HomeMy WebLinkAboutPermit Building 1976-9-22
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CONSTRUCTION
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NAME
. LANE COUNTY PERMIT FOR: . PERMIT NO.
,OJ 379- }(:;
[] MOBILE HOME [] PLAN REVIEW [] CHANGE OF OCCUPANCY [ ]
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- CIU I' 'ZIP CODE PHONE
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o CDntractor
NAME
ADDRESS
O.S. Reg. #
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Subdivision"fJl/7 /)1 ,,-j'/IJ (i
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Section d).. YTa--:~ot /71>1) Code
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II Block "_'? Acreagp
Access to Property (Road Name): ,iJ/J/IrY. (I "Ia; hl l?>>'
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Existing Structures on Property:' i? 1t-1/...1 O. j .'+-,f./(....vz /J. ~
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Census Tract
Lot
Width
Depth
Directions to Property. Address:
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STRUCTURE (,#.BEDROOMSI
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Vj\LUATION
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SEWAGE DISPOSAL:
PUBLIC [] SEPTIC TANK [J OTHER [
BUILDING JI.(J()
PLUMBING
3% SURCHARGC L:;' I
MOBILE HOMc
WASTE DISPOSAL
PLAN REVIEW
PLUMBING INSTALLED BY:
OWNER r I OTHER I I NAMF
WATER SUPPL Y: PROPOSED [ ]
EXISTING [J
[ ] PUBLIC
[ ] COMMUNITY. NAME:
[ ] PRIVATE WELL
[ I OTHER - SPECIFY:
:'..
':-
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TOTAL
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CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY:
GALS. MIN. DRAINFIELD
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r -. v-
L1N. FT. MAX. TRENCH DEPTH
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INCH ES
TYPE OF CONSTRUCTION _r.../ GROUP
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FIRE ZONE
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STAY lOa' FROM ALL WELLS
USE CLASSIF. ~::;.?_,., ,,.. .r", "A~,... ,.
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SETBACKS2 ~T. FROM CTR. OF rlW:
FRONT '7 (), SIDE EXT.
FT. FROM PROP. LINE: _-I
SIDE INT. . '" I REAR.:)
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AUTHORIZED SIGNATU.RES: f-.
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BLDG~ PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
./ .J ISSUANCE DATE:
rn~'-v..j.t.J.-"h. ef- ')'7-7/ ihr E. ",,'-L;7?:&<: '76.:<-> ,.~:.
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Call 687-4065 to schedule all required construction inspections. Call 687-4061 to schedule all required
IMPORTANT: 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 of
occupancy before being occupied.
(See Details on Reverse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
C55.!3
LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
,
:.... . LANE COUNTY PER!1!T fOR: . PERMIT NO.
"' , . ,,"-- () 37<7- '76
CONSTRUCTION [ ] "MOBILE,HOME [] PIAN REVIEW [] CHANGE OF OCCUPANCY [ ]
o':Owner .1/)l) ~/ R'\ P 'j}1" ~ ~ ~:;Sil:trJtJ1..W(J..1 J-J;.(
NAME . ~' ADDRESS. ._.lCITY . ZIP CODE PHONE
o Contractor . Q <!: (/!1. C;",Llt) / 7X... 7~
NAME ADDRESS ~ rev · "~P CODE PHONE
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O;'S, Reg. #.
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Twp----L....L- Range~ Section ~. 'Tax Lot~{..IU_ Codo
SUbdiViSi,!f};Jtll;t'ltJ~, Lot-1t Block J:;1,. Acreage
'. ..,1//1." . ,. .;.1.....1....... J~./}
Access to Property (Road Name): ~-;Li#'ri:' "1re.vt u; ,'" d! ,.,' Depth
Existing Structures on Property: ...,~t !> U,;(.I (' .. " ..' ,j Ji./f...:J.-<;:; ...LL,., ~ . . . /1
Directions to Property , Address:<./af;~,fL':! Iii R~!f.... I). d j ..~ff) IJ<
Census Tract
Width
ST2J(Jf(j;. .BFDR~?MSI
,/!':1 .1..1, '"
T
/ fi ; ,.' ,SQ. FT.
tfj ~F} ~:j~~.i! A R-!. /J
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. ,SEWAGE DISPOSAL:
PUBLIC [] SEPTIC TANK [] OTHER [
17.0C}
'.~L
BUILDING
PLUMBiw:
3% SURCHARGE
MOElILE HOM"
WASTE DISPOSAl
PLAN REVIEW
PLUMBING INSTALLED BY: .
OWNER I J OTHER [J NAM"
WATER SUPPLY: PROPOSED [ I.
EXISTING []
[ ] PUBLIC
[ ] COMMUNITY. NAME:
[ ] PRIVATE WELL'.
[ ] OTHER. SP\,CIFY'
....
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CONSTRUCTION PERMITS & INSPECTIONS AND WATER .POtLUTlON CONTROL SPECIFICATIONS
~IN. SEPTIC TANK CAPACITY: .' 1:.,',":,;:,: ..:.,
GALS. MIN.DRAINFIELD UN. FT.' :MI':X"TRENCH'DEPTH
_'9J,l t.id~t"'d._. /Uf pJji'~ .."ut: 1,:'Nt;,J.:..' ,,';,' .,."..0.""
.
~....
TOTAL
.-!'J.Sf
INCH ES
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STAY .100' FROM ALL WELLS
USE'CLASSIF. D...I,....,.J...~,./.;
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TYPE OF CONSTRUCTION...!!""'L/ GROUP
fiY";,,' FIRE ZONE~~\
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SETBACKS, I}"];..F~OM CTR. OF r/W:
FRONT &.off j SIDE EXT.
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~~D:~~TM ~P/UNE~EAR $'
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AUT~OR. IZE. 0 SIGNAT~rS~. ...,/
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, BLOJ! PERMIT - WHITE
OFFICE COPY - WHITE IMPORTANT'
COUNTY TAX - PINK .
PLUMBING - CANARY
BUILDING - GREEN
SANITAT1DN,- GOLDENROD
...1 ~ ISSUANCE ElATE
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~I! 687-406~b schedule all reqUired c~nSlructlOn inspectIons Call 687-4061 to schedule all required
septic system inspections. All construction shall comply with the Stale Buidling Code, D.E.Q. standards
for subsurface sewage disposal and the Slale 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 ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
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SITE I NSPECTI ON
ApPROVEO ~
OISAPPROVEO ~ DATE
REMARKS
FOUNDATION INSPECTION
ApPROVEO L-,/ 01 SAPPROVEO c=7 DATE
REMARKS
FRAMING INSPECTION
ApPROVED ~ DISAPPROVED Cl DATE
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVED L-I DISAPPROVED .c::J DATE
REMARKS
FINAL INSPECTION
ApPROVED Cl DISAPPROVED Cl DATE
REMARK 5
rf ~____
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CERTIFICATE OF OCCUPANCY
READY TO ISSUE Cl NOT READY TO ISSUE Cl DATE
REMARK 5
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INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
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