HomeMy WebLinkAboutPermit Building 1983-11-3
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FOR OFFICE USE ONLY
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~ D Three Copies of p'iot Plans
TOWNSHIP JNGE3. , ,', ,SECTION ,3' , TAX, L,OT DOUT OF DM.ech/p~umbing -Checklist
17 0'" ''2- ' ZCJ(J,' DLegal Interest D~cument
SJBDKr0rARITJOJ1~{fhli LOT(fJCEL (bCK ,Dplan Check Info Sheet
I STREET \ /: J\. ~ I . _. ~,/'l 1C':.-J \ G7(.' ~I~ ZIP PROPOSED USE OF PROPERTY
V ULU..J U'\ GV/tJ ~ 4/ I czr;:side~~tial:' D Industrial
, ' '"0 t ~lluYw" ,. Jr;L :. ttnl ~ {/gO .' . '. .'. .. 0 Commercial [J PUb~.
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:OFr~ 'O'OWL.' r\ono.... rJdwn- ~aL' ~~~~~~~
O'ONER~d'" . .y 3415 ~YLU0~,,~(d 747-.'74M
. have the following legal interest in the:property: Downe~ of record; 0 contract purchas~r; authorized 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, and that NO OCCUPANCY will be rnadeof 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 ORS 701.055, "that if exempt; the basis for exemption
'is noted hereon. and that only subcontractors and employees who a~e in compliance' with ORS 701.055 will be used on this project. I HAVE READ AND
-CHECKED THIS APPLICATION THOROUGHLY.
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Lane County, Authorizatio~
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for:
_Denl?,~~K(/?&)E~
NAME (please print)
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DATE
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ri.FLOODPLAIN:
READ THIS SECTION CAREFULLY'~UR'AUTHORIZATION HAS BEEN BASED ON THE ~OLLO~NDITIONS~
o PLANN'ING/ZONING; " 'Zone "t-'" Partit'ion # Parcel' #" ,Parcel Size'
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Date:~h.l?JjffiOJ
Date:_Jt)-Jq-8~ ,~
In flood hazard area,~ JXr No DYes, SEE ATTACHED SHEET.
~NITAT;~N::' -~.'L :iv .. ,., B. P. # Installation Record ISSued?DYes,DNO
WSAt \ ,
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Installation "'" Gall'?I! Lineal Feet Maximum Depth
Specifications: Tank. . of Drainfield of Trenches
COMHENTS:1JD Mri ltl6Y-r1L> r30(j\'O)ynj(1AQ'vntflti:t) ~&~Q?I
~QJ1 01 'l101)~-"{~.J{~.flIu--") rf)2i1rhl~\ ~%-nt1+-drtUf) rl~
_~)OlM!TIOmClmoc:l (D~JCf1&K . D~te: }-~ 10/)5 1~
PLANS EXAMINAT(.-01';,' Type ~ ' (J Group, e'? ' , , Use
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cmmENTs:j!AlL'~ t~~
Date:
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TOTAL VALUATION $
CONSTRUCTION AUTHORIZED BY THIS PERMIT
TOTAL FEE
IC).GO
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$ /JkI,:;:;-
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$
$
$
, . Description
(i/liliJ-r An) r1Mri .
,tJYV\rri aL, -
Sq. Ft.
Fixed Feel
Unit Cost
Floodplain Fee
Subsurface Fees
Building E'ee
!-13ch/Plmbg Fee
Plans Check Fee
State Surcharge
DEQ Surcharge
PERMIT APPROVED BY BUILDING OFFICIAL/DESIGNEE (pe~ ORS~~~~ II
LANE COUNTY DEPARTMENTOF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
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DATE
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,WHEN, READY FOR INSPECTION'; ,CALL '687-'4065. A'MINIMUM OF AT LEAS'P'241 HOURS ADVANCE 'NOTicE 'FOR "INSPEC-
TION REQUESTS MUST BE GrV~N. Have the folio~lng information ready:' permit number, job address, type
of inspection, when it will ~e-r,eady,'y,our ,name ~n9,phone",humber, ,and any,sp'ecial..directi?~s .t~ site.
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,BUILDING DIVISION :".
:;.:
, REQUIRED,'INSPECTIONS:
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,1:.;, Foimda tion, Inspection: To be made 'after trenches are, ex cava tedand forms erec,ted and when, all '
'materials tor the foundation are delivered on the job. Where ,concrete' from a central mixing
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plant (commonly termed "transit mixed") is to be used, materials need not be on the.,job; ,,'
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2~, Concrete.S,lab.',or Under-F.'toor Inspection: ,To be mad'ea,fter--all in-sl-ab.er.,under-floorbuilding
'service equipment, conduit, piping. accE:lssories, and: o,ther ancillary equipment items are in, ...
pl~ce but before_any concrete'is,po~red or f~oor ,sheatHing instal~ed, :including the subfloor.
'3. i~~~:;:n~ -1 ~-h:~l~~ion Inspections: To be' made ~~'~'e~"the, roof"a~~ ',fr~~~~~', ~ir/:bl~Cking, and"'"
bracing a.r~, in p~il.ce_ and al'l p:ipe~, :f-liep~a9,es, ,chi!llneysl. and \Tent!>. ar:,e, 'complet~ ~and al,l rough
: ,'... ,electrical and plumbing are appr'oved; : '1\'1:1 wall :i:nsula'tiorian,d vaporbarr ier'" are in place.
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'4., ,Lath and/or ,Gypsum -Board ,Inspection,: To be",made after a,l.l -lathing and' gypsum board, interior
and exter\or, is'in place but before any ~l,astering is,~pp~ied'?ndbefqre gypsum 'board joints:
." '-"'.~_~~. ~a:.te:Iters. are _~~.p~ed an~ finished:_ ,.' '
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5~' Finaf Irispection: I To be made\after the buildin~ ls,co~plete and before ,occupancy.
.) .':' . .:._......, ... ...... ...:~~.. ,~_'.l_..,.'. 0': __.+~ _._ .._. ___ .' _.~_~_ ..:. ,_....
A~PROVAL REQuiRED.- No work shall be done ,on any par,t ~f the buildlng or-structure beyond the poini
",,'i~~icated_in"eachts.!:lCcessive inspectiol} without 'fj,r'st, obtaining the approval o'f the building official.
" Such, approval shall, be -given only: after,:: an . inspection sha'l'l 'have been -made of 'ea,ch' successive"step'
in the construc~iori as' indicated b;y each of',the inspections required. ;,
, , NOTE: All building permits' require: inspections for''-the' work" authorized, such ,as ,but not limited to:
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A. Block Wall:, ,To be'made'"after reinforcing is in place, but before any g'rouf., is poured.' This
inspection ,is ,r,eq1:!ired,'for ~ach,bond beam pour." There"will,be no approval",until the 'plumb,ing
and electrical inspections have' been made and approved'.
B'. Wood Stove: To be made after completion 6f,masonry (if applicable) and when installation is
,,~; "'X' "co~plete. Installation' shal'+- ,~~ <in' acc<;,rdal!ce' w.i th, 1m "approved, na.tioJ!~~ly ~ecogn~;~ed _test~ng r ':"
~..~ ..., \, agel)cy and, the 'Il}amlfacturer' s' ~n~ta,};Latl.on l.nstru.ctl.ons. '. , \',..... ',_..' ,\,'\ \,~ \
,C. Mobile, Home: ,'An inspection, is required after the mobile home is.connected to, an approved
sewer ,or sepf.'ic ~y,s,tem"f6r se-cback requirements, bIocKincj, 'fo'otirig corinecti'bn',' tied,?~ns,
skirting, and plUmbing connection's ~ ., , .' , ", " .. "
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1., Footings and piers to c,?mply with State foundation, req'uirements for, mobile homes, or as
're'commended by ,the manufac,ttirer. " ..'
2. Mobile home minimum finish ..f160r el'evation sha,ll, be certified, when required "by a flood-
plain management lett~r. I t
3. Mobile- home t'iedo'wns, when- reqifii'ed', -and 'skir'tirig' shaLj:' 'be installed ,and--ready fbr inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
P'er"enc'losure .,;:-
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_ D'._ Swimming":'_HooL:. Below grade, when 'steeL is in.place and before concrete is poured. Above grade
" -~' " ~ when, poc)]" is in.f!talled.
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o.::>"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 'MAY OCCUR IF THIS PERMIT WAS ISSUEP ON THE BASIS OF INCOMPLETE OR ERRONEOUS"
INFOBMATION. " ,,', .-.'
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ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
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SUBS.URFACE AND ALTERNATIVE SEWAGE' ,DISPOSAL SYSTEMS: " ,,~,
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1. Permi-ts'sha-ll-be-:e'f"fect:Lvefor one'yeai f'rc5m th-~ -datE~' of' issuance.
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2. . upon' comple,ti'ng _the construction..,f.or, which a,..permit.has. been, issued "thE:l- permit holder:,shall.
notify the Lane ,~o'u!1ty Department 'o,f , Planni~ng , and Community Developmen1;: by. submi tting the
ins,ta.lla tion recoFd, form. The- Depar,tment shall inspe.ctthe c'onstr,uc,tion ..to~determine. if it
" i ?o,n;gHes/~.:j.!=-!1''''th~ \r:ulT~,con~,:ined in thi~~?i '1ision. I~ 'the const:tu.Gitiol! does, comply v:~ thsuch
",.::0':';'<".,,1 :j:''UIes~ ,\tl}~::lJ),E:!pa'ttlnent, sha.ll l.ssue,a certl.f.J.cate, of satl.sfactorY' 'c.ompletl.on to.'the perml. tl holder-.
If the cons,truction\doe's not' comply with such ,rules., ,.th'f. Ql;!partffiegt,s:ha1l-;notify, t~fT permit
hO.l,der and, shall require ,sa tisfactory comple..f10l1':;~ef6'r:e'.li:,s~uing t,i:,he''Cer't:i'f'ica te;;"_Failure to
meet the requirements for satisfactory completionw'ithin,a reasoriable'time constitutes a vio-
lation pf ORS 454.605 to 454L745 and this rule~ ~ '
Se tb~'ck:s~,~;'~;Sub.su:r;;f ace, Sewage Di sposal
Septic Tank
.Drainf ield
From:
Interior eroperty lines
Edge of roaa right~of=way
Building foundat;i?n
Wells. other water sources
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50'
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10 I,
10'
10'
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.. .e 14'-25"'
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CHECKLIST
PLUMBING I M,ECHANICAL
OFFICIAL USE ONLY
Appli./
Pemi t #
, ,
APPLICANT INFORMATION:
PlYWIJW'"d PJe(~e~
(Name orFim-p~~rlnt)
PLUMBING CONTRACTOR [] Yes
?t'?~J/\) .L~VlL- ,~y)'d_ Dl<aQ7t77,
" (MaIlIng ActreSS) (CIty or 10wrU (Zlp~, .'
Fim Cont. OSR#
Address
D NoDSelf
MEGIANICAL CONTRACTOR D Yes Finn
Address
Cont. OSR#
o NoDSelf
Type of Fixture
.PLUMBING --
Nwnber of Each
f
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'--lst 50ft.
each additional 100 ft.
Water Service--lst 100 ft.
each additional 100 ft.
Stom and Rain Drain--lst 100 ft.
each additional 100 ft.
Special Waste Connection
Sewage and Swnp PumP (eiector)
Mobile Home Sewer and 'Water
Other (specify)
SUB-TOTAL (Minimwn $10.00)
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:2'
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Fee On Each
$ 5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
5.00
15.00
10.00
15.00
10.00
15.00
10.00
5.00
5.00
10.00
Total
'E )(, '6; 7: 'L-<
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TOTAL FEE
, ,
Type of Equipment
MECHANICAL
Nwnber of Each Fee on Each Total
$ 10.00
$ 6.00
7.50
/ 3.00
.3 3.00
~ 4.50
/' 6.00
6.00
6.00
6.00
.50
Mechanical Permit Base Fee
Furnace UP to 100,,000 BTU/H
Furnace over 100,000 BTU/H
Clothes Dvyer Vent
Bathroom Ventilation Fan & Duct
Ran~e Hood with Mechanical Exhaust
. Wood Stove
, Air Conditioner Only
Heat Pwnp
Floor Furnace
Gas Piping System 1 to 4 Outlets
Per Outlet
Other (specify)
SUB-TOTAL
TOTAL FEE
LANE COUNTY DEPT ENV'MGT RECEIPT . 182983 DATE 101383 ,
APPLICANT CARNEY, DENNIS ADDR 703 SPRAGUE,' EUGENE, OREGON
TL..:ll:' 1703::,~30000200 SUBDIV , LOT, BLI(
JEW BLDG TYPE USE R BDRMS 1 UNIT~ 001 SiORIES .BLDGS 001 PHONE 746 8444
OWNER NME BdYLES,DURWARD ADDR 3415 BALDY VIEW, SPRINGFIELD, OREGON 0 .
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST ~ALUATION ,FEE DAy~Jl
JP ADDITION
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BP ,
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LC 1829B3 RAD
NO. FIXTUI~ES:
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NO. C()NNECT()I~S:
,MECHANICAL FEE
STATE SURCHARGE
PLAN CHECK FEE
;ATG: APP 'F~A
S't;GlIJ . 0
~rt.tfKE:N BY F~L.H
FP SDS SI PCK
1 2
EST.' COMPLETIO~ DATt
100000
15.00'EACH :::
4%
65i~'
OTH ISS
,3
TOTAL FEE~Hf
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1 n I
'111
433.00
17.:3'2
281.45
10.00
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741.77.CK
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CX:tober 12,1983
10: lANE COUNTY PLANNING DEPARTMENT
I hereby authoriZe DENNIS CARNEY to sign necessary documents and permits '
regarding construction and remodeling at the property listed under Tax Lot No.
17 - 03 - 23 - 200 and site address 3415 Baldy View Lane,Springfield, Oregon 97477.
Dum'lard cL", Boyles
~ko/
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. lane county
:. . ACTIVITY INFORMATION SHEET .~Pi
COMPLETE THIS SECTION. INCOMP~ETE FORMSI W.ILL BE REJECTED! ."'-.{}~. .. I..'H
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~ Ml\KF 1i?~T.1U,I:~-'~ I
~I~ ~Ipf 7C2S s7J/9./l(J//c 4vt=,
. , ~AIL MAILING ADDRESS
~n' .t,e1 of. t)fe~ C11A..-1i Et-~ t ~ 7')1-tJ5 _ ,
... r ~t' STAJt. ~ '--CITY - - STATE ZIP CODE
~ONE # Hd:-7E.J~f'# ~fI~~r,it:riNE # ~Mft~~~1
2", PROPERTY ADDRESS ~~f:....
(IF DIFFERENT FROM MAILING ADDRESS)
3 MAP & PARCEL NUMBER
(REQUIRED INFORMATION)
(from tax maps in Department of Assessment and Taxationj
or from tax statement) 1
11 D? '2:;
TOWNSHIP RANGE SECTION
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TAX LOT(S) OR PARCEL # ZONING
TOWNSHIP RANGE SECTION
TAX LOT(S) OR PARCEL 1 ZONING
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TOWNSHIP RANGE SECTION
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
4 SUBDIVISION (if applicable)
II 5 REQUEST (state exactly what you plan to do) __~
,.,~ re.~9_
TAX LOT(S) OR PARCEL # ZONING
ACRES
! '.
LOT
BLOCK
6 DIRECTIONS TO SITE:
ZONE/LAND USE:
BY: DATE:
NUMBER
DATE
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** FOR STAFF USE ONLY **
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LAND MANAGEMENT DIVISION / 125 E. 8th AVE., EUGENE, OR 97401 / 687-4061