HomeMy WebLinkAboutPermit Building 1984-2-28
FOR OFFICE USE ONLY
.Appl~catie:r6 ? 7- O./J
Perffi1.t #_""J~ 6 7
D Two Copies of Plans
D,Three Copies of Plot Plans
DMech/Plumbing Checklist
DLegal Interest Document
o Plan Check Info Sheet
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LOC~O~~SS ~,:~T~ . ) V' . /' ./.?-7 ZIP PROPOSED USE OF PROPERTY
dc;L~' ~ ~~?~:#~//'fjp'~, K~~' 47~ij' J;a'Reside.ntial 0 Industrial
STRU~..?:::'CURRENT~"pROPE_R ./?' t/' .p"~ ./ G/,7 ./'"' // /" D" ". , 0 .
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TOWNSHIP
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Lane County Authorization for:
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:/7, RANGE C3
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SJBDIVISION/PARTITION (if a!,pli~.able)
SECTIO~ 3 T~02'UT OF .
LOT/PARCEL BLOCK
DECLARED $ VAL~
c:::la t1~& -
-Q :r:;po~ed
~st~ng
TELEPHONE NUMBER
2?6"-3S'? '
T.E~ONE NUMBER
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. TEL~NE NUMBER
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I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION FOR PERMIT, and do' hereby certify th~ll information hereon is true and correct, and that I
have the following legal interest in the' property: Downer of record;' 0 contract purcha~er; ~authorized ,agent with eyiden.ce of autl)ority 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, and that NO OCCUPANCY will be made of any structure without the permission of the Building Division. I fur-
ther certlfy that.reglstrat~on wlth' the Builder's Board is 1n full force and effect ~eqU1red by ORS 701.055, that lf exempt the basis for exemptlon
lS noted hereon, and that only subcontractors and employees who are in compllance'wi h RS 701.055 w111 be used on this pro]ect4 I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY: L .
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- . NAME (please pnnt) . - SIGNATURE, . DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION HAS BEEN BASED ON THE FOLLOWING CONDITIONS!
o PLANNING/ZONING:. '. zone/l0/ ... Partition # Parcel # Parcel Size / ~~ M...-.
Hinimum Setbacks:
COMHENTS: --rJn'
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CL, side
interior
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rear ,;:;;).07
rst FLOODPLAIN:
In flood hazard area'? I)ZI No DYes, SEE ATTACHED SHEET.
Date::J -;3- '8' <1
Date:--Z_~-S~
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X SANITATION:
Installation
Specifications:
#/~90- ~3
Installation
Record Issued? ~s D No
Maximum Depth
of Trenches
S. 1. #
B. P.
Gallon
Tank
Lineal Feet
of Drainfield
CO~IHENTS :
fPLANS EXAMINATION: Type .;?~) Group lZ-?
COMNEN~S:J!AiJ~ fQ- ~W--1iah
.~ Date: ,2-/ /o,/8"'cJ
Use I>.JX)/Tlxtn
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TOTAL VALUATION
$ ~~ t?t?t?
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Date.:~"1~~f31
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CONSTRUCTION AUTHORIZED BY THIS PERMIT
.. ~. Desc~~
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Fixed. Fee/
Unit,Cqst
Floodplain Fee
Subsurface 'Fees
Building :E'ee
H3ch/Plmbg Fee
pl ans Cl}eck\Fee
State Surcharge
DEQ Surcharge
Sq. ,Ft.
TOTAL FEE
/bJ, ,v
$
$
$ /L//J .>0
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$ 63' '
$ ,//.. ~
$ <":(,.?-
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$
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PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (per ORS 456.8051(1)) .'" - - DATE
LANE COUNTY DEPARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISIQN, 687-4061,
125 EAST 8TH AVENUE: EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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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 INFRACTION ORDINANCE, AND/OR OTHER
REMEDIES, ALLOWED BY LAW. '
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WHEN READY FOR INSPECTION.,' CALj:: 6S'7-4065. A MINIMUM OF AT ~Ef\ST .24 HOURS ADVA!'JC,E NQTICE:'FOR INSPEC-
TION REQUES'lIS MUbi et; GIV'EN. Have' the -fo"l-lowing-- in-forma t~o"n--read'y: . ~permi t numbe'r, job address,. type
of inspection,. when..t t will be ready, your name and phone ~umber, and any special directions to. site.
BUILDING DIVISION:
REQUIRED INSPECTIONS~-
Founda tion Inspection: To be ,made. af,ter trenches are e.xcava ted and~ forms er.ecte.d_ arid '~h.en all
materials for the foundation are deliv~red'on the job. . Where doncret.e frbm ~'c~ntral mixin~
. plantJconunonly termed "transi t mi~e~,,:"). is{ to .::~:~ u:sed, ma.ter :tals, ,~e:~. .n~.tpe.~n _:~~ ,job. "
Concrete Slab or Under-Floor Inspection: To'be rii!i~e af:ter all in-slab '0):' under-floor buildirig
serv~ce equipment, conduit, piping. accessories, and"othei>.ancillar'y equipment. items, are in
place, b~t before any' concrete is poure~ or 'floc)r, sheathin'g instalie'd, inc'luding the"subfloor.
" . .......", '...., ~ .
Framing ~ Insulation. Inspections:.. .To be. made. after. .the' roof., _ all: framing; . fire. .blocking, and. '..
bracing are in place and all pipes, fireplaces, chimneys, and vent's, are complet~ and 'C!,Il rou'gh:.'... .,,'0
electrical ,and plumbing are approv~d. .' I'~l wall. in'sula hon ,!-nd .vapor barr i.er ar~ in, place.
'. .- .-. .-..",:' "',~- - ..-... .., ~. .
Lath and/or Gypsum BQard Inspection: To be made after all lathing and gypsum board, interior
,and. !=~teri<?r,l is in place ,but before any p'lastE?ring .is applied and before ~ypsum board joint;s'
and fasteners are taped,~n? finished.
Final Inspection: To be made afl'{er the building is complete al}d before occupancy.
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of. 3.
APPROVAL REQUIRED. No work shali be done on a~y part. of the building or structure beyond the point
indicated in each su~cessive insp~ctio~ withoU~first obtaining the approval of the b~~l~ing 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 inspections required. ,'. '
NOTE:. All 'building permits require ~nspecti6~s for the ~ork authorized, .such~as but not limited to:
, . . . '_., f . -, . . .'" -.-.....
A. Block Wall: To be made after reinfor~ing is in place, but 'before any grout is' poured . This'
ins'pection is required' for 'each bond', beam poilr. There will' be no approyal.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 with an approve9, nationally recognized testing
agency:~nd the manufacturer's installation instructions.
C. Mobile Home: An inspect:Lo'n'.is' required after the mobile home is connected to an approved
sewer or septic system for se.tback .requirements,. blocking, fOO,ting connection, tied0wns,
skirting, and plumbing cbnnecti'ons. '- .. '
1.. Footings and piers to comply. with State foundation requirements for mobile homes or as
rec,o~ended b~ the m~nufacturer.
Monile home minimum finish floor elevation shal~ be certi!ied when required by a.flbod-
plf~~ man~~.emeEt. letter. . . >
Mobile home tiedowns, wheri required, and skirting shall be installed and ready for ins~ec-
tion within at least 30 d~ys after occupancy. Tiedowns and skirting shall be installed
per enclosure.
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D. Swimming Pool: Below grade when steel is in place and before concrete is poured. Above grade
when pool is installed.
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APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGINWI,THIN.lSO. DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN ISO DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF THIS'PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
'}NEORMATIOr. .' ';
~~ 'ANYONE PROCEEr.lrNG 'PA~T T,!lE POINT OL,'REQUIRED INSPECTIONS WILL DO so AT THEIR OWN RISK.
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SUBSURFACE AND ALTERN]:J.Tr.vE SEWAGE: DISPOSAL SYSTEMS:~
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Permits shall be effective for one year fr.om the d!ite,of,issu~nce,.,:.", .,~.,
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Upon completing the construction for which apermiE has"beenisstiea~-t~~ permit holder shall
notify the Lane County Department of Planning and Community Development by. submitting the
installatiQri rec'ord'forrri: . The Departm~nt shall 'inspect. the construction to determine if it.
compi-ie-;;'v.:{'ih,the"F'ul~scontained in this division. If the construction does comply with such
rules, Ehe Department shall' issue a certificate of satisfactory'completion to the permitI' holder.
If the construction does not 'comply'with such rules, EheDepartment:shall notify the permit
holder and shall require ',satisfactory completion' before issuing the cer~ifi~~te~ Failure to
,meet the requirements for satisfactory completion within a ,reasonable time constitutes a vio-
,lation of ORS 454.605 to 454.745 and this rule.
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1.
2.
Setbacks _ Suqsurface Sewage Disposal
." Septic Tank
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From: .Interior p~operty lines
Edge of ~oad right-of-way.
Building foundation
Wells, other~water sources
10'
10'
5 "
50'
Drainfield
10'
lQ'
10'
100'
~ 914-25
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Plot
Subdivision
Lot
Plan
Block
C74-1S0
Vicinity Map
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Permit II
Permit II
Permit /I
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For
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Permit fI
Permit #
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CHECKL'ISY,
PLUMBI NG I MEeHAN ICAL
OFFICIAL.USE ONLY
. Appli./'
Pennit #
AP:;6;::=fIONg~' . '3;J~/ #a-L. ~ 0uJ.
.-:- (Name or Fmn-Please hmt) (Malhng Address). (CJ.tior~ (Zlp c:If( .
PLU!\1BING CONTRActOR
~ Yes Finn
'Address
"DNo DSelf
!vlEGLANlCAL ,CONTRACTOR r8l Yes Finn
Address
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o NoD Self
Type of Fixture
t'LUMBING
Number of Each I
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Cont. OSR#
Cont. OSR#
'Sink
, Lavatory (Wash Basin)'
Tub (with or without shower)
ShowC'r,. separate
Water Closet (toilet/urinal)
Dishwasher
Disposer (garbage grinder)
Washing Machine
Water Heater'
Floor Drain
Sewer--lst 100 ft.
each additional 100 fL
Water Service--lst 100 ft~
each additional ZOO-ft.
Stonn and Rain Drain--lst 100 ft.
each addi bonal 200 ft.
Special Waste Connection
Sewage and Sump Pwnp (eiector)
Mobile Home Sewer and Water
Other (specify)
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SUB-TOTAL (Minimum $15'.00) ,
TOTAL FEE
- j\lECHANICAL
,Type of Equipmept r,'umber of Each
Fee On Ea<;:h I
$ 7.50 ,/
7.50
7.50'
7,50
7.50
7.50 I
7. ~O ,
'7,..50 I
, 7.50 I
;.7.50 I
30.00 I
15,00 I
20.00 I
15.00 I
30.00
15.00
7.50 I
7.50 I
15.00 I
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Total
j\lechanical Permit Base Fee
Furnace Up' to 100,000 BTU/H I
Furnace' over 100,000 BTU/H ' ,
Clothes Dryer Vent' I I
Bathroom Ventilation Fan & Duct I I
, Range Hood wi th j\lechanical Exhaus t I
Wood Stove ,(Wood Stove Vent $3.00) i I
Air Cqnditioner Only !
Hea t Punp "
Floor Furnace j
.Gas Piping System 1 to 4 Outlets I
Per Outlet Over 4 I
Other (specify) I
SUB-TOTAL I
I on Each r J
Fee Total
I I s 10.00
I, $ 6'.00 I
I 7-.50 I
I 3.00 I
.1 3.00 I
I 4.50 l
l 6.00
I 6.00 I
, I 6.00 I
I 6.00 I
, 2.00 I
,I .50 I
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'!DTAL FEE
C74-200
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ACTIVITY INFORMATION SHEET
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COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
I~ptd Lf~
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~'L_~~L~: Adt. 91/77
C ~'STATE ZIP CODE ,
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BUSINESS TELEPHONE # HOME TELEPHONE #
2. PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
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- ~ - STATE ZIP CODE i -: -
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HOME TELEPHONE # ; i
BUSINESS TELEPHONE #
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(from tax maps in Department of Assessment and Ta~~tionl !'
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or from tax statement ". " ' I :.'
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I 3 MAP & PARCEL NUMBER,
j (REQUIRED INFORMATION)
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. TOWNSHIP . RANGE SECTION
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TAX LOT(S) OR PARCEL #
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ZONING
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TOWNSHIP RANGE SECTION . TAX LOT(S) OR ,PARCEL #
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i 5 REQUEST (state exactly what you plan to do)
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6 D~CTIONS TO SITE: .J:~ ~ tfli~__7;_ ~ ~7J4;:i
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v ** FOR STAFF USE ONLY ** NUMBER ~.
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TOWNSHIP ,RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
! 4 SUBDIVISION (if applicable)
ZONE/LAND USE:
BY: DATE:
TIME IN: OUT:
ZONING
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. LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 ! 687-4061
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~~PLICANT GIVEN,
TLI 1703230000500
NEW BLDG TYPE
OWNEF~ NME
CODE APPL NO ACtION DESCRIPTION
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LANE COUNTY DEPi ENV MGT RECEIPT 0 32784 DATE 020384
AD DR 3361 BALDY VIEW LANE, SPRINGFIELD, O~
'LOT BLK r ;' ~
IBLDGS 001 PHONE 726 7357 . )
UNITS '001 STORIES
ADDr~
. SQ FT UNIT COST VALUATION
FEE
Df~ Y S
LC 32784 F~AD
NO. FIXTURES:
NO. CONNECTORS:
MECHANICAL FE~E
STATE SURCHARGE
.PLAN CHECK FEE
20000
1 5. 00 EACI1 ~-
140.50
4%
65%
5..62
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Sf~EF
91 .33
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EST. COMpLETION DATE
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TOTAL FEE**
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247.45 CK
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