R~,^Y'l'f~... *- 0:;;0:: pi D{- r I o..~ DRAIN FiElD REQUIRED L1N. FT, ;( /}t) TRENCH WIDTH FT, 2. -f.-r) h<- IA S:./Ct Ilee! WITH OIST. BOX: GAl. OR SQUARE FEET L..J'1 n ('eL>~ ~ r.>.d a ~ oe(' / --</ /> ~ TYPE OF STRUCTURE OCCUPANCY ZONE 'RA- t REAR l (') J Dale, ,LOG, INSP.". / ~ ~ ?Ii ' ..- I /.' ,--, /;/ .'~' , BLDG. SETBACKS - FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT ~ t;t SIDE INT, t;; I SIDE EXT. ~!:o~'. ,ol:;~;~~:.:' lj:':L- COPY 1 - OFFICE COPY 2 - JOURNAL COPY 3 - AUDIT Form # CSS-1Z REAR YARD PUBLIC UTll. EASEMENT USE CLASSIFICATION , '/ ;.-/ .4' / / '._// II" -- Ir ~;:.. /,?ate ;- ~