HomeMy WebLinkAboutPermit Building 1978-9-11
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PERMIT #
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JOB LOCATION
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LANE Cciu~ITY PEFlIVIIT" t.
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Acreage or Lot Si7Q', I .:.
Contractor's O.S. # ' -
Partitioning #
i? (}-.j(Completed
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Subdivision /.'. ."J>-
Lot Bloc~
APPLICANT'S NAME AND ADDRE~C:; ;
OWNER'S NAME AND ADDRESC: -
CONTRACTOR'S NAME AND ADDRESC:
Mail permit to ( ) Applicant ( ) Owner ) Contractor, )'< ) Prefer to pick up.
,.TRUCTURES NOW ON THE PROPERTY.:,) ,..'
"THISPERMITISFOR .,', -.illf:'.)''/! :'._
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Phon~
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(owner, etc.) when ready,
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.' ~ 8EDROOMS~_~ PLUMBING CONNECTIONS2-.._
WATER SUPPLY,
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SEWAGE DISPOSAl
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THIS PROPERTY IS WITHIN ONE MILE OF THE CITY OF
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,PLUMBING BY
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I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: X. owner of record;
contract purchaser; - potential buyer; _ realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid <l: ' SignatureJl/ '" " , <..... '. {.. t' , , DatQ~>~; . (~
0'(1 NEW ADDRESS (A6') FACILITY PERMIT TO TRANSPORTATION DEP!,2==-- (vl'S~ECIAL PMT. AREA. MI~, ELEVATI~: A/A:)
SANITATION :3 b cfrJo",-, BUILDING
"C 'hJ Minimum Septic Tank Capacity (Gallons) (Jil1 Type of Construction f,'i // Group
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Drainfield Required. Lineal Feet ~, J-f) , 'se Classification
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..,JXlmUm ept 'I Comments 1 . t, '
_-.--Comments: CI)W':..!,..."'T .t;.'ltAd I J",t ,.b...f{"'.... ~J:' ~- 1-1. ar~tt.. . :';'0 _.... '
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By: -/ !~ ) Date: '7 z'; ~ By; Date;
PLANNING REQUIREMENTS SATISFIED. By: /.:" '_' , _ _ Date: //~/ /:,.':.~ Date Issued:
ZONE: -' SETBACKS: FRONT:' 'SIDE FACING STREET .' - (FROM C/L) INT. SIDE YARD.., REAR
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE" EUGENE, OREGON 97401
POST THIS PERMIT ON MAIN BUILDING AT SITE
BLDG. PERMIT - WHITE; BUILDING - GREEN; PLUMBING ~CANARV; SANITATION _ GOLDENROD; OFFICE COPY _ WHITE
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0' (F ROM PILI
PHO~~4394
C55-13
LANE COUNTY~EPARTMENT OF ENVIRONMENTAL~NAGEMENT
125 EA.8TH AVENUE, EUGENE, OREGON 9.1
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partlt~i 9 ( ~endin~~Plet;d
Parcol NO.a.. \. . ~
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PLANNING DIVISION
Otherl
~ATER POLLUTION C~NTROL
New Sit. InBpectlon(8)
SOS Construction [] New CJ Ropair
Number ot Bedrooms I
CO~strh.l -I' of Employees
Oth. ,,;"-...~ <0. ~~
'- cc:::......("":i<::....
I ot Sites
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CONSTRUCTION PERMITS AND INSPECTION
(See above for I of bedrooms/' of employees)
FEE
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:~obl1e Home'
$
o Per"manent
o Temporary
~"r\;J Renewal
~r ~\ 0
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Sq. rt~on
$
$
$
$
$
Each $
;=..) \-4
)( l.....C)
rotal V,luation $
$
\
~ Plumbing fixtures at
Sewer/Water Conn. ~t
r:ach S
Suhtota 1
$
$
:h\'-{O
4, State Surcharge
Phne Check Fee
Change of Occupancy
o
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TOTAL BUILDING PE~IT FEE
Minimum atructural setbacks: D:!-.r"""-
From centerline ot street: Front <:. ~)
Exterior ,ide _ ~\ j
FrOm interior lot lintts: Sid{!~ R(>a~( ')
[] Comm'l plans :h:~ t~PPlicant [J Curb ~t to applicant
PUBLIC LANDS ~89 .... ~mum Elev.1otion
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PUBLIC WORKS
Facility Permit
Ca8h
ENVIRON~NTAL ~ __
Ch.C,~-
FeE
AVERAGE PROCESSING
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If this permit is for an agricultural bui ing, I hereby declare that this building
or agricultural purposes as allowed by z 'ng and/or the State Building Code, and
ge. I further certify that the statements and other information submitted on
io ar true and accurate, and that I have the following legal interest in the
owner record; contract purchaser; lessee; holder of an exclusive option
y authorizeo-to act for a person wruo-has the lOIlowing legal interest:
.... } ; or that the owner of record is knowledgeable of this
apPUC8tirn if! not the owner. I further agree comply with all pplic<lble codes relatin9
to ~ pe mH.
Dat~ \ \.. Appl ieant' 8 Signature
;' YOUR RECEIPT, AND 00E5 NOT GIVE YOU PERMISSION TO BUILO.
FOR INF~TION ABOUT THE PROGRESS OF YOUR APPLICATIO~. CALL PERMIT CONTROL, 687-4357 (687-HELP)
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Written Directions l/2n,p .lo J,'Jj,IJ.2.'" - L~ !L.eI- J-o idu ~/ ~ /~u U ~ J f2'~/ k a....-d ff
INFORMATION SHEET 141- rill '{.I-k S,/ver DO/!Ir' ~A... T
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) Building Permit
) Site Feasibility Study for Septic Tank. Number of sites__
Acreage or Lot Size 5' tt C I" P of Test holes will be ready
Partitioning #W1 3/2 -J?.. ()4Completed Subdivision
( ) Pending
APPLlCANT'SNAMEANDADDRESS A!,,,"'-t ;j"".J,I?-I.. l/~'} )1l..~,.;./~ ~-"-""'. r)r-
OWNER'SNAMEANDADDRESS,ifdifferentfrom pplicant's I.,,~ T",;lo,> I'id,./9>,., <>,p-t;/,
NTRACTOR'S NAME AND ADDRES~ '
- II or resu;i:s or site }j,SIlJi'Lrii.~. '~~Iicant ( ) Owner ( ) Contractor,
W Prefer to pick up. Call ~ 'f . r wner, etc.) when ready.
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STRUCTURES NOW ON lHI:: t"HUf'ErW'Y' /y? ,., '" p ,
Lot
_ 810ck
tPf9-~II~
Phone fcRR-/tJ99
Phone
Phone
Contractors O. S. #
PROPOSED USE (this permit) TIIll'" hiP u)j/p lIl1t:>fJf~ JLJ"'e.. ..+--I.h~OO s'.1:l's'l! RPr1rnans-3
WATER SUPPLY O"'-J'o/7Ar.p./ 1,)17/ (existing or proposed well, etc. If public, name of system)
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SEW AG E D ISPOSA I () .../I n" (' ~ .I S'12-/7-/ : r (existi ng or proposed septic tank, etc,) S..1. '" 7 % - '>1(".2..
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PLUMBING BY
Address
f)4PROPERTYISWITHINONEMILEOFCITY( S/,..;H; [;/L-fe:! )
r*f'i*~****.*********************************OFFICE USE ONLY BELOW THIS LINE ****************.**********-11'******........*****
~2C\~ssarY ( ) Facility Permit Necessary ( ) Special Permit Area. Minimum Elevation
ZONF ---- SETBACKS: Front Side Facing Street Interior Side Yard Rear
(FROM CENTERLINE OF ROAD) (FROM PROPERTY LINES)
To: Planning/Building Inspector/Sanitarian/Surveyor.
This applicant appears to have a problem with
Your assistance will be appreciated.
By
Permit Processing Section
Response'
C55-12
By
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT
Permit Processing Section
125 East 8th Avenue
687.4394
Division
~~'RS TL/UrJ -()(g if). ~ 700
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Job Location (Street, mile post) <:?7o-=? ~ao-1~Y1 ..4o,o,n(/r=:
Subdivision, Lot Block'
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~m. Approved D System Disapproved
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D Needs Correction
FOR SANITARIAN'S USE ONLY:
COMMENTS:
Signature:
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Date//hh
FOR INSTALLER'S USE: Trench Depth .:J.. oJ
Tank Capacity 1000 Manufacturp, Eve, ~ h''''
Measured distance to well from tank_/l?t::l
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Filler Depth Below
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fro-m drainf~eld-,f S
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INSTALLATION RECORD AND CERTIFICA E OF SATISFACTOR" OMPLETION
When signed by the County Sanitarian, this certifi e is evidence as per (, 454.665 of sat.
isfactory completion of a subsurface sewage disposal _ stem at the ab{e ,0 ation.
Return this form to: Permit Processing Section, Departm t of 'l..r1.ironmental Management,
Public Service Building, 125 East 8th A.nue, Eugene 97401
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BOLD
APPLICATION ~/J7)/ 0797t'J-78
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c/,/ Zi P Code
The above application is being held by the Permit Processing Section for the following
reasons: 1/,. ,a.T"-<-L0-7{.(y/) /~CGLO/ '" &':Z~<2kj:l G,1 -.sD~<l.L-CZ'~V
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, ~d ~ vrtffun-1.-Q:.~'/1 0-,-. ~(]o./ /2.L.-o-n,
~-e'~ ~^_ lJ) .o.-H.,,^^L.6I J.-':'~,
Name
Address
Division: ///nh; ?,.f~"a'~"'/1 /?"',,-;hp/'
Si gnature: '--~,~/ -<'>_ .Lf~~.....,~.. Date /'l..:7"/7f?
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Division:
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Si gnature:
Date
7
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This application will be held until If the, information
required above has not been furnished by that date your application wi'll be cancelled.
Fees paid for was~e disposal systems (site inspections and/or applicai~~ns to install
the septic tank and drainfield) are nonrefundable. Some refund may be" made on the
building and plumbing portion of your application if cancellation is necessary.
In the event a Planning or some other long-term problem exists over which you have
no control we will hold the permit until the problem is resolved and we receive word
from you as to whether to proceed with permit issuance or process a cancellation.
,
,
C74-139
PERMIT PROCESS ING SECTION - 687-4394-
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PERMIT #
TRS, TI
JOB LOCATION
LANE COUNTY PERMIT
Acreage or Lot Si70 '
Contractor's O,S. #
Partitioning #
:;: (' '~Completed
Subdivision
Lot
Block
APPLICANT'S NAME AND ADDRESs
OWNER'S NAME AND ADDRESS
CONTRACTOR'S NAME AND ADDRESS
Mail permit to ( ) Applicant ( ) Owner (
. .
"
Phone
Phono
Phone
(owner, etc.) when ready.
) Contractor. ,( ~ ) Prefer to pick up. Call.
.STRUCTURES NOW O~ THE PROPERTY_
THIS PERMIT IS FOR
'f' 8EDROOMS~_;t PLUMBING CONNECTIO~i~
WATER SUPPLY
SEWAGE DISPOSA'
S.i. #
THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF
,PLUMBING BY
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: ~owner of record;
contract purchaser; - potential buyer; _ realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
Fee Paid c::
) NEW ADDRESS
SANITATION
Signature I ' Date
) FACILITY PERMIT TO TRANSPORTATION DEPT__-,--- (. ) SPECIAL PMT. AREA. MIN, ELEVATION: '
<
~omments:
Minimum Septic Tank Capacity (Gallons I
Drainfield Required - Lineal Feet
Maximum Depth
BUILDING
Type of Construction
"se Classification
Group
Fire Zone
Comments:
','
8y: Date: ~y: Date:
PLANNING REQUIREMENTS SATISFIED. By: . 'Date: Date Issued:
ZONE: SETBACKS: FRONT SIDE FACING STREET (FROM C/U INT. SIDE YARD REAR (FROM P/Ll
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE" EUGENE, OREGON 97401 PHONE: 687-4394
POST THIS PERMIT ON MAIN BUILDING AT SITE
C55.13
BLDG. PERMIT - WHITE; BUILDING - GREEN: PLUMBING - CANARY; SANITATION - GOLDENROD; OFFICE COPY _ \'VriITE
.
.
SITE INSPECTION
ApPROVED L:::7 DISAPPROVED L:::7 DATE
INSPlCTOR
REMARKS
FOUNDATION INSPECTION
ApPROVED L-I DISAPPROVrD L-I DArt
INSPECTOR
REMARKS
FRAMING INSPECTION
ApPROVEO / / DISAPPROVED C1 DATE
INSPI.CTOR
ROURKS
LATH OR SHEETROCK INSPECTION
ApPROVEO L:::J DI SAPPROVED L-/ DArt
INSPECTOR
R04ARK 5
FINAL INSPECTION
ApPROVED C1 01 $APPROVe:O C1 DATE
INSPEC.TOR
RE:MARKS
-?() tU> -r' ~ .-t? ~r t:h1...;:/.,.:t- _~-9-7 f -IP!I-
CERTIFICATE OF OCCUPANCY
READY TO ISSUE C1 NOT READY TO ISSUE C1 DATE
INSPECTOR
REMARK S
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PERMIT #
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JOB LOCATION ::-. l'/ :'i r:'Af<c1e/) 14./;::,
'-l,?-:.F: tiJ")"i',<I;;?K~Lf}I~('LL (14 --i'-JL~~/l'/ Ilve,-S" <//t f', 'c.~.i . ,<,
1~..t!.J.'~ t..:> ,.,l ~/rl'C J' oLI Ai" ...Jp~ '..
, LANE COU'NTY PERMIT __rr ( n - ~"'Y'. '
Acreage or Lot Si?O .::;- Ii-r, Partitioning #/1 "1/-?7(7.i>;r;JCompleted
Contractor's O.S_ # JV 1.- y/J/<.cd... ;;l-
APPLICANT'S NAME AND ADDR<=cocoAJ/l-ti C\/ IladA-F <;'- //;1\- \/II)I/{<': '/"r.J'.JJ&
OWNER'S NAME AND ADDRFC::C:: J "n,,",, f-t:';vL'C>/t ~,,"f,l,-,//Au<.- r /.~r~rI
.- - , J ...., .
CONTRACTOR'S NAME AND ADDRESC::
Mail permit to ( ) Applicant ( ) Owner ( I Contractor. )\.') Prefer to pick up. Call~r9'- -:1//:1.
"",,!.Me,!
. ,_STRUCTUR ES NOW ON THE PROPERTY _ hJ 0/1.1 &-
-THIS PERMIT IS FORJ),'u.l..l... Ode<" :Jt/)((;O'}:ok"I"'/!oAe
- /
Subdivision
Lot
-,i/ P?-
Block
Phon'" Lrr?_~'1 ~
,..-,....
.Rhone {?<;;:!--/{... ,.. 9
Phonp
(owner, etc.) when ready,
IAlfT)1t( <;;"'~'7'v '" SEDROOMS-3'..A PLUMBING CONNECTIO~;S:L __
,
WATER SUPPL y, ~) eLl.-
SEWAGE DISPOSAL S~.!J/' d .~v~r<"..&-1
. J
S.I.# ')-jj-<;'-S;:-,7.
THIS PROPERTY IS WITHIN ONE MI LE OF THE CITY OF /1) 11- , PLUMBING BY JV I/- ! 1'0.\( \"'\('11...)(-\
I hereby certify that the above statements are true and accurate, and that I have the following legal interest in the property: .X owner of record;
contract purchaser; _ potential buyer; _ realtor or agent. I further certify that (if not the owner) I am authorized to act for the owner of
record, and that said owner is aware and approves of this action. I hereby agree to comply with all applicable Codes relating to this permit.
FeePaid<:: 'lb,90 :- Signature/("'/I/J/i-iV'-lI /1o"'/~e5 Dato 9'////"79
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(X) NEW ADDRESS J'\b~) FACILITY PERMIT TO TRANSPORTA.!ION DEPT_~~ (v)'SPEC~AL PMT, AREA. MIN, ELEVATION: A/A'''
SANITATION -3 b r"J.'~')J ~~ BUILDING ",'.
I 000 Minimum Septic Tank Capacity (Gallons I IYJ J.I- Type of Construction /.1{ J.,/' Group '3 Fire Zone
~, .J -'~n .
I ~ Drainfield Required - Lineal Feet -" .-. "se Classification
\~ .'-''' Maximum Depth ,. _ ,,, "., Comments: 'T'~~l?'_,/-~~ ,~. ' --r.>.u-""...Y.; <:.c-.-"I, '.r','"
~C (~""'.'~'.6,,-t\"'Y'JL-.I.J.j:.1(l:.;~{..)..-./- .1 J~"" d '", _~ ..;"
omments. u".t'.... ~..:t; ~.>..,\--c;/;t,.-.. ~~-..,'J.-,;:;t,' ~(/_..-,..'-,.rc,,'
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Date: 'I /~ ,'/ /'f>
BY~~~~ ^ ~, ~u../
PLANNING REQUIREMENTS SATISFIED. By: DeJA/1II4 Lt::,f ;}/::/C5 () Date: 7"/// /?If/ Date Issued: C/--:) h.- 11r'
ZONE: I~;, ~- SETBACKS: FRONT.5!J' SIDE FACII\JG STREET 11Jf9- .(FROM C/U INT_ SIDE YARD.6-- REAR'@!)'(FROM PILl
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT, 125 EAST 8TH AVE" EUGENE, OREGON 97401 PHONE: 687-4394
pate: q - ?-&.. ?f-
C55-13
POST THIS PERMIT ON MAIN BUILDING AT SITE
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BLDG. PERMIT - WHITE; BUILDING - GREEN: PLUMBING ~ CANARY; SANITATION - GOLOENROD:.~OFFICE COpy _ WHITE
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SLAB fLOOR
PLUMBING GROUNDWORK
ApPROVED / / DISAPPROVED L:::7 DATE
INSPECTOR
REMARK $
GAS PIPING GROUNDWORK
ApPROVr.O /' / DISAPPROVEO L:::7 DATE
INSPECTOR
REMARKS
ROUGII PLUMBING
ApPROVfD L7 O'SAPPf,>OVCO L:::7 DATE
I NSPF:(T('tR
RCMARK S
f<OUGII GA~, PIP I NG
^~PROV[D L:::7 DISAPPROVED L:::7 DArE
IN5P[(TOP
F~tM^RKS
F'IN^L PLUMBING
ApPROVED
L:::7 DISAPPROVED / / DATE IN5Pr.rTOR.
(\ ... -- . j #~ .....of> ""/4 i", J..A-... 4'~ </f?- '?t?
V ~ (f ~ - .
f~[MM~I\ ~
fiNAL G^S PIPING
ApPROVEO L:::7 DISAPPROVED L:::7 DATE
IN'3P[CrO~
REMARKS
CERTIFICATE Of OCCUPANCY
READY TO ISSUE Ii NOT READY TO IS5UE Cl DATE
REMARK~;
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INSPfCTOP
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