HomeMy WebLinkAboutPermit Mechanical 1977-1-27
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PERMIT #
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JOB LOCATION /" /'.J
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!-ANE COUNTY PERMIT
Acreage or Lot Si7Q
Contractor's O.S. #
Partitioning #
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Subdivision
Lot
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APPLICANT'S NAME AND ADDR"'<:<: /1 !;/
OWNER'S NAME AND ADDRES~ ~ ;. 'f
CONTRACTOR'S NAME AND ADDRESS
Mail permit to ( ) Applicant ( ) Owner
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(owner, etc.) when ready.
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) Contractor. (
) Prefer to pick up. Call.
STRUCTURES NOW ON THE PROPERTY
eTHIS PERMIT IS FOR
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# BEDROOMS
# PLUMBING CONNECTION&...-:
WATER SUPPLY
SEWAGE DISPOSAL
S.1. #
THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
. PLUMBING BY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _owner of record;
contract purchaser; _ potential buyer; _ realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
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Fee Paid $ -'. I " Signature ,'... <":. "- DatQ I' " /"
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) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION OEPT ) SPECIAL PMT. AREA. MIN. ELEVATION:
.mments:
Minimum Septic Tank Capacity (Gallons)
Drainfield Required. Lineal Feet
Maximum Depth
BUILDING
Type of Construction
Use Classification
r.roup
Fire Zone
SANITATION
Comments:
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By: Date:
PLANNING REQUIREMENTS SATISFIED. By:
ZONE: ;:.,' ,-j SETBACKS: FRONT
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By:
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Date: 1- .V' ,,}. -7 - / Date Issued:
(FROM C/L) INT. SIDE YARD REAR
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SIDE FACING STREET
(FROM PIll
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST- 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
PHONE: 687-4394
C55-13
BLDG. PERMIT -WHITE; BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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JOB LOCATION.
A PERMIT# /t3-71
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LANE COUNTY PERMIT
Acreage or Lot Si?p Partitioning # ( ) Completed Subdivision
Contractor's O.S. # _ 0 Lot
APPLICANT'S NAME AND ADDRESS -/Y7IJA f. a A-/-,,-,,~ t1) / </d" 81151: ,.J!d/f.
OWNER'S NAME AND ADDR""" .A;t'J1,d...klf, :d' .f)/I";/.~/1 P/). ./-Yri/ 3Rt:,) Cr~ d v
CONTRACTOR'S NAME AND ADDRES" -- / /7
Mail permit to ( ) Applicant ( ) Owner ( ~contractor. ( ) Prefer to pick up. Call
STRUCTURES NOW ON THE PROPERTY ,-../L",-~
eHISPERMITISFOR w~cf S~
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Phonp
(owner, etc.) when ready.
# BEDROOM"
# PLUMBING CONNECTIONs..............
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WATER SUPPLY
THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
SEWAGE DISPOSAl
S.1. #
PLUMBING BY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: _owner of record;
contract purchaser; _ potential buyer; _ realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record. and that said owner is.aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid ~ ":;'/0 Signature '-Mew(. {I. ?L~e..- Datp /-';;;1-77
) NEW ADDRESS ( ) FACILITY PERMIT TO TRANSPORTATION DEPT. ( ) SPECIAL PMT. AREA. MIN. ELEVATION:
e"ments:
Minimum Septic Tank Capacity (Gallons)
Drainfield Required - Lineal Feet
Maximum Depth
BUILDING
Type of Construction
Use Classification
Group
Fire Zone
SANITATION
Comments:
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By: Date:
PLANNING f,lE;(}UIHEMENTS SATISFIED. By: VLJ....../Z.e..;C.
ZONE: /!/ n SETBACKS: FRONT v SIDE FACING STREET
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Date: j-Dl '7- - / - / Date Issued:
(FROM C/L) INT. SIDE YARD REAR
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>;.1. r;C:Date:
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(FROM PILl
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE., EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT S'TE
PHONE: 687-4394
C55-13
BLDG. PERMIT - WHITE: BUILDING - GREEN; PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY - WHITE
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SITE I NSPECTI ON
ApPROVED Cl DISAPPROVED Cl DATE
INSPECTOR
REMARK 5
FOUNDATION INSPECTION
ApPROVEO /
/ D,sAPPROVEO 1--1 DATE
INSPECTOR
REMARKS
FRAMING INSPECTION
ApPROVEO / I D,SAPPROVEO Cl DATE
INSPECTOR
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVEO 1--1 DISAPPROVEO 1--/ DATE
INSPECTOR
REMARKS
tI NAL I NSPECT I ON
ApPROVEO 0 D,sAPPRoVEO Cl DATE ~/51- 7 7 INSPECTOR~rL
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE Cl NOT READY TO ISSUE Cl DATE
INSPECTOR
REMARKS
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Job Location 8 IS"
SA'ME' ~M
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INFORMATION SHEET
) Building Permit
) Site Feasibility Study for Septic Tank.
) Would like to meet on site. Call
Test holes will be ready
Subdivision
. Lot
Bloc~
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Number of sites
(owner, etc.)
Acreage or Lot Si 7~
Partitioning #
) Completed
( ) Pending
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APPLICANT'S NAME AND ADDRESS \\~ V"Q...~\.J,," 14:~_ D 'S'I.
OWNER'S NAME AND ADDRESS, if different from applicant's s,1E\lB-J L. DQJ.~c::l2...
CONTRACTOR'S NAME AND ADDRF<:C:
M'ail permit or results of site feasibility study to ( ) Applicant ( ) Owner ( ) Contractor.
.. ) Prefer to pick up. Call /'1 ( owner, etc.) when ready.
STRUCTURES NOW ON THE PROPERTY ~.4r--?A.-<;::/ 17_
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PROPOSED USE (this permit)
WATER SUPPL Y (,e,~isting or proposed well, etc. If public, name of system)
SEWAGE DISPOSAl (,e,xisting or proposed septic tank, etc.) S.1."
PLUMBING BY Address
--7f- ( ) PROPE RTY IS WITH I NONE MILE OF CITY (
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I ******************************************* OFFICE USE ONLY BELOW THIS LINE *******************************************
....... ) New Address Necessary ( ) Facility Permit Ne'cessary
.NF SETBACKS: Front Side Facing Street
(FROM CENTERLINE OF ROAOI
) Special Permit Area.
Minimum Elevation'
Interior Side Yard Rear
(FROM PROPERTY LINES)
To: Planning/Building Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
Permit Processi.ng Section
ResponSl"
C55-12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687-4394
r'livision