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READ CAREFULLYI Your Authorlzatlon ls Based On The Fo Condltlons
FEES DUE: $APPBOVED BY:DATE
oALL FOB INSPECTIONS (SEE BACK OF FORM
SEPTIC permlts are good for one year. ALL other permlts explre after 180 days unless lnspectlons are cufient.
I NSTBU CTTONS) 687-4065
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VIOLATIONS
SETBACKS A!.ID OTHBR. CONDMONS OF APPROVAL MUST BB STRICILY OBSERVED. VTOLATION CAN RSST,JLT IN RBVOCATION OF THIS PBRMIT.
CITATIONS MAY BA ISSI,'ED T'NDBR THB PROVUiIONS OP LAI{B C1oT'NTY'S TNFR,ACTION ORDINANCE ANDr'OR OTHBR RBMEDIES ALLOWBD BY LAW'
A MINIMUM OF AT LEAST 24 HOURS ADVANCE NOTICE MUST BE GTVEN FOR INSPECTION REQUESTS
Have the following information ready when you call: 6874C65
Perrnit number - Job address - Type of inspection required - When it will be ready
Your name and phone nurnber - Any special directions to the site
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BT.ITER, UPC'N A}IY LAITID AI{D MATE EXAMINATIONS AND STJRVBYS AND P!.ACB AI{D MAINTAIN THE NBGSSARY MONI,'MBNTI TNO UENTCNS TTUNSON.
REQT.TTRED INSPECTIONS
FOUNDATION INSPECTION: To be made after excavations for footings are complete and any required reinforcing stoel is in place.
LJNDERGROLTND PIP.INC INSPECTION: To be made after all underground piprng has been installe4 pnor to any backfill.
CONCRETE SLAB OR LINDER-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 installd, including the zubfloor.
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 !o being covered
FRAMING INSPECTION: To be made after Ore all framing, fire blocking, bracing and roof are in place and all pipes, chimneys and vents re complete
and the rough electrical, plumbing, and mechanical inspections have been made and approved
INSULATION INSPECTION: To be made after all insuluion 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 ury
plastering is applied or before gypeum bord joints and fasteners are teed ard finished.
ADDITIONAL INSPECfiONS MAY BE REQIIIRED, such as but not limircd to;
BLOCK WALL: To be made after reinforcing is in place. but-before any grout is poured. The inspection is rcquired for each bond beam pour. There
will be no approval until the plumbing and electrical irspections have been made and approved.
FINAL MECHAMCAL INSPECTION: To be made just prior to the stnEure or remodeled area being occupied and pior to operadng ury equipneor
EINAL PLUMBING INSPECTION: To be made jrst prior to the building, stmchre or remodeled area being occupied
FINAL BUILDING INSPECIION: To be made after finish gradfury and the building, stnrcture or reflrodeled area is completed and ready foroccupanry.
MOBILEA,IANUFACTURED HOMES: An inspection is required after the mobile home is connected to an rylnoved sewer or septic
syslem, prior to covering sewe,r or water lines, fq setback requiremens, blocking, tiedowru and plumbing cqrnections.
Footings and piers to comply with State foundation requirenrents for mobile homes or as recommended by the mrrufacturer.
Minimum finished floor elevation shall be certified when required by Floodplain Management
Tiedowrs, if require4 shall be installed ard ready for inspection within 30 days after occupancy. Tiedowns shall be installed per enclosure.
APPROVAL REQTIIRED
No work shall be done on any part of the building or structure beyond tlre 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 Ore inspections required.
APPR,OVED PI.ANS MUSTBE ON THE JOB SITE AT ALL TMES DI,JRINGWORKING HOIJRS.
T}TIS PERMIT WILL E)(PIRE IF WORK DOES NOT BEGIN WTII{IN I8O DAYS, OR IF WORK IS STOPPED OR ABANDONED FOR MORB TIIAN IEO DAYS.
SUSPENSION OR RBVOCATION MAY OCC1JR IF TI{IS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS INFORMAfiON,
aIYYONE PROCEEDTNG PAST TIIE POrNT OF REQUTRED TNSPECTTONS WILL DO SO AT THErR OWN RISK.
Your signature on ihe'front of this form verifies'the following: I HAVE CAREFULLY EXAMINED TI{IS 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 ttrat 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 certiff that if I am not the owner of the property, my regisuation 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 ttrat only subcontractors and employees who
are in compliance with ORS 701.005 will be used on the job.
SUBSURFACE & ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
When subsurface construction is completg the permit holder shall notify the County Land Management Division by submitting the installation record
form. An irspection will be made by a qualified sanitarian. If construction complies with all rules a certificate of completion will be issued to the pernrit
holder. If construction does not comply with rules, ttre permit holder will be notifred, and all corrections shall be 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 to 4il.745 and this rule.
SUBSURFACE SEWAGE DISPOSAL SETBACKS SEPTIC TANK DRAINtrIELD
From: Interior property lines 10' 10'
Edge ofroad righrof-way 10' 10'
Building foundation 5' 10'
Wells or other water sources 50' 100'