HomeMy WebLinkAboutPermit Building 1984-4-24
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~ FOR OFFICE USE ONLY
" Lane Coun~y Authorization for; ~~~~t~aiion'//tt~=,f7'
~/~~..d~ o Two Copies 0' plans ,
t /~ /'...- ~ :jf D Three Copies of Plot Plans
TOWNSHIP / 7 RANGE /) ~ SECTION ~ 3- TAX.? /J OUT OF DMech/Plumbing Checklist
U J C7) a.1/i DLegal Interest Document
SJBDIVISION/PARTITION (if applicable) LOT/PARCEL BLOCK 0 Plan Check Info Sheet
?u7 ~~$~ /B" ";;;::i~S:n::::O'DTY,ndustCiaI
~~,~~~~ ~ _~L~co~eccial DPuhlic.
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';)~ ~F..PRO~. WORIC- BE SP"r'.T"w-, ~ / /~ ./ ~ - - _ / . ~~'~CLARED $ VALUE
~cP~-~ ~~~~~Z ~~~~~.
.~ OF BEDRO MrJI # OF It/h I # OF;Z;~ ,WATE~ SUPPLY ~~ ~~~~~~
~;~:REM/~ ~b~~~~~1 TEL~PHONENUMBER
~ A~k _A:j/f? {f?{/ ~~ ~;r&
P~4~M~/~/W.' ~
. -. ~HAVE CAR~~~INE; THE ~MPLETE~- APPL~ON FOR PERMIT, and do hereby certify that all information hereon is tru~ and correct, and that I
have the fOl~:~legal interest in the prope~[]owner of record; []contract purchaser~uthorized agent with evidence of authority attached.
I f~rther certify that any and all work performed shall be done in accordance with the or~ 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 ORE; 701.055, that if exempt the basis for exemption
is noted hereon, nd 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 AP ICATION THOROUGHLY.
.VH~~
NAME (piease print)
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SIGNATURE
DATE
kNITAT'ON'
Installation
Specifications:
READ THIS SECTION CAREFULLY YOqR AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS!
o PLANNING/ZONING: z~ner~--.\ . Partition # Parcel # . ,
Hinimum ~~: }L,. f~onr ~., I jL' side interior .;&.Zt)
COMl.1ENTS: <<-. \j 0,..--4. ~ '\ f/ '-- --.... ( l
CWO~D(~ A C Q.~\/'-\.....O ~~C), ~~~.A U~~
- ~ . - r \\'l ~ ~~~ Oate: / _. n
In flood ha.acd ma;zJ NoD '.', SEE AT:A:" ;;' Da~r',/jJ -h~JJf!-
S, L . / " ". c?'l U - 0 V '",ca11aCio" ReMd '",O.d'~" 0 No
~allon Lineal Feet Maximum Depth
Tank of Drainfield of Trenches
Parcel Size
rear ~ZD '
.I.N.:
CO~lNENTS :
;(PLANS EXAMINATION, TyP' \I-N
COMl-1ENTS :
Group B - 2.
o.,",~--j~W ~
Use r1-~JAL. ~->~Q..y Be'tr!r.
(1Jn COHIAEUtAL ~~ t!Jt2-
sm~ P~( I LetL>)
Date:-#18/s+ D
TOTAL VALUATION
$/(0990 ;B.
CONSTRUCTION AUTHORIZED BY THIS PERMIT
Description
Sq. Ft.
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Fixed Fee/
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4.(~ P~~~B~DING OFFICIAL/DESIGNEE (per ORS ~ 5;1a./sj,B
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
G7 .~5
Floodplain Fee $
Subsurface Fees $ /~... S7'
Building Eee ,~~ ~ ~~
~18ch/Plmbg Fee _j~ -?! !!--.
P 1 ans Check Fe;l~ S' ......
State Surcharge ~ L/ ~
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DEQ surchW7 0.3 $ C// 75
TOTAL F~~ $$ / 0 (0'-
--...........
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SETBACKS AND OTHER, CONDITIONS OF APPROVAL. MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT 'IN REVO-
CATION ,OF THIS PERMIT, CITATION UNDER PROVISIONS OF LANE COUNTY'S I~FRACTION ORDINANCE, AND/OR OTHER
'REMEDIES ALLOWED BY. LAW.'
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WHEN'READY .FOR INSPECTIOt:l, CZ\LL: 687-4065. "A MINIMUM. OF AT LEAST 24' HOURS ADVANCE NOTICE FOR INSPEC-
TION REQUESTS MUST BE c;IYE~. .Have ~h~ following informa tio'n' ready': perfiH' number, job-address,': type
of' inspection', when, it' will be r~ady, your na,me,and phone number, and any special directions to site.
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BUILDING DIVISION:
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REQUIRED ,INSPECTIONS:
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1. , Founda,tion Inspection:.' To .be-~made a~ ter tr.eFlches -are - excava ted'''and forms erected' 'and- when 'a:U,.
materials 'for.the, foundation are: delivered on the jQb: Where co'ncrE;t'e from a ,central mixing'
plant (conUnonly t;e'rmed "transit.rriixed")"is to 'b~ used,materials' need ~ot be on th,e job." .
. . '...~ '. _ .'. .. ~ _. ..... ,.... __./ ~ . . '. '" "nO ... . _ ~.. . _ _.. _ _. _ .
- 2.' ,Concrete Sl~b or Under-Floor Insp'e'ction: To be ~m,~d~' 'af.t~r all in-'s'lab or under':'f 100L'bui.'lding
service eq.uipment, :conduit", piping accessories, and'other. ancillary .equipment items..are ,in '__ ..
place but before any concrete is poured or floor sheathing in~talled, including: ihe sUbfloor;
," ""'.
'3:. Framing-'~ i:ns'ulati:on Inspections: 'To 'be made after the -roof', all framing" fire' blocking~..:and.
:-:.: br,aci-rig are in place and all' Ripes; 'fireplaces,' chimney.s, , and vents are comple,te and all rough
ele9t'r.ical and fllumbing a~e aI?pr,ov~d.,., .A.ll wa.ll in;;ul~ HOl}, and vapor barrier. are _ in 'pl,,!-ce. .
. . . " .. ","\'. - -,\.. . .
.4.', Lath and/or.Gypsum Board Inspection::. To be' made,aft.er 'all lathing. and gypsum board; interior
.", , ,and exterIOr, .is. in ,place. but before..:any ,plas.teii-ng is' applied .and..before gypsum boa'id joints, '
and fas;teners are tap,ed,and tiriished.
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5 . Final Inspection: 'To be:-m.~de<aJ,!:er' ~rebuil~li,ng 'f's: complete and before occupancy,
APPROVAL REQUIRED.' No work shall .'be. done ,bn, ,a~y' ,pq'~t 'of, ,th~ ,S~ildi.ng'c:ir ~tructure'bey~nd the point
indica ted in .each successive inspection ,without fir st., 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 eac~,of the inspections requireq.
/ ,.NOTE.:: .. All building perm:i, 1:s r,equir.e iflspe<;:tions fO,t _th'e ;work aut,ho~iZ'ed, such as but not limited to:
'A. Block Wall: To, b.e made cift;er' {~i,nfo:r;.cing, is .in pla~e, but b.efore any grout is_ J:,oured. This
inspection-is requir~d for each bond beam pour. There.will be'no approval until: the plumbing
ande'lectr,ical inspec'tions have been, made and approved.
B'. Wood Stove: To be rnadeaft,er completion of rnaso~r.Y, (tf applicable). and when installation is
cornp;Lete. Instp.~l~ tion shall be in accordance with an. approved" '.na-t{onally recogni zed: tes tin'g
Cagenc'yx:and the nl'ahufac,tiirer I s installation instructions. . .
"'_" ....., _,_,' ".-... .; .~ - ...." . I _.I. . .
C. Mobile Home: An .inspe'cti,on is required after the mobile home is 'connected to 9-n app:t:"oved
. sewer ,or septic. ~ystem tO,r se,tback requirements, 'blocking, . footj.ng . c~ol)nection, - ti'edowns,
skirting, and plumb.ing connections. ,. . .
L -Footings and' piers to comply wi th~ S.tate .foundation reqc:irements' for m~bile homes"or .as
recommended by the_manufacturer.
2. MObile. home 'minimum fini~h flo~r (;levatio~ ;ha'ii :be 'certified 'when 'required 'by a flood-
. pl.3.in m~n,agEfm~n,t letter. . .. .'
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after pccupancy. Tiedowns and skirting shall be installed
_per enclosure.,. .... ' . .
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D.
Swimming Pool: Below grade when steel i~,in,place and before cons~~t~ is poured.
when poo~ ~s installed.
/
Above. grade
APPROVED PLANS MUST BE ON THE JOB. SITE AT ALL TIMES DURING WORKING HOURS: THIS PERMIT WILL EXPIRE
IF WORK DOES N0T BEGIN WITHIN 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 .' -
,.1~ . ~~ - ~ \ ....
./. ANYONE PROCE-EDIcNG' PAST/THE POINT or REQUIRED INSPECTIONS WILL DO SO ,AT THEJ;.R.OWN RISK.
. ......q .. . <t. . . . . ',.' ~ \ I -, ~ ,- -.-' - . ,- ::.-,... ..~. - . ._. . - . i .~
, :SUBSURFACE"AN.D~A.LTERNAT-tVE"SEW](f}E' DISPOSAL SYSTEMS':,' ,,: I ' ;..... 'J
..\ ~),. :pf;)r.rni:\:s shall .)be'!eff~c.tiv,e'\fo~ one year from the date of issuance.
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:' '_.2...,~Qpop. 'cornp,leting.tl1e c:on~truction for .wh{ch a. permit has been' {ssued, 'the permit holder shall
:. :...~::".'; no:t:i:f,y'.;tne iLan-€,;,Cop.n:ty' De.pa.r:tm,en:t of,_Pliim~ing. ~I}d <;::QffiI1}l,mity.Deyelop1l\E!n,t b.y s1.!bmitt.ing. the
installatiqn r.eCord form. The Department shall inspect the construction to determine if it .
compJiE!~ "wif'J:l:t,he. .,~}llescontained ip.. tl)is di vi~ion. .. H th~ cO!1s,truction does" ~o.mply wi th such
r,illes, .tl1eDepartIJlent shall. issue a certificate.of...satisfactory completion to the, permit/' holdE!r.
If the 'construction does not comply with such rules, theDepartme~.!..' sh,a,ll .not,ify the permit
holder and shall. require' sati~'f.a'ctorY'.'compl'eti6n' b~f9r_e~Js~uing ~he.. cer'ti',ficate. ,Failure 'to
meet the requirements for satisfactory completion within a reasonable time constitutes a vio-
latiori of, ORS' 454.605~to A54.7,45 and this rule. '
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Septic Tank '. ..
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5'~':;;:;:1:' ~S~~, ~f; ;~~;":
Drainfield
.Setba,cks ~SubsurfaceSewage
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From,;" Interior -property lines'.
" . ',~;'~:::'Edge .of road right-of-way
':" B~fldirigfoun~atron
'--. 'Wells,., .other 'wa tElr sourc.~,s.:~
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LANE COUNTY VEPT ENV MGT REU~IPT # 110584 DATE 052284
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'T'i...~ 1703230000300 . SlJBI)]:V, 1...(:)'1'
N"E:W BI._I)(; 'I'YF~E: l.JSE X BI)RMS 0 l.JNJ:"rS 001 S'r(:)F~]:ES :~B!...D(;S 001 !::'f'1(:)NJ~~:
()WN!~R NME: l_ANI) I:~L..ANNIN(; C()NSl..A AI)DI:~ 209 QA Sl'AJ SF:'F:'I)A) ()F~
CODE APPL -NO. ACTION DESCRIPTIUN SQ FT UNIT COST VALUATION
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PL NO. FIXTURES:
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Permit II For Permit II For
Permit It For Permit II For
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H.O. APPROVAL
LANE COUNTY
GENERAL LAND USE APPLICATION
DIRECTOR APPROVAL
~#- .
FILE NO./y7};!-/,1/
~
Zone Change
Partition: Preliminary
Final
Subdivision: Preliminary
Final
Cluster Subdivision:
Preliminary
Final
Condo Use Permit
Greenway Dev. Permit
Temporary Use Permit
Special Use Permit
Variance
Site Review
Special Exception
Hazard Check List
Site Investigation R~O~ ~~~ .
SPecial Use Permit /-~~
Planned Unit Development:
Preliminary
Firial
PLANNING COMMISSION
Request for Interpretation
FEE PAID
COMBINATION FEE
additional
DATE SUBMITTED
(Applicant's optioh~higfiest fee plus $25.00 for each
application) .
DATE RECEIVED
..-.-.. .. ..... -" .
----------------------------------------------------------------------------------------------------
I. APPLICANT AND OWNERSHIP IDENTIFICATION
1. Name of Applicant~~-~~Phone ;?Z?'-crSc3
Mailing Address ~<f4'.7? ?:~~~A~_~q/~~?7?
Street if City / /' ,# Zip
2. Legal Interest - Titleholder
Other
Contract Purchaser ><-- Lessee
3. Signatures
I (we) have completed all the attached application requirements and certify that
all statements are true and accurate to the best of my (our) knowledge and beiief.
I (we), am also authorized to submit this application as evidenced by the signature
of the owner below. .
Owner's
Signature
Signatu~A.
Address I if
Date
Agent's
a, c l~rarY-
Date
4--23-84
Agent's
Phone
Zip
II. PROPERTY LOCATION
Assessor's Map /;7-z:;J, -5 1'/1 3
Tax Lot
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Size / -",Tax Code ./
Property Address 3~7 ~~~/~ ~~~
. ,_~/ - ~.." / 7v /' ~
.Road Status - State County Rd. ~ublic Rd. Easement ~~
Abutting Property Owned
~ap
Present Use ~~~~
(acreage)
Tax Lot(s)
.Present Zoning
. -
Structures --
. "j. n
wat~r Supply - Public
Onsite Wells
~ommunity Water System
If Community Water System, please list name
Sewage - Public System (list name)
Community System (list name)
Individual Onsite
Hrg. Date
~I" /~ ,-;'/.A:7,P Jf;<42~ ~.
Report Available
III. SCHEDULING
PUBLIC WORKS ~EPARTMENT. ~AND MANAGEMENT DIVISION
COURTHOUSE-PSB 125 E 8TH AVE. EUGENE~ OREGON 97461
C- 98-239
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ACTIVITY INFORMATION SHEET.
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- . PROPERTY OWNER
3427 ~AUJY. 0EW LAJ
MA"ILING ADDRESS ,I i
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Spt<J1l)6A~ Oe.. QZi/-77! "l:
CITY' / STATE ZIP CODE
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RANGE SECTION TAX LOT(S) OR PARCEL # 'Zor i~
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COMPLETE THIS SECTION. INCOMPLETE 'FOR~S WILL BE REJECTED!
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. . PERSON MAKING REQUEST
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( MAILING ADDRESS
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CITY STATE
cnt.f.77
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BUSINESS TELEPHONE #
HOME, TELEPHONE #
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HOME TELEPHONE #
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3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
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TOWNSHIP
TOWNSHIP RANGE. SECTION
TAX LOT(S) OR .PARCEL #
ZONING
TOWNSHIP .RANGE SECTION
TOTAL CONTIGUOUS PROPERTY iN SAME OWNERSHIP:
TAX LOT(S) OR PARCEL # ZONING
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** FOR STAFF USE ONLY **
NUMBER
ZONE/LAND USE:
BY: DATE:
DATE
TIME IN:
OUT:
LAND MANAGEMENT DIVISION / 125 E. 8th AV.E., EUGENE, OR 97401 ( 687-4061
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LANE COUNTY DEPT YNV MGT RECEIPT
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