HomeMy WebLinkAboutPermit Building 1975-1-29
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, .t.0 ': l: ", . . LA,NE CO",.,.olTY;"BU,I~D'ING ,PERMIT' OR 'MOB'ILE . ...)ME' U,SE.' PERMIT ' ,I
'~ . ~~: . ';k':";::"'BUILDI~G IJl}C ,".MH 0 ", " :PERMI.T NO., l-i5... 7,
I PROP.ERTY OWNER' MA.llINC;; ADDRESS "1 PHONE'
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JeMNSOJlJ, 'ff'lCHARD C .ANO RUtH G', '957 ANDERSON UCSPRINGF'Ie:LD ,7~7"'9660,
, CON.T.R-ACTOR . . . "M.A:llINCf' ADDRESS' : ','. " PHO~E . "
l~'I..i..tR CONsr. 102 V'f\N ,Buru:w EU~ENE, , ,.. 688-96)0"
',P.R()PERTY, LOCATION....,: INCLUDE:~OST OFFICE " " " . '.
:9,57, ANDEI1SQN LAiH~ S'P~' NGFI El.Dt' (l';ltGt:>N97477
'PROPERTY LEGAL. DESCRIPTION:': METES,., BOUNDS, :: .';:'., ','.. "
" "'lfe",.'/o' . PoRI; , ::~,:' ~'NJ 4~' A~l!)rJ,', R~c-/<, J1'
"TWP, 'RANGE' SECTION ' TAX LOT NO, , : CODE':'
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, CENSUS TRACT
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01
. 27~3~. :3
-It-'/6,.g(}O '
EXISTI':'lG, STRl).CTURES ,ON 'PROPERTY
AN~~A~GN~bAH~-~ EXISTI~QH$u~k
LEGAL' ACCESS' TO PROPERTY
..ANOERSON l.ANE'
PROPERTY SIZE"':: FT.
,: 'ApPL.
'NAME "
. .4'__'''".
TSllER 'CO"fST.>
&
MAILING
.'
.--"
:102, VAN BUREN":'
,~ADDRESS ' EUGtN'E., OREGON, 91-.402 .
'FOR 'MOBilE HOME PERMITS ONLY,
,'No. of Ber;lro'o,ms '
, STRUCTURES TO BE BUIL:T T,Hi,s P,ERMIT' " ,
," '.,
'AOOfTl:ON',( RECREAT I-ON ROOM}'(20,X: HI-)
WI[)TH:
70. DEPTH,' 87 I , AREA:
.'~ ~ '
,Connect,'to Existing Sewa,ge 'Sy~tem' D, '-:New System D
TYPE..S:ONSTRUCTION ' SQ,. FT, ',', # BDRMS VA,"UATION,
,280 @'16..:10' '~, $4;508.00 ';
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,PUBLIC D
,BUILDING
'WA'STE DISPOSAL'
PLUMBING~ '
PLAN REVIEW
PARK TRAILER
SEPTIC TANK' D OTHERD
: $ ~2':OO..",
~ .~". .,
'FEES
PLUMBING'INSTALLED BY
; OWNER D.' OTHER: NAME
WATER SUPPLY
I',
SEVy' AGE DISP,QSAL
PUBLIC D,
'0, OTHER '.
i '
.:
',!
'TOTAL
~. ~. ~2
,t ',~..~2 t"
CQUNTY: BUllDINQ& SANITATION SPECIFICATIONS
. DRAIN FIELD REQUIRED
'L1N:' FT, ' 'TRENCH WIDTH FT.'
I,.
. MIN. SEPTIC TANK CAPACITY
WITH OIST, BOX:'GAL.
OR SQ, ,FT.
2r-EET Of. QRAVELREQU I REO.. ,AOD 'MAXAlf.JOUNT ,OF ORA IN'F" I no THAT SPACE: AI:.L'O\;'/S..
'.....,
'TYPE OF STRUCTURE
OCCUPANCY
,ZONE : , ~
RA
USE CLASSIF!CATION '
P'U,BLlC UTIL. EASEMENT
~N:"
BLDG, SETBACKS ,_ FT, FROM CTR, OF, ROAD, RIGHT OF WAY
FRONT': 40 ' SIDE INT. ; I) , SIDE" EXT.
AUTHORIZED SIGNATURE - DATE
j sl J.' E. BO$S By, CHAR~.lPE HARfllAUGH' ,
REAR, 6.
JOHN SHOOK SANITARIAN
DATE
1..29..75 l014;
1
BLDG, PERMIT ~ WHITE
, OFFiCE COPY"':'" WHITE
COUNTY TAX- PINK
PLUMBING - CANARY
BUILDING - GREEN
SANITATION -" GOLDENR'OD
IMPORTANT:
Call '687-4065 to schedule all requireqinspections. All co'nstruc-
tion: shall 'comply wit~, Uniform Building Code, D.E.Q. standards
for. subs'urface sewage disposal and county regulations covering
plumbing.' All buildings require a certificate "of occupancy before.
be:'ingoccupied. ,
(See Det~i1s on, Reverse Side)
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r ",.., F.ORM # C55-13
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(POST THIS PERMIT, ON MAIN BLDG. " AT SITE)
, LANE COUNTY, DEPT. OF ENVIRONMENTAL MANAGEMENT
COURTHOUSE ANNEX, 135 EAST 6th, EUGENE, OREGON 97401
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sUP""eMENT T~BUI~~ING ~ERMIT NO: -I :;-1'5= ':Z r
. - ) Lane County, Oregon '... ~,
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OWNER ~>7""'lk~~ll:'L/t"";:t.JI, R' '-t'./i/..'l(;;' j.-':;'
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CONTRA~TOR \..-;fi,tl.-f.r'f. .",/
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MAILJNG f.D~FlESS -:;'~''J' .... ,'-[i7/-l/Z.'~~0.~ 1 It c.:'C ;i'( ,(
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MAILING ADDRESS J'''''' , '.-6.-'<:.;//./" Jt./:..,,,. r..f' . '.
PROPERTY ADDRESS
en 'ADDITION:
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o CORRECTION:
.?J'r:., /0 l'fo 0
CHANGE RESULTS IN: 'D REFUND OF FEE, OR
,
D ADDITIONAL' FEE:
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BUILDING
SEPTIC TANK
SANITARY CONNECTIONS
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Dat~ /...2'1-70
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TOTAL $ /..'), /)t) []] 0
DATE FEE. PAID J -r,"};";/ ,- ' ),,~' ras~ Check
LANE COUNTY DEPT. OF HEALTH & SANITATION
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Supplement
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_ '1861
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5 By ~/Lfl.lV
C?Jj~ ()...-i'.'V
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. 1 ENVIRONMENTAL MANAGEMENT
, 135 EAST 6TH AVENUE
EUGENE, OREGON 97401
YOUR BU I LD I NG I 1$5-75) MOB I L E HOMEL
jb~~
IPERMIT IS BEING HELD FOR THE REASONS
STATED ON THE BUILDING SITE EVALUATION SHEET. 'WE WILL HOLD THIS APPLICATION
F;h .5/CJ75 . IF, AT THAT TIME, YOU HAVE NOT FURNISHED
)
THE REQUIRED INFORMATION, AS SHOWN ON THE ATTACHMENT, YOUR APPLICATION WILL
UNTIL
BE CANCELLED AND ONE-HALF THE FEE REFUNDED TO YOU. HOWEVER, IF THERE IS A
PLANNING DIVISION PROBLEM OR SOME OTHER LONG TERM PROBLEM WHICH YOU HAVE NO
CONTROL OVER, WE WILL HOLD THIS PERMIT UNTIL IT CAN BE ISSUED.
M55-88
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/ .
~ T 7 R Q3 s.{2,7 TAX LOT,
SUBD I V I S I ON: - . !
" LOT:, BLOCK:!
. T;'l1er- (&n:;r
I-rZ/-7/-)
CK'D BY: ~;?' /-;;.,p....:J~
6. Setbacks from c/l of road:
\
Front -7" ti
Side Exterior '
S,etbacks from inter i or 1 i nas:
Side '~
Rear ~
BU I Lll I'NG ~ irE 'EVALW~T ION -,
c\t
( r BUILDING PERMIT APPLICATION NO. ' I "tl. t"-,'?,J;:....
() SITE INSPECTI9N
. AP'PL I CANT
DATE
PLANNING DIVISION
1.
2.
3. .
4.
5.
'Not ,
. Appl icable ,No Yes
Zon i ng Ord i nance Comp 1 i ance: Zone ~ () () ( )
Subdivision OrdinanceCompl iance ~, ()" ( ) ( )
Required Access ,', () () ()
Building Site (Area, Width, Frontage) () () ( )
Other (see comments) r (), () ( )
r
COMM~NTS:
PLANNING DIVISION ACTION: PENDING: 'YESl j NO,l ) APPLlCATlON#
BUILDING INSPECtiON DIVISlb~
,Not \
App 1 icab 1 e
( )
(IC)
(Il )
(,)
No Yes'
,() VO
( ) (")
( ) ()
( ) ( )
.7.- Pl ans Submi tted ~
8.' Soil St~bil ity (footings)
9 . Flood ' P 1 a in' ,
10. ,Other (see comments)
\ -
COMM'ENTS:
Not '
Applicable No' Yes
11. Meets Department of Environmental () r-) ~
Quality Standards.
12. Other. (see comments) , () .fIjiY ( )
COHHEIJ.TS~! ~ ~ U/LM/ "'" jwu;41
~,_, ~At/I'M~ '.M,J'/iU(', ,'O,,^,- \S~
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WATER POLUTION CONTROL
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CK"D BY~Itdf-1'~~o~~,~~
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C~'D BY:\'UljA~/I;
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) #'
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-' TO APPLICANT: , )'"
Your ~uilding I Site.lnspection: ,
( ) Can be approved~
~Cannot be ,approved at this time as indicated on item,NO. /';1 above.
Questi ons 'and further informat i on on items 1 -thr6ugh 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 b~ held in this office until you can resplve ~he problems indicated.
( ), ,Is b'eing returned.' "'
( ) Your building permit aeplic~!..L2.!l_Je,~_L~!?eing, ,=~turned un.s!er,_seoarate cover.
DEPARTMENT OF ENVIRONMENTAL MANAGEMENT ,
, , " 135 Sixth' Avenue East Eugene Oregon 97401 \
PHONE: \687-4065
LANE COUNTY PLANNING DIVISION PHONE: 687-4186
, I
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C55-28
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lME USE PERMIT
PERMIT NO.
~/
LANE CO, fV BUILDING PERMIT OR MOBILE
BUILDING DM MH 0
'PROPERTY OWNER MAILING ADDRESS'
":,."/",I,;~ (~~(~AQO [. AND nut$~ e r;;51 ik~Dt)~J()'l l:' Jf\JH~j'(fdl:~.@
CONTRACTOR MAILING ADDRESS
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~:iPROPERTY LOCATION - INCLUDE POST- OFfiCE
,~~j( i~~~~tR;'jO'. ~{i,:.!(l: 3~QWf:'9-ijr,:U:Jj') (:wnC(];J ~rq!,Yrr
: ',PROPE.'~F~ESCR[pT ION - )!>fjES, BOUNDS#
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, I" TWP ," RANGE' S ION TAX LOT NO,
:'~ f ' 'tY1' fL(
i'Zi<,. '?
PHONE
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PHONE
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CODE
CENSUS TRACT
,"",
. EXISTING STRUPURES ON PROPERTY
(?,!'.\OOQClGW"'&4~C""<;,> C~l *t'W ~;::(', ~~<n3~:,C
LEGAL ACCESS TO PROPERTY
At~~ti'~~t3,,~ ~,M~e
PROPERTY SIZE - FT.
WIDTH t~ j) DEPTH f.jr "AREA
APPl.
( NAME'
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YQ~,,-tt(.~ C(~c91.
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lO:,"::' '\INJ ,G!5~Q';i~~
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MAILING
! ADDRESS Ct;:'1 f,<~'E,O:lU:,i)f2;<J 9Tbr]
,FOR MOBILE HOME PERMITS ONLY
, .
, No. of ,Bedrooms, '
STRUCTURES TO BE BUILT THIS PERMIT
~,j[.),: nr vC;,' Q ~~t.:::;:~ftA'fe''Q::<''i~6C''':'' ~ ,~:@, ~ ~k\p
Connect to Existing Se~age System 0
TYPE,CONSTRUCTION SQ, FT, # BDRMS
r"I.!j.~ .... t \"1 f-~ ,\^
l :O;jj c. ~ 4iwo )j\;~.'
New System 0
'VALUATlON
(}~J.t ~2'{;:'~:4'
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"
--1
~UHDING
. WASTE DISPo'SAL
t .
, 'PLUMBING ' \
. ' \
~L-AN REVIEVv' """ i
. '
PARK TRAILER
~
OTHERO
<,~;,.t~~;
FEES'
PLUMBING INSTAllED' BY
OWNER 0 OTHER: NAME
. WATER SUPPLY
1 SEW(lGEDISpoSAL
. PUBLIC 0 ' SEPTIC TANK 0
PUBLIC' 0
, o OTHER
I ",
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1~C>TAL
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i tMIN, SEPTIC ,TANK CAPACITY . ,_ ' '
I ! ~1'rH DIST, BOX: 'GAl. ", \""
;, "~\"
';'~ v(r':.I' .:: "~ttC:~, ;~~clt'
~'
'{e,: '~,:l,
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FiElD REQUIRED
> '
, ,
'L1N'. FT
TRENCH 'WIDTH FT.
OR SQ. FT.
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"^-~H !\~~>;.7W\r,.'~ "\':('1 v~~U;,nj~V D?L\q;C
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ZONE
,ret.,
USE CLASSI~ICATION
PUBLIC UTll. EASEMENT
~TYPE 'OF STRUCTDRE
1 ':1 .
, 0 BLDG, SETBACKS _, FT, .fROM CTR, OF ROAD RIGHT OF WAY
t(.. )!,rt: .~
'. 'FRC>NT ,.:, , , SIDE INT. ,,:I SIDE EXT.
:~, \ I ' AU:rHO~IZED SIGNATURE - DATE '.
.' :/[1' 'J~ C'" &0'21<:) thC'L'V"'!\ is ~1l,:1r'DY::::t:l
,,', ' Y' .
OCCUPANCY
REAR
rs
DATE
"J:,'~;'J r;:K~.en ~CliJ i .'M, ~ n:1.
i ,{..: ~' .~. \
BLDG, PERMIT - WHITE
'OFFICE COpy -WHITE
'COUNTY TAX - PINK
~ 1\ PLl,lMBING - CANARY
i 'BUILDING'-:GREEN ,
SANI!ATION - GOLDENROD
IMPORTANT:
, Call 687-4065 to schedule all required inspections. All c:onstruc-
tion shall coOmply with Uniform Building Code, D.E.Q. standards,
for subsurface sewage disposal and cO!Jnty regulations covering ,
plumbing. All buildings require a certificate of occupancy before;
beiJ;1g occupied. '
(See Details on Reverse Side) .
,FORM :F, C55 -13
(POSY THiS PERMIT ON MAIN BLDG. Ai SnlE)
LANE COUNTY, DEPT. OF ENVIRONMENTAL ,MANAGEMENT
COURTHOUSE ANNEX, 135' EAST 6th, EUGENE, OREGON 97401
~~
.0
SITE INSPECTION
ApPROVED / / DISAPPROVED / I DATE.
INSPECTOR
REMARKS
FOUNDATION INSPE~~~ON ~~
ApPROVED / V j DISAPPROVED / / DATE"z,w 7- 7~ I NSPECTO~
R'"'.KS f)/(~ ~1-;:~$~;;':/-2?-1.r~ t::P.).
,
FRAMING INSPECTION
ApPROVED / v: DI SAPPROVED / / DATE.,),-7.....76-
I ""'CTO&! ~ /.
REMARKS
LATH OR SHEETROCK INSPECTION
ApPROVED /
/ DISAPPROVED /
/ DATE
INSPECTOR
REMARKS'
/
FINAL I NSPECT ION ./
ApPROVED / ~~DISAPPROVED /
I DATE tj-r- ?~
'"S"CTO..~
REMARKS
CERTIFICATE OF OCCUPANCY
READY TO ISSUE / / NOT READY TO ISSUE / / DATE
INSPECTOR
REMARKS
I JJ,7J'-
J~
~/~1f1 /i/)~ ~ (,)
9'~-7 ~
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LANE. COUN
BUilDING PERMIT OR MOBILE H( . USE APPLICATION
t3S-7S
. PERMIT TYPE - BUILDING IX!
PRO"ERTY.OWNER MAILING ADDRESS '
1Z.j~hA'(r1 E. ~ Ru.-rt,' G-. :TohlLl-SoN 9511-l.4!cI~rL~I'JJ lA,J,
MAILING ADDRESS
-riiL!! /2, ~A1STI6u.f!.1 ,.n~J /t<bJ. UAAJ ttJ./"reJJ fua,e Ale
PROPERTY LOCATION - INCLUDE POST OFFICE I
-9J)'1t))Jd~19 iJ Lp.JJ~. Sf!-~/' JJ C~i'p.ld/ (Jre 9flAl ..114 ;7'1
PROPERTY LEGAL DESCRIPTION , '-;:7 I. ' A AI j I-r. ~ I.' , .--;-) METES & BOUNDS DYES
LOT - BLOCK - SUBDIV. LO/.=? DIDc.K f{' 0eCo.u.rI (KZ/I/d./J 10 /YlpA)i.(;. -M/l.K ATIACHED D NO
TWP RANGE SEe. TAX LOT # CODE CENSUS TRACT
97
MOBILE HOME DOSC REG. #
PERMIT #
. PHONE 7tf1-
Soe;v ClP,'t::./r/ 9~hf)
, -..J PHONE .
~??~9'=.5tJ
CONTRACTOR
"'7
t73
APPLICANT _, 'A ')
NAME -I 'i L l t- e c I'J A)ST~ u.ti, I ,..-1 AJ
,AND I j) ~tl1;u1) B ur (J~ A.J
MAILING
ADDRESS k u- 4 t tV .e...) () r ~ a IJ ..J
FOR MOBILE HOME PERMIT 'ONLY . I
q 1 t/-D ;L
DESCRIBE EXIS1NG STRUCTURES ON PROPERTY IF ANY GX' ;ST/.<J 7
~IJ ...5. t" ~-:t~ ,.) ,(. .-. .k #{)ILS~
LEGAL ACCESS TO PROPERTY - ROAD NAME OR #
A.JJder.5t!) A.) Lf\JJ It
PROPERTY SIZE-WIDTH DEPTH AREA
~7 0 (''/
Number of, Bedrooms Connect to Existing
STRUCTURES TO BE BUILT THIS PERMIT TYPE CONSTRUCTION
add~iLnr)/~vLZ1~)~) ~XJ4)
" - ..-/
Sewage System 0 or New System Req. 0
~. FT. # BEDR009 VALUATION ,
7_ff)~ II/) J l n ./(> ~ 5~g-, 1J 7J
/
TOTAL
,3 2-
32.32-
/-
/
/,p'
PLUMBING INSTAllED BY
/~
OTHER D A'0WNER D OTHER D NAME
FEES WATER SUPPLY../" PLANS FURNISHED FACILITY PERMIT
PUBLIC D OTHER' /" YES iK NO D YES D NO M
~J~~' SIGNA _ E OF ~PP~T4~) /~zd:15
r\{ ~~E EIVED BY DATE
CASH.l:":o SEWER
CHECK n CONNECTION FEE / - to -/5'
PERMIT #
PUBLIC WATER
CONNECTION FEE
SEWAGE DISPOSAL . A
JIIV ,,\
PUBLIC D ' SE 'TIC. TANK D
$ -.:52, 00
BLDG.
WASTE D'S.
PLUMBING
PLAN REVIEW
PARK TRLR.
MIN. SEPTIC TANK CAPACITY
WITH DIST, BOX: GAL.
COUNTY BUILDING & SANITATION SPECIFICATIONS
DRAIN FIELD REQUIRED
L1N. FT.
TRENCH WIDTH FT.
OR SQUARE FEET
2-' o-V B NJ.,~~l
i-Aa + <SDa r ~
,/
~P(t.'A" red.
Q !ityU \ .S' .
4&/ Jh6~_
a n1..A~ -f
("'}~
afret I~,",-D~ IrJ
TYPE OF STRUCTURE
, A ~ OCCUPANCY
01V I
BLDG. SETBACKS - FT. FROM CTR, OF ROAD RIGHT OF WAY
ZONE
REAR YARD
PUBLIC UTIL EASEMENT
6<..~
FRONT Y t:7 SIDE INT, . $" SIDE EXT:
NITARIAN I /' .Jate PL~NNING
~ ) '1 <6 1 ~ ~ /- ..:lL"? -?.s-
! f , ' ,
Date
REAR c::::, ,
BLDG. INSP,
USE CLASSIFICATION
1 .tI'\ .I)
J IF.!;; h !J d 11/ V Date
1A2 (;PU.~lf r.;:,t:L 1= d< (f! -:;yf
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Property:
1/
COpy 1 - OFFICE
COPY 2 - JOURNAL
COpy 3 - AUDIT
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Form -# C 55' 1 Z
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