HomeMy WebLinkAboutBuilding Miscellaneous 1980-9-30
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OEPARTliENT OF ENVIRONI1ENTAL r1ANAGEMe
PSB. 125 EAST 8TH AVENUE
EUGENE, OREGON 97401
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Job Address /7 S- (-7/91VJ I? t='flf{m i? D. !&!l:!i;j EU&rAj(l-
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Application for AJ\.,,-r,.....^J.. BfDr:?rl.\n. -+- 84rtl
Structures now on the property .[)/~ 'rLL"Jt'~ fliVl...'/ /...
lil!P\lhle&lllliM1!"iiiltl!IlJitLWJl t2I !~.'ti\iii 0 ftQlOOllj~ll'] I () H!il!il~;tirtil; 0 r~;I!l1!J~i ';) 1 C;r; l;:f.I~,.....
Affidavit: \, '-If/f),,; /1- \I1J;i$..tllttil~Ij)~ LA.& , hereby certify that this information is true and accurate.
If this application is for an agricultural building it will be used for purposes allowed by the Stilte BUilding Code and
Lane County Code Chapter 10 (zoning) and for no ather purpose. I have the following legal interest in the property:
)( owner of record; contract purchaser~ lessee; holder of an exclusive option to purchase;
duly authorized to act for the owner, who is knowledgeable of this application.
Signature/Address <Jj,~'Y"'-t:1L? .'-. ..2....1!./klZJ;:z:7 /75" G;<;"7~ /-'fiIM-, aD
'. Telephone 7<//",o:<.t,7 or t,,(;,7 .7.1K.l,t) Date
When permit is ready notify: 181 Appl icant () Owner CI Contractor
Owner -7hf\rn r"I.( dMJ.) (1;\ ~j'" E 191, DO t.4 (
Contractor <::: <;.. f J':
Contractor's OSRU
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rli\}i1#I!edIiNililiilll!\~l
"vi /Ou)f (zio) Cf 7'101
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(ZiD)_v7VO,-
Phone
'J 5/e:;.() <C,"/
(ZiD)
Phone
Plumbing by
=
If Commercial: rfl~fiii~1'11 . # of ~~ ~~Te::ITE BELUW THIS~~~;~UriltlM \J~~
Residential: oo;~ii6l.ru~tf. 3P~hJVVl !~1'11r/-; Existing, BP # -46-~ t-.J:^ _
"SI test hol;~ ready LYVI. I... I~I Proposed, S\ # v I
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;'&1$'\1
OescH iitfoii
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Valuation
Fee
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Total Valuation: $
. 'lll!iibflf1fflitUfis' at $
r.:~2rJIHli~~)1 at. $
'Subtotal.
$
$
$
$
$
each $
each $
$
$
~
~ ~~~~rnu
g 111~ll
Recei ved bv
Water Supply
Proposed
Year Installed
Existing _
4% State surcharge
Plans check. fee
-~\..,
M;O~~4uW
=
PERMIT PROCESSING
Minimum setbacks:
Zone RA Part. #
ct. front ~ / ; ct, side
--
Parcel #
Parcel Size~:I tn(}
; into ~/ ; rear ~
Comments
To be typed on permit
A.b ~ -7ZJ ~4J.
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CP&1 Type ,""9l/
To be typed on permit
Group
~
A!y
Fire Zone A.J ~
/
Date /
Use Classification ~Id/}o/----
/
By ,#'/~I" ~..AOr ~
Oa te :::;J.-~
For plans infonnation call (area inspector) Phone
Directions to site f.4k')" ~A"L..(tJAI f2.u ,..,.-:, (::.t:!ME,cAfl-kJ -rlARN 1-, tr-r ""C\
f7", c:.ANll= Ol1ll.tn Dl\.
CI SIFO Plans to: CP&I set(s) Date Hold Slip Date Date to
WPC set(s) Required to PCC Completed PCC
~ CP&I
1$1 WPC
CI Planning
CI Public Works
CI Elevation t5f; n/a
CI Address
/::/ Facil ity Permit
/~/ Environmental Health
C74-171
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INSPECTION RECORD
4. Lath or Sheetrock Inspection
5, Final Inspection
~~
Approved
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Disapproved
Date
Inspector
1, Site Inspection
2, Foundation Inspection
3, Framing Inspection
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/0- f"t, -80 a~r:e.....;j
p-" 0
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9- 2.1-81 -_~
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6. Slab Floor, Plumbing Groundwork
7. Gas Piping Groundwork
8, Rough Plumbing
9. Rough Gas Piping
10, Final Plumbing
11. Final Gas Piping
Remarks:
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1-/2->?z
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12. Certificate of Occupancy:
_ ready to issue; not ready;
. -
date;
inspector,
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IRS,~tl'ft.J7-tJ3-22rC;:'I Yt?O ADDRESS /7s~~~d - :7/Vcr/
lane county C H EC K L I 51 OFFICIAL USE ONLY
Appll.. / '7/- <f'L
/:J ,--.L- L? p;)~.23 cP cFc?cY
APPLICANf INFORMATION: II~ ~ Pr '
IfiOI'hAS .C 4LJ)ov.S 17S (?lImt.~/U(m tUti?fjJt. 97rO{
(Name or rInn-Please Pnnt) lMaIling AddreSS) (lity or TOwTI) lZIP Code)
1
o Yes Finn
PLUMBING CONfRACfOR
Cont. OSR#
Address
o No ~lf
o Yes Finn Cont, OSR#
Address /'
DNoDSelf DIRECTIONS TO SITE k2f/~k./~~$~
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MEGlANICAL CONTRACTOR
pLUMBING
Ntnnber of Each
Type of Fixture
Fee On Each
$ 5.00
5.00
5.00
5.00
5,00
5.00
5.00
5.00
5.00
5.00
15,00
10,00
15.00
10,00
15.00
10,00
5.00
5,00
10,00
Total
Sink
Lavatorv (Wash Basin]
Tub (with or without shower)
Shower, separate
Water Closet (toilet/urinal]
Dishwasher
Disposer (garbage grinder)
Washin~ Machine
Water Heater
Floor Drain
Sewer--lst 50ft,
each additional 100 ft,
Water Serviceulst 100 ft.
each additional 100 ft,
Stonn and Rain Drain--lst 100 ft.
each additional 100 ft.
Special Waste Connection
Sewage and Sump Pump (eiector)
Mobiie Home Sewer and Water
Other (specify)
SUB-TOTAL (Minimum $10,00)
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J TOTAL FEE
.,:;?...C;- -Z. ~ .
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MEGlANI CAL
Ntnnber of Each
Type of Equipment
Fee on Each Total
$ 10.00
$ 6.00
7.50
3.00
3.00
4.50
6.00
6.0"0
b.OO
6.00
.50
Mechanical Permit Base Fee
Furnace UP to 100,000 BTU/H
Furnace over 100.000 BTU/H
Clothes Dryer Vent
Bathroom Ventilation Fan & Duct
Ran~e Hood with Mechanical Exhaust
Wood Stove
Air Conditioner Only
Heat Pump
Floor Furnace
Gas Piping System 1 to 4 Outlets
Per Outlet
Other (specify)
SUB-TOTAL
I certify thatall plumbing work will be done in I
accordance with applicable provisbns of Oregon TOTAL FEE
Revised Statutes Chps. 447 & 693 and applicable coaes, ana tnat no nelp Wl II~e em ~
unless licensed under ORS 693. ~
Signature:2A/VV<_~ <: 4~ Date /,./S~~ Permit issued by ....~/:":'2 .
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APPLICANT ALDOUS.
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'r I NEW Bt..Dc; TYPE
CODE APPL NO
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LANE COUNTY nEPT ENV M~T R~CF'TPT :~ 7182 I)ATE 0.11582 L
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SUBDIV .
USE R BDRMS 0 UNITS 001 STORIES IBLDCS 001 PHONE 746 0367 ~
ACTI'ON DI:SCFniPTION SG~ FT UNIT COST W':...LJ(.,THJN FEE N;YS.' ~
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LC 7'\ 82 PI..
NO. FIXTUF<ES:
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NO.
CONNI:TTm;:s:
MECHMnC,~L FEE
ST,~n: SUI'(CHAr~GE
I"L,,,N CHECI( FEE
1~)..00 EACH ...
. 1~). 00
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TOTAL
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2~>. :,5 CI( .
0.60
9. T3
41.
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EST. COMPLETION DATE 011582
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JOB ,ADDRESS:
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CONDITIONS OF APPROVAL: No evidence of failing system. Addition '>'Ii11 not ;.<~\./;.!
encroach' on existing drainfield. Certified adef!uate for proposed use. ~:~..~~
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POST TillS PEHfaT Oi'l nJ,I;l ~lJILDIi;C I\T SITE
Ci}!lSTRUCTIOll PER-lIT II LC 238~1-80
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175 Game Far", i'<d., EU'1c!1c, Ore\jOlI 97401
TRS. TL: 17-03-22.4.4, 5900
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SUBOIVISIO~: N/A
COilSTRUCTIml APPftOVED flY TIiIS PU;:~IT: 2nd story addition,
460' sq. ft. 2 pl umbi n0 fi xtures. Va 1 uat i Oil: $l:l.O6<1.
Certificate of !\deqllacy.
i1i nimulfI structura 1 setbacks:
(No chan'le to existing setbacks).
PERiUTTEE:
Tholilils Aldous
~J.lm I~SUED:
October 2. 1 %0
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BY.:.., Roger McGuckin/Colleen Allison/Carol Dyal
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DIRECTIONS TO SITE:
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Take flarlow Rd. to Game Fann, left to 175.
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INSPECTION RECORO
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^rprovrd Disapproved
Dille
I nspec lnt"
1. Site Insprction
2. Foundation Inspection
3. Framing lnsprction
4. Lath or Sheetrock Inspection
5. Final Inspection
6. Slab Floot", Plumbing G.'oundY/ork
7. Gas Piping Ground~lot"y.
B. ROUY;l Plumbing
9. Rough GelS Piping
10. Final Plumbing
11. Final Cas Piping
.
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RpfIlJrks:
--- .-----.--' -.-. --.------
---------_...._----~._---------------_._~._--------
--_.__._-------,--_._-----_.._--------_._----~ .---.----..--.--.---- .--.-
----.-..------... .__.._----_.._~------'- --- --.--.-.--------
------.---------.-.--.------.--------
_________.._._.~______---'______.~_____ _.._____.___._..~__.________.._n___
12. Cet"tifjc~le of Occupancy:
ready to issue;
no t ready;
da t,~ ~
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POST THIS PE:CIT O;j ;J'U LUILDli;t~ AT SITE
CO!!;,HUCTICr: PE~;iIT f LC 23e~-GO
JOJ .',iJJ;;::SS: 175 'Jane Farri ,:u.. [u:'!C!1(1. Creel on :'74,11
TI{S. TL: 17-13-2:?"-:.i!. 5S!:D
SUJJIVISIO..: NIt\
CO:lsnUCTIO;; l\PP;~GV:':i) :1Y TliIS PEnIT: 2nd story ad'litic:J. ~"jror.L1/b:lt!.roc'~--
~uJ 5~. ft. 2 ?lwnLinu fixtures. Valuation: S13.CG~.
Certificate of litlcq'lacy.
cu;mTIIJ.tS CF liPrilQV,iL: i.lJ evidellce of fd1l1n:J sjstm. AJoith, '.ill not
encroach on ex1stiuc! clrai.lficld. Certified a::leouate fer ;>ro:,usc:; us!:.
::illi!,:U'1 structural 5ct!Jec!:s: (no c!la:lflc to f2xistinq setrccks).
?L: iITIEl: TilOi.j(ls Aldcus
U~TE ISSuE]: Jctovcr~. 19S0
t,y: RCJer: :c:1ucl.infCollccn i\1l1sonfCarc1 Dy"l
::r::ECT!(,:;S TO SITE: Take iJar1o~! i~d. to CJ!~e Far..:. left to 175.
-tANE COUNTY, OREGON . . CONSTRUCTION PERMITS
, - DEPT. OF ENVIRONMENTAL MANAGt::..,ENT . & INSPECTION DIV.
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JOB ADDRESS ~ g~ 0 .::tt:f~ rf2,..j DATE 1- t 2..- ~ '2.--
TO: ~)IA~~ BLDG,PERMIT: 2.~Sl5{'-)ftJ
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ofJOT;:@ ~!~ . ~3-1'1 JJ..P .Zt~".~. f~' H~~.l~~
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o'6-{/ ({i) e..&?~~J .fJ./1~ '!.~ I ()~ ~ -r..k. I..db /Ie.. /;ZL Jl~,
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I Jo $71
t' ll' - RE-INSPECTION REGUIREO
...... ICII1'1IEl 18i1EJ#'-~(Q)(Si5 C=OR APPROVAL
INSPECTOR:
C1Ak~' _II.
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/7';;- ~ ~ I!Jl DATE 1-2..~-g /
TO: {) ~ BLDG, PERMIT: :z. 3 ~ 8' - 80
NOTE:i7J ~J1~..) r:f h~4.7~{/J-a-4.- h1~
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~ANECOUNTY.OREGON It
DEPT. OF ENVIRONMENTAL MANAGEI\iiENT
(g(Q)[gj[g]~(gUO(Q)~ ~(Q)uO(g1E
JOB ADDRESS
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C55.73
ll'l15-INBl"'IEC"i"ICN ll'l15~UIll'lI5C
PhCU"ilGl 1Si1Sl~-~(Q)S5 L"'Cll'l Al"'l'Oll'lCVAI.. INSPECTOR:
.
CONSTRUCTION PERMITS
& INSPECTION DIV.
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POST THIS PERI:IT Oil i'iU;! iUILDIi;': AT SIT!:.
COiJSTRUCTIOiJ PE:lJ.1IT 1'1 LC 2300-00
JOr.; A:JDnESS: 175 Garno Fi.lrEl Rd., Eugene, Cregon S7/l0l
TI{S, TL: 17-93-22.~..~" 5900
SU3:JIVISW;j: r~/I:\
COilSTllucnOi; APPl10VCD BY 'i1iIS pm;iIT: 2nd story llucJition. bo:lroom/bi.lthroc~--
(GO sq. ft. 2 D1L~Qing fi~tures. Vului.ltion: $13,064.
Cer'~Hici.lte of I'.clcqui.lcy.
COi:ilI'iIOi!S OF APPROVAL: .10 evicJencc of failin!) systc.l1. Addition \'Iill not
cilcroilcl1 011 o:tisi:i:1U cir1\infield. Ccrtificli adequate for I1ro~osed use.
ilinim~n.1 sl:rllctural sotbi:cI:s: (.!o chai1go to cxistiilfj set"Gc':s).
P E;;i iITTE[ : T:lO:,las Aldous
DATE ISSUED: October 2, lDGO
BY: RO!l~r jicGucft1n/Coileen Allison/Carol DYi.ll
Drn[Cn\.l.~S TO SITE: Ta!to I:arlo';! l~d. to GaLlO Fam, kl't to 175.
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J......75 (".,AIVlf. F'ARM RDAb
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DEPARTfiENT OF EIlVIROili1EiITAL IlANAGEM8
PSB, 125 EAST 8TH AVEilUE
EUGENE, OREGON 97401
p,~'rc 1'50
Assigned Numbers
Job Address /7,t;" r-o.AIV/ t=' r:lIl?m i? D. City Eur",,~Al&
Township, Range,'Section, Tax Lot '/7 03 :2."), LJ." ~q/lE1 cr.;:,.. /<:I'O-=!.
Subdivision . ~~:xtl_..1.~~ Lot Block
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Application for tll'll'l,-r",^,\ - R1'1'IJ?^.~..,., .... r:?.rJ~JJ
Structures now on the property 111.1 'C J L ,,J/-, ~\ I1JL Y
Proposed use of property: /X Residential C/ Commercial C/ Industrial () Publ ic
~
Affidavit: I, -r1-l F\ rYJ #- ,C .s, 19 1_ 1',,^ '''< .<::
, , (please print)
If this application ;s for an agricultural building it will be used for purposes allowed by the State Building Code and
lane County Code Chapter 10 (zoning) and for no other purpose. I have the following legal interest in the property:
~ owner of record; contract purchaser; lessee; holder of an exclusive option to purchase;
duly authorized to act for the owner. who is knowledgeable of this application.
Signature/Address --:J 4. "p... /,~ . ('. L7 ~-'~ /7, (':.,,4 hi" ""AIPm /? D
.... . Telephone 7{f/-, () -i.t.'7 or t:. ~7-~~.c;-il Date
When permit is ready notify: /)( Appl icant C/ Owner C/ Contractor
Owner -1'/-1"".., A ( 4.P,) (l"" 1.11// E ,Q L b'l.J.!' (
. .. - - . - -.
Contractor c: (; I ,c
. hereby certify that this information ;s true and accurate.
~u ("~Alf (ziol q 7<{fU
1? - 7 <""- PI)
(ziol-$?,.7 '10 I
(ziol
Phone
7 V?;-O"<c, 7
Phone
Contractor's OSR#
Plumbing by
=
If Commercial: # of stories
Residential: # of bedrooms, i'lfO 1
51 test holes ready
DU NOT WRITE BlLUW THIS
# of employees
~5~
LINE
# of units
SDS: C/
()
Existing, BP #
Proposed, SI #
\J~k1\r{JJ.L
4~-~_ ~rA .
. ( ,
Fee
Code
Description
Sq. Ft. or
# of Sites
Unit
Cost
Valuation
Fee
.
$
$
$
$
!.J~) '~f"lrt ^'
\......./ ( )
KfrtIh~ 1r?<t1.H.'\ f]n7/yy. nr1rV+lnYI )
() -- 'U . 4("rilrr ~40
2
Total Valuation: $
Plumbing fixtures at $
Sewer/water conn. at $
$
each $
each $
$
$
&\J-, d>t (%JQQ: 4: ) ( .n
TOT~..) \ Ir
Subtotal
C/ Cash
C/ Check #
Received by
Water Supply
Proposed
.Year Installed
Existing _
4% State surcharge
Plans check fee
Gllailll"-o~ru:-:y-
PERMIT PROCESSING
Zone RA Part. #
1., front' ~ / 1., side
Parcel #
Parcel Size 6y)'/ 1,;--,'-)
into ~./ ; rear C-...(
'-'
Minimum setbacks:
Coments
To be typed on permit
By
Date
WATER POLLUTION CONTROL ~-'
Installation specifications: gal. tank;
. To be typed on permit
I.I~ r->~ 0\ ~ <~ (~",lQ
c.LWl:~~ o.La.;.lo..1t <:wJ fl .,nO'.l d ,.....,
ft. of drainfield; max. depth of trenches:
~ ~'o.LAD ",';', o(h ~n.i" O:;~ dNl,..J).v-l.
J
Directions to
Telephone C..rl.,,<J51-
site -1"14//.< ..JA(2/., , lA/ r2d ,..,.-,
J Ie:-- ~LJ /l-?C C'tJ /) f1.--1 01\
, ,
Plans to: epsI set(s)
wPC set(s)
BYC/~
r.:. ~ JV1 ~ ,{."t} f2 fh
Date 'l,-2'1-;rO
-rIA t:!. AI I-- ~ Fi ...,-"
,
,
, -
1.../ SIFO
~ CPSI
~ WPC
1-/ Planning X
C/ Publ ic Works
Date
Requ ired
Hold Slip
to pce
Date
Completed
Oa te to
pec
() Elevation ~ n/a
CI Address ("'
/~/ Facility Permit
/~/ Environmental Health
.'
",..-
\..
['
j
1, Site Inspection
2. Foundation Inspection
3, Framing Inspection
.
4. Lath or Sheetrock Inspection
5, Final Inspection
6. Slab Floor, Plumbing Groundwork
7. Gas Piping Groundwork
8, Rough Plumb~ng
9, Rough Gas Piping
10, Final Plumbing
11. Final Gas Piping
Remarks:
12, Certificate of Occupancy:
_ ..ll.........w ~
INSPECTION RECORD
Approved Disapproved
---,--
_ L-"-'
, I .Z//~/ .
---r- ' -,
1/
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r
, ......,,~
_ ready to issue; _ not ready;
date;
1
1_
Date
".
Inspector
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1/-c1<)::QJ @.Cf2
l- /d-YJ,
/9 i.
inspector.
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LANE COUNTY'UILDING PERMIT ·
,
lane 20unty
POST THIS PERMIT ON r~IN BUILDING AT SITE
CONSTRUCTION PERMIT # LC 2388-80
--
JOB ADDRESS: 175 Game Farm Rd., Eugene, Oregon 97401
TRS, TL: 17-03-22,4.4, 5900
SUBDIVISION: N/A
CONSTRUCTION APPROVED BY THIS PERMIT: 2nd story addition, bedroom/bathroom--
460 sq. ft. 2 plumbing fixtul'es. Valuation: $13,064.
Certificate of Adequacy.
CONDITIONS OF APPROVAL: No evidence of failing systenl. Addition vli11 not
encroach on existing drainfield. Certified adequate for proposed use.
Minimum structyral setbacks: (No change to existing setbacks).
PERMITTEE: Thomas Aldous
,DATE ISSUED: October 2, 1980
BY: Roger McGuckin/Colleen Allison/Carol Dya1
DIRECTIONS TO SITE: Take Harlow Rd, to Game Farm, left to 175,
Setbacks - Subsurface
Sewaqe Disposal
Septic Tank Drainfie1d
10' 10'
10' 10'
5' 10'
50' 100'
Existing or new SDS
specifications:
From:
Interior property lines
Edge of road right-of-way
Building foundation
Wells, other water sources
gal. min. tank;
feet of drainfield;
*************************************************************
max. depth of
trenches
l\
SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION
CAN RESULT IN REVOCATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LAN~COUNTY'S
INFRACTION ORDINANCE, AND/OR OTHER REHEDIES ALLOVIED BY LA\I.
WHEN READY FOR INSPECTION (see reverse side) call 687-4065. Have the fo110winq information
ready: Permit number, job address, type of inspection',Vlhen it will be\eadY"your name
and phone number, and any special directions to site.
Envi ronmenta 1 t,lanagement Department
125 East 8th Avenue / Eugene, Oregon 97401
, r -. "I-'''''''' ~'-~ -' '.- ,'. ":~"} '-".T.';~';'-'-":!~",,~r~"~';:""'~""".~"'':,,~~.''ffi~-~'''>:'~,~~:,
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y ~:;:;;-:;:;';~'."-~~.1%_"~:1."':~\:;;:;""')~~~~-\ft~.it,;:,~~;!.":2l't:i~~~.'t~~\: ~~".~:~-;<~~~::... ~'~-1.t~''i'-i'.~j"..Sf~ ~~~
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of ~.{"..-.
-r':'~ft"'" ';-"r~~ '. ..:~. :or~~""';' .t,.its:':r._.!~,:;-...........i~ :.<"t;r'" ".r.:;."',:.:,,-::.JrJ '1'>,.,..,.. .,...~~~: ;~,~.'-':I '...-,1~.',h..i~'....~~._...~~1
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. ~lit~;;."'":~~;:;;.:.~~:.~ff::;.~-&!}.:;::#~'tl..;:~::.,::..:~~.:.~[...;..l~.;~~~"'l,"t;..~{t:.t..~:!.:/f~~lV"'i.~...~€:'n:~?::~}..
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Mft.~ /1'1~.\. -rl-/rJI'r1AJ ALDCu-5
-'75 ("..,.A,..,t FARM Rr;~D
.sU.(?,~>JF /)Q.i:. 97'10/
T/h r ni" tv!J. /7-3~2;J.~'if.{.S'100
.
PhM,L~ ROOM
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ORq,Hw"Y
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PROP. j..,olE.
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DEPARTriENT OF ENVIIlOlII.iEiITAL I\ANAGEI'iEIJ.
PSB, 125 EAST 8TH AVENUE
EUGENE, OREGON 97401
I "~. I ) , I
I. \. . ';' I
Job Address 1'76-; 1("7/7 >v/ ("' i:A (,' ,.'1'1'.: r? D. :~f.fYi [1.1 (:/ f /,i,
~liil~I,~I~t9&~i~i~%i~L%&~~ii~e,~ ",~!7. ,~3 ';2). <I 'I' to~r i n o~;6~~i' I '1 u "
Application.for ;:~;/~:-',;~:~~\ ~ 'P'i If>,1fl\,''~ ,_, l':<'..;'\-/~
Structures now on .the' property':-:, . . J)~.! i~LL',J?~ /\/Ih._.\/ ! I
ip'i"o'''os11aYiJseTof'' r~llr'~'~'1 'rR;;;fil;iOt'i~ 1 -/ !tliiii1iilrc:f.m.' {} iifMiJ'SJi:\r~t!:1 0 :eJilUc::
,.....R.............,.........P.R..,..t\I.< . t2I ^<...,.......,~,~.l. . L c..,...,............"
Affidavit: I.:"--r;-i/l~::~~:;r. (.._...:S,_,:',<~,/:-...j)r/~~,/t t hereby certify that this information;s true and accurate.
. ,.', ' IpJ~~~~JP))Jn:tI." '... . . .
If this application is for an" agricultural building it will be used for purposes allowed by the State BUlldlng Code and
Lane County Code Chapter 10 (zoning) ,and <for: no o'ther. purpose. I have the following legal inter~st ln ~he property:
'<. owner of record;. contract purchaserj'.' . lessee; holder of an excluslve optlOn to purchase;
duly authorized,to act for the owner; who is 'knowledgeable of this application.
Signature/Address 'JA>~'l;_"';~-J ~,-:.$,"-_h~- .:0/"~-i~.f.:;:~:JI1'l;... ;::,)!_C~'2_-!_ ,<',)
-, -
Telephone 7</('''("0''(.,7 'or (,;'''7..'~9~,,,D Date
When permit is ready notify: /~ Applicant /~/ Owner /~I Contractor
Owner --1;'/>;);;.' '" ;-:i/l,'.) (';-'./i)/,Jl F /.)J_j:;'dr/ ('
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.r~JJ9'fi'~~x'@,MW~H~;,
=
~'d (.' ../I~ (zip)"'j 7V{J!
.c? '- ? <..~ ,.V<..l
Con trac tor
Contractor's OSR#
c. <;~ f ,"::
(zio) <//(/(1/
(zjol
Phone
Phone
Plumbing by
~:s ~::~::: ~ i l~!!~f~!~;if~ 'l( ~ ..l
SI test holes ready
00 NOT WRITE BELUW THIS LINE
p.,/; of emptyuo ees :~~f~f~'L~~~xistin9,
V' :3 IYY\ ., _
CI Proposed,
V~fi
BP # ~6-61\., N~
Sl # .. I '
Ieel
Code
l~:~g~.~~'~1f~~_
Valuation
lo~Tt1
'cohl
bt{$~ci1ftiiion1
~
~
~hMYYl j(-?vIth. h(~ n(1(lti1m\)
() f (.; -4(,i) ?A40
. --'
z
Total Valuation: S
I~~~wl~i~~~!~iti :: :
Subtotal
CI
o
Rece i ved by
4% State surcharge
Plans check fee
~<\ r ",- -" -,.-.........Jof-
&0-;5~3G2Oa~~CD
Part. #
~/
~€-p~j5pL1 ~
Use CIassification~~~_---------
Water Supply
Proposed
Year Ins ta 11 ed
Existing _
PERMIT PROCESSING
Minimum setbacks:
Zone
1., front
Parcel #
Parcel Si ze
V\/
1., side
; int.
Conrnents
lobe typed on per'nd t
A-b
CP~l
To be
Type (~
typed on permi t
,,1ly
A/M
/
~
Group
Fire Zone
/ Y (. f.' :;. (~ /
-::
Fee
$
$
$
$
$
each $
each $
$
$
rear
ihn
5/
/
-t:' / ~
By ,r?';/"C7"/ y ~ Oa te J-%J---W
For plans infonnatian call (area inspector) Phone
Oi rec t ion, to site -:td.k'..L J...( ~<J...w...BJJ_'L:,_.GfJf!JJ,';;IlI1/!')_--r:J1_I?.~tL'----.::I ()
17.::- r;,A1Ylf. (:J{JR.~j),
I-I slro Plans to: 'CP~I set\s~ Date Hoid Slip Date Date to
~ q,"d))
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,
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.
OEPARTlIENT OF ErlV I ROIli1E1IT AL IIMAGEMEN.
PSG, 125 EAST 8TH AVE1lUE
EUGEI1E, OREGOrl 97401
Job Address
/7 ,;:;- (:, A frI r::
r-: II ,Q ;1,
/7 01
;( JJ.
City
Fu r'-;I)'-AJr:~
Appl icatian .#
(......- '}:i (I "',_-/ \
__/'")f)( \- r\ 1_.1
-;'1.
As signed Numbers
Township, Range, Section, Tax Lot
Subd i vis i on r"~kr~l..1I.\,.f=-r:;~,,7.'fR~
---'
Application for' t.)hT-lrr,^Al - 1=<~J\/.'/,\...t. _'. I~..-r-IJ
Structures now on the property 1')/,1 ~ J I IF\...I,~ '.1 \~
Proposed use of property: Ij{ Residential () COllll1ercial
Affidavit: I, :"''1-,../1\,.,.-, H-i ,<:" ,::J 7),,,,,.'
. , (p lease print) .
If this application is for an agricultural building it will be used for purposes allowed by the State Buildlng Code and
lane County 'Code Chapter 10 (zoning) and for no other purpose. I have the followlng legal lnterest 10 the property:
V owner of record~ contract purchaser; lessee; holder of an exclusive option to plJrchase~
duly authorized to act for the owner, who is knowledgeable of this application.
Signature/Address "7/" ~ ..J/ .'''.-;. ';',' '," ..' '.Il ,.,t'..} (zip) 07'11'1.
~. T~lep-hone ~'{./;:'-I'j''Zl,~ or /.~("-;9"" .~('
..~ ").
I.L
(./ _J,:,', . I)" I
Lot
.:' ..""1'" 9/(1 .()~.
Block
=
() Industrial
c/ Pub 1 ic
, hereby certify that this information is true and accurate.
Date
"
'. -
"". r--_
..r"rJ
When permit is ready notify: /~{' Applicant /~/ Owner
Owner --r-1Jr-. ...........? C /J _dr'\ (1 '"'\ , l.A I ,s;: "1 1 /'-,,)
Contractor r: c:: I ;C
Contractor's DSR# Plumbing by
() Contractor
. ,
(zip)
(zip)
(", ,
'/" ,
Phon<l
Phone
(//.fC :->f.. 7
If Commercial: # of stories
Residential: # of bedrooms ;..., l)t {
SI test holes ready
DO NOT WRITE BELUW THIS LINE
# of employees # of units
(~i?, :3 (:/3"~\l~,\l) SOS: () Existing, GP #
J- I'"
,. C/ Proposed, S I #
, \ . r
\,1.",:,,) //'\JO-/.}~
. """.. ...,...} ~ ,\..............
,,;:, .(" ".\ .[, I A
. I \ " l'J . /- \,'
,
Fee
Code
Descriotion
Sq. Ft. or
# of Site:;
Unit
Cost
Valuation
Fee
$
.... "';'"Y()y r',(f"\f;['PJn\/r--;",I+h hn()nl nn((( l'lnn j $
'oj I) () , l j ...-:)(,...(' ) ell ;:;.p., <10 $
$
n
r.j
Total Valuation: $
Plumbing fixtures at $
Sewer/water conn, at $
$
each $
each $
$
$
$ I
Co..)J . Ch)' (]~o $ {t: }
r .,..... I
TOT AL_ "- $'
Subtotal
() Cash
C/ Check #
Received by
. ,
4% State surcharge
Plans check fee
Change"of-~~upancy_
:,')
Water Supply
Proposed
Year Installed
Existing _
PERI~IT PROCESSING
Minimum setbacks:
.Zone I:::<'A Part. #
~, front r:-..;:.,....." /
:1 -----
Parcel #
'i., side
into
Parcel SizE'
t-'\/
i .'.j
..'
/ i ,:,......) ....)
,/
; rear
'.-
Comments
To be typed on perm; t
. By
Date
WATER POLLUTIOII CONTROL ,
Installation specifications: gal. tank; ft. of drainfield; max. depth of trenches:
To be typed on permi t
II~ ~~ -{ (~<1,~...) 1\J,j:I,~ ,\.d' ,.,d. ~~'-0A'~,J-, (h yxi.,k~ JJ~0J.1..
('1JN-t~,.J nl""'; ' J.l \/lrl f1",nlN~ (J"".l..
Oirection5 to site
", - ~ ) .' ' "
Telephone r,p.f(/'i-,c1!>,-
. I ..' ? I I
Gy C_tlU..u;......>
~ ". I. J",
Date '\,-21'1- K'O
W,' lA t:' "Ii /. " r"j '/';"\
, '; -....
" J .I.
o SIFO
PldllS to: (PSI set(s)
WPC ===== set(s)
Da te
Rcqu ired
Hold Slip
to pee
Date
rnnmloto..l
Date to
Water Pollution Control
DiViSi. 125,East 8th / Public Service .ding / Eugene. Ore.
RECORD OF EXISTING SYSTEM
687-4061
DIAGRAM
l Sv.. (Y'o(JvJ:) ~" -?-<:J r
,
~ ,,(.2,,<,~
TWP. II RANGE <:>3
SUBDIVISION/PARTITION lJolJE
ZONING DESIGNATION ~A
OWN ER -r" 0'T'I.llS <;. ~ I d... Llf, ADDRESS l 7 5" G: (l/v'-C Y (J/VY'A '"i2..A.
EXISTING DWELLING NUMBER OF BEDROOMS 2. -.3 (d..tHl ^'j~PHONE ?'llo ,03"10 1
IF NO DWELLING EXISTS, LAST KNOWN NUMBER OF BEDROOMS SERVED(FROM A&T RECORD)
PREVIOUS SITE INSPECTIONS OR PERMITS ~
SEPTIC TANK SIZE lono GALLON CONCRETE S METAL 0 FIBERGLASSO OTHER 0
LAST KNOWN PUMPING DATE "",,1vx..<lV'Yl _
CONDITION OF SEPTIC TANK: SATISFACTORY
DISTRIBUTION METHOD: EQUAL
CONDITION OF DIST/DROP BOXES: SATISFACTORY
NUMBER OF LINES
LENGTH EACH LINE 1) ft, 2) ft. 3)
5) ft, 6) ft.
CONDIDTION OF FIELD: SATISFACTORY [] UNSATISFACTORY []
COMMENTS M.d..J,,-,,,-,J.>J~r.J. ~ CH>..~71M{1-. eYJ u;c..<0 ~~,
A-..ofL :..... n.lruial).o ~_W lH..fJrU:V. Jo O.J1 ion..Lt oJ. e,l t.k.t-
, ( I
SECTION 2.2.--+'1
TAX LOT
PARCEL
[;900
LOT
BLOCK
o
[]
[]
UNSATISFACTORY [] ~
SERIAL OTHER 0 (SEE COMMENTS)
UNSATISFACTORY []
ft, 4)
ft.
FINDINGS
1) This system is in compliance with provisions of Oregon Administrative Rules, chapter 340,
division 7 and is sized to accept a sewage flow of up to lfS;O qa110ns per day,
2) This system is not in compliance with one or more provisions of Oregon Administrative Rules.
chapter 340, division 7. /t /J()11 .
(' dJf(l/~ t ;{~ 9",7.-'1..- J1J
M74-176 ~!bNAIUK~ -' - .- UAI~U
.
BOLD
.
SLIP
bne county
-
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"
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- 17?~AME.~Bo.
~a~1
APPLICATION # Z,3e6-f!O
LOCATION 177' C!.AMl::: ~~
NAME
ADDRESS
I=:UGFt\...h;.
.
ZI P CODE
The above application is being hel or the following reasons:
~De- axjlt~Ff:'!f; ~1VI4" . \He: I>Cet-JAGY cP ~SjiN1 C/'<J2fV,e.r
f?l.j~ ~ lY'~p T?~' '(!:-T 2'1;J!2 vfQel Ar;,or)lCJ'J ' f:E~ :SH~( L...
:EI':'O ~Y'./v0 ~-J AtA~ CiZ- 'At0EE~, .
~Uilff\ WHe7fl~ e'xI~~ ~)~) ~ \.-e.<.E<"-Ql.. 2~LJ:'.tA:./... tli.:\~
~eA) <:::taeD. ~e..f'{..AJ'..J Cf' ~Ii' ~? ~ 5H:::>w AU-- t.::Y'ENlfVZr"5
~ <S1zt:.-"S q-~1VI"-G-;' lb ~ ~~.
U~rF\ J.bN' ~ ~ I~ p,>e ~~ ' ~ ~--
--I I ~oe ~t)C.,11c::N ~I ~)t.-lp. .~... -~
T,~r;e ~lcN ^,z:<~,-( I P ~ CtA-Z./p( I;=-LA'r-W
<:::Zi\)fC::e1.-\<719 ~'C !tJ~I~' "l2e.;s.iI~CIl- f2<'2'p-S.
Cl2- V~~ yeW: tt47
R. Ll,,'h/~1 JLlLliJ
SIGNATURE
M-1.'f:' {3~-:5
OFFICE HOURS
,/
Y')-9-f
DATE
C:f81- 40CI
- PHONE .
This application will b~ held until .")-Z9-~D ' If the inform~on required
above has not been furnlshed by that date your application will be cancelled.
Buildi~g fees paid for permits cancelled under these circumstances will be prorated
accordlng to the work that has taken place as of the ..date of cancellation...; ".
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BUILDING & SANITATION / ENVIRONMENTAL MANAGEMENT DEPARTMENT
125 East Bth Avenue / Public Service Building / Eugene, Oregon 97401 / (503)687-4061
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DEF'T E:NV MGT REC:::I?T ~'238880 !)AT::: 082680.
ADDR 175 GA~E FARM RD., EUGENE, DREGO~
LANE COUNTY
THOMAS
SUBDIV
U~E R r~~ BDRMS 82
AC7ICN D~SC~I?TIDN
A'="D TO D:'ELl...:~:G
2ND STC~Y ~~D~OC~I
P.ND BATHROOM
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SQ ~- UNIT COST VAL~AT:Q~
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FIXTURES:
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~jECHAN I C!~L :O[E
s-; t~ TE SUF~C:4:AF~GE
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~3J64
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COM?L:::TION DAT::: 0?2380
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69.00
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-""''-'0 ADDRESS /?S- _'"'~//.t/_~ft"'/C~~ 7- .?V~/
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OFFICIAL USE ONLY
TRS, TL/7-0 3. 22', c(. y
~ne county
~ CHECKLIST
~I~ PLUMBING/MECHANICAL
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APPLICANT INFORMATION: ;/r.:/ev., '/ pt'.,
7f;Uf'h&S \. r-lLJ)OLAS /7S.(SArne.r-/Jt;m tUGfr)t 97r01
(Name or Flnn-Please Pnnt) (Malllllg AddreSS) (Llty or lown) (Zlp ,Lode)
PLUMBING mNrRAcroR
o Yes Finn
Cont, OSR#
Appli./ '7~cPL
Pennl t # /~
Address
o No [B~lf
MEGlANICAL mNrRACTOR 0 Yes Finn Cont. OSR#
Address / _ ../
o NoD Self DIRECTIONS TO SITE /p:-j':': ,~~/.7/ ?~/~~
PLLJMBING .' &:..)q- / .7.s-~~~;:;;;-
Type of Fixture Number of Each Fee On Each Total
Sink
Lavatorv (Wash Basin)
Tub (with or without shower)
Shower, separate
Water Closet (toilet/urinal)
Dishwasher
Disposer (garbage grinder)
Washing Machine
Water Heater
Floor Drain
Sewer--lst 50ft.
each additional 100 ft,
Water Service--lst 100 ft.
each additional 100 ft.
Stonn and Rain Drain--lst 100 ft.
each additional 100 ft,
Special Waste Connection
Sewage and Sump PumP (eiector)
Mobiie Home Sewer and Water
Other (specify)
SUB-TOTAL (Minimum $10,00)
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$ 5,00
5,00
5.00
5,00
5.00
5,00
5,00
5.00
5,00
5.00
l5.ob
10.00
15.00
10.00
15.00
10.00
5,00
5.00
10.00
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, TOTAL FEE
Type of Equipment
MEGlANICAL
Number of Each
Fee on Each
Total
Mechanical Pennit Base Fee
Furnace up to 100,000 BTU/H
Furnace over 100.000 BTU/H
Clothes Dryer Vent
Bathroom Ventilation Fan & Duct
Ran~e Hood with Mechanical Exhaust
Wood Stove
Air Conditioner Only
. Heat Pump
Floor Furnace
Gas Piping System 1 to 4 Outlets
Per Outlet
$ 6.00
7.50
3,00
3,00
4,50
6,00
6,00
6.00
6.00
.50
Other (specify)
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$ 10,00
SUB-TOTAL
1 ccrt1fy thDtal1 plu~blng ~or~ ~111 be done In t
accordance ~lth applicable provlsbns 01 Oregon TOTAL FEE
Re~ised Statutes Chps. 447 & 693 and applicable c ""'''' 'UI" ~""~ IIU lie.... '-'", IJO:: l::I"I'IUY;;;" ]
unless licensed under ORS.693. . /'~r/ /
Slgnature"2L _ ( ,,::l..J1jL ~, Date /.-/ ~--R'"L Permit Issued by ~_ d/h?
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