HomeMy WebLinkAboutPermit Plumbing 1996-6-4
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, REQUEST
FOR: /]#AJN PIFLrJ
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STR:.rr-..)?PROPERTY
PRClf'QSCOUSE SEPTCNSTAl..I..ED
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NO OF STOftES
NO OF EMPlOYEES
CONSll'IUCTlON QJSTNALUE
DESCRPTJ;;NCFPR:lPC6EDVo'l:H(
/i'E~OCA7E L2./lAJ/'JI ~/NE
OlRECTlOHS TO SnE FROM NEAREST IoIAIN MEASECTlCf\I .
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APPU?ANT NAt,lE . ADDRESS
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PI-lONE
OwNERS NAME & ADDRESS
PHONE
CONTRACTQfHMTAlLEW8UllDER NAME
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PHONE
)MAIL PERMIT TO: ../.
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I have carefully reed BOTH sides of this appllcailon and hereby certify that all Intormailon Is true and correct
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PRNT NAME
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BY:
DATE
r'..' CALL F~~ I~;PECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS).'~I!.t:~'Vr::1!'
SEPTIC permits are good for ona year. ALL other permits expire alter 180 days unless Inspect'/ons are
lMD 040 Rev. 6/92 APR 3 0l1a06
.
current. J
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VIOLATIONS
-.SBTBACKS AND OTHER. ......_........>10 OF APPROV ALMUST DB snucn. Y OBSERVED. VlOLATION CAN RBSULT IN REVOCATION OPnDS PBRMrr.
CITATIONS MAY BS ISSUBD UNDER. nm PROVISIONS OF LANB COUNTY'S INFRACTION ORDINANCB AND/OR OTHER. RBMBDIBS AlLOWED BY LAW.
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A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GIVEN FOR INSPECTION REQUESTS
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Have the following information ready when you call: 687-4065
Pennitnumber - Jobaddress - Typeofinspectionreq~ired: j ':Whenit'willbeready '- '.~
t ~ Yournameandphonenwnber- -Anyspecialdirectionsto,thesite.,\- ':\. _~ ..., ,.
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PUBLIC OmcJALRIGlITlU TRESPASS ON PRIVATE PROPERTYORS ns.OIO .' .:":\ ::....
POWER TO BNmR UPON LAND. nm COMMISSION, AND ANY Of ITS MBMBERS, OFPIalRS AND BMPLOYBS,IN niB PBRFORMANCB Of nmIR. PUNcnONS, MAY
ENrnR UPON ANY LAND AND MAKB BXAMINATIONS AND SURVBYS AND PlAal AND MAINTAIN nIB NBCBSSARY MONUMENTS AND MARKERS THEREON.
REQUIRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete aitd any required reinfoicing steel is in place." _, :'" ',\...
UNDERGROUND PIPING INSPECTION: To be made after all underground piimii ~ ~n installed,'Pri';;' to-';;y backfill.
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,placed or floor sheathing ihstalled"including the 5ubfloor. \
ROUGH MECHANICAL INSPECTION: T~'be 'o;aJb after all'ctricting and'g~piping has been ~tall.rl and'pri~~ to tieing covered: \ \ ",
ROUGH PLUMBING INSPECTION: To be made after all plumbing rough-in is in place, prior to being covered.
FRAMING INSPECTION: To be made after the all framing, flre blocking, bracing and roof are in place and all pipes. chimneys and vents are complete
and the rough electrical, plumbing, and mechanical inspections have been made and approvad.
INSULATION INSPECTION: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECTION: To be made after all lathing and gypsum board, interior and exterior, is in place but before any
plastering i~ appliad ~r before gypsum board joints and fasteners are taped and fmjs)1ed. ,
ADDlTIONAL.INSPECTIONS'MAY BE REQUIRED, such as but not limited to; .J'. . ". . "...,
BLOCK WALL: To be ;'ade afterreinfon:lng is in place, but before any grout is poured. The inspection is required for each ~nd ~ pour. There
will be no approval until the plumbing and electrical inspections have been made and approved.
FINAL MECHANICAL INSPECTION: To be made just prior to the structure or remodeled area being occupied and prior to operating any equipment -
FINAL PLUMBING INSPECI10N: To be made just prior to the building, structure or remodelad area being occupied.
FINAL BUILDING INSPECTION: To be mad" after finish grading and the building, structure or remodelad area is campletad and ready for occupancy.
MOBILE/MANUFACTURED HOMES: An inspection is required after the mobile home is connected to an approved sewer or septic
system. prior to covering sewer or water lines, for setback requirements. blocking. tiedowns and plumbing connections.
Footings and piers to comply with State foundation requiremmts for mobile homes or as recommended by the manufacturer.
Minimum fmishad floor elevation shall be certified when required by Floodplain Management
Tiedowns, if required, shall be instalIad and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
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APPROVAL REQUIRED
No work shall be done on any part of the building or structme beyond the point indicated in each successive inspection without frrst obtaining the
approval of the building offlcial. 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.
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,.; , APPROVED PLANSkST BE ON TIlE JOB SITE AT ALL TIMES DURJNG WORKING HOURS.
THIS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS . .un"" OR ABANDONED FOR MORE TIlAN 180 DAYS.
SUSPENSION OR REVOCATION MAY OCCUR IF TIIIS PERMIT WAS ISSUED ON TIlE BASIS OF. INCOMPLETE OR ERRONEOUS INFORMA nON.
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. ~ ANY9~~. PR.<?.9;ED~G PASJ,:r~ POINJ' PI{ REQUIRED INSP)':~TIOr;\S WIL~ DO ~O .AT, THElR O~N RIS\<..\
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Your signatUre on' the front of this form verifles the following: 1 HAVE CAREF'uLLY EXAMINED THIS'COMPLETED APPUC";TION~ and do
hereby certify th~ all information hereon is true and oorrecr: and that I have a legal interest in the y-"'r"'--.. as owner of record or authorized agent. I
further certify that any and all work performed shall be done in accordance with the Ordinances of Lane County and the laws of the Stale of Oregon per.
taining to the work described herein. 1 further certify that if 1 am not the owner of the ~. .~-..l, my registration with the Builders Board is in full force
and effect as required by ORS 701.055. and that if exempt the basis for the exemptign is noted hereon, and that only subcontractors and employees who
are in compliance with ORS 701.005 will be used on the job. ($ ~ _ <:f. M . .~
SUBSURFACE&ALTERNATIVESEWAGEDISPOSALSYST~M~~~ q;>~'ilt>~<:) ~ .~~ ~O~0<<'",
When subsurface construction is complete. the permit holder shall notifyJlij,<!ounty Land M8iia~Divis~i~'~mibmitting the installation record
form, An inspection will be made by a qualified sanitarian. If construction complies with all'rutes a certificate of completion will be issued to the permit
holder. If construction does not comply with roles, the permit holder will be notified, and all correCtionS shalibe made before a certificate of completion
will be issued. Failure to meet satisfactory completion within the allotted time constitutes a violation of ORS 454~605~o"4S4.fjl~ and this rule.
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SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior property lines 10'
Edge of road right-of-way 10'
Building foundation 5'
Wells or other water sources 50'
DRAlNFIELD
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. w: 2 2 3 LANE COUNT~' DEPT ENV MGT RECEIPT l.r'14'9S96 DATE 0509'. .
D~tiH APPLICANT HEWETT, M'ARK ADDR 2277 Gf~EENBRIAR STi., C;SPRINGFIELD, q.ftl1ll~
. TLO:> 1703252100900 SUBDIV .. LOT BLK I~ 8
NEW BLDG TYPE USE R BDRMS 0 UNITS 001 STORIES ~BLDGS 001 PHONE 726 375'.?,l
OWNER NME HEWETT, MARK ADDR 2277 GREENBRIAR ST., SPRINGFIELD, dRE t:
. CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DAYS'
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SDS LC 149596 SDAR
. SDEQ FEE SDAR
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SEQU:
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SWF~ :
FT. WTR:
MECHANICAL FEE
STATE SURCHARGE
PLAN CHECI( FEE
ELE PCK
ISS
COMPLETI ON DATE
2
FT.
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DEPOSIT u
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SYSTEM DEVELOPMENT CHARGE
WORKSHEET
:
PHONE: !rtJ.t.KS'7
STATE:fl:fL.. ZIP: Q74-z
LOCATION OF PROPOSED BU~L~NG SITE: f\ ,,.,\
Street Address: (~C?t6 1-, ~OOIJ( fidDL. ( .1 )1"..)
Plat Name: \\, (l) Ta~Lot :J;er: IF OlCfo/~JnO() 2..
1. DEVELOPMENT TYPE. (Check appropriate dwelling(s). SDC calculations and dwelling t
ype definitions are on the back.)
A. Sinolp.-F::>milv Detached
\ Single Family home
NO. OF UNITS L
Manufactured home not in a pai'k
X $1,000 pef unit = $ llW ,crJ
B. SiIK"p,-FRmilv 8llilched,
NO. OF UNITS
X $924 per unit = $
C. Multi-Familv Aoartment
NO. OF UNITS
X $692 per unit = $
D. Manufactured Home Park
NO. OF UNITS
WILLAMALANE SDC
X $699 per unit = $
$ /fYD,CD
2. SDC CREDIT (if applicable) SDC-payer must furnish proof of
Willamalane Credit approval. See SDC Credit Worksheet.
$
.JY
$ tccOPO
3. TOTAL WILLAMALANE NET SDC ASSESSED
(if SDC reduced for Credit)
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DevelopmemServi e
City of Springfield
or
'Department
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Date
7 I 5'b