HomeMy WebLinkAboutPermit Building 1986-2-11
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WCKEO:E8 I 3,
Lane County Authorization
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for:
FOR OFFICE USE' ONLY
Renew Temp. Mobile Home
Application/
Permit #
%S-R \P
"'WI'5HIP 17 I RANGE 03
S~BDIVISION/PARTITION (if applicable)
SECTION
22.4.1
I TAX LOT
4801
LOT/PARCE~ I
DOUT OF
PROpOSED USE OF PROPERTY
o Residential 0 Industrial
o Commercial D Public,
BLOCK
LOCATION ADDRESS
STREET
CITY
ZIP
2983 Game Farm Rd., Spf1d OR 97477
STRUCTurES CURRENTLY ON PROPERTY
Dwelling & TMH
DIRt.:L"TIONS TO SITE
Between Game Farm Rd and the railroad tracks.
uESCRIPTION OF PROPOSED WORK - BE SPECIFIC
DECLARED ~ VALUE
FRnf.~ ~MH 1051-84
:: OF BEDROOMS [If OF STORIES
O;~"NER I S NAME AND ADDRESS
Donald & Erma Hartwick
CONTRACTOR'S NAME AND OSR #
I If OF ENPLOYEr:S
\~ATER SUPPL'i
D Proposed
n Existing
TELEPHONE NUMBER
TELEPHONE NUMBER
P':;RNIT TO BE MAILED TO {NAME AND ADDRESS)
TELEPHONE NUMBER
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION "'OR PERMIT, arId do horcuy cert.ify t.hat: all information hereon is true and correct, Ilnd that I
have the following legal interest in the property: Downer of record; 0 contract- p1U:chaser; Oauthorized agent.
I f:.:rther certify that any and all work performed shall be dOne in accotdanc& with tht! Ordinanct!s of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will be made of ani:' st.ructure without the permission of the Building Division. I fur-
ther certify that rcgistration with thc Builder's Board is in full force and effect. dS rec;uired by ORS 701.055, that if exempt the basis for exemption
is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used On this project. I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY.
Donald Hartwick
NAME (please print)
Bv Mail
2/4/86
SIGNATURE
DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION ~AS BEEN BASED ON THE FOLLOWING CONDITIONS!
Kl PLANNING/ZONING: Zone
parti tion #
Parcel #
parcel Size
Minimum Setbacks: eL, front
CL, side
interior
rear
CO~"ENTS, This permit is valid until 1/1/88 or until hardship c:a::~~~i~~(~omes fir~
o SANITATION: S. L H B. P. H Installation Record Issued? 0 Yes DNa '(
Installation Gallon Lineal Feet Maximum Depth
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Pl.) E IN 10: Type}" Gr rr- U ..r-
COW1ENTS:
Date:
n
: rv<7~ ~J'.r: .;z~ II-/t
~P~T APPROVED BY BUI~G OFFICIAL/DESIGNEE (oer ORS 456.805(1)) DATE
LANE COUNTY DGPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SRR RRVRRSR FOR TNSPRr''T'TON TNF'ORMA'T'TON
n'l/_ ....~ Ol:Ll
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SETB;,CKS ASD OlliER CQ::OITIO::S OF APPROV"IL ~:UST BE STRICTLY OBSERVED. VIOLATIOX CA~ RESULT IN REVQ-
C..7IO" OF illlS "ER~ll'i', CITATIO:l UNDER PROVISIO:JS OF LA:>;E CQU:>Tl'S INFRACTION ORDI::ANCE, A:>JO/OR OTHER
REMEDIES ALLOWED BY LAW.
WHEN READY FOR r::SPECTION. CALL 687-4065. A ~IINHlU~l or .;, LEAST 24 !lOURS '\OVAl,CE NOTICE FOR INSPEC-
1'10" Kt;Ql.;t;STt> ~jUST fiE GIVEN. Have the following information ready: permit number, job address, type
of inspection, when it will be ready, your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED INSPECTIONS:
L
Foundation Inspection: To he made after trenches are excavated and forms erected and when all
rnatcrldlS ~or tne raundation are delivered on the job. Where concrete from a central mixing
plant (co~~only termed "transit mixed") is to be used, ~aterials need not be on the job.
2.
Concrete Slab or Under-Floor Inspection: To be made after all in-slab or under-floor building
serVlce equipment, conduit, ~lplng accessories, and other ancillary equipment items arc in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3.
~raming & Insulation Inspections: To be made after the roof, all framing, fire blocking, and
raCing are in pLace and alL pipes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
'.
Lath and/or Gvpsum Board Inspection: To be made after all lathing and gypsum board, ;.nterior
ana-eXFCrTOr, 1S 1n place but before any plastering is applied and before gypsum board joints
and fasteners are taped and finished.
5. ~ Inspection: To be made after the building is complete and before occupancy.
APPROVAL REQUIRED. No work shall be done on any part of the building or ttructure beyond the point
indicated in each successive inspection without first obtaining the approval of the building official.
Such approval shall be given only after an inspection shall have been made of each successive step
in the construction as indicated by each of the inspections required.
NOTE: All building permits require inspections for the work authorized, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, hut before any grout is poured. This
In$pectlon is required for each bond beam pour. There will be no approval until the pl~binq
and electrical inspections have been made and approved. .
B. wood Stove: To be made after completion of masonry (if applicable) and when installation is
co~pl~ Installation shall be in accordance with an approved, nationally recognized testing
agency and the manufacturer's installation instructions.
C, Mobile Home: An inspection is required after the mobile home is connected to an approved
~or-septic system for setback requirements, blocking, footing connection, tiedowns,
skirting, and plumbing connections.
1. Footings and piers to COmply with State foundation requirements for mobile hOmes or as
recommended by the manufacturer.
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-
plain management letter.
J. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
O. Swi~~inq Pool: Below grade when steel is in place and before concrete is poured. Above grade
when pool 1S installed.
APPROVED PLA~S MUST BE ON THE JOB SITE AT ALL TIMES DURING WOR~ING HOURS. THIS PERMIT WILL EXPIRE
IF WOR~ DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION ~~y OCCUR IF THIS PE&~IT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POIl<T or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SE~AGE DISPOSAL ~:
1. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installation record form. The Department shall inspect the construction to determine if it
complies with the rules contained in this division. If the construction does comply with such
rules, the Department shall issue a certificate of satisfactory completion to the permitiholder.
If the construction docs not comply with such rules, the Department shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. Failure to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
lation of ORS ~S4.605 to 454.745 and this rule.
. Setbucks - Subsurfuce
from:
Interior property lines
Edge of road ri.qht-of-way
Budding foundation'
Wells, other water sources
S~waqe Disposal
Septic Tank,
4 .....---=..l.
10'
10'
5'
50'
,..DroJinfield
10' '
10'
10'
100'
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'~ 405B6 DATE 0205B.
RD., SPRINGFIELD, ORE
LOT BLK
UNITS 001 STOI~IES i~BLDGS 001 PHONE 999 999S'.
ADDR 29B3 GAME FARM RD., SPRINGFIELD, ORE,..
SQ FT UNIT COST VALUATION FEE DAYR
.~
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LANE COUNTY DEPT ENV MGT RECEIPT
APPLICANT HARTWICK, DONALD ADDR 2983 GAME FARM
TLO 1703224104B01 SUBDIV
.NroW m.DG TYPE USE R BDRMS 0
OWNER NME HARTWICK, DONALD
CODE APPL NO ACTION DESCRIPTION
.BP
Bt-'
BP
.BP
II fJP
.F'L
MECH
SUf(
.F'CI<
HH
SDS
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OFIX/BATH:
SWR:
FT. WTR:
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
FT.
f(AIN:
FT
.
4%
2~5%
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LC
405B6 TMHR
SDSC
25..00
60.00
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AP.F'
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BY JLB
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SDS
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PCI<
OTH ISS
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TOTAL FEEH'
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10
B5.00 CI<
,2
EST. COMPLETION DATE
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'APPLICANT:
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MAILING ADDRESS:
Marcy Tigner
2983 Gam e Farm Rd.
Spfld OR 97477
CITY, STATE, ZIP:
RE: Temporary Mobile Home Permit Number: . \ \)S\ -5<'-\
Map/Tax Lot No.: Vi-\)?'-3d-l.\\ \L\'9.nl
1) Person with medical hardship
2) Person providing care 'C>""v AL\',.
INFORMATION PROVIDED BY THE APPLICANT
to,~) Htffl~
J./fJ r... flU I c.K
3) Famiiy relationship of the above
SON
4) Resident of the principal dwellinp; ho,vAL-i'I J.iAA.rt.UfCK
5) Resident of the temporary mobile home 2n/VYlL1./ II anr~./
6) Signatures: f/)/l'V,4.1 #MJ(--u,:...),. Date: r2/Zz./g'~
Pe~n with Me. dica.l HardshiPJ.1 I I '
W~J)O J/~JSI Date: r'/2Z-/&'S-
Person Providing Care' ;r .
INFORMATION PROVIDED BY THE PHYSICIAN OR THERAPIST
1) Name of patient .EN /VI A flA PT /1// CJ(
2) Nature of the medical hardship ~ (;~./Y'V1(
> I
3) Does this hardship necessitate that a J;amiJy.}"ember pr
Please comment: ,~ ' -frJ~
,~0f ~ ~ Df/2
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City, State, Zip:
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/)~~'~1 . Date:
&e:d/"--4tL /~~ 0/ ~
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efiBWf ftlJie c7 L?71 ~ f7.7 Y}7 /'
-c:::;7 / C7
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4) Physician's Signature
Mailing Address:
LAND MANAGEMENT DIVISION / Public Works Dept. / 125 E. 8th Ave., Eug. OR ~7401 (503)687-4061
~!w._
Marcy Tigner
2983 Game Farm Road
Springfield, Oregon
Land Management Division
Public Works Dept,
125 East 8th Ave.
Eugene, Oregon 97401
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