HomeMy WebLinkAboutPermit Building 1982-7-16 (2)
CONSTRU,- t~ION/PLACE~NT - I
. PERMIT " 1\ \/7' "~h Applicatior{~'~'O/J'
, L/ Permit #~-' ~/J
o Two Cqpics. of Plans
COMPLETE THIS BLOCK. ,PLEASE USE BLACK INK AND PRINT., : 0 T~oco~ies of Plot P12ms
RANGE03, SECTION4 : Tiooz~OUi; or:' ,r D'~1e.chanical Checklist
. I . 0 Plumbing Checklist,
L01,T/PARCEL I BL.OCK
, OPlan Check Info Sheet
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DESCI.iPTION OF. PROPOaWOPK ' I ~ , ~ ~ ~ . ..L 0 S VALUE
~n~ ~i)1 0 (LC1J( LA-I r~ ~
#OFBE4MS ."#OF~R;;S'I""'~ 110F~YEES ,~S~r1']~ ,,' ~~~~~~~,.
O<fflOR" N^M' ^Mb:oo~~rr~ . C'A47LBtLlrl \!f.aLIJ L1i:'7.,;r~"Gn.~-
OON' c~~ oOOllfJ =;c:h-l ' ll&t ,,( ) q Y'7'l """,I N",m~ . '
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certify that any and all work performed shall be done in accordance with the Ordinances of Lane Count_y an La,...s o[ the SUtl:e of Or~~q:)II Jil~~ l~lillillq
to the work. described,herein, anq. that NO OCCUPANCY will be made o,f any struct~r0 without the permission of the Building Division. I fUl.-th0.r certify
. that. registration with the Builder'? Board is in full force and effect as required by ORS, 701.055, that if c"xempt" the basis for exe.mption is noU:d
hereon, and that only s~~~a~t~rn and e~l~es who are In compllance wlth ORS 70 t. 055 wlIl be uS0d on thlS proJect. I HAVE REi'\D ArlO CIIECI'~.ED TillS
APPLICATION THOROUGHLY. MAJ."'H1"\ .' V~ ~ <9:Y\ ~ . . '
) b'dn1A' S C\~~~ER' K S;j/h1t\. .J. ,())~ B~::~::~c~o~
Ni"'.ME (please print) SIGNATURE mITE 0 Ac.ent
~.
FOR OFFICE USE ONLY
TOI'il'iSH'IP
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SUBDIVISION/PARTITION (if applicable)
o PLANNING/ZONING:
,.zone~
Partition rr
Parcel if
Parcel
s'~ze e.t:A
Ni:limum Sctback~:
Comments: '" ~
,. ~(,
{/J IV , 7\i-~
- L .
o FLOODPLAIN:
[JRURAL ADDRESSING:
o SlUHTATION:
C
L, front
c .
L, ~].d(~
interior .
rear
pC1Jr\~ Od:J~lhO(L rlLlJPJ 1m1f1J
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GRID COORDINATE
N
E
Date:
([J1)
n
o
In flood hazard area?
DNO
[j Yes,
see attached sheet.
Date:
S. 1. \# "
.E. P..#
Installation Record Issued? [] Yes [] No
Installation
Specifications:
Gallon
Ta"nk
Lineal Feet
of'D~ainfield
Maximum Depth
of Trenches
Comments:
"/
o
urPLA~S EXAMINATION: Type Group use'W(J~ D p, p;';CA.JcS~R.T
, co:~nent~:A .'56 ,U'R E:" . T..Jb6c-r E)( / ~ 7"1 kJ ~,' t= ., 'TeE-. P '--A (,~
C"'o~RA'\S Ll)' CVR.R-E./VT ~ ~~UIILE:Mf:1JrS
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CONSTRUCTION AUTHORIZED BY THIS PERMIT
. Date:
DeS'cription
~e~~
r .
Sq. Ft.
Fixed Fee/
Unit Cost
Floodplain Fee $
Subsurface Fees $
Building Fee $ -j::r
Sewer/Storm Drain/Water $
Plumbing Fixtures $ \ q LOO
Mechanical $
Plans Check Fee $ 4.7F:>
State Surcharge $ ,{~
TOTAL FEE $ ~>:SJ
FEES PA~ Check 0 Cash
\.~ OVS~ :::e'~ V kO
PERMIT APP~OVED _BY BUILDING OFFICIAL/~EE (;:'e~'-ORS 456.805 (1)) t-U' DATE
LANE COUNTY DEPARTMENT' OF .PLANNING . & COHHUNITY DEVELOP~lENT / 125. EAST EIGHTH AVENUE. EUGENE, OREGON 97~Jl
TOTAL VALUATION
$
<tL
SEE REVERSE FOR INSPECTION INFORMATION
\
"
SETBACKS AND OTHER CONDITIONS Of APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CAN RESULT IN REVOCATION OF THIS PERMIT,
CITATION UNDER PROVISIONS OF LANE COUNTY'S INFRACTION ORDINANCE, AND/OR OTHER REMEDIES ALLOWED BY LAW.
WljEN READY FOR INSPECTION CALL 687-4065. A MINIMUM OF AT LEAST 24 HOUR ADVANCE NOTICE FOR INSPECTION REQUEST MUST BE
GIVEN. Have the following information ready: Permit number, job address, type of inspection, when it will be ready,
your name and phone number, and any special directions to site.
BUILDING DIVISION:
REQUIRED I~SPECTIONS
1) FOUNDATION INSPECTION: To be made after trenches are excavated and forms erected and when all materials for the foundation
are delivered on the job. Where concrete from a central mixing plant (commonly termed "transit mixed") is to be used,
materials need not be on the job.
2) CONCRETE SLAB OR UNDER-FLOOR INSPECTION: To be made after all in-slab or under-floor building service equipment,
conduit, piping accessories and other ancillary equipment items are in place but before any concrete is' poured
or floor sheathing installed, including the subf100r.
3) FRAMING & INSULATION INSPECTIONS: To be made after the roof, all framing, fire blocking and bracing are in place and
all pipes, fireplaces and chimneys and vents are complete and all rough electrical and plumbing are approved. All
wall insulation and vapor barrier are in place.
4) LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place
but befon! any plastering is appned or before gypsum board joints and fasteners are taped and finished.
5) FINAL INSPECTION: To be. made after the building is complete and before occupancy.
APPROVAL. REQUIRED. No work shall be done on any part of the building or structure beyond the point indicated in each
successive inspection without first 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 each of the inspections
required.
NOTE: All
A.
B.
building permits require inspections for the work authorized, such as but not limited to:
BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured. This inspection is
required for each bond beam pour. There will be no approval until the plumbing and electrical inspections
have been made and approved.
WOOD STOVE: To be made after completion of masonrv (if applicable) and when installation is comolete.
Installation shall be in accordance with an approved nationally recognized testlng agency arid the manu-
facturer's installation instructions.
C. MOBILE HOME: An inspection is required after the mobile home is connected to an approved sewer or septic
system for: setback requirements, blocking, footing connection, tiedowns, skirting, and plumbing
connections.
(1) Footings and piers to comply with State foundation requirements for mobile homes or as recommended
by the manufacturer.
(2) Mobile home minimum finish floor elevation shall be certified when required by a floodplain
management letter.
(3) Mobile home tiedowns, when-required, and skirting shall be installed and ready for inspection
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 SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN
WITHiN ;~J 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.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT HIS OWN RISK
SUBSURFACE AND ALTERNATIVE SEWAGE DISPOSAL SYSTEMS
(1) Permits shall be effective for one year from the date of issuance.
(2) Upon completing the construction for which a permit has been issued the permit holder shall notify the
Depar.t~ent by submitting the installation record form. The Department shall inspect the construction to
i.- '~\aeier~ilne.if itCflfQjJ1~es..with't1J..e rules contained in this division. If the construction does comply vlith
such rules, the.Depar~e~t sha~l'i~u~ a certificate of satisfa~tor~ c?mp1etion. to.the perm)t holder. If ~he
'.eonStructionldoi:!~ npt.coTllp1y wlth suc~ r..iJ.l1e,S, the 9~pal'tmentls.l1aJ'hnotlfy tbe p'ert11Jth91ger~and shall requlre
. I . ''':lsatisfa~tory comp1.etion bet"or,e issuing the c.er~iTiCate. failure to ,meet the requirements fo~ s~tisfa~tQr'y ,
. I ' , .' ':cemp1etlon,wWiill. ~ reasQnab1e time constiWtes a vi~la.tion. of'Q~S ,454.605 to 454.74~ and thlS: ruJe.. \
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... .. .,~. Setbacks;..: .SubsW"face Sewaqe -Of sDosa"
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Drainfield
10'
10'
10'
100'
,
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From: Interior property lines
Edge of road right-of-way
Building foundation
Wells, other water sources
Septic Tank
10'
10'
5'
50'
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rOVE
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',:->:'/..:TH~<FOL~OWING INFORMATION IS REQUIRED: rD.
,;:,;;','::>::!;;>" APPLY FOR A STOVE PERMIT:
:.:;.'i:;; ::i'L::)){.i'i':,,;:,(': '. '.' . .
, ::<-::;'.:~','rn': .::2 "C~'pies.~of :t he manuf act u re r 's inst all at'(on I nstruct Ions ~.
:'~>~/:'::~'" ':, .'<';;':,':<'::'~":'>,:.."'" ." . ,".
'.....:.:.~;. [2]:' 2' :Co:Ple~:.'~'(:the floor plan and elevations;,',
. '" . '. . ',:' . '
. ~';,' a. .Indlcate all clearances to walls and w'nd~ws..
b. Noncombustible materials to be useei' fO'y th~' 'hearth
. .' I, : '..1.
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for reduced clearances to walls.
c. The model name or number of the stove.
M 1> Lt~
e. Details of the combustion air duct and opening.
d. The chimney manufacturer.
NO PERMIT WILL BE PROCESSED, UNLESS ALL THE
REQUIRED INFORMATION IS SUBMITTED.
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4
['ll ANNING & COMMUNITY DEVELOPMENT
ACTI\, 1 TY INFORMATION. vHEET
Idne cOunty
COMPLETE THIS SECTION. INCOMPLETE FORMS WILL BE REJECTED!
. ".........
f"........-.-......., ............ .,.........,.... ... ........ ......."... ...
: 1., 6<~B12r<:r 'DEA+! (2AAMe~
I PER$ONMAKING REQUEST.
3 'f~' 8FrL'D Y V I S:-tV LA-I
MAIlING ADDRESS
'~M1~
PROPERTY OWNER
MAl LI NGADDRESS
~rpFL1)
CITY
D~
STATE
9'7'177
ZI P CODE
CITY
STATE
ZIP CODE
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2~ PROPERTY ADDRESS
(IF DIFFERENT FROM MAILING ADDRESS)
BUSINESS TELEPHONE #
7d.J7 G 101-
. ~OME TELEPHONE #
BUSINESS TELEPHONE #
HOME TELEPHONE #
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(1 03 1-(
TO~NSHIP ~A~GE SECtION
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(from tax maps in Department of Assessment and Taxation!
or from tax statement)
/1c~T[...(o. 150043
17 0"$ /4-0/<AtJ?-
TOWNSHIP RANGE SECTIoN TAX LOT(S) OR PARCEL #
flCC/ N-o. 15'~03.5-
() I <(\ 0''2-
TAX LOt(S) OR PARCEL #
i-l
ZONING
1-1
ZONING
3 MAP &. PARCEL NUMBER
(REQUIRED INFORMATION).
TOWNSHIP RANGE SECTION
TAX LOT(S) OR ~ARCEL #
ZONING
..
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP:
SUBDIVISION (if applicable)
'?-' -z-q \.
LOT
ACRES
BLOCK
. j i
REQUEST .(state exactly what you plan. to do) P!3//'( t-1,'T
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FO(C FiICE-PLAce.
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6 DIRECTIONS TO SITE: I::A5f- 01:L..J<-6LT L{ N E TI L (3f+",,0tI FMY1 r<b -r<JRN /J(OR..rrf
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** FOR STAFF USE ONLY ** NUMBER ~
V>
ZONE/LAND USE:
BY: DATE:
DATE
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'TIME IN:.'
OUT: