HomeMy WebLinkAboutPermit Building 1983-1-10
I L. ane County Au thori zation for: ApplicationO ;:::;: 0/ /
_ . ' ~ADO"J1l1J,TO Permit # 7d -(J.~
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. 1~ . 1" DThree Copl.es of Plot Plans
RANGE SECTION TAX LOT DOUT OF DMech/Plumbing, Checklist
17 03 29 2[X) DLegal Interest Doc~ment
SJBDIN~A~~ LOT(/)RCEL q;CK. Dpl~n Check' Info Sheet
LOCATION ADDRESS STREET \ r: . PROPOSED USE OF PROPERTY
,34-15 ' ~olclur--' vUlli Lam 0) J [J'Reside.ntialD Indu:',tr'ial
" c~~~=~il~:J . IN~r~ o Public
. oh 21l1/maJ~u:m~:\ I M ~dl?f V'~l
:~,~T;N OFrm~W01()B(1E F C , , _ . ){[nL-L ~ €)CJr-ed DECLARED $ VALUE
= OF 13EDROO~'- # OF ~IE.S S" ( # OF EMPLOYEE~ WrnER SU~ . _ . ~A ~, ~. Proposed
(rY),.o! ( )1fUL., rtJrLO -' ~ ~7JrUYTX l'vOl L. ~isting
RiSt~(E,y\)1(r 5f.?Y1Y.~.P *~1 0 J={' ~5<ri' TE EPHONE~
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have the following legal interest in the property: []owner of record; []contract ure aser;~thorized agent with evidence of authority attached.
I f~rther certify 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, ?nd that NO OCCUPANCY will be made of.any structure witho~t.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 701.055, that if exempt the basis for exemption; .
.is noted ,'hereon, and that only Subcontra.dO"' '"' .."."" ," m '" ~~H.a, nee with ORS 701. _,.0;.; ,m ",' o~ "" '"'l:f~'. 'l"~-=n",If). .....
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READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION HAS -BEEN BASED ON THE FOLLO~NG CO~DITIONS!
o PLANNING/ZONING: zone~ / - Partition # pa:r;cel # parcel~
--~~~~~ft~./~ rtP~t~:8=S
JfJ'?JW:._'A' aCO....>ecl.~c...10.11() ~/oC~=tPrn I c!P
o FLOODPLAIN: In flood hazard area? @NO DYes, SEE ATTACHED SHEET. Date: n
331-1 b ,n".11.llon "",cor' ',"0'" ~
TOWNSHIP
EJ SANITATION:
S. 1. #
B. P. #
Installation
Specifications:
Gallon
Tank
'Lineal F",e~
of Drainfield
Maxirn~ Depth
of Trenches
CO~lHENTS: fJJ/lS /}; /J,lIl :~, ~~ ~. 1"1 h>.4",:....~ c-,'"
~~~u~ ~pju~~~>Lr/- d;__~.
~PLANS EXAMINATION: Type
cmlHENTS:~
~ Group R~
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- Date: 7 ~--/1 r!Y ~
use_UJttEv ~
Date: Z,., 1~ 8~
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TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
Description
Sq. Ft.
Fixed Fee'! Floodplain Fee $
Unit Cost Subsurface Fees $
Building J;ee $
~12Ch/P 1mbg Fee. $
plans Check 'I;. $
Fee
S ta te Surcharge $
DEQ Surcharge $
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'~~~~~E ~;' TOTAL ~~;~f5~
PERMIT APPROVED BY BUILDING OFFICIAL/DESIG~:: (per ORS 4 6.~ . -DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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SETBACKS AND OTHER CONDIT,IONSOF 'APPROVAL MUST BE STRiCTLY OBSERVED. VIOLATION CAN RESULT IN REVO-
CATION OF THIS PERMIT, CITATION UNDER PROVI'SIONS OF, LANE COUNTY'S ,INFRACTION ORDINANCE, ,ANp/OR OTHER
REMEDIES ALLOWED BY ,;LAW. \' ' ' . .
WHEN READY FOR ,INSPECTION, CALL 68~-4065.. A MINI.MUM' qF AT LEAST 24, HOURS 'ADVANCE NOTICE FOR INSPEC-,
TION REQUESTS MUST BE GIVEN. ' Have the following inf,orma tion -ready :permi t ~umbe'r , "job address, type'
of inspection, when it will be ready". your- ~a:me aIld}phone number" and any speci,a1' ',d{rl?ctions 'to site.
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BUILDING, DIVISION:,
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REQUIRED INSPECTIONS:
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1. Founda tion .fnspe;,~ion:~ Tb~(be ' i'nad~" ~f te/ t~~nch~'s are ~x~av.a ~ed and fo~ms erected and when' al,l
materials for the ,foundation are delivered on the job. Where concrete from' a~central mixing.
plant (common'fy "Itermed', "transj}:-t mixedp, :is' to b~ .used, 'm~terials re:d '.not, be ,9,n t::h~ jbbJ
. -. . - ~ . - ~ - .~.... # '.. " - ... .-
2. Concrete SlabQr Under-Floor Insp~ction:' To be made after all in-slab or und~r-floor building
?eryice equipl}l~n,t,~ <;:ond.u;j. t ;.pipil)ga,ccECspor,ies', ~~ other a~ci llary ,equipinen f. i terns are ,.in .
'plac.: but bef9re any concrete i's po~red or floor shea thing instal,led, includ~ng, the' .subf loor.
.~ .~ ;"' , ' ," ,~ i ~ ' j '. . '. \ ..,.. .. ~ .
,- 3,. t ,Framil}g; &.',InsH.la tion' Inspections :-, To be ,made .af'ter ' the 'r,oof ,.all framing" ,Lire. blocking". ,and_ -.
, br~cing are in., place and ,all pipe~'i fireplaces, chir~meys, arid vents are <:omplet€7'and all rough' ,
, e;l.ectr'ical an,d plumbing ,ar(;! approvE!d.. . 1\ll.'wall'insD.lation ,and vapor: ba,rr}!ef are in plac,e,.
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4,... La't)1 and/or Gypsum Board Inspect yon: . To be made after all lathing and "gypsulll board, interior
J' ,:.and:ex~e'r.IOr,~'.. is in place'. b~t befpre', an:y\ pl2.?te:r'irg. i~ appli~Q~eD9 p~f'ore gyps_wE .I:~oard_join,ts
and fasteners ~re tapep andfinis~ed. '
5. Final Inspection: To be made after th~ building is complete and before occupancy.
, ,
APPROVAL REQUIRED. No work shall be done on' "any part of the building or structl.lre beyond the point
indicat~d,in each successi~e inspection"without first obtaining the approval of the building official.
Such app,roval s,halI ,be, g,iven only after a'n inspection shall have been made of each puccessive' step
in the construction as indicated by each of the inspections required.
NOTE: 1?~1. building.,permits :.equi~e_ ~~sp:c,tions for the' work authorized, ,~\lCh a.p})~~ not limited to:
A. Block Wall: To be made after ~einforcing is in'place, but before any grout is poured. This
inspe,ction is required for each bond beam p'our. There will be no approval until, ,the ,plumbing
and ele~tricalinspectioi1s have been made, and approyed:
B. Wood Stove: To be made after completion of masonry (if applicable) ~nd when installation is
complete. Installation shall be in accordance with an approved, na~ionally recognized t~sting
agency'and the manufacturer's installation instructions.
C.' Mobil~ -Home:' An inspection is required after the mobi'le home is connected to an approved
, s,ewer or septic system, for. setbacki 'requirements i' bloc!<~ng, 'footing cpimecHon, tiedow,ns,
'skii-Hrig, and pluiilbi"ng connections. ~ _.. '. . .., . - '- ...~-' .' - ;_: -' ..
_ . _ L .Foo,ti1}gs and piers tocomp~ly~ wLth :Sta te : foundation" requirements 'for mobile homes_or as,
recOlnrfiended by,. the ma!,!ufacturer., " , ,
2': ' MoJ:iir~ borne rriinimum iinish floor 'elevation shall be certif,ied when -require'd by a flo'od'- '
pla~n manag~ment let~er.
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
'. 'pe,r enclosure. '. '-: "
D. Swimming Pool: Below grade when steel is in place and before concrete is poured. ~bove grade
when pool is installed.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING, WORKING HOURS. THIS ~ERMIT WI~L EXPIRE
IF WORK.D'OES.:t-lO,T'-BEGIN"W,ITHIN '180~DAYq., ,OR"IF WORK, IS SQSPENDED OR, ABANDONED ,FOR MORE THAN' 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS PE~~IT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
"!,NFORMATIpN. -""'1
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'. A~YONE PROC~ED_ING PAST TH~ POIt-lT '{~r REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
SUBSURrACE~A,~D,(AI,TE~NA:r,r:::~ ~ ~tWAG~ DISPOS~L SYSi~'ME?,::; i :'1" :""
1. Permits shall be effective for one year fr.9~m... :fb.~_.ga~~\l~~~~~~s~~t:~.' 'J ",',~'t '\;-'1' . ',; ,~\ \
2. upoil completirig the construction for which "'a pe'r~i'~Ba\s:)been i's;3'ue'd, 'thEi-p'ermi t.i101der shall
I)otify the Lane County Department of Planning and Community Development by submitting the
install'ation r.ecord' form. The Department shall inspect the construction to determine if it
complies"wlth.'t,he ,rules contained in this division. If the construction does comply with such
rules, the Department shall issue a cer'tifi'cate 'of satisfactory completion to the permitiholder.
If the construction does not comply with such rules, the" Department shall notify the permit"
holder and shall require satisfactory completion before issuing the 'certificate~ Failure :to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
lation of ORS A54.605 to 454.74~ and this rule.
Setbacks ~'subsuif~ce Sewage Disposal
Septic Tank
From: Interior property. lines 10'
Edge of road right-of-way 10'
Building foundation 5'
Wells, other water sources 50'
Drainfield
10 "
10'
10 ·
100'
C 14-25
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LANE, COLJ~T~ DEPT ENV MGT HECEIF'T ::: 9884 DATE 02078l\.
DENNIS AD~R 3415 BALDY VIEW LANE, SPRINGFIELD, OR
SUBDIV lOT BlK
USE XBDRMS 0 UNITS 001 STORIES OBLDGS 001 PHONE 747 7400
ADDF<
SQ FT UNIT COST VALUATION
FEE
nr:WS
APPLICANT CARNEY,
lL::: 1703230000200
~EW BLPG TYPE
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NO. FIXTUF~ES:
NO. CONNECTORS:
MECHANICAL FEE
'STArE SUF~OlAI:::GE
PL..AN CHECK FEE
15.00 EACH'....
4%
LC
9884 supp ,
140.5!:)
10.00
17.50
109.20
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TOTAL FEE*~
283.92 CK (~
EST. COMPLETION DATE
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ACTIvITY INFORMATION SHEET
, lane coun(y
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
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. '-'" - MAILING ADDRESS
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- STATE ZIP CODE
~3t/-.2- b 5/4
HOME TELEPHONE 'II
T:14<.,
GeITY
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BUSINESS TELEPHONE #
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31 /,C; 'Ea/~s:: !/r>.r(te,) L.:-~
MAILfNG~ESS -
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I Cm STATE ZIP CODE
7 ~~-~'i7'-cj 747 ?7t-OeJO r
BUSINESS TELEPHONE # HOME TELEPHONE #
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I 2. PROPERTY ADDRESS '
I (IF DIFFERENT FROM MAILING ADDRESS)
13 'MAP & PARCEL NUMBER
I (REQUIRED INFORMATION)
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(from tax maps in Department of Assessment and Taxation i
or from tax statement) i
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TOWNSHIP RANGE SECTION
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TAX LOr(S) OR PARCEL #
ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S)OR PARCEL #
ZONING
TOWNSH I P RANGE SECTION
TAX LOT(S) OR PARCEL #
ZONING
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t TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
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14 SUBDIVISION (ifapplicable) LOT
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; 5 REQUEST (state exactly what you plan to do) 8.8././/S /r7Y7 'Th
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16 DIRECTIONS TO SITE:
ACRES
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** FOR STAfF USE ONLY **
NUMBER
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ZONE/LAND USE:
BY: DATE:
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OUT:
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LAND MANAGEMENT DIVISION / 125 E. 8th AVE.. EUGENE, OR 97401 / 687-4061
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APPLICANT CARNEY,
I'L_:~~ 1'763230000200
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DEPT ENV MGTRECEIPT
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CODE APPL NO ACTIONDESCRIPTJON
SQ FT UNIT COST VALUATION
FE:E::
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PL NO. FIXTURES:
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CHECKLIST
PLUMBING / MEeHAN leAL,
OFFI,CIALUSE ONLY
Appli. /
pennit #
- APPLICANT INFORMATION:
(Name or Flnn-Please Print)
(Malllng Address)
PLUMBIN~ CONTRACTOR' 0 Yes' Finn
Address
D No DSelf
ivlEG-lANICAL CONTRACTOR DYes,' Firin
, Address
o NoD Self
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 grinder)
Washing !\'Iachine
Water Heater
Floor Drain;
Sewer--lst 100 ft.
each additional 100 ft.
Water Service-,-lst 100 ft. ' I
each additional 200 ft. I
Stonn and Rain Drain--lst 100 ft. I
eachaddi tional 200 ft. ' I
Special Waste' 'Connection I
Sewage and Sump Pwnp (eiector) I
Mobile Home Sewer and Water I
Other (speci fy) , I '
SUB-TOTAL (Minimum $15.-00) I'
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I TOTAL FEE
-
j\lEG-IAN I CAL
l\umber of Each
Total
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T)~e of Equipment
j\lechanicaf Permi t Base Fee
Furnace up to 1001.000 BTU/H
Furnace over 100,000 BTU/H
Clothes Dr,:er Vent
Bathroom Ventilation Fan & Duct
,Range Hood with Mechanical Exhaus t I
Wood Stove nlJood Stove Vent $3.00)
Ai I' Conditioner Only
Heat Pump I
Floor Furnace j
Gas Piping System 1 to 4 Outlets', I
Per CUtlet Over 4 I
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, Other (specify)
SUB-TOTAL
roT AL FEE
C74;'200
(C~~y or Town) (Llp Code)
, Cont. OSR#
Con t. OSJ~#
Fee On Each
$' 7.50
7.50
7.50
7.50
7.50
7.50
7.50
7.50
'7.50
7.50
30.00
15.00
20.00
15.00
30.00
15.00
7.50
7.50
15.00
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Fee on Each
S 10.00
$
6.00
7.50
3.00
3.00
4.50
6.00
6.00
6.00
6.00
2.00
.50
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