HomeMy WebLinkAboutPermit Building 1988-1-12
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Lane County Authorization for:
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FOR OFFICE USE ONLY
REPAIR EXISTING SEPTIC SYSTEM
Application/ ~/-__ ~~
Permit # b. 0 ~
roW:,SHIP
RANGE
17
02
I SECTION
I TA1X3' OLOOT
19.4.1
I WT!Pf.RCE'S I
OOUT OF
?RO~OSED USE OF PROPERTY
c:J Residential 0 Industrial
o Cc,mmercial 0 Public.
S~BDIVISION/PARTITION (if applicable)
BLOCK
LOCATION ADDRESS
STREET
CI'~'Y
ZIP
3859 Hayden Bridge Road, Springfield, Oregon 97477
STRUCTURES CURRENTLY ON PROPERTY
Existing Single Family Dwelling
Ultili{';TIUN~ "1'0 SITE
East on Hayden Bridge Road, on the right hand side of road
uESCRIPTION OF PROPOSED WORK - Be SPECIFIC
Repair existina seotie
= OF BEDROoMs J * OF STORIES
PC'
O;,"NER '5 NAME AND ADDRESS
DECLARED $ VALUE
Sl..lstem
I
It OF EHPLOYECS
WATER SUPPLY
MA
no
Wp]1
o Proposed
f1 Existing
TELEPHONE NUMBER
None Gi ven
TELEPHONE NUMBER
na 71"J-~
TELEPHONE NUMBER
Harold Fochtman, same as the Job address above
C0NTRACTOR'S NAME AND OSR #
Same as above
P::;RNIT TO BE MAILED TO (NAME AND ADDRESS)
Same as above
na
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION }o'OR PERMIT, dlld ,](', tlcrc:J't' certify r.hat all infonnatioll hereon is true and correct, and that I
have the following legal interest in the property: f90wner of record; 0 C(.",:rdt::;. p.u:chaser; Dauthori:l:cd agent.
I f:.:.rther certify that any and all work performed shall be done in aC(.:(,lldiJll<;.. ",'i th tt:~ (),dl.nance~ of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will be :nade of ar.,. st:ructure ....ithout the pcrttlission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force and effect as resuired by ORS 701.055, that if-exempt the basis for exemption
is noted hereon, and that only subcontractors and employees who are in cO/llpliancc wit~ ORS 701.055 will be used on this project. I HAVE READ AND
CHECKED THIS APPLlCATIONO-ROUGHLY.
Harold Focl]tman
(NAME (please print)
w~/ /:&c_~,"?cvU/
SIGNATURE
DATE
,
-READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION ~iAS BEEN BASED ON THE FOLLOWING CONDITIONS!
[] PLANNING/ZONING:
Minimum Setbacks:
Zone~
eL. front
Parti tion #
Parcel #
Parcel Size
na
CL, side
interior
rear
eOMHENTs:
Nn PT.1J.lvNTN(; l!lr'l'TnN R'RnnTR'Rn
Date:
J-08-88
:wL-ib8
(SANITATION: s. 1. i
Installation ~llon
speCificatiO~Tank
eOMHENTs: d ../ I':I.A^
~ ..i~I, i-/)-f?17
lJ' P-LANS EXAMINATION: Type
/sn
U-<<",t
6"
Li ncal Feet
vf ilr;dnfielrl
~)
.L. st' V
~2::~~
Date: /-/2..n ~
Record Issued? 0 Yes 0 No
M.aximum Depth
of Trenches
,
B. P. It
lnstallation
GrOUT:
Use
eOMHENTs:
Date:
n
.~~0) ~. i~/'L-//
~~ROVED BY BUILDING OFFle~A SIGNEE (oer ORs 456.805 (1)) - DATE
LANE COUNTY DEPARTME F PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EA T 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
C 14-2~ RR4-
..........-
I' _.
.
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SETS;.CKS ';:;0 07!!::R CC::OI't'!O:;S Of APPRO','i,L :.:VS'!' BE STrlTC7:''.: OESERVED, VIOLATIO:: CA:: R!:SL'LT I:.l REVO-
c;;:-ro:: OF ':'!IIS ":::R~ll" CIT;,110:: U::DSR PROVISro:.S Of r.,;:-:E ':O;:::1'Y':; I:-1FRACTIO:1 ORDl::.;::CS, ;SD/OR O'!'HER
RF.~EDIES ALLO~ED BY LAW.
\\"HE:/ READY FOR r::SPECTIO::, CA:':", 687-~065. i\ lL:':r:::U:.: Of ,;T LE;,ST 24 1l0URS.ADV/\::~E ::o~rcr. FOR I:1SPEC-
1":0:: IU.'.'{'~ST:. :.j';,ST BS GJ.Vl::::. ;l'-l':e the :ollo''''l:\g In:O::-::Iatlo:\ ready:. ,(lrml.t number, JOb'address, ty?e
of inspeCtlOn, when it wlll be ready, your :\ame and ?~or.~ 4n~::\ber, and any s?(lcial directions to site.
BUILDI:-:G DIVISIO~:
REQUIRED I ::SPECTIO:.lS:
1.
foundation Inspection: To be made after tr(lnches a!:"e excavato;Jd and forms erected and when all
~aterlals for the toundation are delivered on the Job. \~here concrete fro::\ a central mixing
plant (commonly termed "transit mixed") is to be used, materi<ils need not be on the job,
2,
Concrete Slab or Under-?loor Inspection: To be made after nIL in-slab or under-floor building
serVl~e equipment, conoult, plpl~g accessories, and other ancillary equipment items arc in
place but betore any concrete is poured or floor sheathing installed, including the subfloor,
3,
~raminq !. Insulation Inspections: To be made after the roof, all 'framing, fire blocking, and
rac1ng are 1n ?laCe and all ?lpeS, fireplaces, chimneys, and vents arc complete and all rough
electrical and plumbing arc approved. All wall insulation and vapor barrier are in place.
4.
Lath and/or Gvpsum Board Insoection, To be made after all lathing and gypsum board, ;.nterior
~exterror, is 1n-prace out Detore any plastering is applied and be:ore gypsum board joints
and fasteners are taped and finished. \
5. Final Insoection: To be made after the building is complete and before occupancy.
APPROVAL REQiJIRED. :;0 IOork Shall be done on any part of tl1e building or Structure beyond the point
indicated in each successive inspection without fir3t obtaining the approval of the building o!f~cial.
Such approval shall b~ given only after an inspection shall have been mace of each successive step
in the construction as indicated by each of the ins?ections required.
NOTE: All building permits require inspections for the IOork authorized, such as but not limited to:
A. 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.
B. Wood Stove: TO be made after completion of masonry tif applicablel and when installation is
complete. Installatlon shall be in accordance with an approved, nationally recognized testing
agency and the manufacturer'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 conneCt1ons.
1, Footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufacturer. ,. ,
~ 2. ~obile home minimum finish floor elevation shall be certified when required by a flood-
plain managcment letter.
3. ~lobile home tiedo....ns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and sk~rting shull be installed
per enclosure.
D, SWlmmln9 Pool: Below grade when steel is in place and before concrete is poured. Above grade
wnen pool-rs-lnstalled.
,iPPROVED PLANS :.lUST BE ON THE JOB SITE AT ALL TI~ES DURH:G WORIONG HOURS. TIllS PEIU-IIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN laO DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR ~10RE THA:.l IBO DAYS.
SUSPENSION OR REVOC,iTION ;.IAY OCCUR IF TillS PERlnT WAS ISSUED ON TilE BAS.rS OF INCmIPL~TE OR E~RONEOYS
INfO~~TION. .
AIIYONE PROCEEDING PAST THE POI:;'!' or REQUIRED INSPECTIQ:1S WILL DO so AT TIlEIR OWN RISK.
SUBSURFACE AND ALTERNATIVE ~ DISPOSAL SYSTEMS:
1. Permits shall be effective for one year fro~ the catc. of issuance.
2, Upon completing the construction for which a permit has been issued, the permit holde5 shall
notify the Lanc County Department of Planning and Co~~unity Development by submitting the
inst~llation record form. The Department shall inspect the constr~ction to determine ~f it
complies with the rules contained in this division. If the construction does comply with such
rules, the Dep~rtr..cnt shall issue a certificate of satisfactory completion to the pcrmit,~older.
If the construction docs not; comply with such rules, the Department shn11 not!fy 'the permit
holder and Shall requ1re satisfactory completion before issuing the certiflc~te. Failure to
meet the requirements for satisfactory completion I01thin a reasonable lime constitutes a vio-
Union of ORS 454.605 to 45...745 amI thi-s rule, - - ,
Setbacks - Subsurface
S':l'~.a<Je Oisoosal:..
Septic '!'ank
10'
10'
5'
50'
10'
10'
10'
100'
Dr,J;infield
:':-0::1:
Interior propcrt, llnes
Ed<:;e 0, road ru:,ilt-of-way
Bllll<.ilnq fCL;ncat~on
~clls, other ~ater 30urces
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ACTIVITY INFORM A TION SHEET
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l".........N..."...'.... 0'''''''''_
O'-...M.........'~.~___..
Please complete all Items above dotted line
FILLING OUT * LINES WILL GET YOU INFORMATION ONLY
*DATE / /
*PERSON ~~
MAKING
REQUEST , ,
AOORESS
?I ?Y
~;!;r;, ACTUAL
Fi- A.J1 PROPERTY
,_r/(: ~OWNER
ADORESS
CITY
STATE
liP
CITY
STATE
liP
TELEPHONE (BUSI (HOMEl ' " TELEPHONE (BUSI (HOME)
*PROPERTY ADDRESS '3 f?S'1 ~d~_ ~h...lV
OR . 0 0
MAP & PARCEL NUMBER (Found on tax maps in the Assessment & Taxation Depl.)
13th:) STAFF WILL
/7 O,? ) y. '/, / U 6-zS -
Townshtp Range Section Tax Lot Zoned
Township Range Section Tax Lot Zoned Flood Plain
Township Range Section Tax Lot Zoned Flood Plain
TOTAL CONTIGUOUS PROPERTY IN SAME OWNERSHIP: ACRES
* REQUEST".."". .-.. ,., w.o, .. ~~d:t~ 7p'~
Directions to sit~ _~, "~.;F ~ ~~_ < &v d"p,
.,/)~f --u~.-.'!/ ~/, _~, t7
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....................5taff Use On~....................
Comments:
'Land Management Division, Public Works Department 125 E. 8th Ave., Eugene, OR 97401 phone 687-4061