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Lane County Authorization
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for:
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FOR OFFICE USE ONLY
sns 19~n Rpview - Exi~tina Svstem
Application/ ~L'~~~~
Perml.t t ..:;JYJ .-tIJ
17
03
SECTION
23.4.4.
) T4600 DOUT OF
LOT/P1TE~ I BLOCK 03
PROpOSED USE OF PROPERTY
[] Residential 0 Industr ial
o Commercial D Public.
Ww:\5HIP
RANGE
S~BDIVISION/PARTITION (if applicable)
Northwood, 2 add'n
LOCATION ADDRESS STREET
1085 Delrose Drive, Springfield 97477
CITY
ZIP
STRUCTURES CURRENTLY ON PROPERTY
Single Family Dwelling
OI~7~;~~tflk ~J2r:-d~/ ~~
. .A'Y'-'~...!4- ""'" ~~h, /'
~ESCRlvrioN OF PROPOSED wORK - BE SPECIFIC e7
Loan Review for Existing septic system
= OF BEDROOMS lit OF STORIES I If OF EMPLOYEr:S
O;vllER I 5 NAME AND ADDRESS
Robt. & Pamela Case
DECLARED .s VALUE
WATER SUPPLY
o Proposed
I!l Existing
TELEPHONE NUMBER
CONTRACTOR'S NAME AND OSR #
State Federal Say. & Ln. - Chris Hough, Office Mgr.
P':;R!'llT TO BE MAILED TO lNAME AND ADDRESS}
State Federal Sav. & Ln., P. O. Box 1927, Eugene 97440
TELEPHONE NUMBER
686 2134
TELEPHONE NUMBER
:r HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION ~'OR PERMIT, dnd uo hcrel.>y cettify t.hat all information hereon is true and correct, and that I
have the following legal interest in the property: Downer of record: 0 ccmtract purchaser; !Klauthorized agent wi th evidence of authori ty attached.
I f.:.rther certify that any and all work performed shall be done in accordance with thtl OrdInances of Lane County and the Laws of the State of Oregon
pertaining to the work described herein, and that NO OCCUPANCY will be mile'le of ar.}' structure without the permission of the Building Division. I fur-
ther certify that registration with the Builder's Board is in full force nnd effect as required by ORS 701.055, that if "exempt the basis for or-emption
is noted hereon, and that only subcontractors and employees who are in compliance with ORS 701.055 will be used on this project. I HAVE READ AND
CHECKED THIS APPLICATION THOROUGHLY.
Requested
By mail 3-1-85
NAME (please print)
SIGNATURE
DATE
READ THIS SECTION CAREFULLY. YOUR AUTHORIZATION YAS BEEN BASED ON THE FOLLOWING CONDITIONS!
~ PLANNING/ZONING:
Zone
Parti tion #
Parcel ..
Parcel Size
:::::s~t; ~t ~~CL' side ". o~:teri; r ~
~ /.7~~ ~~4r Date,~~-RS
\ 0
lXJ SANITATION: S. 1. .. B. P. # Installation Record Issued? 0 Yes D No
Installation Gallon Lineal Feet "'-aximum Depth
:;:::::tij2 ~ S1J~. ;:el~ /u, /,'. ,L::.~:e:Che~+ .
M ;tl'A' ~D J_ VDate: ;J-~ilr ~
#
o ~ EXAMINATION: Type
GrouD
Use
COMHENTS:
Date:
n
~tJ ~ 1\ s-: ;J-s-J7r
'PERMIT APPROVED BY BU~NG OFFICIAL/DESIGNEE (eer ORS 456.8QS(l}) DATE
LANE COUNTY 02PARTMENT OF PUBLIC WORKS LAND MANAGEMENT DIVISION, 687-4061,
125 EAST 8TH AVENUE, EUGENE, OREGON 97401
SEE REVERSE FOR INSPECTION INFORMATION
,
C 14-25 R84-
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SETBACKS A~D OTIlER CO:<OITIO~S or APPROVAL MUST BE STRICTLY OBSERVED. VIOLATION CA~ RESULT IN REVO.
C';.IO~1 or TlIIS PER~llT, CITATIO:l UNDER PROVISIONS Of LiI.::E COU:':TY',5 INFRACTION ORDI:-;';NCE. A:-IDjOR OTHER
RENEOIES ALLOWED BY LAW.
WHI:N READY FOR r::SPECTION, Ct\LL 6137-4065. A ~lINI/>lU~l OF AT LEAST 24 1l0URS AOVA::CE NOTICE FOR INSPEC-
'nu:-l IUA,l~t:i:i~~ ;"Ut.:'1 tlt; (;1 veN. Hllve toe lo11owing informa tion ready: permi t number, job address. type
of inspection. when it will be ready. your name and pbo~c number, and any special directions to site.
BUILDING DIVISION:
REQUIRED I:':SPECTIONS:
1. Foundation Inspection: To be made after trenches are excavated and forms erected and when all
materla~s lor tne toundation are delivered on the job. Where concrete from a central mixing
plant (commonly termed -transit mixed-) is to be used, materials need not be on the job.
2. Concrete Slab or Under-rloor Inspection: To be made after all in-slab or under-floor building
serVl~e equIPment, conault, ~lplng accessories, and other ancillary equipment items are in
place but before any concrete is poured or floor sheathing installed, including the subfloor.
3. Framln.9' Insulat10n Inspectlons: TO be made after the roof, all framing. fire blocking, and
Draclng are 1n place ana all plpes, fireplaces, chimneys, and vents are complete and all rough
electrical and plumbing are approved. All wall insulation and vapor barrier are in place.
4. Lath and/or Gvpsum Board Inspection: To be made after all lathing and gypsum board, 'nterior
ana-extcrIOr, 1S In-ptaCe but before any plastering is applied and beiore gypsum board joints
and fasteners are taped and finished.
5. Final Inspection: To be made after the building is complete and before occupancy.
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.
NOTE: All building permits require inspections for the work authorizod, such as but not limited to:
A. Block Wall: To be made after reinforcing is in place, but before any grout is poured. This
rnspect10n is required for each bond beam pour. There will be no approval until the plumbing
and electrical inspections have been made and approved.
a. Wood Stove: TO be made after completion of masonry (if applicable) and when installation is
compl~ Installation 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 connections.
1. Footings and piers to comply with State foundation requirements for mobile homes or as
recommended by the manufacturer.
2. Mobile home minimum finish floor elevation shall be certified when required by a flood-
plain management letter.
3. Mobile home tiedowns, when required, and skirting shall be installed and ready for inspec-
tion within at least 30 days after occupancy. Tiedowns and skirting shall be installed
per enclosure.
D. SWlrnrn1n9 Pool: Below grade when steel is in place and before concrete is poured. Above grade
wl'len pool-rslnstallcd.
APPROVED PLANS MUST BE ON THE JOB SITE AT ALL TIMES DURING WORKING HOURS. THIS PERMIT WILL EXPIRE
IF WORK DOES NOT BEGIN WITHIN 180 DAYS, OR IF WORK IS SUSPENDED OR ABANDONED FOR MORE THAN 180 DAYS.
SUSPENSION OR REVOCATION 11AY OCCUR IF THIS PERMIT WAS ISSUED ON THE BASIS OF INCOMPLETE OR ERRONEOUS
INFORMATION.
ANYONE PROCEEDING PAST THE POWT or REQUIRED INSPECTImlS WILL 00 SO AT THEIR OWN RISK.
SUBSURFACE ~ ALTERNATIVE SEWAGE DISPOSAL SYSTEMS:
1. Permits shall be effectivo for one year from the date of issuance.
2. Upon completing the construction for which a permit has been issued, the permit holder shall
notify the Lane County Department of Planning and community Development by submitting the
installation record form. The Department shall inspect the construction to determine if it
complies with the rules contained in this division. If the construction does comply with such
rules, the Department shall issue a certificate of satisfactory completion to the permit,holder.
If the construction docs not comply with such rules, the Department shall notify the permit
holder and shall require satisfactory completion before issuing the certificate. Failure to
~eet the ~~quirements for satisfactory cQmpletion within a roasonable time consti~u~e$ a vio~
latioo of ORS 454.605 to 454.745 and this rule.
Setbacks - Subsurface Sewage Disposal
~~
Drainfield
From: Interior property lines
Edge of road rlqht-of-way
Buildinq foundation
Wells. other water sources
10'
10'
5'
50'
10'
10'
10'
100'
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