HomeMy WebLinkAboutPermit Building 1976-9-22
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LANE COUNTY PERMIT FOR: i
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CONSTRUCTION [] MOBILE HOME [] PLAN REVIEW [J <CHANGE OF OCCUPANCY [ ]
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C/ NAME" ADDRESS (j CITY I ZIP CODt
o Contractor C" ,." Cj 7 c/o /
- oZ7Y I ZIP CODE
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PERMIT NO.
PHONE
NAME
ADDRESS
PHONE
O,S, Reg. #
Twn
/7
Range
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Section;) 1 C/ ~fax Lot!/J.:J 0 0 Code
Census Tract
Subdivision
Lot
Block Acreagp
Lh.,nr.,L/-1/VA JV.-J...-'
J..il-:tL<;.P ' ,r;)/')A /J c,.J?
/_<)~ ~f/nR--4afrvJ
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Width
Access to Property (Road Name):
Depth
Existing Structures on Property: '
i
ReO
I
Directions to Property. Address:
STRUCTURE 1# BEDROOMS) <:>
/-fA,1-! AAY, A tJ fJ/J //7) ~
(/.;... '~II"U.t/).' '/
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SQ. FT. '
..I)()t7/ h- ,t"r/J',..J./"'-r.l1.-/
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VALUATION
.::;-./) /"
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SEWAGE DISPOSAL:
PUBLIC I I SEPTIC TANK I I OTHER I I
BUILDING .c;- I? ()
PLUMBING
3% SURCHARGF . / c;-
MOBILE HOM"
WASTE DISPOSAl
PLAN REVIEW
,
PLUMBING INSTALLE~ BY:
OWNER r I OTHER II I NAME
WATER SUPPLY: PROPOSED II
EXISTING I ]
I
I
I ] PUBLIC ,
I ] COMMUNITY. NAME:
I I PRIVATE WELL I
[ ] OTH ER . SPECI FY:!
TOTAL
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'fi'7A./V1-:?~ ..,14
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY: i
GALS. MIN. DRAINFIELD L1N. FT. MAX. TRENCH DEPTH
I
I
INCH ES
TYPE OF CONSTRUCTION GROUP
FIRE ZON"
STAY 100' FROM ALL WELLS
,
USE CLASSIF.
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FT. FROM PROP. LINE: ~
SIDE INT. REAR
I
zoNFI / ,,4
/ .. -
SETBACKS. FT. FROM CTR. OF r/W:
FRONT SIDE EXT.
AUTHORIZED SIGNATURES: . ,/
Isl \. J P r. 4-dd-7&7
Buf. PE:MlT --WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
J 1(:::\ ISSUANCE DATE:/ l
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Call 687-4065 to schedule all required construction mspections{~Call 687-4061 10 schedule all required
IMPORTANT: septic system inspections. All construction shall comply with the State Buidling Code, D.E.a, standards
fOf subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of
occupancy before being occupied. I
(See Details on Reverse Side)
I
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
C55.1;l
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT 'I
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
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,0 Contractor
. PE,RMIT NO.
t7I ~9s. 7,6
CO~.,s.:rRUC;ION~.J MOBILE HOM~ [) PLAN R;~YIEW [ ] jH~NGE~F O?CUPANCY [ ]
o Owner U~. tAtl/.. ,;.j a..' ;i...j"t.tJ IJA: L"'. 1"5 ,<r;" i/t)..,J'Ju.' l,(2rr.lJ-i I.le} .
ADDRESS ,"/ ,CITY.f I . ZIP CODE
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LANE COUNTY PERMIT FOR:.;
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v
NAME
PHONE
NAME
ADD RESS '
ZIP CODE
PHONE
O.S. Reg. #
Jwp_17
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Range ~OO
"'''I llll · ..) " 0
Section uJ.. 'I' ifax Lott........ '''' '.. Code
Census Tract
Subdivision'
Lot
B loc~ Acreagp
if.., 4.,
.ililO rtu:'...' --/L;t,4 b-l .-'"
~l ~ f}l~.,( . .(;J..<:),./ d e:,d ._
/. ..- /'*f"";,/ ",I. f,,,t .
....} t~ ,,;..'t1 /'kt......y '*"1 /1'~. ;'
.l.~/
...
Width
Access to Property (Road Name)'
Depth
Existing Structures on Property:
t~~(!
Directions to Property, Address:
STRUCTIIIRE 1# BEDR..Q.OM~I ~
/YA~ A ,1.,,7: J~ (I i.;t".U.i
/I";" . "'''' a" .' A ....
,
&l ~~!l(J:. 7:.1Q;~;t- ,.t n~ :/~, f~vt.,l
,}
VALUATION,
t~-~,~;~J
-- ~'
SEWAGE DISPOSAL:
PUBLIC [] SEPTIC TANK [] OTHER [ ]
BUILDING ...:'5: t; (}
PLUMB IN"
1<:--.
3% SURCHARGE . ."_
MOBILE HOM"
WASTE DISPOSAl
PLAN REVIEW
PLUMBING INSTALLED BY:
OWNER r I OTHER r I NAMF
. . - -
WATER SUPPLY: PROPOSED [ I
EXISTING [I
[ I PUBLIC
[ I COMMUNITY. NAME:
[ I PRIVATE WELL
[ ] OTHER. SPECIFY:
TOTAL
..;""~15
~ f)o-v;4 .1~.u<"'r~
CONSTRUCTION PERMITS & INSPECTIONS ~D WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY:
GALS. MIN. DRAINFIELD
L1N. FT.
MAX, TRENCH DEPTH
INCHES
TYPE OF CONSTRUCTION
GROUP
FIREZON"
STAY 100' FROM ALL WELLS
USE CLASSIF.
SETBACKS. FT. FROM CTR. OF r/W:
FRONT SIDE EXT.
FT. FROM PROP. LINE:
SIDE INT. REAR
zON~//J4
~" - -
AUTHO~IZED SIGNATU~ES: ,<'} ",. "A~
/ /' \ .J n,... . <../.... .;;;", ~/,. '.
5 .......''''. ..r. {,.~ (,;,jI"t:J!&,
tI
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GAEEN
SANITATION - GOLDENROD
IMPORTANT:
>./. ~. ISSUANCE DATE:/. /..
." , " ~', ~." ',.....,:' to., ,.,"'/','.
t. . 1it.,J:t.! l)-e., d4 i........:.t ...;;:;..:'.>. J>4
'. ' ., I ~..' "" ;.
V , A .
Call 687.4065 to schedule all required construction inspection.Call 687-4061 to schedule all required
septic system inspections. All construction shall comply with the State Buidllng Code, D.E.a. standards
fOf subsurface sewage disposal and the Stale Plumbing Code. All buildings require a certificate of
occupancy before being occupied.
(See Details on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
C55-13
LANE COUNTY, DEPT. OF ENVIAONMENTAl MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th. EUGENE.:. ~,~~GON 9740t
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SITE INSPECTION
ApPROVED Cl OISAPPROVED Cl DATE
REMARKS
FOUNDATION INSPECTION
ApPROVEO 1--1 DISAPPROVEO 1--1 DATE
REMARKS
FRAMING INSPECTION
ApPROVED Cl OISAPPRQVEO Cl DATE
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVED ~I DISAPPROVED /
/ DATE
REMARKS
FINAL INSPECTION
~DISAPPROVED
Cl
DATE
ApPROVED
REMARK 5
CERTIFICATE OF OCCUPANCY
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INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
/ -17 -;7 INSPECTOR (k. rt:...-
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READY TO ISSUE Cl NOT READY TO ISSUE Cl DATE
REMARK 5
INSPECTOR