HomeMy WebLinkAboutBuilding Miscellaneous 1980-12-4
, .-
~ ~ INS P E C T ION ~ 0 R D
.3703 ~ rAtX'.soLd ,/
TOWNSHIP RANGE 'SECrIO~ TAX LOT
/9 (;.;2 ("X... </. 02 700
SUBDIVISION/PARTITION LOT/PARCEL
--
.'
OWNER'S NAME AND SITE ADDRESS
/Jux:fi/ ~7
CONTRACTOR"S NAME AND ADDRESS
# BEDROOMS
# PLUMBING FIXTURES
Seri a 1 Equa 1
SDS INSTALLATION
SPECIFICATION:
Ga 11 on Tank
Ln. ft. Drainfield
Max. trench depth
New ___ Repair ___ Alteration ___
DIRECTIONS TO SITE ~/./.-<Jf "W &
A~ /7r'7.A'_~~ n/II //L///~,,/ 'P
INSPECTION~PE APV/DISAP~' DATE
# EMPLOYEES
SECTOR
-.
FIELD. CARD ~
PERMIT NUMBER
..3.:2 02 3- go
BLOCK
TELEPHONE NUMBER
//J k'P- 97..;//
I TELEPHONE NUMBER
WATER SUPPLY
REMARKS
CL, front
CL, side
I~or
,1";<,
;) r,
Sf
MINIMU~l SETBACK
r-EQUIREMENTS:
.&.u ~I d ,A,(}Q/
07/' .:: </7c.J. 0 I
~x3{j~_ ~
~_-1_'lul %2/ :1l~ r{.. 1~
t/ (7 ./
J7.~A
@
~ ,
.
r'
,
,
"
.
(2-S--8Z) ~ VtC: ·
.
.' y:d-~z ,e)k
,.
L
.
~
-
.
'. 'Ck:;:.,'/U.?A /'.-$/
.. . FLOODPLAIN ~lAUAGENEf
, Depar,tment of iWironr.lentill' f1ana'gement/125 East AIle., Eugene, :Oregon
:"::':);;(iHi:ii}V!'(~:'>< 687-4357 .. " :':1
., 'i~'.Datey,;,:,',:,!/'-2~-&::> B~ !J.U
':(~)1:;:Tg;i\AMr'''! , :: . '
. "P',"ll,;";:;,.,,,.fia penmt Processing
.....,'~:.~:.;t:..~jj.;:f~,,~:!;::',.?, 0 :', .:' '.
';) 1"I~,;.l,~,.,h';' ",,"', Plann1ng
:;,~~;f','~:~?~iil\UF:',\:,~ .: "'.
"!",;,;i':.rH';'~;;~"";,;,, ::, ~ Pub 11 c l~orks
'r!;' . ',t,..",.,,,,,,,...,.. "". H
'\'.I~~!":,~~~I':"'~i~ :~,~,,'! .,. ',' ..' .
".! .~' r It '. t,': It ,J ,,'
)~,~, i:~\;!::/ A~p 1 i cant Name
" ~ I . . f 'I . .j
. ,. .
";,.."""""''' . ~,..- ,- ".,
I', f .' .-
..:r, .
~. i
~ '~l
',. ,',
;; t'.t.:"::;,'
, '
, .
::;'.. <.<>/,.:.
.', "
- Addres s of site
SFD
-P A \hn J. FN /,? ,~)
,370 -=) GcA 'k: (0' F.,C::! )\\!.-'~_
rUL ADD. COMM.
o
,0
[J
o
o
.~
, ' r-..J
o
CA0~)
Approximate flood hazard study area, extra precautions may be appropriate to
assure that the building site will be reasonably safe from flooding. .
.Detail flood hazard study area.
'Mobile home tie downs required.
Substantial improvement.
,site in ,"egulatory floodwa.v channel, building prohibited unless it is demonstr'at
that the cumulative effect of proposed de{elopment .!ill not increase the base
flood at'any point.
BASE FLOOD ELEVATION + l' =
this elevation required as
I
472.0
cFccke(( be'fow.
, (MSL). Certification ~t or ahovs
\ ~('71 (;0, f' ',:>r -c:-,,,c,. .:;;:{ dicf
-. ~
OTHER
**********************+*********************~*******************~*1:*****~****~********~*****~*;
.l
,~".
"~:("""
I!\('{"'.:'
;~~,{~';rt~'.~ c';,,".'
r.H~", ~'''JJ:,.,.(\. \
j~~~;i-~;~:~i~~;~i!::::;,~t1
;,J.' -".. "
~
CERTIFICATION OF ELEVATION
I, D.41J/J3 ,;;: C;'//',AIAJ0r.J/'J , a Registered Professional
L/1/,/J;? 5,t./EVL"Y:'J/" in the State of Oregon, do hereby
certify to Lane County, that the following elevatio~ represents a survey
made' by me or uii'd!!'r, my 'supervi ,ion.
~; ,. "
The foundation elevation (including
. r '
,The ground elevation thlt,structure
The first floor elevation -
The elevation of the top of floodproofing =
Other
~
,
,
"'
r
\
D
~
D
o
D
basement slab) =
will be placed on -
/,t 75-,f3'
, (r1SL).
(~ISL): ~
,
, (MSL).
, (MSL).
I
r ,./. r>- -? 7/ 1/41.-.l/'"
Reference Bench Mark -NO'. L.--177-' 0;- -;-;/;'::'/A.V:,;::;c;tP _v:!'?:r,oJl- '/2/Ck./?nv/J-'...J f
Location-;:W?CJa'. (,-;;",,:-' :J9rJ/ ,4- .e./Z#Mt0/17 '
///~"/_ /'..- r I ,/::, /-->
t:...-/-t/ ;~.,L;.L-L:V7 .I.;;, r'_J>t-J."..)..c."c /~<./ ;r;~?.r- r:9...L.:- L-L/.--e.-?
-" 'Jlr'
Signature 1..-"'/,-dT.c, .l'- \ LlIA-""~,~'-,~_.
Date /2-.~ -;;::l.,.;'
#
SEAL
REGISTERED "r
PROFESSIONAL
LAND SURVEYOR
Original to be certified and returned to Lane County
Floodplain Management
1st copy with appl ication/inspection
2nd copy to applicant
3rd copy to Floodplain Hanagement
~r/;;~ ~~
\,
"
"h;
."
OREGON
NV;-.,ll'''
DAVID S. SWANSON
... 1103
'-").'
APPLICANT GERL, SHARON
..rLt 1802064200700 SUBDIV
. NEW BLDG TYPE MH USE R BDRMS 2 UNITS 001 'STORIES tBLDGS
OWNER NME ADDR
~~OD~ APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION
BP
aBP
~P
" BP
LANE COUNTY DEPT ENV MGT RECEIPT 0
AD DR 3703 GARDEN AVE.,
.
6983, DATE 011983
SPRINGFIELD, OREGON
LOT BLK.
001 PHONE 686 9263
. FEE
DAY"
.
~HLC
~HPL NO.
MECH'
SUR
.PCK'
SDS
.sUR
~P
69B3 MH
FIXTURES:
NO.
CONNECTORS:
MECHANICAL FEE
STATE SURCHARGE
Pl.AN CHECK FEE
15.00 EACH =
.CATG:
, ',SEQU:
.TAKEN
APP
o
BY RLH
RA
FP
1
EST.
SDS SI
PCK
2
OTH
ISS
3
TOTAL FEE**
62.50 .
10.00
2.90 .
10.00 , , ,
5.00 .
10.00
.
.
4
100.40 CI( .
.
4::::
0::::
SDSC
COMPLETI ON DATE
".
.
j0 . A):.' ~~OZ~rA'-~2"t,,47aT.~ml=.._"..~ftll;~ rtc:;~~
.:--" . LANE COUNTY~~SPECTION RECORD I~ed)'~'; I /ZO/g 3'5
O~' S NAME (' I PHONE NuMBER '
QJVn c )~(
C~rRFCTOR' S NAME AI/". PHONE NUMBER
":-ZL~ o..s r-'OVc:..
-rf ~~~~/~~~-~~T~lDE INTERIOR IS REAR 2.0 #PLUMBING FIXTURES
~K AUTHORIZED BY PEIQiIjF-. ,~ . J h'
YldCJJ. VY/liJ'L, Of- VYf)r.) I /? nVYI,:? ,
PlflECTIONS TO SHE . {) I . - . I /1. __
4~/JO in J..6pu- -fqJ) nffJht- ill UMM'cJ /' l. f.A.-+1c-r mCld
erd CyytD Gcu--den \ fu.x-Vi n'(l(hL. -R-rST- L. Drl dn' u-f_
.~Y~~S Cft-rdeYi./ Aue.... 50~.' _ f0.JrJ. PERMI~B_E~3
Rl6TlNb Tr~flTIGN IrCf:C;:X'; OR MOBILE HOME ~./INSPECTION M .
Approved Correction Disapproved Date2-, _'X~ Inspector
. I _ '---
CONCRETE SLAB / UNDER-FLOOR INSPECTION
Approved Correction Disapproved Date
Inspector
UNDER SLAB / PLUMBING GROUNDWORK INSPECTION
Approved Correction Disapproved Date
Inspector
ROUGH PLUMBING INSPECTION
Approved Correction Disapproved Date Inspector
FRAMING INSPECTION
Approved Correction Disapproved Date Inspector
INSULATION / VAPOR BARRIER INSPECTION
Approved Correction Disapproved Date Ins pec tor
LATH / GYPSUM BOARD INSPECTIoN
Approved Correction Disapproved Date
Inspector
FINAL PLUMBI~ INSPECTION
Approved ~ Correction
Disapproved
DateU4-f~Inspector~ _
FINAL WASTE DISPOSAL SYSTEM
Approved Correction
FINAL INSPEC}ION BUILDING
Approved l/ Correction
INSPECTION
Disapproved Date Inspector
MOBILE HOME / J a..
Di sapproved Date 2. -I':f~ ~~ I nspector C'~~
CERTIFICATE OF OCCUPANCY
Approved Correction
Disapproved
TEf1PORARY CERTIFICATE OF OCCUPANCY
Date Inspector
Form C74-197