HomeMy WebLinkAboutPermit Building 1983-4-6
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La" Cou~ty Authorization for:
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RANGE ()~ SECTlo;? 3 5Z'OJOUT OF
,(if applicable)~ ' LOT/PARCEL, BLOCK
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TOW1~SHIP , 17
SJBDIVISIO~ARTITION
FOR OFF~CE USE ONLY'
APP1~Ca'tiO~a, / _Y?'
Perml.t #~ ~ ~.~
D Two Copies of plans
D Three Copies of Plot Plans
DMech/Plumbing Checklist
D Legal Interest Document
D Plan, C,heck Info Sheet' ,
PROPOSED USE OF PROPERTY
,gEes'ide_ntial, D Industrial
D 'Commercial ' D Public "
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I HAVj':CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERMIT, and do hereby ce t' y that all information hereon is true and correct, and that I
'have the following legal interest in,the prop~rty:[]own~r of record; []contract p' chaser~~uthorized agent with evidence of authority attached.
I f~rther certify that any and all work performed shall be done in acco dance with the ordi~s of Lane County and the Laws of the State of Oregon
pertaining to the work ,described herein, ,and that NO OCCUPANCY will be ade of any st,~ucture witho.ut the permission of the Building Division.. I fur-
ther certify that r'egistration with the 'Builder's Board is' in full for and effect as 'required by,ORS 701.055, that if exem'pt the basis for exemption
"is noted hereon, and that only subcontractors and empl~yees who are i ompliance with 'ORS 701'.055 ~il~'be used on this'project. I HAVE READ AND
C>OCJ;;:.,;noo .~a'M"e-te. . .
N~~~~:e print) ~ ~~
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READ, THIS SECTION CAREFULLY. YO~~~~HORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS!, J~)~
o PLANNING/ZONING: Zone /t/ 4 Partition # Parcel # Parcel SJ.ze /'V~
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I-linimwn S/~.kS" >>fr::nt.-L./ 'L&,..MfW~ ,~.in. i~r"" ~r., F-/
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Date: d / V <J
~ lb 193
DATE
o FLOODPLAIN:
In flood hazard area? D No D Yes, SEE ATTACHED SHEET.
, Date:
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I)( SANITATION:
Installation
Specifications:
COI-lNENTS: ~<J.()/1.-<.. p
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S. 1. #'
B. P. #
Installation
Record ISSUed?,D Yes D No
Maximwn Depth
of Trenches
,~ }1~fL ~L:'V
Gallon
Tank
Lineal Feet
of Drainfield
X PLANS EXAMINATION: Type
COI-lNENTS:',;?~ ~....
52J Group ep
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Date: ..:3f~/1-,Y3
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uate: c?#~b-55?
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CONSTRUCTION AUTHORIZED BY,THIS PERMIT
TOTAL VALUATION
Sq. Ft.
Fixed Fee! ' Floodplain Fee $
Unit Cost Subsurface, Fees $ ("'6
Build ing Eee $ c,,/,, ~
!,12Ch/P 1mbg Fee $ ,~
Plans Check Fee $ :,/-0: ~
S ta te Surcharge $ ..,i. r()
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DEQ Surcharge $ . .;;...--
TOTAL FEE $$ //J-S: 63
~C'/b- 1"--3
DATE
LANE COUNTY DEPARTMENT OF PLANNING & COMMUNITY DEVELOPMENT / 125 EAST EIGHTH AVENUE, EUGENE, OREGON
97401
SEE REVERSE FOR INSPE~TION INFORMATION
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SETBACKS AND OTHER CQNDITIONS OF APPROVAL MUST BE STRICTLY' OBSERVED. VIOLATION CAN' RESULT IN REVO-
CATION OF T~IS ,PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER
REMEDIES ALLOWED ,BY LAW." >,
.WHEN READY FOR INSPECTION, CALL 687~4065., A ~INr~QM OF AT LEAST, 24 HOURS ADVANCi'NOTICE FOR IN~PEC-
TION REQUESTS MUST BE GIVEN. Have the follovling 'iriforfna"tTon ready: peimi t number/roo" a<;1dYess, tYPE?,
of, inspection; ~when it will be ready, your name and phone 'number, and any special dire,s;,tion:5 to si te.
BUILDING DIVISION:'
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REQUIRED INSPECTIONS:
1. Founda,tion Inspection: To. be made af te'r. trenches. are ,excava-tedand, forms e:d'lct.ed and when all',
mater'ials for the foundati'on are delive'red on the job. Where concrete from a central'-,inixing
plant (commonly termed "trans~~ mixed") is to be: _u~~d.' materials need not be' o~ the job.
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2. Concrete Slab or lJnder-Floor' Inspe'ction: To be made after all, in-slab 'or under-f'loor, huilCl,ing
service equipment, c::onduit; p;i,ping accE!!3sories, and,' other. ancillary equipment:." items are in
place but before 'any concr-ete i,s poured' or floor sheathing installed, including'tlie suhflo'or.
. ~., . '. '. .' i . . ". . '.. ' . ., '. '. '- . . . . '. .
3".- Framing, &- Insur~ti6n Inspection's:' To' be' mad;;;' af,ter' the roof,' all framin'g'; f,ire-b-locking,. and
bracing' are in p'l'ace and, all pipes, f.ireplaces'" crimneys" and vents are complete" and, all rough~'
elect~ical' and plumbing ar-e approved.., All' wall insulation and vapor barrier are in pl~ce.. '
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4,. Lath and/or Gypsum Bba~d,I~pection: To b~made after all lathing .and gypsum board, interior,
and ,exterior, is in. place but~beforE! any ,plasteFing,.:.ik...app,ll.ed and,'before gypsum board, j:oints.' ,
and fasteners are t~ped.a~d finished~ , ,
5. Final Inspection: To be made .aE.~~r 'th,e 'building: is complete and15ef<;>re occ~pahcy.
APPROVAL i<.EQUIRED., No work shall i:le 'done ,on any part of the buildi~g or' structure' beyond 'the point
indicated in each succe,ssive in,spection w,~thout, f.irst,obtaining the approval of tfie building official.
Such approval shall be given only after an inspection shall have been made of each ~uccessive step
in the construction a~ indicated by each of t~e inspections required. ' ,
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" NOTE: 1\.'11, 'bui lding, permlts' require Qnspet::t'ion~' fOF':the work au thor,i'zed'",such a,s, l:111t not limi ted to:
~. .'... -,' . .~. . .,..... .', .~., .,... '. .' '. -
A. Block Wall: To be made after :reirlforc'ing is in place, but before any grout is poured. This
inspection is required for each bo'nd beam pour." There will be no -approval 'until the plumbing
and electrical inspections have, been made and approved.
Ir. W,ood Stove: To be made after completion of masonry (if app'licable) and when installation is
complete. ;rnstalla tion shall be in accordance' with 'an 'appr'o':'ed, , nationally recogni z'edtes ting
agE!ncy and'the manufacturer's il}stallation'instructions.
C. Mobiie Home: An ~nspection is'required after the mobi'le home i~ connected ,to, an approved
. sewer ,:or' s~ptic isys,t.eIn :for,' setbacl<:.Fequirement.s~ :'l;Jlot.k~ng, f;ooti!lg .cc:z:nec,tion, t:i'edowns,.
skirting, and plumbing connections. .', - -
~~ FootiDgs and ~iers to co~ply 0ith Sbate,foundation requirements for mobile, homes or as
,f. ' re'commended. by the manufacturer.
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-
pl~in,management letter.
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
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 S'ITE AT ALL TI~ES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK DOES ,NOT -BEGIN WIT,H'IN -i80 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.' . , , ... -"
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: .ANyONE PROCEEDING'~PAST,THE POINT ,or REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN 'RISK.
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SUBSURFACE ANp)AIi:r'ERr'if1'i.'fiy,E'S'EWAGE DISPOSAL SYSTEMS_:~,
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2.
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Permits shall be eff~cti~e for 'one year from'tne dat~ of "issuance '"
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Upon completing the construction for which a,permit has,been issued,.~the per~it holder shall
notify the Lane County Department of Planning and,Community Development by slibmitting the
installation reco,.l;:dform. The Depa'rtme'nt shall inspect the construction to determine 'if 'it'
compi.ies wit:h the'fules contained in this division. If the construction does comply with such
rules, the, DepC!-r~,ent' sl1all issue 'a, certificate of satisfaptory comple'Hon ,:to' the 'permi t(holder.
If the construction does not comply with such rules, the Department.shall.nqtJfy the permit"
holder and shall require satisfactory, completion before ~ssuing the ca~tificate. Failure to
meet the requirements for sat~sfactory cqmpletion within a reasoBabletime constitutes a vio-
lation of ORS 454.60~to 454.745 and this rule. ~
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Setbacks -Subsurface Bewage Disposal
Septic Tank
From: Interior property line~ 10'
Edge, of road right-of-way 10'
Building foundation 5'
well,s, other. water sources '50'
Drainfi'eld I
10'
10.' , ~
10'
100'
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la~e county
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CHECKLIST
PLUMBING I MECHANICAL
OFFICIAL USE ONLY
Appl~. / ?'7'l-,y:/
penmt ~ / q I
APPLiCANT INFORMATION:
, (Name ot~irm-Please Printj
P~~ OR 0 Yes
.-:;.
(Maillng,AddressJ
/
or Towp) _ CZip 'C Code)
Cont. OSR.#'
Firm
~~
D NoDSelf
MECHANICAL CONTRACTOR 0 Yes Firm
Address
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Con't. OSR#
o NoD Self
Type of Fixture
PLUMBING
Number of Each
Sink
Lavatory (Wash Basin)
: Tub (with or without shower)
Shower, separate
Water Closet (toilet/urinal)
Dishwasher
Disposer (garbage grinder)
Washing Machine
Water Heater
Floor Drain
Sewer'. -1st 50ft.
each additional 100 ft.
Water Service--lst 100 ft.
each additional 100 ft.
Storm and Rain Drain--lst 100 ft.
each additional 100 ft.
Special Waste Connection
Sewage and Sump PumP (eiector)
Mobile Home Sewer, and Water
Other (specify)
SUB-TOTAL (Minimum $10.00)
.,
Fee On Each
$ 5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00, '
5.00
5.00 '
l5.ob
10.00
15.00
10.00
15.00
10.00
5.00
. 5.00
10.00
Total
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TOTAL FEE
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Type of Equipment "
MErnANICAL
Number of Each
'",,-.
, Mechanical Permit Base Fee
Furnace up to 100,000 BTU/H
Furnace over 100,000 BTU/H
Clothes DFyer Vent
Bathroom Ventilation Fan & Duct
Range Hood with Mechanical Exhaust
Wood Stove
: Air Conditioner Only
Heat PlUIlP
Floor Furnace
, Gas Piping System 1 to 4 Outlets
Per Outlet
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Other ( specify)
SUB-TOTAL
TOTAL FEE
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[..): 2 I...t~NE 'COUNTY DEPT ENV !"IGT r::ECE IPT :~: ::~7?f.l3 D(.~lTE
APPLICANT MCALEXANDER, JIM ADDR PO BOX 2832~ EUGENE, OREGON
TI.... 1703230000300 SUBDIV LOT
NEW BI...DG TYPE USE R BDRMS ~ UNITS 001 STORIES tBI...DGS 001 PHONE 345
, OWNER NME ADDR
I."' CO:6E" (.lPPI,., NO f~lCTION DES:CFn:PTION S(~ FT UNIT COST' \h"-lL.l..JATION '
E: F'
ElP
,BP
BP
BP
BP
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sur~
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NO., FIXTUI:::ES,:
:::;I~:EF
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FP
C(.~ITG: (.lPP
SEr~U : 0
TAKEN flY F:I...H
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EST.
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CONNECTOF{S:
i'1ECHAN I C(.~LFtE
S'T;o~TE 'SUF~CHt~RGE
Pl..(.~N CHECK FEE
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COriPI...ETION , D(.lTE "
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FEE
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40.,63
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PLANNING & COMMUNITY DEVELOPMENT
ACTIVITY INFORMATION SHEET
Idne county
.......~
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
34S - '1 ~'2. ~
BUSINESS TELEPHONE #
bf31- '-~ 1 'S.
HOME TELEPHONE #
BO'''':LE'', T ER~e, ~().(A. e . r~<-.
, PROPERTY OWNER
'S~\S -gA\...~'f \J\6.w L~E-
, MAILI~ ADDRESS
SR\~I"""()~~>C~ OR-. 91 t:111, ~,
CITY STATE ZIP CODE 1
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L-~HONI~lC- D E~'(J.u7 . 't'"Mc...
PERSON MAKING REQUEST
Yo bu)(. "'2...g3,-
MAILING ADDRESS
'E.u G .
CITY
OR- q\~O'-
STATE ZIP CODE
BUSINESS TELEPHONE #
HOME TELEPHONE #
2c, PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP &. PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxatior
or from tax statement)
\'1 D~ '2..3
TOWNSHIP RANGE SECTION
00 - Dc,) 3 vcr
TAX LOT(S) OR PARCEL # ,ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
TAX LOT(S) OR PARCEL # ZONING
ACRES
LOT
BLOCK
5 REQUEST (state exactly what you plan to do) ~E:.M.UIJY 'FxT. ~~\Q.c:..
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** FOR STAFF USE ONLY **
NUMBER
DATE
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ZONE/LAND USE:
~Y: DATE:
TIME IN:
OUT: