HomeMy WebLinkAboutPermit Building 1984-6-14
C;6~GLS
':)) \3' FOR OFFICE USE ONLY
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fn() 10~) OJK,'ut, If{;,,,-(](jr(JrJ1eJ, f2f1cLattac.JrwrL DTWO copie~ of Plans '
, I. Ir - --U-; \ (-JtL.(ytflltDThree Cop~es of Plot Plans
~ TOWNSHIP I RANGE I SECTIO~ 4 I TAX LOT Dm.@OF 'lJt DMech/Plumbing Checklist
17 05 ZOo 2606 DLegal Interest Document
SJ(1M~TIr;;an (1f~e) fb..rL~ LO~RCEL BL01K D Plan Check Info Sheet
LOCAT. ION ADDRESS !l A::REET . I /1,......... /I Q .-tJ1: /i~Y ZIP PROPOSED USE OF PROPERTY
L/2'2/) LJ.jfl~ J..-U./fl.J/JJ ~ '1 "-174/7 ~ide.ntial DIndustrial
"W~o$i~4arriL ~r1Q/~c.~eL o public.
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'fJi&~f{ftt;n"nnc Oh,~=:aamrVJCLAREO $ VALU'
-;; o:..J.BEDROOMS # OF STORI:D'" # OF g:~f WA7r A S~PPLY IJ . '_",", u (j'-' CJ yoposed
chf1..-U2J . ~ "n'ffilL ,ULJX.Jotvr I ~xisting
0;, '~~Lvu 42Z{) {1nal./l~(Jh In. '19J!J77BER
, 's J?ho;;/Ch~~ '(v /I QIr~t) &m ~lJ~~(J!/ffJ
tilL ~#Ai-; ~ Jgr fJU'JJ ~up. T'L'P"O", NUMB'R ·
I HAVE CAREFULL:~~'::E COMPLETED APPLI~AT ON FOR'E~IT, and do hereby certify ti!'at all information hereon is true and correct, and that I
have the following legal interest in the property: wner o~cord; [Jcontract purchaser; []authorized agent with evidence of authority attached.
I f~rther cert~fy that any and all work performed shall be done in accordance with the Ordinances of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I fur'
ther certify that registration with the Builder's Board is in full force and effect as required by ORS 701.05 , tha if exempt the basis for exemption
is noted hereon, and that only subcontractors and employees who are ~n compliance with ORS 701,055 w~ll be ed 0 this project. I HAVE READ AND
'"~=i;!;;e'; ~;'7'PL~, ~;;6;-/L~ / 7- /~DAT-E ~if
v - NAM~ (please print)' - /" SIGNATURE '/
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Lane County Authorization
for:
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READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS!
o PLANNING/ZONING: Zone OC>r't" Parti tion # I' J . i>;[.C caee.l # Parcel Size
. :RJP</t\/ V. t:=:.. I 'I"oiLAJ!.J 10/ r1 / 01 'E
Hinirnum Setbacks: X front ~.~) I\:.. s~de. :_) . .E~-.km~r , rear~ U
COH}IENTS:~{'~t1 J?JuhlLl1i:?fLrTYl), '*,nU()<;;hOYU On
piLlm~ ,7Jf'tJ. tyJn f(:po/YJch 1'-1b-(j3?f! ,
Date;{} uno J.J 3 r1931-<fJb
o FLOODPLAIN: In flood hazard area? ~ No 0 Yes, SEE ATTACHED SHEET. Date: D
o SANITATION:
S. I. #
B. P. #
IOJ3-1/
Installation
Record Issued? DYes D No
Haxirnum Depth
of Trenches
Installation
Specifications:
Gallon
Tank
Lineal Feet
of Drainfield
~/bV.~~ A.uJkt:lA'/'~d
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COMMENTS:
-11 Q..aQh -ILR. j
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Date:
o -I'i~/Y
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o PLANS EXAMINATION: Type VN Group R3/M Use add; t S _ F _ n _ I c;",r",o-p
PLANS APPROVED BY LANE COUNTY. RESUBMIT TWO (2) SETS OF PLANS APPROVED BY
LAUE CJaNIYwliBN 8.rrL1:".Ll~\.:7 r-vi\ 1:.... DUl.LU.ll'l\.:7 r.c.N.VU.L. 8. nu .LLlJ.LNG !:,J:;KJV.l1T 1:; KJ:;~U1Kt:D
PRIOR TO THE START OF CONSTRUCTION.
COH}IENTS:
Date:
07-26-84
n
TOTAL v~. "UA.;,I., N.....,.....:;.:.'...~..... .,;..... ?..lid..... ." ......CON .S, TRU CTION
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lPYU ~J --ZZ X 20___
AUTHORIZEO BY THIS PERMIT ~,?i~~
Fixed Fee/ Floodplain Fee $
Unit Cost Subsurface Fees $
Building ~ee $
M2ch/Plmbg Fee $
Plans Check Fee $
State Surcharge $
DEQ Surcharge $
Ft.
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TOTAL FEE
$$
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PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.805 (1)l '-i...- DATE I
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061, C 14-25
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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SETBACKS AND OTHER CONDITIONS OF APPROVAL :MUST .BE STRICTLY OBSERVED. YIOLATION CAN'RESULT IN REVO-
CATION OF THIS PERMIT ,'CITATION UNDER PROVISIONS OF LANE COUNTY I S INFRACTION 'O'RDINANCE, AND/OR OTHER
REMEDIES ,ALLOWED BY LAW.' ' ' ,-" - ,- - '... , . ',t'
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WHEN READY FOR, INSPECTION, CALL 687;-4065. ?> MINIMUM. OF AT,LEAST::24, HOURS ADVANCE NOTICE FOR INSPEC='
TION REQUESTS MUST BE GIVEN. H,ave t,h,e, following - i,nforma tlon ready: -, permi t nhmber,' job addre'ss,' typ'e
of inspect~:jh:,~" ;,he~n, ~ti ;w,H'~' ,be ~ea,dy~" Y.~~\,; name ~nd ,'p~o~e .,numb~r'~, ,a!ld ~ny special" .p.ir"ecti,ons . to si te " .
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BUILDING DIVISION:
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REQUIRED INSPECTIONS:
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'Foundation I'nspection:' . To be-made 'after 'trenches are 'ex'cavated ,and..forms erected' ahd when all
material~' ,f.orth~ ,foundation a:r;:e;:del<ivered ',on ,the job._ Where ,c'oncrete fr~m a, 'central ,mixing,
plant . (c,o~'(:mli terme~ .'~transi t' mix~~ ")_ is .!:,o b~ us.eE..:I ,~ateria'ls need not be 'on the job.
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Concrete Slab or Under,-Floor Inspect:ioh: To be, made, af,ter al;l in-slab ~r...imder-'floor'buil:ding
service ~quipment, condui,t,. piping accessories,. ,and other"ancillar,y equipment items, are' ifl '" ,
place -i=>uj: before any, concrete is poured or floor'.she~thing, instal~ed, includinij:':j:h'e .subf:loor. ~.
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Framing' ~ Insulation' inspections:' To be.'made aft'er' the' roof,-" all 'fr'am~if;l-g-; fi"re blockinci; .~q..n:a~""""", __.
bracing 'are in place' and all pip!"s" fireplaces; ,chimneys, and vents .a're cO,mplete'an,d a~l rough.'~
el~_ctr'ic~l and::plum~i}"lg a~e..'approyeq~, "Al,l wall' i,n,!51,J,la tion_and vap()r,b~r~ ier a're, , i~, pla_c:e. . '.: ...: .
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Lath and/or 'Gypsum Board Inspection: To be'made af'ter all lathing and'gypsuril board, interior
and exterIOr, is in .place, but. before, any, plasterin'g:,:is,'~applied -and" before gypsum board joints
and fasteners are taped,a~d fi~isheg~
-,~.' Final Inspec'ti'on: : To tiE; mad.eafter the 'building )s c.o,inp"tet:E?~ri4 .bei~ore; ,?ccupancy"
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'APPROVAL REQUIRED. "No work shall be done on any part.of the building or structure .beyond the point
,indicated in .each successive inspection.without fi'rst ob.taining the approval of the building official.
Such approval shaI1 be giveI;! only after an inspection shall" have been made of each su'ccessive step
,in the cQn~tructton as' in4iciated by each of th~inspections required.
,)~OTE: ' All ,building permi tsreq~ire' insp'~ctions_ f9r,,!J:le. l'lork ,a~thori~e9-,.' sU_C,h a's b}lt I]-ot limi t~d to:
A. Block, Wall: To be made after rei.nforcing ,is. in place", but before any giout .1S ~oured. This
inspection is required for'each:bond beam pour. 'There will'be no approval until the plumbing
and electrical inspections have been' made' and 'apprciv'ed. "
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B'. Wood Stove: To be made ~fter cpmpletion of masonry (if applicabl~) and.when installation is
complete, Installation shall'. be' in 'accordance with an appro,ve~"na:'tion(Hly recognized testing
agency <:J.nd the manufact1;1r.er ',!?,..ij1Rtallation ins'tructiops. .' ',' . ,'....
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C. Mobile Home: . An inspection is required ,after the mobile home is cqnnec~e~ to ,an ,approved
sewer, or septic.sy.s:t~m .for setback requirements.,.. blocking" f~oting, c_onne.c,tio,[l', t!.~90~ns,
skirting, and plumbing connections.., . ". ' " ,'., I , '" . .:'
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'1. Footings 'an-d piers to comply' wi'thSta te 'foundatl'oh' requi:r!l~en'ts' 'for "inob-i Ie- homes 'or a's
rec?mm~.nded ?? ,~he manufacturer.
2. Mobile, home minimum finish floor elevation shall be certJfied when r~quire~ by a flood-
plain management'letter. .,
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days aft~r occuRan~y. Tiedowns and skirting shall be installed
per enclosur,e.
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Swimming Pool:.. Below grade when steel, is in place and before concrete is poured.
when pool ~s installed.
Above grade
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APPROVED PLANS MUST BE ON T~E JOB'SI'TE AT .ALL, TIMES DURING WORKING HOU~S. THI~. 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 INCOMPLETE OR ERRONEOUS
'INFORMATION.
',>,_'ANYONE PRQCEF;DING' PAST; THE POINT OF. REQUIREJ:) INSPE~TION.S :WILL pO SO AT THEIR. OWN RISK.
SYBSUFFACE AND ALTERNATIVE SEWA~E- DISPOSAL SYSTEMS:.. '
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Permits shall be effective for one year fromthe'date of issuance.
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Upon completing the construction for which a permit, has, !:'een 'issued, the perr;ni t holder shall
notify the Lane County. Depax:tment of Planni,ngarid Communi,ty .Development, by submitting the
installatio,nrecord form. The Department shall inspect the construction to determine if it
complies: wi th the rulescontaineq, in this division., If, the__construction does comply wi th"such
rules., ,the .Department shall issue a certificate of, satisfactory ,completion to the permitl"holder.
I f the cons.truction does not comply with such rules, the Department shall notify the permit
holder'an'd shiillre,quire _' sat~sf'a'ctciry comple't~onb.~fo:.e 'i;~s~ing ,_tJ:1e ce:t.iF~?t.e: Fa~'lure, to.
meet the requirements for sa t~sfactory complet~on w~,th:L.n' a reasona,ble ',<t:l;me co~s1;~ t~,tes',.,!-,:~y~o-
la tion, of ORS 454'.605 'to' 454.745 and th,is rule. ,_,I .-' , :',.' \' \' \.' " ..
_ ,~_-=.. ?etbacks Subsurface Sewage Disp'osa'l '.'
. -..."...,.. Septic T,ank Drainfield _ _
From: Interior property lines 10' 10'
Edge of road right-of-way 10' 10'
Build'ing foundation 5' 10 I
Wells, 'other water sources 50 I" 100'
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ACTIVITY INFORMATION SHEET
.~
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
1 ~ ~T /r..-;;~:Zb~- P~.A/ .#.re4J/e#
PERSON MAKING REQUEST
2./7- RJ -
'-T" , '5" /
MAILING ADDRESS
5P/(/Ur;~EL../) O~ J'1<fL7J
CITY STATE ZIP CODE
B~~-~<f-TELEe~ 1 HOME TELEPHONE #
2. PROPERTY ADDRESS' ~~...ff~ .
(IF DIFFERENT FROM MAILING ADDRESS)
.8,CRT. N~E~L.EI'€
PROPERTY OWNER
4-ZZ,O ANPtSRSod CA&fttt'.e"
MAILING ADDRESS
5/?e#'YC","r-/~
CITY
6~ 97~7? ;
STATE 'ZIP CODE
BUSINESS, TELEPHONE #
HOME TELEPHONE #
3 MAP & PARqEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxation!
or from tax statement) ,
/7 63' z B -f- 28 03
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL #
~.a.5'/ ..?'.d"..-v'.?/~
ZONING
TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL #
ZONING
I TOWNSHIP RANGE SECTION TAX LOT(S) OR PARCEL # ZONING
1 TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: ~1~~~c
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I 4 SUBDIVISION (if appl icable)CO:?~E G..-'f-...ep~ ?A~KLOT ~ BLOCK I
J 5 REQUEST (state exactly what you plan to do) RE~c;PaC. 'Ek/5/7"~<?-
G/{~C;;L I" ~~r...everA/c~ C:;:4.pefPcrL 7
: ,-1L/P EU'CT/</cfC. .::5E/<'V/ce: r-o"e /Y7/c~c> ~~ <!)v~.A/ ,zL
j j(tSJy/r- ~~-';;;c/y'.A/R~-RA~ti!E: ~ ,c:,...r/_::>i-~~C?" ,</TC,-.,'I6/l1.
',6 DIRECTIONS TO SITE: ~/~r~ &f=r C"cAtt'T.t:~A./~c. ,Be YD. ~.J(./
EA'fT .5/P4E .or /-L"- F~L::t.2~4'Y
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ACRES
** FOR STAFF USE ONLY **
NUMBER
ZONE/LAND USE:
BY: DATE:
DATE
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TIME IN: .
OUT:
LAND MANAGEMENT DIVISION / 125 E. 8th AVE.. EUGENE. OR 97401 I 687-4061
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