HomeMy WebLinkAboutPermit Building 1976-11-2
LANE COUNTY PERMIT FOR: .
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CONSTRUCTION [Xl MOBILE HOME [ ]
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o Owner .,,,.... '\: "'.-, -'.Ar'",
. ~ NAME - . -.-
o Contractor~' '. ,,"'-
NAME
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O.S, Reg, #~
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~ PERMIT NO.
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PLAN REVIEW [] CHANGE OF OCCUPANCY [ ]
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CITY ZIP COQE ~HONE
CITY ZIP CODE PHONE
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ADORESS
ADDRESS
\'.:J("{"'"") Code' Al...\' ()...\
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Subdivision
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Range>c '-- ") c--.l. _I Tax Lot
Block
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~ 'Pl.,,.\~18'ING INSTALLED BY: Y ~
.<{)W~ER I I OTHER I I NAME
~~ ~~ATER ~U'PPLY: PRO~OSED [ ] <-~",,', \', G:lc.u..L':.)
,,<:....." EXISTING [J \ , r - I -{' \-
(")'.. [ ] PUB L1C '-.. . '-"--..)-<.~
~ C;.. [ ] COMMUNITY - NAME: \:::::", ,,~ :
~~ [ ] PRIVATE WELL
t~"S'" [ ] OTHER - SPECIFY:
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CONSTRUCTION PERMITS 81 INSPECTIONS AND WATER POLLUTION CONTR~OL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY:
GALS MIN. DRAINFIELD
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Access to Property (Road
Lot
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Name):--.......~
Existing Structures on Property:
Directions to Property, Address:
STRUCTURE (# BEDROOMSI k
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SEWAGE DISPOSAL:
PUBLIC [] SEPTIC TANK I] OTHER I
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BUILDING 'oX-- ~
PLUMBING \. c::::.~ <, <,
3% SURCHARG" . '?-.. \~"\
MOBILE HOM"
WASTE DISPOSAl
PLAN REVIEW
TOTAL
TYPE OF CONSTRUCTION e::- "I'
Census Tract
Acreage
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Width
~ Depth
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SQ{T.
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......... Il.ole VALUATION, .
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L1N. FT.
J... hJ,M
MAX:TRENCH DEPTH
I~ I ,) -! 0< ra ,,,,.f,,, /cf
INCH ES
FIREZON" "
STAY 100' FROM ALL WELLS
USE CLASSIF. .,-f;h _ ,.; P'_ -
GROUP -r ,- Cl
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SETBACKS, FT. FROM CTR. OF rfW:
FRONT ::-:::.~ SIDE EXT.
AUTHORIZED SIGNATURES:
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BLDG, PERMIT - WHITE
OFFICE COPY - WHITE IMPORTANT'.
COUNTY TAX - PINK
PLUMBING - CANARY
BUilDING - GREEN
SANIT A liON - GOLDENROD
-:2
-
FT. FROM PROP. LINE:
SIDE INT. \s.' REAR
~Ii' ZON"O.~'\-
ISSUANCE DATE:
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Mer"", le;N'" //),2t....7.c.. _.I:":....j~).Lo 6 i,1
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Call 687-4065 10 schedule all required construction inspections. Call 687-4061 to schedule all required
septic system inspections, All construction shall comply with the Stale Buidling Code, D.E.a, standards
lor subsurface sewage disposal and the Stale Plumbing Code. All buildings require a certificate of
occupancy before being occupied.
r
,
(See Details on Rev~rse Side)
(POST THIS PERMIT ON MAIN BLDG. AT SITE)
C5!5.13
LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
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LANE COUNTY PERMIT
FOR:.,
,
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CHANGE OF OCCUPANCY [
PERMIT NO.
~
.', ,_ t"At ,'j". ./.'_ \. '\,1 ,.- .
CONSTRUCTION [:~] MOBILE HOME [
o Owner . ~~ "
Nl~J ADDRESS
PLAN REVIEW [- ]
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"
CITY
ZIP COOE
PHONE
o Contractor
'''-,.
NAME
ADDRESS
CITY
ZIP CODE
PHONE
O.S. Reg. #
I
Twn '-
Range
Section
"-
Tax Lot
\
Codp
Census Tract
Subdivision
\ .~"
Lot
Block
Acreage
Width
Access to Property (Road Name):--
,
'\
\
.
. .._..-..0,
"
\
, - .,..~, Depth
\"
Existing Structures on Property: .\,. \, I ~
Directions to Property' Address: ..::;5"&.I-.q, t;0AN' (} . ~~ q),-,
'STRUCTURE (# BEDROOMS)
SQ. FT.
VALUATION
~
. "
,
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"
>
.
,-','
.
SEWAGE DISPOSAL:
'PUBLIC [I SEPTIC TANK [
-BUILDING
PLUMBINr.
3% SURCHARG"
MOBILE HOM"
WASTE DISPOSAl
PLAN REVIEW
OTHER [
PLUMBING INSTALLED BY:
OWNER [J OTHER [J NAM"
WATER SUPPLY: PROPOSED [ I \.
EXISTING [J
.. '
..
[ ] PUBLIC
[ ] COMMUNITY, NAME:
[ ] PRIVATE WELL
[ ] OTHER - SPECIFY:
"
TOTAL
\ .
\, \
. \.. '.
"
.
., \ ,
\.~ '\. I l. ,..
CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY:
GALS. MIN. DRAINFIELD
LlN. FT.
.'
.
" .r
.
..
MAX. TRENCH DEPTH
J..' , f
INCH ES
'TYPE OF CONSTRUCTION /~' -"f GROUP
~
FIRE ZONF
STAY 100' FROM ALL WELLS
USE CLASSIF.
SETBACKS - FT. FROM CTR. OF rfW:
,
FRONT SIDE EXT.
FT. FROM PROP. LINE:
SIDE INT. \ REAR
" ,
ZON"-
'.
-.
AUTHORIZED SIGNATURES:
Isl ,
ISSUANCE DATE:
A'
I .
,
.."
BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
IMPORTANT:
.... J'.f " . .
Call 687-4065 to schedule all required construction inspections. Call 687.4061 to schedule all required
septic system inspections. All construction shall comply with the State Buidling Code, D.E.Q. standards
fO( subsurface sewage disposal and the Slate Plumbing Code. All buildings require a certificate of.
occupancy before being occupied,
(See Details on Rev,:rseSide) ..
-'
(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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S LAB FLOOR
PLUMBING GROUNDWORK
.
ApPROVED ;---? DISAPPROVED ~ DATE
REMARKS
GAS PIPING GROUNDWORK
ApPROVED / / 01 $APPRQVED ;---? DATE
REMARKS
ROUGH PLUMBING
ApPROVEO ~ DISAPPROVEO ;---? DATE
REMARKS
ROUGH GAS PI PI NG
ApPROVED ~ DISAPPROVED ~ DATE
REMARKS
.
INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
FINAL PLUMB I NG
ApPROVEO ~ DISAPPROVEO ~ DATE~~~.~ INSPECTOR
REMARKS
FINAL GAS PIPING
ApPROVED ~ DISAPPROVED ;---? DATE
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE j- / NOT READY TO ISSUE / / DATE
REMARKS
INSPECTOR
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INSPECTOR