HomeMy WebLinkAboutPermit Building 1978-6-16
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LANE COUNTY PERMIT
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FOR:. PERMIT NO.
CONSTRUCTION [] MOBILE HOME [] PLAN REVIEW [] CHANGE OF OCCUPANCY [
o Owner
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ADDRESS CITY ZIP CODfo ~_ P~E .
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ADDRESS CITY ZIP CODE PHONE--
NAME
,0 Contractor
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NAME
O.S. Reg. #
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Range
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Section
Tax Lot
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Census Tract
Subd ivision
Lot
Bloc~
Acreagp
Width
Access to Property (Road Name).
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Depth
Existing Structures on Property:
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Directions to Property - Address:
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STRUCTURE (# BEDROOMS)
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VALUATION
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SEWAGE DISPOSAL:
PUBLIC [] SEPTIC TANK [
BUI LD ING
PLUMBIN(;
3% SURCHARGF
MOBILE HOM"
WASTE DISPOSAl
PLAN REVIEW
OTHER [ ]
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PLUMBING INSTALLED BY:
OWNER I I 0TH~R. I] ~IAMF
WATER SUPPL Y: PROPOSED [ ]
EXISTING []
[ ] PUBLIC
[ ] COMMUNITY. NAME:
[ ] PRIVATE WELL
[ ] OTHER. SPECIFY:
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CONSTRUCTION PERMITS & INSPECTIONS AND WATER POLLUTION CONTROL SPECIFICATIONS
MIN. SEPTIC TANK CAPACITY:
GALS. .MIN. DRAINFIEL\l
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,.MAX, TRENCH DEPTH
INCHES
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TOTAL
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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
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AUTHORIZED SIGNATURES:
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ISSUANCE DATE:
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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
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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
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FINAL INSPECTIO~
ApPROVED ls;;z! DISAPPROVED Cl
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DATE 6//~ht"
REMARK 5
CERTIFICATE OF OCCUPANCY
READY TO ISSUE Cl NOT READY TO ISSUE ~ DATE
REMARK 5
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INSPECTOR
INSPECTOR
INSPECTOR
INSPECTOR
I NSPECTOR~f
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INSPECTOR