HomeMy WebLinkAboutPermit Building 1982-9-21 (2)
~ CONSTRUceON/PLACE.~ENT . ;,,;;;.;;;;;c'.rZ-
COHPLETE THIS BLOCK. PLEAS:~: ~L~:K INK ~;;PRINT. 6 ~:: ~::::: :: :~:~s Plans
- TOloJNSHIP /Z RANGE /}__ :? I SEC~ _ / // t. / _I TA~~.. 8_ Ou'l' OT' DHl2chanical Checklist
/~.~ ~~ r ~ Jr ~~ -=' []Plumbin~ Checklist
~:UB N/PA T r','/ ,>t applic ) 6/ . .1 LOYPA~EL _ I BLOCK LL I
:...tI"""..A"'..... , / V,. _ / J:]Plan Chect~ Info Sheet
TIO' ^ D;:F ~~/ . ~d/A?'.~~7Y7/ PP;:;:iU:~n~::~crO~ndustrial
. S R .5 cu " " ~R:Y cts: ('/ '" r~ . ~ 0 commemal Dpublic
_, _, ,_ .~os '- wff-k~ k~~~~ ~ I $ VALue
, OF;:;:3: I'-OF/d~/ I ' O~-I_WATER ~~~~ ~~~~~~~~~ I
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CONn- TOR'S i'Ai~~S </. . _ TELEPHO:;E ',">:BEk
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I llAVE CAREFULLY EXAMINED TilE COMPLETED APPLICATlotl FOR PERMIT, and do h~rr'bi' "r;'I'lirj' thilt "II infnrm'ltion h""rfHln i'\ llll" .1no ~orn.-t ,,,-11 I,HI'l' r
certify that any and all work perforll'lCd shall be done in accordanClj with the On.linil:1CCf> of Litnl' County and t.hl' J,a"'~ of ~t... Std'...... nf (J1"'l >" T' . t lll,;n I
to the work described herein, and that NO OCCUPA1KY will be made of any structur~ '..ithout thC' permission of the B'Jilding Oi.vi!'>ion. I ",nth"f r. r'.ll)"
that registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt t.he ba!1is for '-'XO"l'tir'r, i< n It..d
hereon, and that only subcontractors and employees who are in compliance with ORS 70.1.055 will be used on this project. I HAVE RE",D AIlD ('llECYJ-'V Till!':
APPLICATION T UGHLY.
f18c/lr Il R:!.JRSt::Y
NAME (please print)
,
front
Partition;; /lf4-- Parcel
eL, SidP~ interior
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o PLANNING/ZONING:
Zo >
0, nor ....
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DAgllll
Ih_rllmum Setbacks:
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Parcd snel /:J"~)( ;lJ/
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Date:
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Comments:
o FLOODPLAIN: In flood hazard area?
o RURAL ADDRESSING: CRlD CDORDINATE
M SJ>.NITATION: s. 1. #
~ Inst:allation
Speci fications:
~o
[] Yes, see attached sheet.
Date:
N
E
Date:
8, P.
.f~3-1()
Installation Record Issued? [] Yes [] No
Gallon
Tank
Lineal Feet
of Drainfield
HaximW'l Depth
of Trer,:::her.
Comments, /7 A:. ( S' tJ j 0 ~,-..", ~..vA e....
T.u -rile... O"-'-'7,,;/,k:I1'. 7.A-->-kl\~T-::.'~,_ :/.</
~"2.,. A- '" iZ.-c.A (<>-e-r.; "" c/t..
D?PLANS EXAMINATION:
1/1, <.\ ~
NvT /h?pl'Vt/<4 ,--Iv
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Type s: It!
+~ t:VC ~-t- of-
~~ ~ Date'2....=..A~ -/1.
GroupjJ~ -~ ( Use 4Md/!',t:f, .
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Comments:
Date: 9-2/-/1 L.
4ff
CONSTRUC'l'IQN AUTHORIZED BY THIS PERMIT
--
~~;t
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- /~ '-.
:' !;~ 2Jril'//.. 5f1/k,!-
//')( /lfJ/
Floodplain Fee J ~ 'i 5~
Subsurface Fees ~. t ~ /,.-._
, I~~
Building Fee~~ "-'/7
.~ 4. 'L If' (~. r/Storm Drain/Water 5
, '. ~~lumbing Fixtures $
Mechanical A ~L o. 00 $ _ '....<>---
Plans Check PJ ~8.i''$ ~..,~;..--
State surch(#i'O. ~ ~, $ _ /_ _
. .... aLl. "" P"~
'--- TOTAL FEE !:a.1.. , T ~ ~ /...,----
f.eJL~ f. 4C;) FJi;,i~~ C ck Q~h
TOTAL VALUATION $ fil-i\ l:. ,'&-- M
_" ~_"" w,w,::::,~~ ?If;~
!.WE COUNTY DEPARTMENT ;~;"^';~~E&R;;'IU;~~ DE;~:~~'~~:n~:t;~G9~ )33l~
/9j"?
Fixed Feel
Unit Cost
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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.
W4EN READY FOR INSPECTION CALL 687-4065. 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.
8UILDING DIVISION:
REOU I RED IIISPECTI ONS ,
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 (colTlTlonly termed "transit mixed") is to be used,
materials need not be on the job.
2) CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or 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 subf100r. .
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 insulation and vapor barrier are in place. . , .
4) LATH AND/OR GYPSUM BDARO INSPECTION: To be made after aH1athing 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 or structure beyond the point indicated in each
successive inspection without first obtainin9 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
required.
.
NOTE: All bui1din9 permits require inspections for the work authorized, such as but not 1imited- 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 masonrv (if applicable) and when installation is complete.
Installation shall be in accordance with an approved nationally recognized testlng agency alld the manu-
facturer's installation instructions.
C. MOBILE HOME: An inspection is required after the mobile home is connected to an approved sewer or septic
system for: setback requirements, blocking, footing connection, tiedowns, skirting, and plumbing
connect; ens.
(1) Footings and piers to comply with State foundation requirements for mobile homes or 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 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure.
D. SWIMMING POOL: Below grade when steel is in place and before concrete is poured. Above grade when pool
is installed.
APPROVEO PLANS MUST 8E 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 A8ANOONED FOR MORE THAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS
PERMIT WAS ISSUED ON THE BASIS OF INCOt1PLETE 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 installatlon record form. The Department shall inspect the construction to
determine if it complies wJth. the.rules contained in this divisiqn; If the construction does comply with .
such rules, the Department shall issue a certificate of satisfactory completion. to the permit holder. If th~
construction does not comply with such rules, the Department shall notify the permit holder and shall requlre
satisfactory completion before issuing the certificate. Failure to meet the requirements for satisfactory
completion within a reasonable time constitutes a violation of ORS 4S4.605 to 454.745 and this rule.
Setbacks - Subsurface Sewaoe Disposal
From: Interior property lines
Edge of road right-of-way
Building foundation
Wells. other water sources
Seotic Tank
10'
10'
5'
50'
Drainfield
10'
10'
10'
100'
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LANE COUNTY DEPT ENV MGT RECEIPT
ROBERTA AD DR 2568 DUMAS DR.,
SUI'lDIV NORTHWOOD ESTATES
USE R I'lDRMS 3 UNITS 001 STORIES
ADDI,
SQ FT UNIT COST VALUATION
198 4.05 801
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· APPLICMH DOF:SEY,
.Il\.~ 1703234400123
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CODE ,~PPL NO
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.."l NO. FIXTURES:
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ACTION DESCRIPTION
COVERED PATIO
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CONNF.::CTDHS:
MECHANICAL FEE
STATE SUHCHf,RGE
PLAN CHECI< FEE
FP
SDS
SI
PCI(
1
0817B2
EST. COMPLETION DATE
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,~: 'j:3 1 8B2 DATE 08028:;:.
SPRINGFIELD, OREGON
LOT 10 I'lLI< 4
:~BLDGS 001 PHONE V6 %86 .
801
1 '5. 00 EM~H ....
FEI': lifWS
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TOTAL FEE.. 27.04 CI<
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P~NING & COMMUNITY DEVELOPMENT . - EET
ACTIV,-ry INFORMATION SI--I
bne county
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
1 $~ER16N ~r;~UEST
s( /) .II
2"1.:... jN~ 1.4'/J'
MAILING ADDRESS
Jjn"-'i'l.lt'<,/./,;:)12 971177
I (JJffY - I - StATE ZIP CODE
...P~
- PROPERTY OWNER
MAILING ADDRESS
-. CITY
STATE
ZIP CODE
BUSINESS TELEPHONE #
"7.il '-:SP />(.
HOME TELEPHONE #
BUSINESS TELEPHONE #
HOME TELEPHONE #
2. PROPERTY ADDRESS Mift.. .. . .-1l-
(IF DIFFERENT FROM MA LING ADDRESS)
. 3 MAP & PARCEL NUMBER (from tax maps in Department of Assessment and Taxation
(REQUIRED INFORMATION) or from tax statement)
/7.3 :J3V.<( /;)~
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL #
ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL #
ZONING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
5 REQUEST (state exac}lf what you plan to do) ~~ ~
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ACRES
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6 DIRECTIONS TO SITE:
** FOR STAFF USE ONLY **
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ZONE/LAND USE:
BY: DATE:
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FOI CONSTRUCTION
DATE BY
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