HomeMy WebLinkAboutPermit Building 1976-10-18 (2)
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LANE COUNTY PERMIT FOR:_
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PERMIT NO. 5;;;-7"
CONSTRUCTION [J MOBILE HOME'[)cJ' PLAN REVIEW.[ ] - CHANGE OF OCCUPANCY [ ]
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(J v ':lAME' ADDRESS - (;' CITY #' ,. ZIP CODE -PHONE
'0 Co ntractor ---.:.:e..-...... A'
'NAME
o Owner
AOORESS
CITY
ZIP CODE
PHONE
O.S. Reg. #
,Twn
""7 Range b:$ Section ..:z..;z Tax Lot_I.::! -~ Code
Census Tract
Subdivision
Lot
Block
I'C. :7_. ~ p:;__
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Acreage / If . v (-' Width
Access to Property (Road Name)'
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<:)/'5
Depth
Existing Structures on Property:
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Directions to Property, Address: /7.. ~ ~ _ /,.., _. .JC?,/ :r-_, L~ ._. ~ ;.~ ~ -- P / /~-: ..
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STRUCTURE (# BEDROOMSI SO. FT. VALUATION
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SEWAGE DISPOSAL: :?~. (; 1"8
PUBLIC [] SEPTIC TANK lit] OTHER I
BUILDIW'
PLUMBING
3% SURCHARG~
MOBILE HOMF
WASTE DISPOSAl
PLAN REVIEW
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PLUMBING INSTALLED BY:
OWNER [] OTHER [] NAM~
WATER SUPPLY: PROPOSED [ ]
EXISTING []
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[)<I PUBLIC
[ ] COMMUNITY, NAME'
[ ] PRIVATE WELL
[ ] OTHER - SPECIFY'
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TOTAL.
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CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY:
GALS. J aao MIN.DRAINFIELD '1 () 0
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L1N. FT.
MAX. TRENCH DEPTH
INCHES
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TYPE OF CONSTRUCTION
GROUP
FIRE ZONE
STAY 100' FROM ALL WELLS
USE CLASSIF.
SETBACKS - FT, FROM CTR. OF r{W:
FRONT ~O SIDE EXT. -
FT. FROM PROP. LINE:
SIDE INT. S- REAR
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BLDG. PERMIT - WHITE
OFFICE COPY - WHITE
COUNTY TAX - PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION - GOLDENROD
IMPORTANT:
ISSUANCE DATE:
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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 Slate Buidling Code, D.E.Q. standards
for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate 0/.
occupancy be/ore being occupied.
AUTHORIZED SIGNATURES:
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(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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SLAB FLOOR
PLUMBING GROUNDWORK
ApPROVED / / DISAPPROVED Cl DATE
INSPECTOR
REMARKS
GAS PIPING GROUNDWORK
ApPROVED / / 01 SAPPRDVED Cl DATE
INSPECTOR
REMARKS
ROUGH PLUMBING
ApPROVED ~ DISAPPROVED Cl DATE
INSPECTOR
REMARKS
ROUGH GAS PIPING
ApPROVED Cl DI SAPPRDVEO Cl DATE
INSPECTOR
REMARKS
FINAL PLUMBING
ApPROVEO fE{' D'SAPPROVEO Cl DATE ~d7.7 INSPECTOR
REMARKS.J1..ll /11 J.2-/('J- 'Ll_JA,~\."","", ~ ~<'t""
FINAL GAS PIPING
ApPROVED ~ DISAPPROVED ~ DATE
INSPECTOR
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE Cl NOT READY TO ISSUE ;---? DATE
REMARKS
1?2i-
INSPECTOR
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