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HomeMy WebLinkAboutPermit Building 1978-6-16 ~ . JOS LANE COUNTY PERMIT ,;;3S" .3 ~ ~I1MJ! Rllo, /(o-f FOR:. PERMIT NO. CONSTRUCTION [] MOBILE HOME [] PLAN REVIEW [] CHANGE OF OCCUPANCY [ o Owner '~,.. : ,~' ~ '. ",-', ,. , .. - >\~ 0- c.'.-.,...., :1: .; ',:",-,J,) vi ,.....J \.,1 ., ADDRESS CITY ZIP CODfo ~_ P~E . ~ <Ulr. .r. /7 .....,....... ADDRESS CITY ZIP CODE PHONE-- NAME ,0 Contractor ,., NAME O.S. Reg. # .d Twn , .. Range . .. ,.. Section Tax Lot t -'-, Codo .,-" Census Tract Subd ivision Lot Bloc~ Acreagp Width Access to Property (Road Name). "'" I Depth Existing Structures on Property: .."."\ Directions to Property - Address: r'L:~' (~ ~\&W ~ ......,-,. ~'1 ,'., I ',:~.,' ;'j STRUCTURE (# BEDROOMS) , ,."/",;", .-:~. ~'>. so. FT. VALUATION 'f' ., ,', ';',~: : ," .~' ;'i'c:~"";'~ ~~l;i)"':' SEWAGE DISPOSAL: PUBLIC [] SEPTIC TANK [ BUI LD ING PLUMBIN(; 3% SURCHARGF MOBILE HOM" WASTE DISPOSAl PLAN REVIEW OTHER [ ] ,." 'j . .' PLUMBING INSTALLED BY: OWNER I I 0TH~R. I] ~IAMF WATER SUPPL Y: PROPOSED [ ] EXISTING [] [ ] PUBLIC [ ] COMMUNITY. NAME: [ ] PRIVATE WELL [ ] OTHER. SPECIFY: J ~~ ,. . o ,. ,. CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS MIN. SEPTIC TANK CAPACITY: GALS. .MIN. DRAINFIEL\l '1 ~,-, . L,It'J.. FT.. ,.MAX, TRENCH DEPTH INCHES vi tJ1 vi VI ()) ;r;> ~ ft) <11 J> 1 o TOTAL .J '" .i. . .. TYPE OF CONSTRUCTION GROUP FIRE ZON" STAY 100' FROM ALL WELLS USE CLASSIF. SETBACKS. FT. FROM CTR. OF r!W: FRONT SIDE EXT. FT. FROM PROP. LINE: SIDE INT." REAR ZON~ AUTHORIZED SIGNATURES: /sl .. ." .:.1. ;d.~ ..I. ;,: ~ ,... . ISSUANCE DATE: t, I.. BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD IMPORTANT: 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 for subsurface sewage disposal and the State Plumbing Code. All buildings require a certificate of. occupancy before being occupied. (See Details on Reverse Side) (POST THIS PERMIT ON MAIN BLDG, AT SITE) C55.\3 LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 . SITE INSPECTION ApPROVED ~ DISAPPROVED ~ DATE REMARKS FOUNDATION INSPECTION ApPROVED L-I DISAPPROVED / / DATE REMARKS FRAMING INSPECTION ApPROVED Cl DISAPPROVED / / DATE REMARKS LATH OR SHEETROCK INSPECTION ApPROVED ~I DISAPPROVED I / DATE REMARKS b//J f.,{" tf./J Ie h> I-,>.;.a-k> FINAL INSPECTIO~ ApPROVED ls;;z! DISAPPROVED Cl a'D DATE 6//~ht" REMARK 5 CERTIFICATE OF OCCUPANCY READY TO ISSUE Cl NOT READY TO ISSUE ~ DATE REMARK 5 "'III . INSPECTOR INSPECTOR INSPECTOR INSPECTOR I NSPECTOR~f - INSPECTOR