The URL can be used to link to this page

Home My WebLink AboutPermit Building 1982-4-9 ~. APPlicat.iOI'l r:::J':l..~ ~ Perrn~t #t (' t~ r'l 7 QU o Two Copies of Plans COHPLETE THIS BLOCK. PLEASE USE BLACK INK AND PRINT. [] Two Copies of Plot Plans TOWNSHIPt-7" J RANOGE?. ISE7j~.4.4 j T~~rrJ:JOUTOF []Mechanical Checklist I ~ Cj~ ~ L~ [JPlurnbing Checklist SUtl~JO~tRT~o~(;;"a.PPj~~keICLD ...___1 aJL LOT, r~~RCEL I B~K r-~ ~ ~ I~~ ~ ~ [JPlan Check Info Sheet L3>,~Ac:....DDRESS I ~~0 f(J.()"'3.'7'O I I I . C,---.'<ZT':-I ZIP PROP~ USE OF PROPERTY ~~~:J l-J r?~ CJ~ ~L-J~ [!Residential [Jrndustrial ST~u~r1?-rLLnN.' uJl.LLlh' u DConunercial Dpublic DE~tcirPOS~ckb) vt 'QuoJ-QYL I~ # OF B~OMS I "" OF STORIES I ~ES r -t~A~ ~~PLY / _ "'v-l,*-^ ..... ~po~ed ~ I ~ rx..1.. lJl..J-L.tJl.Fl Exist~ng ~WNERr ~AME(r ;r;;; I HLunt) XfJ5 ~ ~~ J~ ~7NUMBER Mr....:..R.nA>~ Af"~:'~ /tl_^ '~.~~ '- TEi:EP.!!?3'~ NUMBEH ~CLr ( .1)Y\ ~d...-v,,-~. .111 W.VJ- (119\ ~I -4m-7ct33 -lr$Z'ILt' I 'i")''''' HAL ~ ~~ ~')~~ ~,~r:.,~~~";,,,?i:.~~.~ ~"~,(jj,,~tr!,~!Zl '.,~;, ....", certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the Laws of the St<lte of Orc.pn pCllaining to the work described herein, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I furthl]r cnrtify that. registration with the Builder's Board is in full force and effect as required by ORS 701.0S5, that if exempt the basis for exemption is notr:d hereon, llnd 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. CONSTRU~ION/PLACEMENT . 1/ Z. FOR OFFICE USE ONLY PERMIT :IlfP G~AAtJ r It' NAME (please print) d/~f0 DOWner ~ontracto= ~ent o PLANNING/ZONING: Zone I\( A Partition # Parcel It Parcel size Ninimum Setbacks: CL, front Conunents: CL, side interior I'li'~ }J 01J 1 kiJdJ Date: rear Date: n n o o o o FLOODPLAIN: In flood hazard area? D No D Yes, see attached sheet. RURAL ADDRESSING: GRID COORDINATE N E Date: SP.NITATION: s. 1. It B. P. " Installation Record Issued? [] Yes [] No Installation Specifications: Gallon Tank Lineal Feet of Drainfie1d Maximum Depth of Trenches Comments: )xlPLANS EXAMINATION: Comments: Type St.J Group ~ J D use_~IJ/Ltkf~/~~. Date: Date, ~v'1!___ 0 CONSTRUCTION AUTHORIZED BY THIS PERMIT Description Sq. Ft. Fixed Fee/ Unit Cost Floodplain Subsurface Fee $ $ $ $ $ $ $ $ --b .5Vv Fees l ~ CYl/nO/ 2f I ICUll.tp Building Fee s~/storm Drain/Water ~Plurnbing Fixtures t-1echanical State Surcharge S2~ d C/...../ $ ;(-"~ ss- FEESB::ID~/~/ _ Date'~ WYL- ~Z~~ DATE TOTAL FEE Plans Check Fee ~ cft?~&t/~ jZJ~ M/f4UJJAJ PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.805(1)) LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT / 125 EAST EIGHTH AVENUE, EUGENE, OREGON TOTAL VALUATION $ 97401 C74-194 SEE REVERSE . . ,.. ....' ~ SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATION OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOWED BY LAW. WHEN REAOY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST MUST BE 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: REOUIRED I1ISPECTIONS 1) FOUNDATION INSPECTION: To be made after trenches are excavated and forms erected and when all materials for the foundation are delivered on the job. Where concrete from a central mixing plant (cormlonly termed "transit mixedll) is to be used, materials need not be on the job. 2) CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor building service equipment, conduit, piping accessories and other ancillary equipment items are in place but before any concrete is. poured or floor sheathing installed, including the subf100r. 3) FRAMING & INSULATION INSPECTIONS: To be made after the roof, all framing, fire blocking and bracing are in place and all pipes, fireplaces and chimneys and vents are complete and all rough electrical and plumbing are approved. All wall insulation and vapor barrier are in place. 4) LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place but before' any plastering is applied or before gypsum board joints and fasteners are taped and finished. 5) FINAL 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 structure 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, but before any grout is poured. This inspection is required for each bond beam pour. There will be no approval until the plumbing and electrical inspections have been made and approved. B. WOOD STOVE: To be made after completion of ma'onrv (if applicable) and when installation is comolete. Installation shall be in accordance with an approved nationally recognized testlng agency alld the manu- facturer's installation instructions. C. MOBILE HOME: An inspection is required after the mobile home is connected to an approved sewer 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 floodplain management letter. (3) Mobile home tiedowns, when required, and skirting shall be installed and ready for inspection within at least 30 days after occupancy. Tiedowns and skirting shall be installed per enclosure. D. SWIMMING POOL: Below grade when steel is in place and before concrete is poured. Above grade when pool is installed. APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS. SUSPENSION OR REVOCATION MAY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOfIPLETE DR ERRONEOUS INFORMATION. ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL 00 SO AT HIS OWN RISK SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS (1) (2) Permits shall be effective for one year from the date of issuance. Upon completing the construction for which a permit has been issued the permit holder shall notify. the Department by submitting the installation record form. The Department shall 1nspect the construct1on ~o determine if it complies with the rules contained in this division. If the construction does comply ".l1th such rules, the Department shall issue a certificate of satisfactory c~mpletion. to.the permit holder. If ~he construction does not comply with such rules, the Department shall notlfy the pe~'t holder and shall requlre satiSfactory completion before issuing the certificate. Failure to meet the requnements fo~ sat1sfactory completion within a reasonable time constitutes a violation of ORS 454.605 to 454.745 and thlS rule. Setbacks - Subsurface Sewaae DisDosal From: Interior property lines Edge of road right-of-way Building foundation Wells, other water sources Seotic Tank 10' 10' 5' 50' Drainfie1d 10' 10' 10' 100' ............ . , -' ... ;/ ~ne county ca . . CHECKLIST PLUMBING/ MECHANICAL APPLICANf INFORMATION: So L-.orR CoN<'i.~ '3:'NG.. (Name or 'Fu1D- Please Pnnt) '.' PLUMBING CONTRAcrOR ~s Finn 2\\ L..).G.t.'b. (Malhng AddreSS) . , .:-.' / 0<0-11/'; (Jf3 Cont. OSR# Address ~v (.. . (Clty or Town) D NopSelf ~s Finn ~~i~\ ~~...E-~ 7-.\uU(. Address iS5,,') N\t:.l'"rioT I.N D NoD Self p-~\\\ MEOiANICAL mNTRACTOR OFFICIAL USE ONLY Appli./ penni t # , .'j')~ \ (Llp ,Code) Cont. OSR# 20 -1"51.0 '>'I' -'n.'i3 Type of Fixture PLUMBING Number of Each Total Sink LavatorY (Wash Basin) Tub (with or without shower) Shower} separate Water Closet (toilet/urinal) Dishwasher Disposer (garbage grlnder) Washing Machine . Water Heater Floor Drain Sewer--lst 50ft. each additional 100 ft. Water Service--lst 100 ft. each additional 100 ft. Stonn and Rain Drain--lst 100 ft. each additional 100 ft. Special Waste Connection Sewage and Sumo PumP (eiectorJ Mobiie Home Sewer and Water Other (specify) SUB-TOTAL (Minimwn $10.00) ~ TOTAL FEE Type of Equipment MEOiANICAL Number of Each Total Mechanical Pennit Base Fee Furnace UP to 100}000 BTU/H Furnace over 100.000 BTU/H Clothes Dryer Vent Bathroom Ventilation Fan & Duct Ran~e Hood with Mechanical Exhaust Wood Stove Air Conditioner Only Heat Pump Floor Furnace Gas Piping System 1 to 4 Outlets Per Outlet Other (specify) SUB-TOTAL ImTAL FEE Fee On Each I $ 5.00 5.00 5.00 5.00 5.00 5.00 5.00 5.00. 5.00 5.00 15.00 10.00 15.00 10.00 15.00 10.00 5.00 5.00 10.00 Fee on Each $ 6.00 7.50 3.00 3.00 4.50 b.OO 6.6b b.OO b.ob .50 $ 10.00 I I I I .- .NNING & COMMUNITY DEVELOPMENT . ACTIVITY INFORMATION SHEET ~ne county " ~ COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED! ,1 5oL'A~ CoN(~ ~. PERSON MAKING REQUEST d.\\ w. ~i:k MAILING ADDRESS ZVb. ".\eS c;'40( CITY STATE ZIP CODE ~~ -\DS~ BUSINESS TELEPHONE # HOME TELEPHONE # . 2. PROPERTY ADDRESS (IF DIFFERENT FROM MAILING ADDRESS) 3 MAP & PARCEL NUMBER (REQUIRED INFORMATION) rlllf. C/ f1f~ f/r;p T PROPERTY OWNER 2555 ~f PJ~Wl MAl LI NG ADDRESS ~f~IIJ".Q-{LO 6f?f '~If'!) CITY STATE ZIP CODE BUSINESS TELEPHONE # HOME TELEPHONE # (from tax maps in Department of Assessment and Taxation or from tax statement) /1 03 23.4.4-_ Z10() TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING TOWNSHIP RANGE SECTION I /~jL1 J . v::u-f--dA j~-f! 11J-dX~_). )~~ . (J 00' \+p. \l\)f.~ ~oQ.; O{.,.f ~ . &t~ClV\ ,1:;1: C \~~\., 7U~ ctr Hcykn iSdS'" ~. TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: 4 SUBDIVISION (if applicable) 5 REQUEST (state exactly what you plan to do) dtJm~(O: : 6 DI RECTIONS TO SITE: ; I TAX LOT(S) OR PARCEL # ZONING ACRES LOT BLOCK ;- = NUMBER DATE .. (ILl- ~ 41L~ ** FOR STAFF USE ONLY ** - -- ZONE/LAND USE: BY: DATE: TIME IN: OUT: .. . HOLD . SLIP lane county ,. ~ Ol~ APPLICATION 1/ ~(...~z.... LOCATION ~ ~~ ~. ~ ~1~~/~~ NAME ' 211 w 0~ ~ ,.l.(~lI!:o, a 4"1~ ADDRESS ZIP CODE The above application is being held for the following reasons: PROVIDE A PLAN VIEW SKETCH SHOWING THE LOCATION or oUMP, oRE-HEAT TANK AND CONTROLS ~OR SOLAR UNIT(S). PROVIDE SPECIFICATIONS THE OPERATING AI~D STAGNATION TEMPERATURE OF THE UNIT(S). PROVIDE SPECIfiCATIONS Of CONS VeTIQN ordfcToR UNIT(S) IN$LUDING BASIC MATERIALS, SIHS, GLAZING MATERIALS, THICHNE ES,xj~! NY OTHER PERTINENT DATA YOU BELIEVE TO BE NECESSARY TO IDENTIFY ~HE CONSTRUCT I N"y HE\~\OS;JLL~R(S)' IF THE SUPPORT FRAMING IS A PREFABRICATED S, THEN \JRI~EN VERIf'lCATION FROM THE TRUSS MANUf'ACTUR(R IS NEEDED TO VERlrY THAT THE TRUSS '.JILL SUPPORT THE ADDITIONAL !"ERMANENT DEAD lOAD or THE COLLECTOR. CLARIFICATION: THE OPERATING TEMPERATURE or THE COLLECTOR MAY RESULT IN Rt-POSITIONING THE COLLECTOR(S) SO THAT A SPACE BETWEEN THE DOTTOM OF THE COLlECTON AND TilE ROOF MEMORANE CONFORMING TO THE REQUIREMENTS OF SECTION 505, 1982 S.S.C., IS ACHIEVEO. AN eXTERNAL 'VIEW' or THE F"ORTION or THE nllltDl1..:G ON \.JHICH THE COLLECTOR 15 TO BE INSTALLED 15 TO DE INSTALLEO 15 OESIRABLE ANa WOULD HELP GENERALLY WtTH THE INspeCTION OF" THE PROPOSED WORK. _ 1:.k.-. Mt...-r-:fi JL~.jJ SIGNATURE _40"1 "7?z.- DATE _~.-bJZY.~:______ __... _ _ . . OFFICE HOURS _h__0!?7~1t2bL___ PHONE - This application will b~ held untiIS-G.::8l-:.. ff the information required above has not been furnlshed by that date your appl ication \'Iill be cancelled. Bu i I di '!CJ fees pa i d for permi ts cance 11 eel under these c i rcums tance5 \"Ii 11 be orora ted according to the ~Iork that hus tuken place as or the elate of cancellation. BUILDING & SANfTATION 125 Eust 8th Avenue / Public Service / ENVIRONMENTAL MANAGEMENT DEPARTMENT BuildinfJ / Eur/ene. Or-Oflon 97401 I (503)687-4061 , , .- .- '.......... ,. ~ ";-J LANE COUt\lTY....&UILDING PERMIT OR MOBILE BUILDING eJ" . MH 0 MAILING ADDRESS 2555 nO~"E ElL OS~O~l OR I V E HOMill.USE PERMIT c~~-l'j . PERMIT NO. . ........ .. ".. PROeERTY OWNER , . ~.~. C:. f 1: ~.T CONTRACTOR ~LLICO~ A:"O PLATZ Cc PROPERTY lOCATION -INCLUDE POST OFFICE ,j~'~ nOO:-:: DLOSSOft. Loop PROPERTY LEGAL DESCRIPTION - METES, BOUNDS '~I):l-;>I.:t100D !~~.TA.I':..n ;~T (';.J:": len MAILING ADDRESS 23 OAl(HAY t:'ALL ...... PHONE SP~ I t~GF I rlO (r~E:OO;; PHONf 3'!5-';j'? [U:--:;H:, ~~_~~(".';:, LOT 6 :.JlOC:~ 2 TWP RANGE 11 3 SECTION 23.11,1:. TAX LOT NO. 2"{CO CODE CENSUS TRACT APPl. NAME & MAILING ADDRESS .lIr::E, O.:cro: FOR MOBILE HOME PERMITS ONLY No. of Bedrooms llLILJr~ h'lU PLATZ Co 20-ED1::C EXISTING STRUCTURES ON PROPERTY ,r..~I;'I" DUEL'-I::n LEGAL ACCESS TO PROPERTY ;-~; LA;XlAY :.~ALL ROSE OLOD!>C:: Lco!) PROPERTY SIZE - FT. WIDTH DEPTH AREA 4114 C 1G. iQ New System "0 VALUATION " I" /" j- ", . " STRUCTURES TO BE BUILT THIS PERMIT Ai)oln.::~ ';I'i1': .:'::,' A;'jJ FAt.lILY ~~oo~~ Connect to Existing Sewage System 0 TYPE CONSTRUCTION SQ. FT. :;: BDRMS SEWAGE DISPOSAL i:.;~ I ~T PUBLIC D SEPTIC TANK D PLUMBING INSTALLED BY OTHERD BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAilER 1::nuRcLf,,:r.:-"" , . !.4'. c.~~ FEES OWNER D OTHER, NAME WATER SUPPLY PUBLIC 0 o OTHER ~.\ II:~' o~.' '"I'. f">:n L~_. j..., . ll:~ TOTAL , , c rr Ub~{'t" MIN. SEPTIC TANK CAPACITY WITH DIST. BOX: GAL. COUNTY BUILDING & SANITATION SPECIFICATIONS DRAiN FIELD REQUIRED L1N. FT TRENCH WIDTH FT. OR SQ. FT. ~~o PA,;r H- "i:,r.: ;;c.... t:l,;..f.....1UCT,O:: TO 8E OV!;~ .:.Rt.~:;VIELD: TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIL. EASEMENT BlDG. SETBACKS u FT. FROM CTR. OF ROAD RIGHT OF WAY fRONT J.~O' SIDE INT. "J I SIDE EXT. AUTHORIZED SIGNATURE - DATE /s/ J. 1:.. I~O~~ LV c. ,l."l:uiAUCB REAR USE CLASSIFICATION P.('T Jo~:;! SHOOl DATE 2/21 i tr, BLDG. PERMIT - WHITE OFFICE COpy - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOlDENROD Coli 687-4065 to schedule 011 required inspections. All construc- tion sholl comply with Uniform Building Code, D.E.Q. stondards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing. All buildings require a certificate of occupancy before being occupied. (See Detoils on Reverse Side) I"ORM == C55-13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY. DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 . _eo. - , ~~'I~~:~lED DY INSTAll. 10.loller's name ~~':-: ;r . _ ~0-,~-'7/,J! _~.A O.i1ding pormil ;,.-;;:~;_/ / V p.s - 6-s M:iI~/adclm. ? c:; .(.,-? /'// ~;l(,,~-::_.e..., Property address -'-'5'-';- ,- . ';-.'. -.!- ~'" ---'-__ ' . . " it TohII .....bor: living .nitt- Oedroom~ Oath___ Dosemenl: Y.s 0 No l'i- Wotorsupply by: Public .yste... ,,r^ Individual.yste:!' Community system Sc.ptic tan&: Di.lonco fro... \1ell v-- _ Feet. Moteria' No. of comportments. Tatalliqoid copocity c;- '" '" gal. Insida lengllt '7. /. ft. Inside "idth _.~v Di=e~' ' ft. liquid d.ptlt..4 ft. Tib d~sol field: Distrib.tian bo.? Y...lU- Ho 0 Other leagtll coch lin. 1..:~ ~ _ _ ft. . Tata'leagtll .,flF(P ft. WKltll of trenc.b --.{SJ ... ft. Toto' sqaoro faaloge _-:- . =i!l7fr= ft. Instanc. bolt7ean Ii.... Q F? ft. )"YIl3 of filler matariol: Gravel'--~_ Other---" D<!ptb of fil~r "",tario' aver iii. 1... ill(b",. fl. Distance from: Wel' NeDr.?st lot line: Fronl 0 Side 0 Rear;& Foundalio.n_/-Y f..t. -. Depth of filter material beneath tile fe.l. feet. inches. san-CH l$eo ;.....~;....I: I o " ;;7/ , f'7I-.r-. ~/' V-~J6d?, b~l ~ $" ')/i,. f' ~l/ m ~u~ ~ Bl~[[ m - "'"- ~ LA/IE COUNTY HE.~LTH DEPT. DE SUDE TO INDICATE NORTHERLY DIDECtlON ::.USEOF SANITARlN;--~--_.~~~~alur~7/??'? c'';''';/ ." Sr.tem apporently "ill ~i11 nolO function ..tisfactojily, .nd ishherefore opprovdfor occupancy ~i~opproved 0 tlomarlr... C:::~~"L.l ~Ya c:: ~ 0.. 1-.,., -F ':7 i-(.."c...t:,_, - / A-01Il. ~H~ . Jhroo n-t ~L-~ ~ ~ (). ~. ~__ .... T ,"-:{ -__ - T"B.:6I>":~ '---- ~ " , Q "0 , \' g v ~J I;, r-"...'>.... ~.--.-- r~ f" ''J I I , (J,' ,~;..... '\) J/ , 0 I I ( I '"' '\ 1'0,' J . . . \ f 7MIQ~~. v . . g~. licaMi.eptll_ ~ ) ~is~$O' field: [()is~rib!l?ion ~1I? '1e~ i~ No ~~ ~ch line ~.1.$-~' ~i i,mgQ{, I_cf:(;) j?~ of ?rendl <ql' oJ ~~ ]JJ square foo?age ::4{f 0 == fai'lCe ~~eei'l li~(Zs ~ b :;;? of fil?er I'i'lo?~nal: Gravd: ~ i~~ oU fil?ei ffic?evioJ o1kr ?il" "I i!lchG?$_ f? . o O?her_______ tt. Distance from: t? Well_ ._ U? Near~st k. lot line: Front - Slce --. ~,~; tt. foundation__ --/.Y--- __ .. _, O?her,f . Depth of filter m;:ter:' L;... _ fcet. = ITeM lSoo i:J~.~.~U': , i \. jl~ . I r~\ , l' ~. , I , j . I , , '-c .,~ \ \ ~ i-. ._ -, ;i7' . , - .I/' 1--~' - ~..' ", _ -=-:: .11(.,/ r-J...!fJ& ' c!)J~ ~-- '\ ~; - ~ ~r > . , - <.J,..... I.V 7 ' 1./, I ., , . \ . ., ~. '., ~ - '=' ~ '," I ["' I :- ,L(, :. I .' ,f\\ . - ~ ~ '- i.\U r. - ... . - - "~~L-;=.; '.' ' ' , :i . J .. ~.... ..,.... t...-,..1:....._ tlr .....:.,. . - . . OlE $ValE yo IIIlDICATlE NChlYMlEl?t Y DIIlEC1IC'" ....!'i: .; ~ Si9ftcture -:-'-1/...1~~~.~~~ I .--, ~ :)iSlE Of SANIYAaD4~ ONLY; ::J re;;i)rllOrently ""on ~m ~@~ n 1 .- -COj-., - J . acmc?io:il ~fu~. ~ U ~r:>f....,:> "........-.4 ,~ Arn . __'. ...r'"' "" ~ ------- B~ILalNr.'SllE EVALUATION . JS JCr~ ( ). BUILDING PERMIT APPLICATION NO. --:2 9;;;- 7..s-_ () SITE INSPECTION PLANNING DIVISION I. 2. 3. 4. 5. Not Applicable Zoning Ordinance Compliance: Zone ~~~ ( ) Subdivision Ordinance Compliance (~~~ ( ) Required Access ~ ( ) Building Site (Area, Width, Frontage) () Other (see comments) ( ) COMMENTS: ~UBDIVIS.: LOT: APPLICANT DATE No ~ T) ly6. ( ) (J , () (~ ( ) (~ ( ) ( ) PLANNING DIVISION ACTION PENDING: YESl } NOl } APPLICATIO~ Not Applicable No Yes () ~T) tIT () () (') () () ( ) () () ( ) BUILDING INSPECTION DIVISION 7. Plans Submitted 8. Soil Stability (footings) 9. Flood Plain 10. Other (see comments) COMMENTS: WATER POLUTION CONTRO~ Not Appl iCilble ( ) ( ) 11. Meets Department of Environmental Quality Standards. 12. Other (see comments) COMMENTS: No Yes T) TI ( ) ( ) S TAX LOT BLOCK: /I + tlu J\ I c--- CK'D BY:~ ~//p/;?.r- Setbacks' frOm cll of road: Front '-I 0 Side Exterior --- Setbacks from interior lines: Side ~ Rear ? CK'D Byl} ~~;t;).r'/~ - ~ - ~ATE . I/, CK'D B~~ 1/ jll 71, . Ci 'DATE TO APPLI CANT: Your Building I Site Inspection: 51fcan be approved. r11:1 () Cannot be approved at th i s time as i nd i cated on item NO. above. ~~~ Questions and further information on items I through 6 contact the LANE- ~ COUNTY PLANNING DIVISION. Questions and further information on items 7 \)\ through 12 contact the LANE COUNTY BUILDING AND SANITATION DIVISION. ( ) Will be held in this office until you can resolve the problems indicated. .< ) Is being returned. ( ) Your bu i I ding perm it app 1 i cat i on f~e Is "be i ns ..~~tu~n.!td under seoarate cover, ~EPARTMENT OF I::NV I RONMlNlAL AANAt;EMt:NI 135 Sixth Avenue East Eugene Oregon 97401 PHONE: 687-4065 LANE COUNTY PLANNING DIVISION PHONE: 687-4186 C55-28 r ~ LANE COUNTWUILDING. PERMIT OR MOBILE BUILDING [] .. MH 0 MAILING ADDRESS HO~ USE PERMIT . PERMIT NO. ~ . PROP~RTY OWNER PHONE . . . . r f.'I' CONTRACTOR ,~; , . ) .' i',,~, ~ ,. MAILING ADDRESS ,) PHONE . :(;': PROPERTY lOCATION - INCLUDE POST OFFICE , ",., PROPERTY LEGAL DESCRIPTION - METES, BOUNDS . ..._." .~) ~: _;.,' If, . :(~ ~ ...... ,., ..."~ .' ,. ,-,.. .. . ,..' J ~ TWP I, RANGE 0,1 SECTION rq ~ ; ::,),,(:tJ TAX LOT NO. CODE CENSUS TRACT .-' -" ~ ' I ~ ~..., ! APPL. NAME & MAILING ADDRESS EXISTING STRUCTURES ON PROPERTY ::.!. a~>":~ ~~'..) :,.'Y, <-, "v r-' .,. LEGAL ACCESS TO PROPERTY CJ . .-t ,:J,.~.J .:',:' PROPERTY SIZE - FT. ,.. .t... WIDTH DEPTH AREA FOR MOBILE HOME PERMITS ONLY No. of Bedrooms STRUCTURES TO BE BUILT THIS PERMIT Connect to Existing Sewage System D TYPE CONSTRUCTION SQ. FT. :rt BDRMS New System 0 VALUATION ..... ~;r:':' L t, ...:;:::-: ,. , ,.1'" ",\ ~ ~..... t I ~~ , ..#" . "- ~.. SEWAGE DISPOSAL ....r PUBLIC 0 ,'" 'SEPTlC TANK 0 BUILDING t: WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRA~LER OTHERD ':L., FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY PUBLIC 0 o OTHER . !!~: .,.., ...., " " .J TOTAL . MIN. SEPTIC TANK CAPACITY WITH DIST. BOX; GAL. COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN F1ELD REQUIRED lIN. FT TRENCH WIDTH FT. OR SQ. FT. ~: ~ p;~:.': 1 ::-~ .,.-.... ~ .... "..p< ..,.\ ,'.. ., ~ . , . '" .:\; c~.:~~. : :<:.:. ':'- r' ...; TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIL. EASEMENT BLDG. SETBACKS _ FT. FROM CTR. OF ROAD RIGHT OF WAY FRONT" SIDE INT. '; ~ SIDE EXT. AUTHORIZED SIGNATURE - DATE USE CLASSIFICATION REAR t' " :~~' '{I,I tJ. ,~. I :~: ,~) ; :t.' , ,. I.:... , ~ ~. . ~ I..., ;,..,.., t, ., ~ ~..~ /.. DATE : t BLDG. PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 6B7-4065 to schedule all required inspections. All construc- tion shall comply with Uniform Building Code, D.E.Q. standards IMPORTANT: for subsurface sewage disposal and county regulations covering plumbing. All buildings require 0 certificate of occupancy before being occupied. (See Details on Reverse Side) F'ORM 11: C55 .13 (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 , SLAB FLOOR . PLUMBING GROUNDWORK . ApPROVED ;---? DISAPPROVED ~ DATE REMARKS GAS PIPING GROUNDWORK INSPECTOR ApPROVED / / 01 SAPPROVED ~ DATE REMARKS ROUGH PLUMB I NG ApPROVED ~ DISAPPROVED ~ REMARKS ROUGH GAS PIP I NG INSPECTOR OATE7-//.- 7r INSPECTORA.// V- ApPROVED ~ DISAPPROVED ~ DATE REMARK 5 FINAL PLUMBING ApPROVED ~ DISAPPROVED ~ REMARK 5 FINAL GAS PIPING INSPECTOR OATE)'"t? '7'.;' I NSPECTOR-4..../ ApPROVED ~ DISAPPROVED / / DATE REMARKS CERTIFICATE OF OCCUPANCY INSPECTOR READY TO ISSUE ~ NOT READY TO ISSUE I / DATE REMARKS INSPECTOR , . ~ , . , . '/q ~ CJ :J 6-1/ LANE COUNTY...,lUILDING PERMIT QR MOBILE _ BUILDING ,,~. MH 0 MAILING ADDRESS HO"1i,. USE PERMIT . PERMIT NO. "'IIJ -- ~ . PROPERTY OWNER / PHONE CONTRACTOR MAILING ADDRESS PHONE PROPERTY LOCATION - INCLUDE POST OFFICE PROPERTY LEGAL DESCRIPTION - METES, BOUNDS TWP RANGE SECTION TAX LOT NO CODE CENSUS TRACT APPL. NAME . MAILING ADDRESS FOR MOBILE HOME PERMITS ONLY No. of Bedrooms -STRUCTURES TO BE BUILT THIS PERMIT EXISTING STRUCTURES ON PROPERTY ". LEGAL ACCESS TO PROPERTY PROPERTY SIZE - FT. WIDTH DEPTH AREA Connect to Existing Sewage System [l TYPE CONSTRUCTION SQ. FT. :;! BDRMS New System 0 VALUATION SEWAGE DISPOSAL . FEES PLUMBING INSTALLED BY OWNER 0 OTHER: NAME WATER SUPPLY _!UBlIC_ JJ BUILDING WASTE DISPOSAL PLUMBING PLAN REVIEW PARK TRAilER SEPTIC TANK n OTHERD PUBLIC [J OaTH ER . . '~.. , , )' ::~':'--""t""J\, ~ I' . . " \, TOTAL < .:::\.. '. .... . . MIN. SEPTIC TANK CAPACITY COUNTY BUILDING & SANITATION SPECIFICATIONS DRAIN FIELD REQUIRED WITH DIST. BOX: GAL. UN. FT TRENCH WIDTH FT. OR SQ. FT. TYPE OF STRUCTURE OCCUPANCY ZONE PUBLIC UTIL. EASEMENT BLDG. SETBACKS FT, FROM CTR. OF ROAD RIGHT OF WAY USE CLASSIFICATION FRONT SIDE INT. SIDE EXT. AUTHORIZED SIGNATURE - DATE REAR DATE SLOG, PERMIT - WHITE OFFICE COPY - WHITE COUNTY TAX - PINK PLUMBING - CANARY BUILDING - GREEN SANITATION - GOLDENROD Call 6B7-4065 to schedule all required inspections. All construc- tion shall' comply with Uniform Building Code, D.E.Q. standards IMPORTANT: for subsurfClfe'sewage disposal and county regulations covering plumbing. All buildings r~quire a certificate of occupancy before being occupied. . (See Details on Reverse Side) fORM:::: C55.\) (POST THIS PERMIT ON MAIN BLDG. AT SITE) LANE COUNTY, DEPT. OF ENVIRON~ENTAl MANAGEMENT COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401 - r rP~ lid F#o~1 f~ f1~~~"1 I e 11 0 17 - . . SITE I NSPECTI ON ApPROVED CI 01 SAPPRQVEO CI DATE INSPECTOR REMARKS FOUNDATION INSPECTION PPROV 0 ~SAPPROVEO L-/ DATE :3"!'~ '1~ INSPECTO~ ~~t'~.i-(J~ ~~:"J.rf4lEk _ 1.Hf. ~~7:'~~: A/~~ .'IIf.-'*"~ ?/-~:7cJ/ ~.1, f" ...' '7" .~. /J /I ~~ u-.... .cUll ''T/C-{~ .r.~ . ~~ I!/ It'- - :1 -6. ~~~ FRAMING INSPECTION ApPROVED / / DISAPPROVED CI DATE INSPECTOR REMARKS LATH OR SHEETROCK INSPECTION . ApPROVED r-b4 DISAPPROVED L-/ DATE .)-/9- 7.';~- INSPECTOR~ $4t.;jf. REMARKS ~~tt((/; .~'-#:;d aPd/0/~,wdHLd~f~( 8ir 4'f '" Kf .f/--P ~ ~V, I FINAL INSPECTION ~ ApPROVED ~DISAPPROVEO ~ DATE if-I.';"" ~NSPECTOm/ . /;)/ ( :.. / ,l~. REMARK 5 CERTIFICATE OF OCCUPANCY REAOV TO ISSUE CI NOT READY TO ISSUE CI DATE INSPECTOR REMARK S /11 /! / / //.A_ ~(I~~~ZWA4t- ~'?~~. /~~.J-l- ~Cf9'7.~ /O~ /:l5"S.jr /~ p~ ~cu~ . ~ . , ,~ PERMIT if :;( ?;7-;::U- BEEN APPROVED NO PERMIT WILeE ISSUED UNTIL THIS APPLICATIO.S APPLICATION FOR: CONSTRUCTION C5<:J. MOBI~ ~ PLAN REVIEW g CllANGE OF OCCUpeCY ~~ ~ .. \.,( t:=J OWNER~.<u~,:::, C. <",," ~ d~~t::.., ~c>s.e~(c.s&--(\'~_ '\. )~m~- \ Address City Zip Phone r'"'v'1 CONTRACTOR ~ 'f-- ~ cO. ~:3 dJd..--.... q..~ ~. 7'7 f/rl/ - J Y.5= VJ f/"r ~ Name" c.I Address C/ City V Zip Phone :/ O.S. REG. U 57J.3:1 I'wp. / 7 Range 0 3 Section 23..~ Tax Lot .;J 700 SUbdivision.tJ1~ .....vD..~ {~ C Block ~ Property Acreage ACCESS TO PROPERTY (Road Name> ~ ~~ ./if~ Existing Structures on property:A.,_~~ '. ~,' ",,' Q'-'~_L~~.j->~ NOTE: Property Location - Address/Directions: Code ;;(f')-~OlEo Census Tract Width______Depth Gtf2tIJ- T ,;..; 4i- .--7/6 ;i:CI;/. -> - F~ ~ -r i,( ~L, . /'. ':--, V ./ Below fo r Of f ice Use Onl vXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXJcxxxy,ryv,nr",r'n,'OOOOOi. Sq. Ft. @/~. /tJ UBedrooms Valuation #1,/(/ j((3) I / Existing Sewage Disposal System 1 or New System Required C==:J Public 0 Other Community ['2"1 N me of Community or Public System ().~ Other~ Name ..2-. ~. -'0 V- /~ , (/ SEWAGE DISPOSAL: Site Inspection D WATER SUPPLY: Well Spring FEES: PLUMBING: qu, 0 () Installed by Owner c=J Bldg. PLUMBING FEES: Waste Disp. C Plumbing ;lJ.c) 0 n of Fixtures Plan Review Mobile Home 1% Surcharge . C, G '~1 CASH TOTAL _t; (, . & ~ ~ Min. Septic Tank Capacity N h )'JdA- ,O-A< "hJU.O '7lt.1~ <./0 oj _ Sewage Connection .:I. Water Connection d. PLANS FURNISHED FACILITY PERMIT .1Rl YES c:::::J NO . C==:J YES t><;J, NO JU/t:r~ d- P/t'i" '.ll (J Signature of Applicant: Ht,. /I'/.4:;?#AH -' ___ - I .r.l-~r~ , Fee Received By:r7/7J11f ~ ~ DBte: ~-"/9-. 7v V ;; Drainfield Required - Lineal Feet r:;.'r-..q t ' -h. h '" _ 6 ~V-- Maximum Dep th r3. ro r.-...r:t pify - Type of Construction ...!J"AJ Fire Zone I Group Bldg Setbacks - from Center of Road Right of Way: Front Y /? Side Int. ~ Side Exterior Use Classification Rear ? Zone...d./.:-T r ,Q -A") -- PlAN!IING: ~ DATE: ::z. - /3-:?f"" ~~~ATION: '} hb(ir.l'f5~Uj;/~~ (\] ~~. , I (JIIf- DEJ)'ARTMENT OF ENVIRONMENTAL MANAGEMENT DATE: ').- 1.1. ~ 05-12 LANE COUNTY .c