HomeMy WebLinkAboutPermit Plumbing 1992-12-9
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> REQUEST
FOR:
SEPTIC SYSTEM VERIFICATION
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LOCAT1OO ADDRESS
3041 GROUSE STREET, SPRINGFIELD. OREGON
STRUCTURes NOW CH PROPERTY
EXISTING SINGLE FAMILY DWELLING
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SEPTIC NSTALLED
WATCRNiTAU.BI
NO OFSTORU
NO OfEMPlOV'EES CONSTRUCTX:HD:l5TNAI.1.E.
PRIVATE USE
OESCRf'TlI:NOFI'fO'ICIla)WClRIl; NOOFElEOFKXMi
SEPTIC SYSTEM VERIFICATION
DIRECTIONS TOSITE FROM ~l MAIN INTERSecr~
BELTLINE TO GAME FARM ROAD. RIGHT ON FLAMINGO, CORNER OF GROUSE AND
FLAr~INGO.
APPUCANT NAME.. AD~
'HONE
746-11619
484-4627
NORMA ALLENSWORTH,
OWNERS NAME' ADDRESS
KENT & JEAN ACHTERHOF,
PHONE
SAME AS THE JOB ADDRESS ABOVE
CCW'rAAcrOflllNSTALLEW ElUILbER NAME
CCB'
PHONE
NA
NA
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> MAIL PERMIT TO:
NORMA ALLENSWORTH, 4475 DAISY STREET. #83, SPRINGFIELD. OREGON 97478
~ -I:; STREET art ZP
I have carefully read BOTH sides of this apPII~tlOn and hereby certify that all Information Is true and correct
NORMA ALLENSWORTH @1/kH7/"./J<JJItUf..J1(lJ/./lllh_////--/9""
PRMNAME ~.
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'BI.!'AN.NIN,G/.ZONING,":' ',j" READ CARE FULL VI Your Authorization Is Based On The Conditions
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FEES DUE: $ APPROVED BY: J :2-.)9,)92.-
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, CALL FOR INSPECTIONS (SEE Bi'iK OF FORM FOR INSTRUCTIONS) 687-4065 )
. SEPTIC permits ara good for ona year. ALL other permits explra after 180 days unless Inspections are current.
lMD 040 Rev. 6192
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VIOLATIONS
SImIACKS AND 0l1iER CONDmONS OP APl'ROV ALMUSTBBsnuCIL YOBSBRVED. VIOLATION CAN RESULT IN RBV0CA11ON oPnns PERMO'.
CITATIONS MAY DB I5SUBD UNDER nIB PROVlSlONS Of LANB COUNTY'S INPRACIlON ORDINANCE AND/OR O1lIERRBMHDIES A1LQWBD BY LAW.
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,A MINIMUM OF A,T,LM-.SJ'24 HOURS ADVANCE NOTICE MUST BE GIVEN-FOR INSPECTION REQUESTS~ r
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Have the fOllowing information ready when you calI: 687-4065
Permit number - Job address - Type of inspection required When it will be ready
Your name and phone nmnber - Any special directions to the site
PUBLIC OFFICIAL RIGIITTO TRESPASS ON PRIVATE PROPERTY ORS 215.010
POWER TO Bm'BR UPON LAND. nIB COMMISSION, AND ANY OP rrs MBMBERS, OJlFICElS AND EMPLOYBS: IN niB PHRPORMANCB OPnmIRFUNcnONS; MAY
ENTER UPON ANY LAND AND MAKE BXAMlNATlONS AND SURVBYS AND PLACB AND MAINTAIN nIB NBCRSSARY MONUMBNTS AND MARKERS nmREON.
REQUIRED INSPECflONS
FOUNDATION INSPECflON: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECflON: To be made after all \Ulderground piping has been installed, prior to any backfill.
CONCRETE SLAB OR UNDER-FLOOR INSPECflON: To be made after all in-slab or \Ulder-floor building service equipment. conduit. piping
accessories and other ancillary equipment items are in place but before any concrete is placed or floor sheathing installed, including the subfloor.
ROUGH MECHANICAL INSPECflON: To be made after all ducting and gas piping has been installed and prior to being covered.
ROUGH PLUMBING INSPECflON: To be made after all plumbing rough.in is in place, prior to being covered.
FRAMING INSPECfION: To be made after the all framing, fire 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 approved.
INSULATION INSPECflON: To be made after all insulation and vapor barriers are in place, prior to covering.
LATH AND/OR GYPSUM BOARD INSPECflON: To be made after all lathing and gypsum boaro. interior and exterior, is in place but before any
plastering is applied or before gypsum board joints and fasteners are taped and fmished. ' ,
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but not limited to;
BLOCK WALL: To be made afterreinforcing is in place, but before any grout is poured The inspection is required for each bond beam pour. There
will be no app.;,val \Ultil the plumbing ';'d electrical inspections have been made and approved. ' , ,
FINAL MECHANICAL INSPECflON: To be made just prior to the structure or remodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECflON: To be made just prior to the building, structure or remodeled area being occupied
FINAL BUILDING INSPECflON: To be made after finish grading and the building, slIUcture or remodeled area is completed 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 fmmdation requirements for mobile homes or as recommended by the manufacturer.
Minimum fmished floor elevation shall be certified when required by Floodplain Management
Tiedowns, if required, shall be installed and ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
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.
APPROVED PLANS MUST BE ON TIlE JOB SITE AT ALL TIMES DURING WORKING HOURS.
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WffiIlN 180 DAYS, OR IF WORK IS S .vrrnu OR ABANDONED FOR MORE TIlAN 180 DAYS.
SUSPENSION OR REVOCA nON MAY OCCUR IF TIllS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS lNFORMA nON.
ANYONE PROCEEDING PAST THE POINT OF REQUIRED INSPECTIONS WILL DO SO AT THEIR OWN RISK.
Your signature on the front of this form verifies the following: I HAVE CAREFULLY EXAMINED THIS COMPLETED APPLICATION, and do
hereby certify that all information hereon is true and correct, and that I have a legal interest in the property 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 State of Oregon per.
taining to the work described herein. I further certify that if I am not the owner of the ........t"...nJ. 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 exemption is noted hereon, and that only subcontractors and employees who
are in compliance with ORS 701.005 will be used on the job. ' ,
SUBSURFACE & ALTERNATIVE SEW AGE DISPOSAL SYSTEMS:
When subsmface construction is complete. the permit holder shall notify the County Land Management Division by submitting the installation record
fOTm. An inspection will be made by a qualified sanitarian. If construction complies with all rules a certificate of completion will be issued to the pennit
hqlder. If construction does not comply with rules. the permit holder will be notified, and all corrections shall be made before a certificate of completion
will be issued. Failure to meet satisfactory CC?mpletion within the allotted time constitutes a violation of ORS 454.605 to 454.745 and this rule.
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior y'_y__,' lines 10'
Edge of road right-of-way 10'
Building fO\Uldation 5'
Wells or other water sources 50'
DRAINFIELD
10'
10'
10'
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AF-'f'UCAN I ACHTERHOF., KENT ADDR 447~) DAISY ST,... SPFnNGFIELD, CmEGON .
',T[& '70--~'7'7400 ~lJlIDIV [('J'T' 1'[1<'
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.NnJ J~LDG TYP~ " I~SE R ~DF(MS 0 UNITS 0~1 S!.~RIES '~BLDGS,'~01 ..':~HONE 48~ 4627.
OWNER NME ALHTERHO~. KENI ADDR 44?J DAISY ST.. SfRIN~fIELD. OREGON
CODE APPL NO ACTION DESCRIPTION SQ FT UNIT COST VALUATION FEE DAAS
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'SITE ADDRESS
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MAIL PERMIT TO:
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NAMe
ADDHI:99
(;ITY
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STAFF
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TRS Verified 'c::JYes.
Allowed Use' c::]Yes
Land Management Div. staff can
not be held responsible for
evaluations or recommendations
based on false, inaccurate or
LMD '49- 2/92 Incomplete Information :::..,: ::
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M14-68 02/92
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Exlsllng Buildings or
Improvements on
Property
JE House
c::J Sam
c::J Garage
c::J Mobile. Home
c::J Shed
......:SEPTIC INSTALLED
Jo<>o' Yes
c::J No
Water District
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Directions to site from
nearest main Intersecllon
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' For Mobile Home
Placement Only
Brand
Year
Size
No. of Bedrms
Ucense #
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" Distance from Mobile
Home to:
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