HomeMy WebLinkAboutPermit Plumbing 1996-4-19
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REQUEST
FOR:
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Septic Repair
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'''''''i'7 03 26
LOCATlCW ADDRESS
_~2_4~__&~249_Haxden Bridge Rd.,
II.SECT~l.lTAXLOT 166olYlSDl/PARTf1l:>>II
LOT ,,'~~. ,.~...(
Springfield
97487
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PAOP<:lSEOUSE sarrCNST.-u.ED WATERNSTAUB> NO OFSTOAES NO.OFEMPlOYEES ()C)NS'fRl.ICTCHCDSTNAU.E:
Res. Yes Well
tlESCRlPTOIICFPRC:I'OSED'NOFI(
Repair existing sewage diposal system; failed drainfield.
OlRECTIONS TO srrc FRaol NEAREST lUJN MERSECTION
Hayden Bridge Road intersection at Debra.
NQOf~
APPUCANT NAME" ADDRESS
DAvid Zarzycki, 131 McClure Ln., Eugene
OWNERS NAME" ADORESS
David Zarzycki, 131 McClure Ln., Eugene
CCHTRACTORfNSTAU.EWllUIlDEA NNoIE
97404
97404
PHONE
688-0243
PHONE
688-0243
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PHONE
IMA/61',ff,f/zl~iYCki, 131 McClure Ln.,
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I have carefully reed BOTH sides of this
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Eugene
97404
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certify that all Information Is true and correct
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Is Based On The
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Conditions
FEES DUE: $
APPROVED BY:
DATE
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CALL FOR INSPECTIONS (SEE BACK OF FORM FOR INSTRUCTIONS) 687-4065
SEPTIC permits Bre good for onB yeBr. ALL olher permits expire Bfter 180 dBYs unless Inspections Bre current.
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lMD 040 Rev. 6192
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VIOLA nONS
f'"_SBTBACKS AND onmR CONDmONS OF APl'ROV ALMUSTBB S'I1UCIt.Y OBSERVED. VIOU.TION CANRBSUL TIN RBVOCATlON OPOOS PERMIT.
~ . '. CITATIONS MAYBE ISSUED UNDER nIB PROVISIONS OP LANBOJUN1'Y'IIMPRACJ'ION ORDINANCB ANDIOIl 011fER RBMIIDIES ALLOWBD 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
Permit number - Job address - Type of inspection required When it will be ready
Your name and phone number ,- Any special directions to the site
PUBLIC OFFICIAL RIGHT TO TRESPASS ON PltIVATE PROPERTY oas 21S.0a0
POWER TO BNTER UPON LAND. nIB COMMISSION. AND ANY OF ITS MEMBERS, OFPlCElS AND EMPLOYES, IN nIB PBRPORMANCB OF nmIR FUNCTIONS, MAY
ENI1!R UPON ANY LAND AND MAKE EXAMINATIONS AND SURVEYS AND PLACB AND MAINTAIN nIB NBCBSSARY MONUMENTS AND MARKERS . j~.."
REQUIRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing steel is in place.
UNDERGROUND PIPING INSPECTION: To be made after all underground piping has been installed, prior to any 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 installed, including the subfloor.
ROUGH MECHANICAL INSPECTION: To be made after all ducting and gas piping has been installed and prior to being 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, fITe 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 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 is applied or before gypsum board joints and fasteners are taped and flnished.
ADDITIONAL INSPECTIONS MAY BE REQUIRED, such as but not limited,to; \
BLOCK WALL: To be made after reinforcing is in place, but before any grout is poured The inspection is required for each bond beam pour. There
will be no approval until the plumbing and electrical inspections have been made and approved.
FINAL MECHANICAL INSPECTION: To be made j~tprior to'~e ~#!iJr~\or remodeled area being occupied and prior to operating any equipment
FINAL PLUMBING INSPECTION: To be made juSt priOr to'thl: building: siructure 'or remodeled area being occupied.
FINAL BUILDING INSPECTION: To be made after flnish grading and the building, slrUcture or remodeled area is completed and ready for occupancy.
MOBILE/MANUFACfURED HOMES: An inspection is required after the mobile home is connected to an approved sewei 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 fOl.mdation requirements for mobile homes or as recommended by the manufacturer.
Minimum fInished 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.
APPRO~:iLRiQumEIi-":""'_'/ ',', ,,' -')
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.
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, :' \ \. ,.' APPROVED PLANS MUST BE~ON,'rnE IO~ SrrE At-A~ ~ DURING WORKlNG HOURS,
TIllS PERMIT WILL EXPIRE IF WORK DOES NOT BEGIN WITIllN 180 DAYS, OR IF WORK IS . JUnnD OR ABANDONED FOR MORE TIlAN 180 DAYS,
SUSPENSION OR REVOCA nON MAY OCCUR IF TIllS PERMIT W AS,ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMA nON,
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ANYONE PROCEEDJNG'PAST,r~p~IlIft: Q~~!>.~SP~ynC;>NS 'W-J.:D.O:~O A'J: 'I:HEIR,O~N ~S", L,-
You, sign~ture on,the front of this fonn verifiis th~ follo~g:J'HAYE'~AJEFULLY EXAMINED THIS COMPLETED APPLICATION, and do
hereby'certify that all information hereon is tru~ and comet. and that I have a legal interest in the t".....y....~J 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 r.....r.....J' 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 subsurface construction is complete. the permit holder shall notify the County Land Management Division by submitting the installation record
form. An inspection will be made by a qualified sanitarian. If construction complies with all rules a certificate of completion will be issued to the permit
holder. 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 completion within the alloned time constitutes a violation of ORS 454,605 to 454.745 and this rule,
SUBSURFACE SEW AGE DISPOSAL SETBACKS SEPTIC TANK
From: Interior property lines 10'
Edge of road right-of-way lO'
Building foundation 5'
Wells or other water sources 50'
DRAINFlELD
10'
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100'
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,,',REQ!EST,FORASSISlwcE
LAND MANAGEMENT DlVISION125 E.8TH'AVE, EuGENE, OR 97401 '
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SEPTIC INST AUED?
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Water District
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Owner of Parcel (iI not ume as above)
Phone
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Notes
I. Loop ends as available based on grade, it may be possible to loop lines
When two or more are able to be constructed at the smae elevation.
2. Use D-boxes may be adjusted depending on distribution system employed.
3. Ifpossible add drainline to within 50' of the well.
4. An effluent lift pump may be required to meet OAR 340-7 I -220 (1 I)
ALL DRAINLlNEWS MUST BE SETBACK 50' MIN TOWELL
SEWAGE DISPOSAL
PLAN APPROVED
pennit# (IA'? - 9<0
DATE , 4-'.~-.'i,c.._t
BY '..\.ot..y ~G1
, ENVtd'NMENTAL HEALTH SERVICES
125 EAST 8TH AVENUE
EUGENE. OR 97401
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_ U~,NE COUNTY DEPT ENV MGT F,ECEIPT ,r" 1 1 8796 DATE 041 :>9....:1
APPLICANT ZERZYCKI,' DAVID ADDR 1247 HAYDEN BRIDGE RD., SPRINGFIELD~
\ Ii jTU' 1703261101600. SUBDIV LOT BLI(I '.,
NEW BLDG TYPE USER BDRMS 0 UNITS 001 STORIES IBLDGS 001 PHONE 688 024tj~
. OWNEF, NME ZERZYCK I, DAVID, 'ADDR 1247 HAYDEN BRIDGE r~D., S'F'f<INGFIELD.
CODE AF'PL NO (~CTION 'DESCRIPTION ,<W FT UNIT con VAL.UATION FEE Df.'YS
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LANE COUNTY DEPT ENV MGT RECEIPT ~ 118796 DATE 041596
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' OWNER NME ZERZYCKI. DAVID ADDR 1247 HAYDEN BRIDGE RD!, SRRINGFIELDr.~
, CODE, APPL NO ACTION DESCRIRTION' SQ FT UNIT COST VALUATIO~FEE DA~S,
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From: DI'IUID ZI'IRZYCKI Gen. _tractor PHOl4E N,o. 503,461 0141 .
I'Ipr.18 1996 2: 18?~1 pm
FACSIMIUE COVER SHEET
DavId M. Zarzydd
(" .." ~Ior. Inc.
131 MoClure I._"
Eugeno, OR. 97404
(503) 688..0243
(503) 461-0141 FAX
SeIld 10:
Compenr No",.
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