HomeMy WebLinkAboutPermit Building 1973-6-12
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BUILDING OO(
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BUILDING
MH 0
MAILING ADDRESS
21)11 iJorth 15th
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PERMIT OR MOBILE HOME
USE PERMIT
PERMIT NO.
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PROPERTY OWNER
tJoYford, 1'1:;1
CONTRACTOR
SprlnJflcld, Crc~on
PHONE
71)7-22/)3
PHONE
MAILING ADDRESS
PROPERTY LOCATION - INCLUDe POST OFFICE
2113 Firth Avenue
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
Loc:' LC;;JO;'ld TOl'rece 1st <:dd. Blocl, 3 Lot 7
TWP RANGE SECTION
17 03 25.'
APPl. .101 \:JoHord
NAME
&- , 21)11 r:orth 15th
i/'?:rNL
CODE
CENSUS TRACT
20-300
EXISTING STRUCTURES ON PROPERTY
tlcno
.LEGAl ACCESS TO PROPERTY
Firth Avenue
MAILING
ADDRESS Spr I ilQf lei cl, Cregon
FOR MOBILE HQME PERMITS ONLY
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
PROPERTY SIZE - FT.
WIDTH
DEPTH
AREA
L.':~cl1Iil9
uoro~e ottocile~ UnCOileD
Connect to Existing
TYPE CONSTRUCTION
Frsr.l6
Sewage System 0
SQ. FT. :# BDRMS
1370 iP 12 OJ)
New System 0
VALUATION
16,l:!:~
:JU:J 1.."'" ;)
I/J~;;
W.l~,S-
In5~DII ~c~anc UISpOSOl ~ys~~"
10 Plu~bina FI~tures
I ~cwor ~cnncc.lon
1 pu~llc water connection
SEW AGE DISPOSAL
.
OTHERD
71.00
20.:10
33.50
FEES
PLUMBING INSTALLED BY
OWNER 0 OTHER, NAME lJo 11 y' S
WATER SUPPLY
PUBLIC 0
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
SEPTIC TANK '0
PUBLIC [3t
o OTHER
TOTAL
$ 12ll.50
COUNTY BUILDING & SANITATION SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX, GAl. SOO
1(091 m:C1 roctlng ClrOlns
'. yor':.
L1N. FT
~o s'Croo'C.
DRAIN FIELD REQUIRED
225
TRENCH W!DTIj FT.
i"'or..t OT OrtJlnrll::IU I.U...lY rltlVU
2'
OR SQ. FT. _ . l;.??
LV lJ~ 1.1 ~Il L I I U'-i:~
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TYPE OF STRUCTURE
S r:
OCCUPANCY
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ZONE
AGT
PUBLIC UTIl. EASEMENT
BLDG. SETBACKS.. FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT IlO SIDE INT. 5 SIDE EXT.
AUTHORIZED SIGNATURE - DATE
Is/ J.E. Goss I>y I-Illrbou>;h
USE CLASSIFICATION
REAR
5'
John laru I ckshcll1k, 11. S.
DATE
6-12-73
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 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 =C55-13
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BUILDING SITE EVALUATION
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)<J Building Permit Application No/tJd,:r:7d
() Site Inspection
() Pre-Permit Investigation
It'
~R ~.3S -,?",- TAX LOT
US TRA~T -, - ; ..
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APPLICANT: . ~/ A
NAME' ---y;n d ?d p--~
ADDRESS ' '
PHONE
DATE
k, - -7'- .?-?
DATE
LANE COUNTY PLANNING DEPARTMENT NOT NO
appl icable
I. Zoning Ordinance compJ~q-r ( ) ( )
(Zone )
2. Subdivision Ordinance Compl iance ( ) ( )
3. Requ ired Access ( ) ( )
4. Bu i ld ing Site (Area, Width, ( ) ( )
Frontage, Setback)
5. Other (see comments) ( ) ( )
YES
NAME
)
(\ IA
6 ~S'-73
(
(
(
( \
COMMENTS:
BUILDING INSPECTION SECTION NOT NO YES NAME DATE
-- ~pp I i cab I e
6. Plans Subm i tted ( ) ( ) ~
7. Soil Stabil ity (foot i ngs) <j ( ) ( )
8. Flood Plain Yl1' ( ) ( )
9. Ot he r (see Comments) yfj ( ) ( ) ~1#~~tI-/I-?"3
COMMENTS: - r' .
SANITATION SECTION NOT NO YES NAME DATE
appl icable ~
10. Sewage Disposal ( ) ( )
11. Usable Area ( ) ( ) yf ~
12. Water Supply ( ) ( ) t4
13. Other (see Comments) ( ) ( ) ( )
COMMENTS:
TO APPLICANT:
Youy/Building Permit / Site Inspect~
('1'" Can be approved. i~J/~?) p
() Cannot be approved at this time as indicated on item NO. above.
Questions and further information on items I through 5 contact the Lane-
COUNTY PLANNING DEPARTMENT. Questions and further information on items 6
through 13 contact the Lane County BuiJdinq and Sanitation Oivision.
() Will be held in this office until you can resolve the problems indicated.
() Is being returned.
() Your building permit appl ication fee is being returned under separate cuver.
l/INL COUNTY PlANN I NG DEPARTMENT
I VI S ixt II I\"t~nue East, EU9CIH'1 Oregon
97401
I'IIONL: '!117-1311
(xT. 231
LANE COUNTY BUILDING & SANITATION DIVISION
135 Sixth Avenue East, Eugene. Oregon 97401
PHONE: 342-131' EXT. 411
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LANE CO.TV
BUILDING 0
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BUILDING PERMIT OR MOBILE HOME
MH 0
MAILING ADDRESS
USE PERMIT
PERMIT NO.
PROPERTY OWNER
PHONE
CONTRACTOR
MAILING ADDRESS ';
PHONE
PROPERTY LOCATION -INCLUDE POST OFFICE
,,'
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PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
'"J '''._ ~ . ~., :.. 'j,.
TWP
RANGE
SECTION
TAX LOT NO.
CODE
CENSUS TRACT
<>
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APPl.
EXISTING STRUCTURES ON PROPERTY
NAME
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LEGAL ACCESS TO PROPERTY
&
MAILING
ADDRESS
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PROPERTY SIZE - FT...
,
,~,
WIDTH
DEPTH
AREA
FOR MOBILE HQME PERMITS QNL Y
No. of Bedrooms
STRUCTURES TO BE BUILT THIS PERMIT
Connect to Existing Sewage System D
TYPE CONSTRUCTION SQ. FT. :P: BDRMS
New System 0
VALUATION
~ <./~
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y,,",'v
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~("oo..:)'O_,,' \"'\.\.~ "".:.~\~~~"
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-. >J"A:~'\:.~~~ .,iJ ,,,-,":,,. ....t-..... \. .........~_
1..." ,\I ~; \ \
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SEWAGE DISPOSAL
PUBLIC 0
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
PLUMBING INSTALLED BY
t. If ~ "". ,
,~
;
FEES
,'1 r ~,C ('
OWNER 0 OTHER: NAME d,.\i. J .)
WATER SUPPLY
PUBLIC D" D OTHER
SEPTIC TANK :0 OTHERD
.,
TOTAL
,,(' ,
t: ~ I " 0,
MIN. SEPTIC TANK CAPACITY
WITH DIST. BOX: GAL.
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
.J \,./
L1N. FT (;,,';; . TRENCH WIDTH FT.
""(['_'."'0 ..l./....~ 'd.... ~..',.:~..~;~ .... I. { t.
tS'\J\~~\
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OR SQ, FT,
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TYPE OF STRUCTURE
OCCUPANCY
ZONE
PUBLIC UTIL. EASEMENT
BLDG. SETBACKS __ FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT SIDE INT. .) SIDE EXT. co
AUTHORIZED SIGNATURE - DATE
USE CLASSIFICATION
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REAR
D~TE
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BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK ,
PLUMBING - CANARY
BUILDING - GREEN
SAN ITA TlON - GOLDENROD
Construction to comply with uniform building code and county regulations
covering plumbing and 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
FORM = r<;<;_11
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SITE INSPECTION
ApPROVED ~ DISAPPROVED ~ DATE '
REMARKS
FOUNDATION INSPECTION
ApPROVED rZ71 DISAPPROVED L-/ DATE Uff..I'J1
REMARKS
FRAMING INSPECTION
INSPECTOR
.
.
INSPECTOR ~
ApPROVEO / / DISAPPROVE~ ~ DATE INSPECTOR
REMARKJ?/k~J.,. ~ (,~;'ff~ ~ ~ 7~-YL..1}?
~F' l' _ /
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LATH OR SHEETROCK INSPECTION
ApPROVEO L-/ DI SAPPROVEO /
/ DATE
REMARKS
INSPECTOR
FINAL INSPECTION
ApPROVED .LEt OISAPP'ROVED ,c/ DATE J~"" / tJ "731 NSPECTOR
REMARKsMA-l4 'i'-Jj'11 ~f~/'l.-"'7
CERTIFICATE OF OCCUPANCY
READY TO ISSUE ;---? NOT READY TO ISSUE ~ DATE
REMARKS
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J{}:Jfr93 YJ~ :1-11~ f~
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INSPECTOR
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D~:) !(i)3C~73
No. A.OC~f'';.~~
PERMIT
IN THE BOARD OF COUNTY COMMISSIONERS OF LANE COUNTY
WHEREAS, the attached application has been fully considered by the Board of
. County Commissioners of Lane County, and it is the opinion and judgment of the Board
that the said application should be granted, and that a permit should be issued, now,
therefore, it is hereby
ORDERED, that a permit be and is hereby issued to
Dol [:~gi?cs-tl
and constructing of the following facility:
for the placing, building
1l'l1"P"''''7r''\\'-'':\~'' f'\=.'.:r ."- .I"i'Iot. {,-1l1.<--~ M,,~1nt ,q'll~_
21110 I7!~lll\von::!to C1.V. O.ll.O '.og~ 011.60
upon the right-of-way of County Road No. . '"'"" ,in strict conformity to the exhibits
attached thereto, and subject to all terms, conditions, agreements, stipulations and pro-
visions contained in the application and permit, the Rules and Regulations Governing
Facilities to be Permitted upon County Road Rights-of-Way, dated March 31, 1960 and
any amendments thereto, and any other applicable regulation, law or ordinance,
Special Provisions:
!)s-l1.VOt:::1J! tJiU T,;,o =L""..D~lro.C!tOO in ~cOE€:llilCQ t1A.~h ~o a~t.ocn--Oa tl~!vo~
oW8'cneh oi]Ot:ll.!ZAooU@oo (1j)ro<:;JUn~ tJ"u-~) 0
DoIn:ll1.~U:o <:;Jill.! !Jo l:Q:JJr)B1lOl1.l)!o 12Cll" Di:J !C=OQwoo lrCJ)vol 012 all.! c.?~. tJ:!..E~
om.!2 42o~!o fir= ~l<::r r;e:)d:~'DY om! s- Jtvh~ o~ tlOy C01.llocQ! ll;]! Mo cr,:ol!o~lio;!.
lc:',v~ th8 l:cn6t:\y nm.tl orca in Q =Q~. ncco~lo c:c"~!~!Otllo
This permit is revocable at any time, and will be strictly adhered to and no work
other than that specifically mentioned above is hereby authorized.
This permit
shall be void unless the work herein
JWtO 1<\ 1~
,19_. Expires
contemplated shall have been
.
completed beforp
. 19
Inspected and Approved
Approved by Board of Commissioners
By
Date
By
Director of Public Works
WHITE - OFFICE FILE PINK - PERMITTEE ORANGE. BUILDING 8. SANITATION DEPT,
GREEN - RESIDENT ENGINEER BLUE. ROAD SUPERVISOR YELLOw. SURVEYOR
Cga-S2
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Date
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APPLICATIDN FDR FACILITY PERMIT
IN THE BOARD, OF COUNTY COMMISSIONERS OF LANE COUNTY
Your applicant,
,~ hereby makes application under Rules and Regulations Governing Facilities to be Per-
mitted Upon County Road Rights-of-Way, to construct the following facility:
Upon the right-of-way of County Road No. 11/ S- , at the following location:
\ J '.1' ",,/1'" ^ I :.....
as shown on the exhibits which are attached hereto. in strict conformity to the state-
ments of the exact nature and amount of work to be done. and to the description of the
facilities contained in said exhibits. Your applicant will be the beneficial owner of the
facility as constructed. or otherwise primarily liable and responsible to members of the
public for its proper maintenance, repair. operation and use. Your applicant accepts all
terms, conditions. agreements, stipulations and provisions. in Rules and Regulations
Governing Facilities to be Permitted Upon County Road Rights-of-Way. dated March 31.
1960. and any amendments thereto. and any other applicable regulation, law or ordinance.
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Signature
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Address
WHITE. OFFICE FILE
GREEN. RESIDENT ENGINEER
PINK. PERMITTEE
BLUE. ROAD SUPERVISOR
ORANGE. BUILDING AND SANITATION DEPT.
YELLOW. SURVEYOR
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Phone N' /',
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PROPERTY OWNER,
t:c17c;'(i,.
CONTRACTOR
LANE cotTY BUILDING ~R~I;'
BUILDING w;, MH D
MAILING ADDRESS
~lljl a '::;r~'1 g;~:l
.
OR MOBILE HOME
USE PERMIT
PERMIT NO.
.1,)(.;
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[:::;u
:;;r~r.cvl()hJ,
C~c;",~;a
PHONE
'."'J' ,'"
I'-.J'-l;" "~r
MAILING ADDRESS
PHONE.
\.
PROPERTY LOCATION -INCLUDE POST OFFICE
2ilj ~Irt~ r,vC~~J
PROPERTY LEGAL DESCRIPTION - METES, BOUNDS
t.oc..':J !.', ::;):~rJ Icrrc!:Cl loC Gr'd. OUcc~;J t.'.JC 7
"
TWP
~7
RANGE
0>>
SECTION
2S!
TAX LOT NO.
CODE
APPL.
NAME
&
MAILING
ADDRESS G:,yJ Of)f! Q U cJ. O!"c:;::n
FOR MOBILE HQME PERMITS ONLY
No. of Bedrooms
::Ji t::::fyor{1
CENSUS TRACT
2Q-2:J
EXISTING STRUCTURES ON PROPERTY
C:c:~
21)6 ~ (::ere:l D5~[)
LEGAL ACCESS TO PROPERTY
rl rCtl AI;::;;:~:o
PROPERTY SIZE - FT.
WIDTH
DEPTH
AREA
STRUCTURES TO BE BUILT THIS PERMIT
Connect to Existing
TYPE CONSTRUCTION
vr=
Sewage System D
SQ. FT. :;t BDRMS
1370 (J 12 tl~
New System D
VALUATION
IJ.I.'.;O
~;C;;)ll'qQ
J~:,:>c"':J Qttoe..~~::J t.:n~~ UC:J
~:..JI;J \J cJ
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~ ~-j, ~. ~
~CJ'30' ~ L-;::--:sn L'J8~30~ ~-'VL"'C..l
DO L)k::>I~c: FI::1€::!"C'3
~ ~,(:e.:.:? GC:::::::~:': oc~
~ c:~::)u:~ t:~~C7 c:..--::::~:::;::ac:~
SEW AGE DISPOSAL
.
OTHERD
,i.JJ
:.\;).aJ
s))).fi;>
FEES
PLUMBING INSTALLED BY
OWNER 0 OTHER: NAME
WATER SUPPLY
PUBLIC DO::, 0 OTHER
Co ll'J' G
PUBLIC 0
BUILDING
WASTE DISPOSAL
PLUMBING
PLAN REVIEW
PARK TRAILER
SEPTIC TANK ~~
TOTAL
.
120.;;8
COUNTY
BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
a2!3
UN. FT
~ TRENCH WJPTH. F.r.
V',-,r L. ...;V '.JlJ UlJ ...Ill 11..": ~;."J l~Y h'-I.....""
2'
lY.>J
OR SQ. FT... '" ~..
MIN. SEPTIC TANK CAPACITY
WITH 0151. BOX: GAl. S~D
~~00t: C.~(I \i'~i.r.;o ::~J '-.:V\...:~~;'J );;,,)
~~~ verd.
ut;~,-..;;..)i;i..
(>,1...1 '-'u t;~ :",~", y ~ 'Io....~
~-.
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TYPE OF STRUCTURE
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OCCUPANCY
I c. J
ZONE
A!J'i
PUBLIC UTIL. EASEMENT
BLDG. SETBACKS u FT. FROM CTR. OF ROAD RIGHT OF WAY
FRONT
l.;D SIDE INT. 5 SIDE EXT. "0
AUTHORIZED SIGNATURE - DATE
101 J.G. 8c~n Lv ~c(~~~Ch
REAR
51
USE CLASSIFICATION
~~:1 O;'tJ~G!~G.~::~o fl.B.
f DATE.-,t
V-:::~"tt',~
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 b~ildings 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 ~ C55-13
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~ FLOOR
PLUMBING GROUNDWORK
ApPROVED !KJ DISAPPROVED C1 DATE,o(-': /1-?J INSPECTOR~ ~
REMARK S
GAS PIPING GROUNDWORK
ApPROVED / / DISAPPROVED /7 DATE
INSPECTOR
REMARKS
ROUGH PLUMB I NG
ApPROVED
w
DISAPPROVED C1
DATE,'\- :?o.?3
INSPECTOR
4:i/
u
REMARKS
ROUGH GAS PIPING
ApPROVED C1 DISAPPROVED C1 DATE
INSPECTOR
REMARK S
FINAL PLUMBING
ApPROVED ~
REMARKS
DISAPPROVED C1
DATE~/.:J ?
INSPECTO~~
. (/
FINAL GAS PIPING
ApPROVED C1 DISAPPROVED / / DATE
INSPECTOR
REMARK 5
CERTIFICATE OF OCCUPANCY
READY TO ISSUE /7 NOT READY TO ISSUE /7 DATE
INSPECTOR
REMARKS
,
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t:J'staiier 's- i4amet:f.
No.LiVing;rits IBe~omsIBa~s
septJ.c TanK:
Ft. from well Steel 0 Concrete
Ins~ae UJ.Inens~on:s: t't:..
Length 'lJ-Width .L/,J"- Diameter
Applicant
Name
I~VIDUAL SE~~E DI~POSAL SYSTEM jikORD
Installer: Compl~te'top part of fll! to
signature and return both copies to Lane
County Building Sanitation Department.
. ,
I Property Address
2118 Firth Avenue
I Basement.l, I Water Supply
Yes 0 No VI Public q' Other-List
ex:
P~RMIT N~_
10~8-7~
Cruickshank
Depth 'i, J--
( Gal. Capacity I tJ() d
Tile Disposal Field:
Distribution Box:Yes ~ No 0
Other Distribution- Type
NO. Compartments
Mailing
Address
Hel Wofford
2'+11 Nann I ~tn
SDrinQfield~ OreQon
Length of Lines - Ft. I Trench
1.76 2.~ 3. 4. 5. 6. _ Width a
Sket;!: (See instructibns):
~ J clY)~~
I'"''" "I".:l"""OIFille
ft.,r"1{~ llin _It} Type
I
Feet from
Well Jundation / ()
Lot Line
Front Si e Rear
. 2-- Filler de th Filler depth
above.., _ below I
u t'l~ ~ n tOle v ,"
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Date L ~ / q - i tJ 7 ~
Signature
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Date: 11)..0 ~':2-.
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For Sanitarian Use Only:
~APproved: System Installation
o Disapproved: Does Not Conform
Remarks:
Conforms to Current Standards
to Current Standards
~
Lane County Building
l:.AJJ~~J
. - sanit~rian's Signature
& Sanitation ept.
CLI..l- ~~-h. fvUL-~
LANE COUN. BUILDING PERMIT OR MOBILE H. USE APPLICATI6'N............
, I'ERMIT TYPE - BUILDINGl( MOBILE H.OME Dose REG.# PERMIT:#= /0313 -73
~ERTY OWNER .J YJ.I, Ii (;7 II rAILI~G ADDR~S7 '-Y1 tt: -/ A J PHONE
...rr'iI--#IHU ( / IlLY f.Xd1.1 .,2'(-// If. Is;, . ///,.LP, ~.
CONTjAV~ - . / . MAILING ADDRESS ' P' PHONE
0/JJ!--('-c' r/~/-.22-~
'1>ROIjtRTY LOCATION - IN~LUDE POSTflFFICE
~I/rf ~l--J/1/:L (~ .t1-,--~ 7-7
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PROPERTY LEGAL OESCR'PTION :::".../ ,/. -/' I --Z I ,I I /l f!lETES & BOUNDS 0 YES
LOT - BLOCK - SUBDIV. :::::~ H.:?'7 ..-x J--7?z..1"4.4 ~\ 4'./>/1 4..4'.f / &1:171 ~ J./' ATTACHED 0 NO
TWP RANGE SEC. TAX LOT # CODE CENSUS TR:l.CT
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APPLICANT t/ DESCRIBE EXISTING STRUCTURES ON PROPERTY IF ANY
NAME '04/7'Y1.fl t/./7 A'~AJ , '-71~
AND ' LEGALffCESS.;O ;RO~#
." 7/-1/p( _ _
MAILING PROPERTY SIZE-WIDTH DEPTH
ADDRESS
FOR MOBILE HOME PERMIT ONLY
Number of Bedrooms
ST";~S TO BE BUILT THIS PERMIT
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~d/lfl J/IJ~
SEWAGE ot~ckAL
PUBLIC 0 SEPTIC TANK ~
BLDG. $ 7 /. ~. FEES
-UJ. ;J-tJ
~3.5Z>
/
AREA
Connect to Existing Sewoge System D or New System Req. D
TYPE CONSTRUCTION //;';o,Jz7:JO)S ;2"~4 ~
~ /
r5-d'.5~:"3 /76-6.
- - 7J;/9.5'
OTHER 0
WATER SUPPLY
PUBLIC '!g" OTHER
PLUM,BJJ:lG FEE~ 3" ~
~F1XTUR~ ,?/2,_/~-iJ
CASH 0 S~
CHECK ~-NECTlON FEE "j _ A..AI
PUBLIC WATER
CONNECTION FEE /. ,<)0
COUNTY BUILDING & SANITATION SPECIFICATIONS
PLUMBING INSTALLED BY "'"' Jl 11 /J j
OWNER 0 OTHER 0 NAME~L?CL---fy:?
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COPY 1 - OFFICE
COPY 2 - JOURNAL
COPY 3 - AUDIT
Form # C55-12
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