HomeMy WebLinkAboutPermit Building 1976-3-30
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LANE COUNTY PERMIT FOR:
.
PERMIT NO.
457-{j
[MJk...:.
[ ]
CONSTRUCTION [ .~
MOBILE HOME [] PLAN REVIEW [ ]
31 /) l
CHANGE OF OCCUPANCY
DOwner
n&bert f:i11 Build('!r Inc
NAME
870 ~'~~t C~ntGnniul Blvd.
ADDRESS CITY
Snrinofi~ld 74G-C~li
ZIP CODE PHONE
o Contractor
S,\q'
NAME
'"
ADDRESS
CITY
ZIP CODE
PHONE
O,S, Reg. #
,Tw~ i:3 Range 2 Section 05. 4-2rax Lot
It,] i\ddHion r,leado~! Green Estates
Subd ivision Lot f.I Block
~ r//JO
- -rv Codp
Census Tract
':l Acreagp
Width
Access to Property (Road Name):
I '=;1I~1 <:'+WIoOO+
Depth
Existing Structures on Property:
Nnno.
Directions to Property. Address:
l1nQ I n_~l ~+~oo+
~~~~n~~~o~~ n~~2~n
STRUCTURE (# BEDROOMS)
fl:",,:~f~. f'nr ~i9g',Q i=':tmil\J nhfOl'inn
~;:'I"'i1n(3
sa. FT.
In>:&; fa ?1 An
>:?A fa t; ~n
VALUATION
<<?":l n?n an
9 7~A Iln
(~?" Ql Q ?f\
SEWAGE DISPOSAL:
PUBLIC [] SEPTIC TANK (] OTHER (
BUILDING 115.00
PLUMBING ?? .00
3% SURCHARGE 11.11_
MOBILE HOME 75 00
WASTE DISPOSAL
PLAN REVIEW
fJet'j
PLUMBING INSTALLED BY:
OWNER r 1 OTHER I 1 NAMF
WATER SUPPLY: PROPOSED [ J
EXISTING []
[ ] PUBLIC
[ ] COMMUNITY. NAME:
[ ] PRIVATE WELL
[ ] OTHER. SPECIFY:
TOTAL
215.11
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY:
GALS. Clnn MIN. DRAINFIELD
TnC:+:ll1 1n ';-ho nnnrv'\\lnl'f ;)1f"n:ll
'"n
L1N. FT.
MAX. TRENCH DEPTH
~:,:II
INCHES
-F"""m ~h/"\ ~'U'\IICn ~;'~1
~~~^~n~"n vn nl^+ nl~~
- ---.", -- ,- - - - l"" --..
rlf'n._n~"..+" 1"ll'lo..... lo-f-l-:.t." ,:~~~~::~~~:l~:
, . . ~ -
C","""" ,,, -I!........<.
---0,1 .- .---
TYPE OF CONSTRUCTION
1:1'
GROUP
T ~.1
FIRE ZONC
STAY 100' FROM ALL WELLS
USE CLASSIF.
SETBACKS. FT. FROM CTR. OF r/W:
FRONT 3!J SIDE EXT. 5
FT. FROM PROP. LINE:
SIDE INT. REAR
7' I'll!' ZONC
n~
AUTHORIZED SIGNATURES:
/s/ J. E. Boss by HarOBUqi,
Grav/sanitar1an
ISSUANCE DATE:
3/20/75 dlm
BLDG, PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
IMPORTANT:
Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required
septic system inspections. All construction shall comply with the Slate Buidling Code, D.E.a, standards
for subsurface sewage disposal and the Stale Plumbing Code. All buildings require a certificate of
occupancy before being occupied.
(See Details on Reverse Side)
tp)JJ
(POST THIS PERMIT ON MAIN SLOG, AT SITE)
C55.1;J
LANE COUNTY, DEPT. OF ENVlRONMENTAl MANAGEMENT
COURTHOUSE ANNEX. 135 EAST 6lh, EUGENE, OREGON 97401
BuiLD IRGc.S ITE' EVALUATION ~ A~~
JXf' BUI'~~ING PERMIT APPLICAH~. ~s7- '/ i
() SITE INSPECTION
PLANNING OIVISION Not
Applicable
I. Zoning Ordinance CampI lance: Zone ~ Q ()
2. Subdivision Ordinance Compliance , ./ . ( )
3. Required Access ( )
4. Building Site (Area. Width, Frontage) ()
5. Other (see comments) ( )
COMMENTS:
T ) ~ R cJ 2. S tJ' TAX LO; ,
SUBDIVISION: 7l1~~C<zX.
LOT: Y BLOCK:_ '?
'-'
APPL I CANT
OATE
No Ye
T)
( ) ( )
( ) ( )
() )
() )
CK'D BY: llfR.!l, d3lntU.7b
Setbacks~om c/l of road:
Front . q.':;-
S.i.d<.. ""cerl or
Setbacks from interior lines:
Side ,~
Rear .,tP 7 Iqe
6.
PLANNING OIVISION ACTION PENDING: YESl } NOl } APPLICATION#
BUILDING INSPECTION DIVISION
Not
Appl icable
( )
~R
(('
7. Plans Submitted
8. Soil Stability (footings)
9. Flood Plain
10. Other (see comments)
COMMENTS:
WATER POLUTION CONTROL
Not
Applicable
( )
( )
II. Meets Department of Environmental
Quality Standards.
12. Other (see comments)
COMMENTS:
No ills
T)
() )
( ) ( )
( ) ( )
CK'D
By:e.113-A'f-?6
DATE
No Yes
T) --rw:
( ) ( )
CK'D BY:. ,4!(}, d_ .:J-.:;s;7~
. - 1/ DATE
TO APPU CANT:
Your Building I Site Inspection:
~)'Can be approved.
~~( ) Cannot be approved at this time as Indicated on item NO. above.
3~. I~ Questions and further information on items I through 6 contact the LANE-
/~v COUNTY PLANNING DIVISION. Questions and further information on items 7
through 12 contact the LANE COUNTY BUILDING AND SANITATION DIVISION.
( ) Will be held in this office until you can resolve the problems Indicated.
( ) Is being returned.
( ) Your building permit appl ica!.~~.'!....fe~~bein.'l,x~tY':'~,!'.d under separat.! cover.
DEPARTMENT OF ENVIRONMENrAL HA~A~~M~NI
135 Sixth Avenue East Eugene Oregon 97401
PHONE: 687-4065
LANE COUNTY PLANNING DIVISION PHONE: 687-4186
C55-2B
'..
LANE COUNTY PERMIT
.
FOR:
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'.1.
.
.
PERMIT NO. 0JJ~!C
CONSTRUCTION
1- MOBILE HOME [J PLAN REVIEW [] CHANGE OF OCCUPANCY [ ]
o Contractor
~~~1:?~
NAME
Sr:.~
NAME
o
ADDRESS
CITY
ZIP COOE
PHONE
,0 Owner
. -,. 'I r~,"1'i1...~~n Vrr'>
.. \l . I l;\;.; Il..........r r.~.v
G1D eJG~ CtJ~C~u~Gl u~~j.
ADDRESS CITY
hsr~ 1Fi'?1 (J]:::
ZIP CODE
d'GG...<"~::
PHONE
O.S. Reg. #
'iI ~ j t) r"
Twn 0, Range (. Section v Tax Lot
(~.^ "~0^ r' ." r. '" 0^
,'L I ,:~u,~uC;] .:)(Jc.;:;tJ d\::::\1 l:ll"a"""o
Subdivision Lot:1 Block
Code
Census Tract
;.)
Acreagp
Width
Access to Pro perty I Road Na me I:
~.r"ml ~~t:\- .l',
Depth
Existing Structures on Property:
~:,)'l~
Directions to Property, Address:
H!1:-. I.N';;,'~ S~R^':>~
~"pi~'fq~()1t'l Oi\i~~
STRUCTURE (# BEDROOMS)
:);~?l~~ yn;' 5\~r:n'in [I,~,n If I'!:-..,U kn
. '.
SQ. FT.
1(;',:" () ~] .rn
[;!"::i n rUJrI
"
VALUATION
~~3,,(nrL:--';
R. ii):1J\t,
~li~-2~':l
.~::..:'~ ,,[~1t n A;':;~
SEWAGE DISPOSAL:
PUBLIC [J SEPTIC TANK [
OTHER [ ]
~=C:J
PLUMBING INSTALLED BY:
OWNER [] OTHER [] NAM"
WATER SUPPLY: PROPOSED [ ]
EXISTING []
[ ] PUBLIC
[ ] COMMUNITY. NAME:
[ ] PRIVATE WELL
[ ] OTHER. SPECIFY:
BUiLDING
PLUMBING
3% SURCHARGE
MOBILE HOM"
WASTE DISPOSAl
PLAN REVIEW
~]Joi;0
llJo~O
1;,';1
Yli.CiJ
TOTAL
~~~J 0 Yi
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY:
GALS._ ~il,) MIN. DRAINFIELD l~il L1N. FT. MAX. TRENCH DEPTH
~:~f\ i:IIH \[l )'':" r-;;:;,c;:::l f1lf{1i1 {l~C,,,";"i;'l i':'l n~,,~ nln ::;0"" Hl {I,,'O(>
\:!.":~u f:;~:') t~l~r'1 (~.r~fj L:n.1r.,i~~~1 ~1r:'~ t'l'i~~~~ '_~l?;r'2'~yv'\)I~'~j~= -
~~o
.\ ,
INCH ES
TYPE OF CONSTRUCTION
r:1
GROUP
'Oil' ~ ':
J't,',
FIRE ZONF
STAY 100' FROM ALL WELLS
USE C LASSI F .
SETBAO:S" FT. FROM CTR. OF r/W:
FRONT J0 SIDE EXT.
I'
U
FT. FROM PROP. LINE:
SIDE INT. REAR
:i"rCi ZON~
[8
AUTHORIZED SIGNATURES:
/s/ v. h 0 ;~~n3 D~/ Ctjf)o:':Oh
,
Qro.:;/G':')~CUU"\lCC'l
ISSUANCE DATE:
3![;')!fG ("!r.;
BLDG. PERMIT - WHITE
OFFICE: COPY - WHITE
COUNlY TAX - PINK
PLUMBING - CANARY
BUILOI \IG - GREEN
SAN IT h liON - GOLDENROD
IMPORTANT:
Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required
septic system inspections. All construction shall comply with,the State Buidling Code, D.E.Q. standards
for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate 01
occupancy before being occupied.
(See Details on Reverse Side)
\
C!55.1;J
LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX. 135 EAST 6th, EUGENE, OREGON 97401
X~/IJf~/
. <
(POST .THIS PERMIT ON MAIN BLDG, AT SITE)
r
.
SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVEO ;---y DISAPPROVED ~ DATE
REMARKS
GAS PIPING GROUNDWORK
ApPROVED / / DISAPPROVED ~ DATE
REMARKS
.
INSPECTOR
INSPECTOR
ROUGH PLUMBING
ApPROVED /V-/ DISAPPROVED ~ DATE4I.- ~tl-~ INSPECTPR~-pitJ:)
REMARKS
ROUGH GAS PIPING
ApPROVED ~ DISAPPROVED ~ DATE
REMARK 5
FINAL PLUMB I NG
'"
ApPRDVEO ~,. DISAPPROVED ~ DATE '7- 9'-"7;"
REMARKS
FINAL GAS PIPING
ApPROVED ~ DISAPPROVED / / DATE
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE ~ NOT READY TO ISSUE / / DATE
REMARKS
INSPECTOR
INSPECT~~~
INSPECTOR
INSPECTOR
.
.
p
'7
~
INSTALLER: Complete top
/)
Z~R'y;/~
No. Living Units /1redrooms Baths
/ f/\J' I
Septic Tank:
Ft. from well Steel 0
Inside Dimensions: Ft.
Lensth _ Width Diameter Depth
~~~~R l~ t~fl;1- ')J;/ t?i/r, ke
MAILING ~x, ).,J ~;/)zA/H/~/' ~~~~ from
ADDRESS 5fl< /1I1C-f. e. L d.l cf}"e, '7'7 f/7 7 ;~~n~ i ne
Length ,~Lines-Ft. lTrench L-Tota) Sq. I Ft. Between
1('27,13. 4. .5. 6. .Width'VT Ft. 30~J Lines /b
'-IW~ian (see Instructions):
" N \~ 1f ~
PRO"D SEWAGE DISPOSAL SYSTEM RECOR~ . . '.' .'
part of form to signature and submit both copies with applif~t~n~~J
PERMIT NO. ~,[ f?~/,~
PROPERTY ADDRESS .~ c;:
Ho~~ .
Water S~ply
Public ^ Other-List
.
Basement
Yes No 'i
"\
No. Compartments
I Gal. Capacity /,Ot!!J (J)
Concrete ~
Tile Disposal Field: X
Distribution Box: Yes "
Other Distribution-Type
No
Foundation
If)
Side. /0 Rear /' 0
IF it} tllrVJFi Iler Depth IFi lie} BelON
TH'a...,.JIAbove T i 1 e VI n Jr i 1 e c.. in.
8) ~~~EIVElJ
MAY
ua 7976
MM .
gIyVIReN~COUN7Y
"'~/Y/"lL MG"
..,T.
RECE~VED
By
f4AY v3 19/0
LANE COUNTY
n EN~I NMENTAL MGMT.
f' j, J ~----1 n .
Date 4- -'5 () _ / /C Si~nature {t~ Yt: ,I.'.Q/7~' fH-if
, , CERTIFICATE OF SATISFACrO}tY CDMPLgPlON ~ E:- r--
For Sanitarian Use Only: Date:. d '~~7~
In accordance with 1973 Oregon Laws Chapter 835. Section 214 this certific e is issued
as evidence of satisfactory completion of a subsurface sewage disposal system at the above
locat ion.
~ Approved: System Installation conforms to current standards
t::)'Disapproved: Does not conform to current standards
Remarks:
C55 -11
//.. dv",
Sanl~~;'s Signar' e
LANE COUNTY
STATE OF OREGON DEPARTMENT OF ENVIRONMENTAL QUALITY
~)
"
· LANE COUNTY PERMIT FOR: .
~~
.
PERMIT NO.
CONSTRUCTION ['J MOBILE HOME [] PLAN REVIEW [J CHANGE OF OCCUPANCY [ J
DOwner
""
, "
NAME
ADDRESS
CITY
ZIP CODe
PHONE
'[J Contractor
NAME
ADDRESS
CITY
ZIP CODE
PHONE
O.S. Reg. #
Tw~
Range
Section
Tax Lot
Cod~
Census Tract
(t, ..
,! .".,'.,
Subd ivision
"'.,
Lot
Block
Acreage
Width
Access to Property (Road Name):
,,'\..
Depth
Existing Structures on Property'
Directions to Property, Address'
.^
I,'; ,',
. .
STRUCTURE 1# BEDROOMS)
SQ. FT.
VALUATION
...
"',
u(}\,:'
'\..\
"
''I .. - ~.
SEWAGE DISPOSAL:
PUBLIC [] SEPTIC TANK [
BUiLDINT'
PLUMBING
3% SURCHARGC
MOBILE HOMC
WASTE DISPOSAL
PLAN REVIEW
OTHER [ J
PLUMBING INSTALLED BY:
OWNER r 1 OTHER I] NAMF
WATER SUPPLY: PROPOSED [ ]
EXISTING []
"
'. \\ ~
."
[ ] PUBLIC
,,-~ [] COMMUNITY, NAME:
,'. '< v [J. PRiv,ATE WELL
, '\' \"~\'~[ .1.~q,THER\,SPECIFY:
~l "~'o:~~ v"........' .
\
\
- ,
, \'
\j ~
TOTAL
. Q ~
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN, SEPTIC TANK CAPACITY:
GALS MIN. DRAINFIELD L1N, FT. .MAX. TRENCH DEPTH INCHES
',.,'
>1
/. r
.'
TYPE OF CONSTRUCTION
GROUP
FIRE ZONE
STAY 100' FROM ALL WELLS
USE CLASSIF.
SETBACKS, FT. FROM CTR. OF r/W:
FRONT _ SIDE EXT.
FT. FROM PROP. LINE:
SIDE INT. REAR
ZONF
AUTHORIZED SIGNATURES:
Is!
,ISSUANCE DATE:
~.' ,
"
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
IMPORTANT:
Call 687-4065 to schedule all required construction inspections. Calt 687-4061 to schedule all required
septic system inspeclions. All construction shall comply with the Slate Buidling Code, D,E.a, standards
for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of
occupancy before being occupied.
(See Details on Reverse Side)
C!5!5-13
(POST THIS PERMIT ON MAIN BLDG, AT SITE)
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
r'
.
.
SITE INSPECTION
ApPROVED Cl DISAPPROVED Cl DATE
INSPECTOR
REMARK 5
FOUNDATION INSPECTION
ApPROVEO L-/ DISAPPROVED L-/ DATE
REMARKS f} j(i[~At1C"'Z:jynJ
/ / .7
,
I NSPE~
&/-/3 - ~tlc:l~
. -
FRAMING IN~~N
ApPROVED DISAPPROVED
I NSPEcrtY!
./' ./.Afl
Cl DATE!J -,6 /lltJ
REMARKS
Om 5-}4"11, ,",,,ff
,~;/.5 '"" 1. 0 -' :/{/
f~/l1 r~f41lt./t .t'/'~ - (; ~ .'10'."7,:, ,
FI~AL INSPECTIOY , /)/}
ApPROVED IE! DISAPPROVED Cl DATE 7-&~ft, INSPEC~
LATH OR SHEETROCK INSPECTION
REMARK 5
CERTIFICATE OF OCCUPANCY
READY TO ISSUE Cl NOT READY TO ISSUE Cl DATE
INSPECTOR
REMARK S
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ell)
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NO PERMIT WILL BE
ISSUED UNTIL THIS APPLlCATl'HAS
LfS'? - -J /
PERMIT il {J<::7
BEEN APPROVED
APPLICATION FOR:
MOBILE HOME c:::::J PLAN REVIEW c:::::J CHANGE OF OCCUPANCY c:::J
>( CJ OWNER~f'l\'trt \~. \\'," ~LI.:~..1Ne.._ ~JO \.1.). te...tI'.Nl\li;\\ ~\bt S~~11&R.f..-"I7qll ; 7</1/'11/ L
Name Address City. ip Phone"
c=1 CONTRACTO~obo<t 'M.l\'I\\'~h:U_~~\g7D to. ~ ~lbJ .$.D"i_~Il.c.. "Il1(11j 7'1b,qQ//P
Name I A#dress City ~" Zip Phone
O,S. REG, D
'< lWp, ~~!?t,w:J- Section to
Subdivi on ~""UI E",t"tos.Lot
<. ACCESS TO PROPERTY (Road Name) kl1.1l. t.1
,(. Existing Structures on Property: '-.bN f:'
~ Property Location - Address/Directions: \ \ ~ C6 LG\.u.fl. 'i...\
Tax Lot
Code
Census Tract
Wida./ Depth212
<;)
$'"
Block ~
Property Acreage
/
,471
I
Below for Office Use OnlvXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX
/l;"s-"h 1()02 to roffByrO~~ )
it:) ;;. Po 5.3 '-.
~;-,
~
.
v
djj;f:Jf;~~ tf
..
~
Valuation
.23 02..0.g'1)
~. 79'7. d7),
"'1 <!- X>I G ") '0
- -..;, I
~
Bldg,
Plumbing
3% Surcharge
Waste Disp.
Plan Review
I/S:o-O
~")-Y'A-J'}
/),t( /it /
Existing Sewage Disposal System
Public c::::::J
or New System Required c:::::J
SEWAGE DISPOSAL:
Site Inspection D
WATER SUPPLY:
Well Spring
Name of Community or Public System
FEES:
PL ING:
In taIled by Owner c::::::J
ING J2ECJ 3
I/JUOf Fixtu
,-
c::::::J Name
Sewage
Connection
Water
~ Connection ?
Mobile Home
PLANS FURNISHED
FACILITY PERMIT
OJ/h, II :::,.:~.'^~->#;Uif ·
Fee Received By, ' _~" ~ Date:_ ~-/7-7 ~
MiI}J Septic Tank capacitY~ A/1 ~. D~alffield Required - Lineal Feet /Sf),;, "1~m Depth .;Jf."
,j~~ ~~ ~-:>.~ l7Ml/A/1 ~/ij ~--!t.-Jf- u ~ lOP-
.f---- ~~.Ab~~;~~- ~. _ -> ~~H
TOTAL
Type of Construction
. /
~ /1/ Group.I 'Yr\{
Fire Zone
Use Classification
Bldg Setbacks - from Center of Road Right of Way: r () Ii r-" ./)
Front ;, ~ Side Int. ~ Side E~ Rear 1 ("VLJ:::zone /<. g..
PIANNI,I~N: ^, ," M Nl1!P DATE: SANITAT~ DATE: ~UILDING'lf ~J./J DATE:
\JI"7 .."lI'IY' ...dUJ. cCV,,,, .3-.J,s,7/ (jo~/~'3-:z q-1/J
LANE COUNTY ;EPAR1M;NTa- ENVI~ONMENT~ ~AGEMENT / '
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