HomeMy WebLinkAboutPermit Mechanical 1983-9-29
\ Lane C!nty Authorization
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LOCATION ADDRE;tj) STREET ...."" ,.' ~"'"'IS<rf /)~J -T'~p P~USE OF PROPERTY
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~ry'P I OF, r'::SED ~BQ SPECIlarl2J Qr)~ t ;' -1: I .
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I HAVE CAREFUL Y EXAMINED THE COMPLETED AP~ATI~ FOR PERMIT, and do her y certify that all information hereon is true and correct, and that I
have the followJ.n legal lnterest J.n the property~ner of record; D contract purchaser; Dauthorized agent with evidonce of authority attached.
I f:.:rther certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the Laws of the State of Oregon
pertaining to the work. described herein, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force and effect as required by ORS 70t.055, that if exempt the basis for exemption
is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. I H1\VE READ AND
CHECKED THIS APPLICA~ION THOROUGHLY.
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FOR OFFICE USE ONLY
Applicatio~/~ ~~_ ~
Perrn~t #/b 77- aL-
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Two Cop~es of Plans
DThree Copies of Plot Plans
DMech/Plurnbing Checklist
DLegal Interest Document
D Plan Check Info Sheet
DECIARED S VALUE
o Proposed
n. Existing
PHONE [friU
7'-
EL P iONE Nt~o?-J....
ELEPHON'~-#H
k'''h'_Th
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NAME
e..~T""~<l'" ~
(please print) I
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SIGNATURE V
U7-'ii'"~
. DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS!
[] PLANNING/ZONING:
Zone --bJ.A
partition #
Parcel It
Parcel Size
Hinimum Setba ks: CL, front CL, side interio~ rear
o (? Jo....c.n _' (2hXD l ) dhl4 0 f\( 0 Dp rut )
acbt"lY1 ) lJ1()Ql1 ,\-t~. _ .1
- / tJ' - Oate, ~pt C~QJ!iP
o FLOODPLAIN: In flood hazard area? 0 No Dyes, SEE ATTACHED SHEET. Date: n
[] SANITATION: S. 1. #
Installation
Specifications:
Gallon
Tank
Lineal Feet
of Drainfield
Installation Record Issued? Dyes 0 No
Maximum Depth
of Trenches
B. P. I/:
COl-tNENTS:
~PLANS EXAMINATION: Type ("Jp,.?
COMMENTS, i tJ'i1@.G /I,)
f~)7. ~AIA)f:tlt- If'
n
. " ~j'jLi,!A";'~~
dyD , Ij)/>> ~Aff/5 A L, A. .n
Date'~'tf/) 0
Date:
TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
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$
$
$
$
$
$
DEQ Surcharge $ f
TOTAL FEE $$~~
Mf/~I jfjU4) 1/'M /<(?7
PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456 .80S'(1')) I / DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 681\061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
o
Sq. Ft.
Fixed Feel
Unit Cost
Floodplain Fee
Subsurface Fees
Building E'ee
!-1sch/Plmbg Fee
plans Check Fee
State Surcharge
.
.e
,
..
l-
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY 085ERVED. VIOLATION CAN RE5U~~ IN REVO-
CATION OF THIS PERMIT, CITATION UNDER PROVI5IONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER
REMEDIE5 ALLOWED BY LAW.
WHEN READY FOR INSPECTION, CALL 687-4065. A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE FOR INSPEC-
TION REQUESTS MUST BE GIVEN. Have the 'following information ready: permit number, job address, type
of inspection, when it will be ready, your name and p~one number, and any special directions to site.
BUILDING DIVISION:
REQUIRED INSPECTIONS:
1. Foundation Inspection: To be made af~er trenches are excavated and forms erected and when all
materials tor the foundation are delivered on the job. Where concrete from a central mixing
plant (commonly termed Utra"nsit mixedll) i's 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-floo~ building
service equipment, conduit, piping accessories, and other ancillary equipment items are in
place but before any concrete' is pou~ed or floor 'sheathing installed, including the subfloor.
3. Framins ~ Insulation ~pections: To be ~ade after the roof, ,all framing, fire blocking, and
bracing are in place and all pipes, fireplaces, 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 Gy~sum Board Inspection: . To be made after .all lathing and gypsum board, interior
ana-exterIOr, ~s 1n place-OUt before any plastering is appli~d and before gypsum board joints
and fasteners are taped and finished.
5. Final Inspection: To"be made after the building is ~omplete 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 obtaining 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 building permits require inspections for the work ~uthorized, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This
rnspection 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 masonry (if applicable) and when installation is
compl~ Installation shall be in accordance with an approved, nationally recognized testing
agency and the man~facturer's ins~alla~i9n inst!uctions.
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 connections.
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 flood-
plain management letter.
3. Mobile home tiedowns, when required, and skirting shalrbe installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns ahd skirting shall be installed
per enclosure.
D. SWlrnm~ns Pool: Below grade when steel is in place and before concrete is poured. Above grade
when po01-rs-installed.
APPROVED PLANS MU5T BE ON THE J08 SITE AT ALL TIMES DURING WORKING HOURS. THI5 PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SU5PEN5ION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POINT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
1. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installation record form. The Department shall inspect the construction to determine if it
complies with t;.he rules contained in this division. If the. construction does comply wi th such
'.! t:ules, t~e. Department s"hall issue a certifiQate of satisfact9iy.cohtpletion to the permitl holder.
I f the' construction does not comply with such rules, the Department shall notify the permit
hold~r and sOq!l requir~ satisfactory. completion before issuing the ce~tificate. Failure to
meet the requirements for satisfactory completion within a reasonable ti~e constitutes a vio-
lation of ORS 454.605 to 454.745 and this.rule.
Setbacks - Subsurface Sewaqe Disposal
From: Interior property lines
Edge of road right-of-way
Building foundation
Wells, other water sources
SePtic Tank
10 '
10 I,
5 '
50 '
Drainfield
10'
10 '
10 '
lOa'
C 14-25
.
~ PLANN~NG & COMMUNITY DEVELO~T
A~IVITY INFORMATlcrN
SHEET
bne county
~
-
,-
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
- l' _k"'I\Mil,.R,?qr+I"rJ&f'
PER~ MAKING REQU
ISOq fnjn~I_e..,~1 \JJ') I;..(u
MAILING ADDRESS
ke.nM'/-h i< P0.......i:.f'lda.,{'J
PROPERTY OWNER 1
\'50"1 ~o ;....Ul-l<'w bl"J v-U
MAILING ADDRESS
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, CITI{
Ur:..9 '
~IATE
Q7W,7
ZIP CODE
Sop r-. ;......, .[,,lli,P
en y--I"
741- SJ?oLf
BUSINESS TELEPHONE #
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STATE
91471
ZIP CODE
')L),- ~gb~
BUSINESS TELEPHONE #
'1.;;)1,- '5'7,.,-10
HOME TELEPHONE #
'Jala-57St,
HOME TELEPHONE #
2" PROPERTY ADDRESS ~QI:\.\:f' .
, (IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER
(REQUIRED INFORr4ATION)
(from tax maps in Department of Assessment and Taxatior
or from tax statement)
/'I."'~4 1703J.7 3~OO!37
:s.u; .:2~
TOWNSHIP RANGE SEC ION TAX LOT(S) OR PARCEL # ZONING
T,175.1:3
",:.Ill""
TOWNSHIP RANGE SECTION TAX LOl(S) OR PARCEL # ZONING
TO~NJn P ~ ;} 7, 3..:;;-- '\, / 31
SECTION TAX LOT(S) OR ~RCEL # ZONING
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
LOT
ACRES
BLOCK
5 REQUEST (state exactly what you plan to do) .\1"" "i' ,... +,.-.... 'plol' 0 Ifl"",n"t:-
I
6 DIRECTIONS TO SITE: \SoCJ ~C\,""ole'~) rbI''';''''''' - ~(Jd>Il.-Ci.,\~,,,,,i:,1 <;;'+ -I-cb. If'(;-
nf\ As?t"V"\.; +U~... V'l<\hi {~'^ \,".-nn""ll,,)l ~ +v.rV\ l"ll_.c-+..:.- OV\ CC-I.V--L;I.Q ~
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** FOR STAFF USE ONLY **
- --
NUMBER
DATE
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VI
ZONE/LAND USE:
BY: DATE:
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TIME IN:
OUT:
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LANE COUNTY DEPT ENV MGT RECEIPT
, .'APPLICANT PARTRIDGE. KENNETH ADDR 1509 FAIRVIEW.
TL~ 1703273200137 SUBDIV
NEW BLDG TYPE USE R BDRMS 3 UNITS 001 STORIES
. OWNER NME ADDR
ICODE APPL, NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION
BP
.p
'IB~
"BI"
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~ 169983 DATE 092783
SPRINGFIELD. OREGON .
LOT BLK
~BLDGS 001 PHONE 747 5804 !"
.
FEE DAYS
.
.
I PL
: .ECH
. SUR'
PCK
: .ECH
, PCK
. SUR
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J.!.
JI, 'cATG:
.,EQU:
TAKEN
NO. FIXTURES:
NO. CONNECTORS:
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
15.00 EACH =
47-
657-
.
LC 169983 WS
16.00
, 4.00
0.64
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.
.
APP RA
o
BY RLH
FP
SDS
SI
PCK
1
OTH ISS
2
EST. COMPLETION DATE-
TOTAL FEE**
20.64 CK
te
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