HomeMy WebLinkAboutPermit Building 1980-12-26
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TO"NSHr~ j RANOZ I sEno~,4. I .I T67CX:POUT or
SU[~'OCGild: -M aPrnr~~~_~Y~RCEL t BWCK
L3940sS I r-\l(M.n~. >>rl, ?J7;CITY7
STRUCTURES CURRENI'LY '0;' "RvPERTY ] ~ ~I...
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CONT~CTOR' S OSR' .1 DIRECTIONS ~O n'TE ~ 11 +b'l ~ I -- ~' f\ I~' ....l
D A ' 'S((}\ /"M _.r\ - GVr. TO _ \ (lV\ U/Y1{-^..,.
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_ C~ ~ (' C2t:l1Qh.rr . n J, Lan ), u1 ~
I HAVE RE ULLY EXAMINED THE COMPLETED AI'PLICATION FOR PE I . and do crl'by certify that all informatioll heTeon is tr e nd correct I further
ce,tify th t a y and all woe' pe,fo"ood ,hall be done in acco ce with the O,d;,,,,,ce, ef Lnne County a"d the La.. of th~ile of 0",,0" ""tn;,dn"
to the work cscribed herein, ilnd that NO OCCUPANCY will be made of any structure without tho permission of the Building Division. I further ccrtif~'
that, registration with the Builder's Board is in full force and effect as required by ORS 701.055, that if exempt the basis for cXC!lllption is notf'd
hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. I HAVE READ AND CIIECY..ED TIllS
APPLICATION THOROUGHLY.
td'
lIP FOR OFFICE USB ONLY
APPlicat~' 0 / ,I </0
Perrut t y...-l\
,
o Two Copies of Plans
[]TWO Copics of Plot Plans
DMechanical Checklist
o Plumbing Checl:list
Dplan Check Info Sheet
ZIP I PROPOSED us!:: Of' PROPERTY
~ Residential OIndustrial
I 0 Commercial Dpublic
S VALUE ef'D
I (;,()(l -
~Liroposed
JZffxisting
TELf:PIlONE NUMBER
7:'?h- () 110
TELEPHO:~E NUHBEK -
...
Y WILL' 0. "^' -V, ~1Je> A'bC.<;
NAME (please print)
7f/L ~~ner
,X 1./J..~!~REtf), -~.Y.. I Z-!rt-Bd 8 :::::actor
o PLANNING/ZONING:
Zone ~
Partition #
Parcel #
Parcel size
J
Qf LPS'S,
,
Ninimum Setbacks: CL, front
CL, side
interior
rear
co_nts.2ni.Q.^ Jc;r--J f1Q!YY".(X1. 0 J )
FLOODPLAIN:
In flood hazard area? [] No [] Yes,
see
attached sheet.
Date,_\z,/c:4/cnL;' ~
If,
Date;
o
Date:
o
o
s
RURAL ADDRESSING:
GRID COORDINATE
N
E
SANITATION:
s. 1. #I
B. P. #
lnstallation Record Issued? [] Yes [] No
Installation
Specifications;
Gallon
Tank
Lineal Feet
of Drainfield
Maximum Depth
of Trenchcv
Comments:
,!,t
,'~~~ ,_::'"'1.'" (.
" .
." .
~.....
'-~I ~ <:p~()
Date, .2fJ ~'isD
Type ,5-:'- Jt) Group fL- 3 Use $ P-t:> - /2.el/l~l>cL
"L. AcJ,J!& e f"!. OIJSJ'2.tJt::T(a6I. I2ESu~\ S"e-~o~
'PLAf.J~tl!:o &"L1-IOH? CtJ, WHEAl A-PPLV/Alt:. FOIlA. BU/C..b.(II(;.
pE~ 'r,....8JJb A FLoof2 FfZf,,uWU C2oc{ '~T10AJ () p:: Dateo~~ /.t-th?,)/;l
A)--EW r:L()(}!L 4fleIJ
~
~PLANS EXAMINATION:
I Al @oRll~p~THORIZED BY THIS PERMIT ~." / 5 J bt)
. - . . 'I
Fixed Fee/ Floodplain Fee ~
Sq. Ft. Unit Cost Subsurface Fees $
3rrp~ ~ ~.5"D Building Fee S
Sewer/Storm Drain/Water $
~ Plumbing Fixtures $
Mechanical $
eo -
_,. _,1 ' ...J. Plans Check Fee+lt> Sd(-. ;z: "0,. 5 0
V~cr~~S-:.so- f~tJ,~ Surcharge S /.o'if
~P~~~II1II6I:iA.nc;/:~
TOTAL VALUATION SUI/) Q'(;,5Z) ..,-.:.....::.\aili., .~D cash~JZfL.
~ It &U/Ll)/vc..PEJ2.M/T1s ~EQu'I2€'O BY:( tlrrf. ~,..,
p(l.lt>14 "10 THE Silf.lI2.T of Ct:)J{)~rRucrIDQ-JI.oateJi7j7.A-/?{n
~~~7f.~~0~e:;g'l4~~=:::(:r:ps:~~~!;b--nJ
LANE COUNTY DEPARTMENT OF ENVIRONMENTAL MANAGEMENT I 125 EAST EIGHTH AVENUE, EUGENE, OREGON 97401
Description
~
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C74-194
SEE REVERSE
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SETBACKS AND OTHER CONDITIONS OF APPROVAL MUST BE STRICTLY OBSERVED. NIPLA~!ON CAN RESULT IN REVOCATION OF TH~ PERMIT~
CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE. ANDIOR 'O'MR .JU:folE1JIES ALLOWED BY'LA'W;" , .-. ,
. i . .' _ I
, ., . .
WHEN REAOY FOR INSPECTION CALL 687-4065, A'MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTic~ FOR INSPECTIQN:REQUES~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 t~ site.
.
~, ,.'
,~
BUILOING DIVISION:
REOUIRED IfISPECTIONS
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 (co"",on1y termed "transit mixed") 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 ac~essories and other ancillary equipment items are in place but before any concrete is' pour~du. .
or floor sheathing, installed, including the subfloor.
3) FRAMING & INSULATION INSPECTIONS: To be made after the roof, all. framing, fire blocking and bracing are-in place ~nd,
all plpes"flreplaces and chimneys and vents are complete and all rough electrical and plumbing are approved. All
wall in~ula~~on and vapor barrier are in place,
4) LATH ANDIOR GYPSUM, BOARO INSPECTION: To be made after all lathing and gypsum bo~rd, interior and exterior, is in place
but before any pla~terlng 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 appro,val 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
A,
building 'permits 'require inspections fo; the~o~k authorized,'such-as b~ ~ot iimited to:
,
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 masonrv (if applicable) and when installation is comolete,
Installation shall be in accordance with an approved nationally recognized testlng agency and 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)
(2)
(3)
Footings and piers to comply with State foundation requirements for mobile homes or as recommended
by the manufacturer.
Mobile home minimum finish floor elevation shall be certified when required by a floodplain
management letter.
Mobile home tiedowns, when required, and skir.ting sha.11 be installed .andready for .inspection
within a~ 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 T~I~
PE~~IT WAS ISSUED ON JHE BASIS OF INCOtlPLETE OR ERRONEOUS INFORMATION. . .,
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO 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 fonn. The Department shall inspect the construction to
determine if'it ,complies with the rules contained in this division, If the construction does comply with
such rules, the Department shall issue a certificate of satisfactory completion, to the permit holder., If the' .
construction does not'comply with,such niles, the Department shall notify the penIiit ho'lder and s~all ,require
satisfactory completion before issuing the certificate. Failure to meet the requirements for satisfactory
completion wi~hin a reasoryable time. constitutes a' violation of ORS 454.605 to 454.745 and this rule,
Setbacks - Subsurface Sewaae Disoosal'
From: Interior property lines
C==E<1gedlfzr.oad=r.;'ghtwoFitay,
Building foundation
Wells~ other water sources
Septic Tank
10'
10'
5'
50'
Drainfield
10' .
1()'
10'
100'
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CHECKLI.ST.,
PLUMBING / MECHANICAL
~
APPLICANT INFORMATION:
"'-.l'1..t..1e-"" 'P. .'Y4C"(.'T'"r"t
(Name or rlrm-Please Prlnt)
'3c\<(/., \2,c:..I-HAI\JT-! S-r_
(Malllng Address)
PLUMBING CONfRACfOR
D Yes Firm
Address
I25l No ua Self
MEQ-lANICAL CONfRACTOR D Yes Firm
Address
~ No IJ1 Self
S?r2'l->b'l=/e..t>
(Clty or Town)
Cont, OSR#
Cont, OSR#
OFFICIAL USE ONLY
Appli,/
Permi t #
.
C}~'7
(Zlp Code)
Type of Fixture
I'LlJ/<<lOll'U
Number of Each
Total
Sink
LavatorY (Wash, Basin)
Tub (with or without shower)
Shower, separate
Water Closet (toilet/urinal]
. Dishwasher
Disposer (garbage grinder)
Washin~ Machine
Water Heater
'Floor Drain
Sewer--lst 50ft.
each additional 100 ft,
Water Serviceulst 100 ft,
each additional 100 ft.
Storm and Rain Drain--lst 100 ft,
each additional 100 ft,
Special Waste Connection
Sewage and Sump PumP (e;ector]
Mobiie Home Sewer and Water
Other (specify]
SUB-TOTAL (Minimum $10,00)
I
I TOTAL FEE
Type of Equipment
MErnANI CAL
Number of Each
Total
Mechanical Permit 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 ~~chanical Exhaust
Wood Stove
Air Conditioner Only
Heat Ptunp
Floor Furnace
Gas Piping System 1 to 4 Outlets
Per Outlet
Other (specify)
SUB-TOTAL
I '!DTAL FEE "
\
Fee On Each
$ 5,00
5,00
5,00
5,00
5,00
5,00
5,00
5,00
5,00
5,00
15,O(J
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
6,00
I 6,00
I 6,00
I ' , 6,00
I
I ,50
I
I
I
I
I
I
"'r.~ "
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S". f:lf)
.3i CI U
/1) fM)
$ 10,00
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.
April 22, 1981
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;$ Yi/? ~/~
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App 1 i cant: .
You were informed / -/c::: -cP'/ by a~ from our office
concernin9 B,P,# ,$" LIe?? c;-KO
that a fee in the amount of
$/t1,o-V' will be required before we can issue your pennit,
The 30 day expiration period has expired in which to pay the required
fees, Therefore you must pay the balance $ /~LC;-O within ten days.
Failure to submit the required amount will leave this office no option but
to cancel the application, If cancellation occurs a new application and
associated fee would be required,
ROY L, BURNS, R,S" MANAGER
BUILDING AND SANITATION DIVISION
RLB/jbw
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