HomeMy WebLinkAboutPermit Building 1985-3-7
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I/~~' SPK
Renewal ofTMH
"
FOR OFFICE USE ONLY
Application/ ( f J ? Os
Permit # I b j-(\-.
Lane County Authorization' for:
. 'I\JWNSHIP
RANGE
'.SECTION
TAX'LOT" OolJ'f" OF
PROPOSED USE OF PROPERTY , I
,K] Residential 0 Industrial
o Conunercial 0 Public,
17 03
SJBDIVISION/PARTITlON (if applicable,)
First Addition to Buena Vista'
LOCATION ADDRESS STREET
22.4.1 1000
LOT/PARCEL BLOCK
11 1
CITY ZIP
35 Ann Court, Spf1d. OR 97477
STRUCTURES CURRENTLY ON PROPERTY
Existing house. TMH. shed
DIRECTIONS TO SITE
Hayden Bridge Way to Wayside Loop to Ann Court (Brownish-Maroon, stained house)
-j
~~SCRIPTION OF PROPOSED WORK - BE SPECIFIC
DECLARED S VALUE
Renew TMH 144-83 __ -....
~ OF BEDROOMS # OF STORIES # OF ENPLOYEE5 \"ATER SUPPLY ~c::. \ \ 1::;= {J I,~ -,
I(jr "-V -lPr~posed
"""., ";::::1 AD:~~r~in:a Booher. 35 Ann :onrt. SPf1d~y::t~::7i!l ~[UlVEb ".~ ':2~:~7~:g~.
, CONTRACTOR I S NAME AND OSR # (84 ' tEL PHONE NUMBER
,,~n, TOS:::"ED TO ,"^" "0 ADORES" .. .. . \0 J:.~:~~~~~ai7REb"ENUMBER~
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERl1IT, ar,d .10 hereby c'ertify that all n~t~~n hereon ~U:and correct, and that I
have the following legal interest 'in the property: Downer of record; o contract, p"rchaser;Dauthor~~tl1i\~~~e of authority attached.
I f:.:.rther certify that any and all work performed shall be done in accorda'l1G8 wi th ~ the Ordinances of Lane _ ad~ e Laws of the State of Oregon
:pertaining to the work described herein, and that NO OCCUPANCY will be made of any st.ructuI.-e without the pemisS-Ton of the Building Division. I fur-
ther certify that registration with the Builde~'s Board is in full force and" effect as re~uired by ORS 701.055, that if 'exempt the basis for eyemption:
is noted 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 .
CHECKED THIS APPLICATION THOROUGHLY.
Mail
2/1/85
NAME (please print)
SIGNATURE
DATE
.a. I . I W'" .
-~... .... .. ", ." ." 01. l. " ,. <, . ".l, 1111.
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION qAS BEEN BASED ON THE FOLLOWING CONDITIONS~
o PLANNING/ZONING: Zone
Partition #
Parcel #
Parcel Size
Minimum Setbacks: CL, front
C'
L, side
interior
rear
CO~~ENTS: This permit valid until 12/31/86 or until hardship ceases, whichever comes first
.. Date: nLnl~ (q()~ '(f)p -
V.,----~- - (J ~
Installation Record, Issued? 0 Yes 0 No
~ SANITATION:
S. 1. #'
B. P. #
~ 'o".11.hoo , Ga,1100. Ciooo' "" .", MaXimum, DoP,""
!~~ft~;jiu~(ffjdii'!~~~.~
DF~~:\3 ~'u . ~~. ~ .
COMHENTS:
Date:
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2-) ~8S-
~
PE~IT APPROVED BY-BUILDING OFFICIAL/DESIGNEE Coer ORS 456.805(1)) DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION ,.I-NFORMATION.
C 14-25 R84-
SETB1,CKS A~D OTHER CO~DITIO:;S OF APPROVAL ~lUST BE STRICTLY OBSERVED. VIOLATION CAN RESVLT IN REVO-
C';';'ION OF THIS PERHIT, CITATIO:J UNDER PROVISIONS OF LANE COU~TY''; INFRACTION ORDI:;ANCS, AND/OR OTHER
REelEDI ES ALLOWED BY LAW.
WHEN RE.~DY FOR INSPECTION, CALL 687-4065. A mNI:'lU~1 OF AT LEAST 24 HOURS ADVA1;CE NOTICE FOR INSPEC-
TIO~ REQt.:ESTS :>ilJST fiE GIVE~. Have the {ollowing information ready: pcrIT\lt number, Job address, type
of inspection, when it will be ready, your name and phone nu~ber, and any special directions to site.
BUILDING DIVISION:
REQUIRED INSPECTIONS:
1. Foundation Inspectlon: 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 (commonly termed lItransit mixedlt) 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
servi~e equipment, condu~t, pip~ng acces$ories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, incLuding the subfloor.
3. Framinq & Insulation Inspections: To be made after the roof, all framing, fire blocking, and
bracing are in place and all piFes, fireplaces, chimneys, and vents arc complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
4. La th and/or Gvpsum Board Inspect ion: To be made af ter all lathing and gypsum board, '.nterior
anc-exterIOr, is ~n place but before any plastering is applied and 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 inspecti~ns re1uired.
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 masonry (if applicable) and when installation is
complete. Installation shall be in accordance w~th an approved, nationally recognized testing
agency and the manufacturer'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 flood-
plain management letter.
3. Mobile home ticdowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirtlng shall be installed
per enclosure.
D. Swimming Pool: Below grade when steel is in place and before concrete is poured. Above grade
when pool-rs-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 :1AY OeCoR IF THIS PERl-lIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POINT or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
1. Permits shall be effective for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and Community Development by submitting the
installation record form. 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 construct~on does not comply with such rules, the Department shull notify the permit
holder and shall require satisfactory completion before issuing the certificate. Failure to
meet the requirements for ~atisfactory completion w~thin a reasonable time constitutes a vio-
lation of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewaqe Disposal
From: Interior property lines
Edge of road rlqht-of-way
Building foundation
Wells. other water sources
Septic Tank
10 .
10'
5 .
50'
Drainfield
10 .
10 '
10'
100'
APPLICANT:
Samuel A. Booher
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MAILING ADDRESS: ")'5~ Ann Court
, ! '
CITY, STATE, ZIP:Springfield~ Or,' 971+77
RE: Temporary Mobile Home Permit Number: 144-83'
Map/Tax Lot No. :17-0")-22.4.1 1000
. , ..
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INFORMATION PROVIDED BY THE APPLICANT
. " .
1) Person with medical hardship
Samuel A. Booher
2) Person providing care Steven R. Booher,
;Ii ~ ..' ,I 1 '. .: ,- " J l. . " .i
,3? famiiy relationship of the above Son
4) Resident of the principal dwellin~ Steven R. Booher
5) ReSid,ent of the te~rary m,Obile h~ ,Samuel. A. Booher
6) Signatures:,4A41'~A(/.~~ Date:' 1.:l-/t'J-rl/
Person with Medical HarcTship
/-7,'- p.. '-H. #
../f/Lt!~ff:,,~ Date: /:J.-/P-~t/
'pe'fson Providing Care
i
INFORMATION PROVIDED BY THE 'PHYSICIAN OR THERAPIST
1) Na!lle of patient ~~_,4. Ar?Y~o fl'/
'.. 0)'- " ~, ' ,
2) Nature" of the medic'a1 hardship ~IJ~, ~~.1 ~.~- /(i4a",~,
i ~ TO .' (f ., E- "
~"'4!:> ~ J.. 12: : -J:-i~ ;rt hJ,-I-~~ G?) p,~~~ ~,IJ';;:;;-?-":"'"
' ; b '..
3) Does this hardshtvneces!1,'tate that a family mem~er provide care? 1/~
Please comment: ~ 0 ~ ~ ~ '~.-.A'-~ 17(~
cLL.6',....; ,:../ 0'- ~ . .
4) Phys ician I s Signature .1(; L.. h:, ,/1 ~~ ' Date: ~ if W /9 r? <(.
Mailing Address:
City, State, Zip:
I'v',.-.1.1 (D tLr:-- ,- '}
- tl. - . ",:;;;-...,,'-'KI~~I crl"~.Il1J-' C.
., ' 1621 Ct?if.~efmv.zl BOIJ'~ri
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LAND MANAGEMENT DIVISION / Public Works Dept. / 125 E. 8th Ave., Eug. OR 97401 (503)687-4061
" ~.: ~"'... '
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CONSTRu~rION/PLACEM ENT
=>ERMIT
,
Application/~,. t;;.. ';J~,
Permit # \~14 ~() )
o Two copic~ of Plans.''':
[]Two Copies of, Plot, Plans
[]Mechanical,Checklist
[JPlumbing Checklist
[JPlan Check Info Sheet
THIS BLOCK. PLEASE USE BLACK INK AND PRINT.
"AAN'GE('~;~ 'SE2~~.'f~r. I 4AIOO~~90UT"-OF,,,u"i
Y",t:S,I"ONf'PARTlTtON (if ap'p~icable) '))'" ~ LOT/PARCEL BLOCK
1\r. C.':' (I A,.....l .'I() l'.'ll (.)"\/1 I>" (J II I I
\.._'.1 .(1 Ll I . ,~' }... ~ ' C v ,i../ '''-''
,tOCI4T!ON ADDRESS (" StREet ,.'" /l\ ,CITY ztPPR0P6~Ef)"'U::;i.:"(iF'"pKoi;-E"RTY"""' ."..,,,.
"4r ~~":~;'-:,~Jr')n C 't)ll!l t . .2JryQi. f :..:.:)~~?'~( 2]'Residsl1tiai Drndustrial
~. ..STl.\UC'rURES CURREN'l'LY ON PROPERTY "'-, ' ~X _t 't }",
~:~~~i\f'I,~:~lt T~(V k1r\H~f' t', If 0')1'\8, ,,/ leI) ( (- Mtirno ),:5 '\(~t~mmercialDpub1ic
',I,(.~,',;,~;~,(r:~(,I,'1'lO; ;\y[EJfX / rZ;1~I'\p. ...tILt, 'Llc\-0r,' ,)n~j ,':}::'1 Yl)~, t ,* "7" ,..., $ !=Sf&<
,1,',,: : '~E~.RO'p, HS ' II OF ST OR, IES # OF ~~YEES t I ~A~ER 5UP ,'LY . , - "'\ ,<.1, ~, " 0 Proposed
:'," ~7~. t....J I (""',~ -" (l/I.-:':")t-/ "'IA,' .1",./'(, , l'..( U~') r.vf; ,t'
J"" ,,,.J ',_ . /.~ ,!l'.... l I '" I '~J" I _..I. -<._ L-!I x~s ~ng
~i i~OlV~ER 'S NA~LE AND ADDRESS \ I " , -; I' r ......,..1, ." ) . TELEPHONE NUMBER
\ ! :~ o:y! 1'1\ 1 ~ ( L, ~'\ \11 rf rt't nJ (l) (..-'p'()()h Cft.! I \,.~t~) (Inn t~ (, I/)-t t )
: CONTFACTOR'S NAHE AND 1DDRESS I ........../ . ::'\1)\ IY~ /1 C '11cl (.-- , (!\--.,.../11'r
../ '......' ( 'K.'Y/\\ C ' i J)'., j It'.:q
CONTRACTOR'S OSR # DIRECTIONS TO SITE "'l,. . i J .'~ ~' " )..,....... t I... \
[1 CZl YT(t C\ct C 'Y') r~iLl ( CAe) \" (L 1" () ~~l. t ,\~) 'l( ( JJc1J ,t ()
'~ " (t ~ i. ..l v (/' ). ~ '-...I -.J f' A ~ A ,', '}':l,' l' i (" .. ( \
~'J "nn" l/~'t"~!.( \ /\i('\ll,li II./!' - /-! LOtc-(Y().'j ."~'l("'tl'rfr. ~\,)'Il'-._'j)
~lil,i:'t,.tllvE CIlREFULLY ,EXl\l'llNED TilE COMPLE~DIlIr.LICII'rION FOR PERHIT, and do h"rd)~-;;-;;'~f:IfY thnt: ~l ~ illfonll,tion h,,"""n ill trun. and correct Blld I~\lrtll'
::& ti'fY,i that any and all work performed shall be done in accordance with the Ordina:1ccs of. Lane County and the La'<\'s of the SUite of Or~q:m p'':f'la ill i 11'
~ 'h,(~6rk describP.d herein, and that NO OCCUPIINCY will be made of any stnJctUl'e wi.thout the permi~s,jon of the' Building Divi~ion. I further cprti f'
~ ,~"g~i:Jlstration with the Builder's Board is in full force and effect as required by ORS 701.055. that' if ey.empt the basis for exemptic", i" llotC!d
I, . .1,.,~,i',i,..,~t,,',:i::':, ::,~, '" ~o" OM',r a, 0'0<0 '",' ':;0'''' woo m '0 =.,"'00' wm 0..",.,,, oW .. 0"'" "0 '0;' "0;'0'., '"<oE ..." ;o:::::'~o ~"
I: At! II th~t:i!,\,~: YJ t l ']1 T~(tt1.}(s~"lq S3 (1.~;' 8:::,::.""'
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TEI,EPHON, N~.MBEj.(
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Hinllnum Setbacks:
.
comments'-~"\'! I"')' lJnHY),"-I.
'~'#"rh\ I( __', /{ li.,,) I hi if I lr:'l_) (1(-._.
:\.0 FLOODPLAIN: In flood hazard area?
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'S]'RURAi/ADDRESSING:
\",CJt: .
~;':'f;P"NITATION :
front.
CL, si.d<-
/./-i!' _;nltef'~~loil ;'4, . i k:,n./r II
~-:::. _.J I)'" l / l ill!
/ ..",.-..'
Date:/X 1'\ 1
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I
see attached sheet, Date :'_./
GRID COORDINATE
N
E
Date:
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S. 1. #
B. p, #
Installation Record Issued? [] ~e; [] No
Installation Gallon Lineal Feet
Specifications: Tank of Drainfield
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; Conunents: r' J ,',; '. "~'ft~.,";" .:' "'fl ';' 7; /1/..',r'~.A()X. /6",./j;';.' >~,W:1/f'/.!.S ';,1
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v;l'A./,t!lJ1.1.:'lhYi. ISl'lilJ//)1 ....lr://flff:1 /JO,I\/~7 ,j2" 'Ii;,
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O<.P,:LANS EXAMINATION: Type Group Use
Comments: .>!.IJJI'I,';'J/', \,-<)0 ffJlJll,ji ()f.'?/I'i IAJJ,fJ.t.It!//.; 11vJ 1 /;:,
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Maximum Depth
of, ,Trenches
( -4 .
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Date:
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CONSTRUCTION AUTHORIZED BY THIS PERMIT
Description
Sq. Ft.
Fixed Fee/
Unit Cost
.Floodplain Fee
Subsurface Fees
Building Fee
Sewer/Storm Drain/Water
$
$ J:Y\, (;/')
$ '.. :'.;'/) ( : ()
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---:-----:----:"""""::"'"'--------------------------------------
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L.f~NE
APPLICANT BOOHER, SAMUEL
'CU:I i 7E)J:~~~>li 01 ()00 SUBDIV
. ~EW BLDG TYPE USE R BDRMS 0
OWNER NME BOOHER, SAMUEL
CDOE APPL NO ACTION DESCRIPTION
COUNTY DEPT EN'll MGT F~ECEIPT ::::, 463B:> DATE OL.!i ::,'.
ADDR 35 ~NN COURT,'SPRINGFIELD,' OREGON
/ L.OT .BL.l<.,,,
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ADDR 35 ANN COURT, SPRINGFIELD, OREGON
S(~ FT UNIT COST VALI..IATIOH FEE Df'~j''{..
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f'L.f-IN CHECI< FEE:
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